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.

OF FEAVERS.

CHAP. I. The Anatomy of the Blood; and its Resolution into five Principles: A comparing it with Wine and Milk.

THE Doctrine of Fermentation being explicated, it remains that we handle the chief Instance or Example of it, to wit, Feavers. For it seems that a Feaver is only a Fermentation, or immoderate Heat, brought into the Blood and Humors. Its Name is derived from Februo (or Pur∣gament, which also is derived from Ferveo, to be Hot) which Word indeed is commodiously put to every Feaver; for that the Blood in this Disease grows hot; and besides, by its fervor, as working must, it is purged from its filthinesses. But that this Fermentation or feaverish Effervency may be rightly explicated, these three things are to be con∣sidered. First, What the fermenting Liquor is; whether only Blood, or any humors besides. Secondly, In what Principles in the mixture, and in what proportion of them this Liquor consists. Thirdly, and lastly, By what motion and turgescency of those Parts or Particles, of which the Blood is made, the Feaverish Effervescency is stirred up. These be∣ing thus premised, the Doctrine of Feavers shall be delivered, not from the Opinions of others, but according to the comparisons of Reasons, picked (though from ours, yet) from diligent and frequent Observation, and confirmed by certain Experiments; all which however, I willing∣ly submit to the Judgment of the more skilful.

It plainly appears, even to the Sense, that the Blood doth hugely boil up, and rage in a Fea∣ver; for every one (though rude and unskilful) being in a Feaver, complains of the Blood be∣ing distempered, and of the same growing hot in the Vessels, and as it were, put into a fury. Al∣so, besides the Blood raging in the Veins and Arteries, it may be lawfully suspected, that that Juice with which the Brain and Nervous Parts are watered, is wont oftentimes to be in fault; for when this Liquor is seen to be carried back from the Blood, into the nervous stock by a con∣stant motion, and certain Circulation, and from thence through the Lymphatick Vessels, into the bosom of the Blood, it is probable, if by reason of a Taint contracted from the Blood, that humor be depraved in its disposition, or is perverted from its equal motion, that from thence the Rigour, and Pain, Convulsion, Delirium, Phrensie, and many more Symptoms of the Nervous kind, usual in Feavers do arise.

After the Blood and Nervous Liquor, two other Humors, for that being apt to grow hot, fall into our consideration, viz. The Chyme or nourishing Juice, continually coming to the Mass of Blood, and the serous Latex, perpetually departing from the same, which, though they be the first and last Liquors separated from the Blood, and distinct from it, yet being con∣fused with it, they ought to be esteemed as its associate parts or complements; for the nourish∣able Juice being fresh brought, is accounted the crude part of the Bloud, and to be assimilated; and the Serum, it's stale part, and to be carried away. And after this manner, so long as either are circulated with the Bloud it self, in the Vessels they participate of the heats of the first begot∣ten Bloud, and oftentimes occasionally begin them, or increase them being begun; but by what means these things come to be be done, is declared hereafter in their proper places. As to the rest of Humors, which are only the Recrements of the nutricious Juice, or the bloud, when they are included, either in their proper Receptacles, or constrained in the narrow spaces in the Viscera, neither wash the several parts of the Body with a continual lustration, as the Bloud or Nervous Liquor, or the other Humors but now recited, are to be exempted from this Rank; sometimes perhaps they may be the occasional Cause that the Bloud doth conceive an undue Effervency, or that it persists in it longer; but it is only the Bloud, (with the the Nervous Liquor, the alible Juice, and Serum Associates)

which boiling up above measure, with its heat, and stirred up with a rage through the Vessels, diffuses the preternatural heat, and induces the formal reason of the Feaver: but how this comes to be done, is not to be known plainly, but by a more near beholding the Nature of Blood, and as it were an Anatomy made of its Liquor.

There are in the Blood, (as in all Fermentative Liquors) Heterogeneous Particles, which as they are of a diverse Figure and Energy, remain a long while in the mixture, by their mutual opposing one another and subaction, the motion of Fermentation is continually conserved; as is perceived in Wine, Beer, and other Liquors: then, if the mixtion of the Liquor be some∣what unlocked by the adding of Ferments, the Native Particles being •…•…reed from their bonds, do yet more swell up, and induce Fermentation, with a more rapid motion and heat: which is seen in a familiar Experiment of the Chymists, viz. when fluid Salts are mixed with saline Liquors of another kind; from thence a great heat and ebullition are stirred up. Wherefore we ought to inquire concerning the Blood, of what Particles it consists, that it should be fit to Ferment, (as Wine, Beer, and other Liquors) of its own Nature: then by the help of what kind of Ferments, both its Natural and Feaverish heats are performed, with warmth, and a more quick motion.

The Mass of the Blood, by the Opinion of the Antients, was thought to consist of four Hu∣mors; to wit, Blood, Phlegm, Choler, and Melancholy: and it was affirmed, that according to the eminency of this, or that Humor, diverse temperaments are formed; and that by reason of their fervors or exorbitances, almost all Diseases do arise. This Opinion, tho' it flourished from the time of Galen, in the Schools of Physicians, yet in our Age, in which the Circular motion of the Blood, and other affections of it were made known, before not understood, it began to be a little suspected; nor to be so generally made use of, for the solving the Phaenomena's of Diseases: because these sort of humors do not constitute the Blood, but what are so called (except the Blood) are only the recrements of the Blood, which ought continually to be separated from it: For in truth the Blood is an only humor; not one thing about the Viscera, and another in the habit of the Body; nor is it moved at one time by Phlegm, and another time with Choler, or Melancholy, (as is commonly asserted) but the Liquor growing hot in the Vessels, is only Blood, and wheresoever it is carried through all the parts of the Body, it is still the same, and like it self. But because by reason of the abundance of the implanted heat in some, and because of the smalness of it in others, the Coction of the Aliment is now quicker, now slower per∣formed in the Bowels, and in the Vessels; therefore the temper of the Blood (tho'but one, and always the same Liquor) becomes diverse: and according to the various disposition of this, it may be said that men are Choleric, Melancholic, or of another temperament. Besides, because whilst the Blood is made in its Circulation in the Vessels, some parts continually grow old, and others are supplied anew, hence from Crudity, or too much Coction, there is a necessity that what is excrementitious should be heaped together: which notwithstanding by its effervescency, (as by the working or depuration of Wines it comes to pass) it is separated from its Mass, viz. the watry humor, fixed in the Bowels, or solid parts, is it which is called Phlegm: some Reliques of adust Salt and Sulphur, being separated in the Liver, and received by the Choleduct Vessels are called Choler; the Earthy feculences being laid up in the Spleen, are termed Melancholy. In the mean time, the Blood if rightly purified ought to want Choler, Phlegm and Melancholy: even as when some Wines, or Beer are purified, the more light Particles are carried upwards, which constitute its Flowers or Head; and the dregs are prest down to the bottom, which grow toge∣ther into Feces or Tartar: yet none can truly say it, Wine or Beer is composed of Froth, Tar∣tar, and a Vinous Liquor. But as these humors, commonly so called, are made out of the other Principles, viz. Choler out of Salt and Sulphur, with an admixtion of Spirit and Water; and Melancholy, out of the same, with an addition of Earth; and as the Blood is immediately forged out of these kind of Principles, and is wont to be resolved sensibly into the same, I thought best, the common acception of humors being laid aside, to bring into use these celebrated Principles of the Chymists, for the unfolding the Nature of the Blood and its affections. There are there∣fore in the Blood, as in all Liquors apt to be Fermented, very much Water and Spirit, a mean of Salt and Sulphur, and a little of Earth. The Blood being loosned by putrefaction, exhibits the same separated and distinct. Also in the Blood contained in the Vessels, or being fresh let out from them, we may discover their energies and effects: besides, when in the Food, whereby we are fed, by the Juice of which the Liquor of the Blood is made, these same are implanted, no man will go about to deny that the Blood also is made from them: wherefore I will briefly run through these, and endeavour to shew by what means the Consistency, the Properties, and the Affections of the Blood are made by them.

1. Spirits (which readily obtain the chief place) are a subtil, and greatly volatile por∣tion of the Blood. Their Particles, always expansed, and endeavouring to fly away do move about the more thick little Bodies of the rest, wherewith they are involved, and conti∣nually detain them in the motion of Fermentation. The Liquor of the Blood continually boils up with their effervescency or growing hot, and equal expansion in the Vessels, and the rest of

the Principles are contained in an orderly motion, and within the bond of the exact mixture; if any Heterogeneous thing, or unagreeable to the mixture, be poured into the bloody Mass, pre∣sently the Spirits being disturbed in their motion, rage, shake the blood, and force it to grow hugely hot, until what is extraneous, and not missible, is either subdued, and reduced, or cast out of dores. By the irradiation, or rather the irrigation or watering of these, the Bodies of the Nerves are inflated, the Functions of the Viscera, and also the Offices of motion, and sensation are performed: from the want of Spirits, also from their motion being depraved or hindred, arise great vices of the Natural oeconomy or Government. The more quick motion and effer∣vescency of these in the blood, (above what is in Wine) chiefly depends upon the Ferment of the Heart; because, whilst the blood passes through the Bosom of the Heart, its mixture is very much loosned, so that the Spirits, together with the sulphureous Particles, being somewhat loosned, and as it were inkindled into a flame, leap forth, and are much expanded, and from thence they impart by their deflagration, a heat to the whole. By reason of this kind of expan∣sion, and suffusion of heat, there is made a continual expence of Spirits, which being rarified, as it were inkindled, continually fly away, and are evaporated forth adoors: and as long as we live there is made a continual reparation of these by aliments, chiefly the most delicate; which contain in themselves very much of Spirit and swelling matter: from which juice being drawn by digestion, and collated to the blood, is assimilated to it and fills up its defects. When the Blood of Animals is distilled, the Spirits (like Aqua Vitae) ascend of a limpid co∣lour, they are made very sharp and pricking, by the adhesion of the Salt; yet they are not so easily drawn off, as the Spirits of Wine, but that there is need of a more intense fire to force them, because they are hardly driven from the fellowship of the thicker parts, with which they are involved.

2. That there is plenty of Sulphur in the Blood, it is plainly seen, because we are chiefly fed with fat and sulphureous Aliments, also the Nutriment from the blood, carried to the solid parts, goes into Sulphur and Fatness. It is most likely, from the dissolution of this, that the red Tin∣cture of the Blood doth arise: for sulphureous Bodies, before any others, impart to the solvent Menstruum, a colour highly full of redness; and when by reason of too great Crudity, the Sulphur is less dissolved, the blood becomes watery and pale, that it will scarce dye a Linnen Ragg red. The Mass of blood being impregnated with Sulphur, and together with Spirits, it becomes very Fermentable: which however, whilst it enters the Ventricles of the Heart, there suffers a greater effervescency, or rather accension; and on the Particles chiefly sulphureous, being inflamed, and thence diffused through the whole, the lively and vital heat in us depends. When the sulphureous part is carried forth, and doth too much luxuriate in the blood, it perverts its disposition from its due state, that therefore the blood being either depraved, or made more bilous or Cholerick, doth not rightly Cook the nourishing Juice; or being inkindled throughout, it conceives heats and ardours, such as arise in a continual Feaver. For the Sulphur being too much exalted; and swelling more than it ought, stirs up great heats in the blood: and they whose blood is more plentifully impregnated with Sulphur, are most obnoxious to Feavers. By reason of the Par∣ticles of this being incocted with the Nutritious Juice, and from thence carried to the solid parts, fatness, softness and tenderness, come to our Body. From the Flesh or Blood putrefying, by rea∣•…•…on of the abundance of evaporated Sulphur, a most evil stink breaths forth: In the distillation of Blood, Sulphur ascends under the form of a blackish Oyl, which also by reason of the Empyreuma, stinks most wickedly.

3. That Salt is in the Blood, is evinced by the Salt; which, tho' fixed, is drawn forth, by being eaten, from Vegetables, and from other eatable things, at first less volatile, afterwards by the most excellent digestion of Nature, and Circulation, is highly volatilised; that it passes through, not only without a remaining Caput Mortuum, all the members and parts of our Body, but also the blood being exposed to distillation, ascends the Alembic, and leaves the dead Head as insipid earth: If at any time the saline Particles are not rightly exalted in the Blood, by rea∣son of ill digestion, but remain crude, and for the most part fixed, from thence the blood be∣comes thick and unfit for Circulation, so that Obstructions are begot in the Bowels and solid parts, and serous Crudities are every where heaped together: But if the Salt be too much carried forth, and suffers a Flux, the Spirit being depressed, or deficient, a sour and bitter disposition is given to the blood, such as is observed in Scorbutical People, and those sick of a Quartan Feaver. Also from the Salt, for this reason being variously coagulated, the Stone, Kings-Evil, Gout, Le∣prosie, and very many other Chronical Diseases arise. But when Coction being rightly per∣formed in the Bowels and Vessels, the Salt is duly exalted, and being associated with the Spirit, is volatilised, then by reason of its mixture, the Liquor of the Blood more equally ferments; also is defended from Putrefaction, Stagnation, and Coagulation: Also the saline Particles, bridle the fiercenesses of the Spirits, and especially of Sulphur; wherefore, those who have their blood well filled with a Volatile Salt, are less obnoxious to Feavers: also hence those who ofte•…•… are let blood, are more apt to Feavers.

4. Besides, There are in the Blood, (as it is a thick Humour, and hath a gross consistence) many Earthy Particles: from hence also, its too great Volatilisation is as it were supported, and its too hasty accension hindered: even as Charcoal-dust, is added oftentimes to Gun-Powder in a greater proportion, that all its parts may not take fire at once, and too soon: Further, from the Terrestrial Particles of the Blood, and Nutritious Juice, the bulk and increase of the Body proceeds. Lastly, from the distillation of the Blood, a light and friable Caput Mortuum, is left in great plenty.

5. Upon the watery part of the Blood depends its fluidness; for from hence its stagna∣tion is hindered, and the Blood is circulated in the Vessels, without growing thick or stiff: also its too great conflagration, and adustion is restrained, and its heat attempered. When Blood is distilled a clear and insipid Water is drawn off, at least in a double proportion to the rest; for from hence the matter of Urin, Sweat, and every humid Excrement, for the most part proceeds.

What things were but now asserted, concerning the Principles of the Blood, and the affe∣ctions to be deduced thence, will better appear, if we consider a little the Blood, according to its sensible parts, and shall compare it with other Liquors which are in daily use amongst us. Those sort of Liquors, which have a very great Analogy with the Blood, are, viz. Rich Wine and Milk. As to the Reasons of Fermentation and growing Hot, it is most fitly compared to Wine; as to its consistency, coagulation, and departure of the parts one from another, it is likened to Milk.

In the first place therefore, it is observed of Wine, that so long as it is shut up in the Vessel or Pipe, its subtil and spirituous Particles, do perpetually agitate, or very much shake others more thick, break them, and render them fit for an exact mixtion; what is heterogeneous, and and unfit for subaction or mingling, is separated by its growing hot: In the mean time the puri∣fied Liquor greatly fermenting, is in perpetual motion, whereby all the parts (as Atoms, va∣riously moved up and down, in a beam or streak of light) do stretch themselves forth on every side, and contend with a constant rowling about, from top to bottom, and from thence to the top again. By the attrition and refraction of the Particles, very many Effluvia of Atoms, go away from the Liquor, which if the Vessel being closely shut, they are kept within; the Liquor grows too exces∣sively hot, and oftentimes causes the containing Vessel to burst in pieces. Blood, much after the same manner being shut up within the Veins and the Arteries, is urged with a constant Circu∣lation: The Vital Spirit makes subtil, breaks, and exactly molds the more thick Particles; what is heterogeneous, and not mixable, it expels forth of dores; in the mean time by the refraction and kneading of the parts, Effluvia of heat do constantly stream forth, and evaporate through the pores; which being shut in, if transpiration be hindred, presently by reason of the too great boiling of the Blood a Feaver is inkindled.

Secondly, We will observe concerning Wines, that they grow turgid, or swell up, if any ex∣traneous thing, and of a Fermentative Nature, be poured to them; yea sometimes, that they are moved more than ordinary of their own accord. For, when by a long digestion, the sulphureous part of the Wine is too much exalted, it conceives a greater heat than it ought, and (unless pre∣sently appeased) perverts the disposition of the whole Liquor, with its swelling up. It seems to be for the very like reason, that the Feaverish heat which is wont to be introduced by reason of the same Causes, is stirred up in the Blood, as shall be shown in the next Chapter, where we treat of the Motion and Heat of the Blood.

The third Observation, or comparing of the Blood with Wine, shall be of this sort: Wines (as a•…•…so many other Liquors, as for example, Beer, or Sider) have their times of crudity, maturation, and defection. For when they are first made, the spirituous parts are so obvolved by the others more thick, that they shew themselves but little, and put forth almost nothing of strength or ver∣tue: and as the other Particles, are not yet subtilised, nor truly concocted, the whole Liquor re∣mains crude, and of an ungrateful taste; and if put to distillation, not any Spirit ascends. From this state it comes by degrees to perfection, and when the Spirits being extricated from their intangle∣ments, obtain their own right, and have subtilized and exalted the more thick Particles of the rest, the whole mass of the Liquor becomes Clear, Spirituous, Sweet, and Balsamick. Lastly, When by a long Fermentation, the Spirits are consumed, and begin at length to fail, the state of defection is induced, whereby Wines, and other Liquors, either pass into a tastlesness, or at last the Salt and the Sulphur being too much exalted, are made sowr or unsavory. In like manner the Blood also, while it is Circulated in the Vessels, may be considered according to this kind of threefold disposition: First, in the making or crudity, which has relation to the Chyme new made in the Viscera, and freshly poured to the Blood; the Particles of which, like to unripe Fruit, are crude and undigested. Secondly, In the perfect state or maturation, which belongs to the Blood being snfficiently wrought, and made Volatile, according to all its Particles after it is infpired by Ferments, and its inkindling in the heart exalted. Thirdly, In its defe∣ction, which respects the Blood; after it hath burned forth, and its spirituous parts are very much flown away, and the rest growing old and poor, have need to be removed; and so they are

either the Reliques of Salt, which are with the Serum strained forth continually by the Urine; or they are Particles of Salt and Sulphur, boiled and baked together, which are strained forth by the virtue of the Liver into the choleduct Vessels: or lastly, they are dregs and earthly re∣crements of the Blood it self, which are carried into the Spleen, and there (as it were a Caput Mortuum, exalted by a new digestion) go into a Ferment, at length to be transmitted to the Blood. Whilst after this manner, the generation of the Bloud, and its due maturation are truly dispatched, it is pleasingly circulated within the Vessels, neither wanting in motion or heat, nor inordinately troubled with them. But if either the supplement of the nourishing Juice, be not made agreeable with the rest of the Bloud, nor assimilated with it, but that either by reason of the defect of Concoction, it is washed into a very crude humour, or because of its excess, it is rosted into a burnt matter; or if the Bloud growing old, does not lay aside what it casts off, and give way to a new nutritious Humor; I say, by reason of these kind of Vices, concerning Sanguification, or the making of Bloud, the Bloud is variously perverted srom its due temper and equal motion, and now becomes watery and cold; now sharp or salt; now acid, austere, or by some other way degenerate; and sometimes obnoxious to stagnations, and sometimes to immoderate heats.

We may observe these kind of degrees of Crudity, Coction, and Defection in the Bloud, both of the sound and of the sick; in healthful persons after a more plentiful Repast, Surfeit, or hard Drinking, when too much of Serum or of Juice, is poured to the Blood, its whole Mass being too much diluted with a crude humor, becomes more watery, and less spirituous; wherefore men are rendred sluggish, and unfit for motion or exercise. In sick persons the Phlegmatic Constitution of the Body, induces such a crudity of the bloody mass, as is discern∣ed in the white Dropsie, the Dropsie, Pica, or longing Disease, and the Chlorosis, or Green Sickness. Also the state of this kind of crudity, comes in an intermitting Feaver, and in truth is the cause of the Feaverish accession, viz. by reason of the dyscrasie of the Bloud; the nourish∣ing Juice being heaped up, is not assimilated to it, but for the most part goes into a crude, or otherwise degenerate matter; with which, when the Mass of Bloud is filled to a plenitude, swelling up, it brings on the Fit.

The state of Maturation, concoction being finished, happens in healthful persons, some hours after Eating, especially in the morning, to wit, when the supplement of the Chyme is spiritua∣lized, and as it were enkindled in the whole, by reiterated Circulations; for then men are made more nimble and lively, and more ready for studies, or any business.

The state of Defection is in the blood of sound men after fasting long, hard labour, and want of Food; for then the Vital Spirit being very much evaporated, the mass of the Blood be∣gins to become as it were lifeless, wherefore they presently languish, and are made weak. More∣over, the blood by a too long coction is burned, and grows bilous, from whence those accustom∣ed to want Food, or fasting, for the most part become sad and melancholic. Some Diseases habitually induce such a disposition of the blood; such are the Scurvy, the yellow Jaundies, the Cachexia (or evil state of the body when the nourishing Juice turns to ill humors) long Fea∣vers, and most Chronical Diseases, in which, the whole mass of blood passes from a spirituous, into either a sowr, sharp, or austere Nature.

So much for the comparing of bloud with rich Wine; what follows, being a similitude of it with Milk, consists in the diversity of the parts, and their setling apart, which is chiefly seen in its being let forth from the Veins, and grown cold in the Dish. For when the heat and vital Spi∣rit, which conserve all things in the mixture, are flown away, the remaining parts depart from one another of themselves, and a separation of the thin from the thick, and of the Serum from the fibrous bloud is made. This sort of separation of the parts, succeeds almost after the same manner, as in the coagulation of Milk. There are in Milk, Buttery, Cheesie parts, and Whey. The like is in blood, so long as it doth not much recede from its natural temper: for it is good, when being let forth of the Veins, it grows cold in the Porringer, its parts do settle after the same manner; to wit, the more pure portion, and sulphureous (like Cream) comes together on the Superficies, which in healthful people, looks brightly red, and this answers to the flower∣ing or head of the Milk: under this lies a purple thick substance, which consists of little Threds and Fibres joyned together, and as it were concreted into a clotty substance or parenchyma, such as the Liver: For the heat being consumed, and the bond of the mixture loosned, the Fi∣brous parts lay holdon one another, and by their weight, settle into a more thick Coagulum, which answers to the Cheesie part of the Milk: In the mean time, the Serous or Wheyey parts, be∣ing thrust forth from the rest, get their own Nature, and constitute a clear Liquor, like water; which as it is thinner, ascends to the top, and swims upon the rest. Further, as the Whey of Milk is wont to be further coagulated, and doth yet contain in it self some parts both Buttery and Cheesie; so this Liquor swimming on the Blood, if it be exposed either to the fire, grows thick, like the White of an Egg a little rosted, or if an acid Liquor be powred to it, it will be precipitated into a white Coagulum. This being seen, some have thought this watery Latex, to be the nourishing Juyce, which imparts nourishment to the whole Body, from the mass of

the blood, in the time of its Circulation, an d that the rest of the blood is only the Vehicle of Heat and Spirits, and serves for no other use. But to me it seems more likely, that in this watery Liquor is contained the nourishing Juyce, which is employed on the Nerves, and the commonly termed Spermatic parts, for nourishment is supplied to the Musculous stock, from the fibrous blood of the Parenchyma, or the Liver, Lights and Milt. After this manner, blood being not much vitiated, goes into parts like Milk; but if it be exceedingly depraved, when it settles, it shews a far different disposition, and as to its single Contents, is allotted into various appearances; for the Cream growing together on the top, is seen to be sometimes white, sometimes green, now yellow, or of livid or Lead colour; also it becomes not tender, but ve∣ry viscous or clammy, that like a Membrane, it can scarce be pulled in pieces. When the blood long growing hot with a Feaverish Distemper, is let forth from the cut Vein, in its Superfi∣cies, instead of a Scarlet Cream, there grows together often a white Skin, or of some other colour; the reason of which is, because the blood is throughly rosted, by two great Ebullition, and its more pure portion, as it were by a certain elixation, is boiled forth from a red and tender substance, to a white and tough; but if in the mean time the bloody mass be not suffi∣ciently purged from the adust recrements of Salt and Sulphur, the colour of this little Skin becomes yellow or livid, and therefore the Water swimming over it, is often tinged by the same means. Further, the Purple Crassament or thick substance is also various, viz. sometimes it is of a blackish colour, when the blood is scorched too much, by a long effervescency. When the Fibres are vitiated, as in the Liver, they grow not together, but the Liquor like Beasting Milk, remains somewhat thick, and yet fluid; which indeed argues a great corruption of the blood; as uses to happen in a putrid Feaver, a very great Cachexy, sometimes the watery Latex is wanting, as in Hectical people, and in too great a Diaphoresis. Sometimes it superabounds, as in Dropical people, neither will the whole go into a white Coagulum, by heat: In some Ca∣chectical people, the blood being made more watery, appears like watered flesh. I knew one endued with a vicious habit of Body, that was wont to have blood of a whitish colour, and like to Milk when it was let forth, and afterwards, when he grew better by Chalybeat Mede∣cines, his blood was moderately red; but concerning the setling of the blood, and its appear∣ances, there is enough. But as blood being emited from the Vessels by its coagulation and de∣parture of the parts one from another, imitates the various substances of congealed Milk, so sometimes being shut within the Veins and Arteries, like some fused by a Coagulum, enters all together into the like mutation from Morbific Causes; by reason of which change, being hin∣dred in its Circulation, or somewhere congealed and fixed according to its portions, it produces many Distempers: for it seems, that from hence the Pleurisie, the Squinancy, the Inflammation of the Lungs, the Dysentery, take their Original, and to this Cause the Pestilent Diseases ow c•…•…iefly their deadliness, as shall be said hereafter in its place.

It is sufficient that we have hitherto drawn a parallel of the blood, from which comparison with Wine and Milk, may be gathered what sort of Particles and Substances it comprehends in it self, viz. Spirituous, and very agil or nimble (such as generous or rich Wine has) for the heat and motion; and besides soft and tender (such as are in Milk) for the nourishment of the Body. Yea also, this Analogy of it with Wine and Milk, is yet further confirmed by the use of them in our Diet, out of which the blood is generated; forasmuch as Milk is the best and most simple Aliment, and with it Infants, and Children, who have need of a plentiful provision of blood, are nourished chiefly: But Wine copiously begets Vital Spirits before all other things, and being weak and fallen, excellently restores them; wherefore it is wont to be esteemed in∣stead of Nectar for old men, or those of ripe years.

The Nature and Analysis of the blood flowing within the Vessels, being opened after this manner, the nutricious Juice deserves yet our consideration, being supplied from the blood, and separated out of the mass of blood, for the nourishment of the solid parts, and cleaving to them (whereby it may be the better assimilated) like Dew. For the Nerves, tendons and the rest of the solid parts of the whole Body, are washed with a certain alible Juice. The Vital Spirits, having obtained the Nervous Bodies for a Vehicle of this, blow them forth at length, and expeditiously execute the actions of Sense: also that Humor coming upon the solid parts, and assimilated with them, enlarges their Bulk and Growth. This is not a place to enquire after the Origin, Birth, and manner of the Dispensation of this: It shall suffice only that we have noted, that it is supplied from the mass of blood, and (as it is rendred highly probable by the most Learned Dr. Glisson, and Dr. Wharton) after it hath past through the Nervous part by a certain Circulation, what remains, being now made as it were poor and lifeless, is sent back by the Lymphatic Vessels, to the blood. Whilst this Juice, being little cocted, or purged from dregs, is sent from the depraved blood, to the Nervous parts, 'tis wont variously to irritate them into Cramps and Convulsive Motions; also, no few Symptoms in Feavers, arise by reason of the depravation, and irregular Motion of this Juice, as shall be more largely laid open in an∣other place.

CHAP. II. Of the Motion and Heats of the Blood.

SO much for the Anatomy of the Blood, as to its primary Elements and constitutive parts, into which it is sensibly wont to be resolved; also as to its Affections, which ap∣pear clearly, by the comparing it with Wine and Milk: it remains for us next to en∣quire concerning the motion of the blood, both Natural, viz. by the help of what Ferment, and by what swelling up of parts, it is Circulated in a perpetual motion through the Vessels) and preternatural, viz. for what Causes, and what fury of parts, when it boils up above mea∣sure in the Vessels, and conceives Feaverish Effervescences. These being rightly unfolded and premised, we will enter upon the Doctrine of Feavers.

Concerning the Natural Motion of the Blood, we shall not here enquire of its Circulation, viz. by what Structure of the Heart and Vessels, it is wheeled about after a constant manner, as it were in a Water-Engine; but of its Fermentation, viz. by what mixtion of parts, and mutual action of them together among themselves (like Wine fermenting in the Ton) it continually boils up. And this kind of motion (as it were truly an intestine war of the Blood) depends both on the Heterogeneity of the parts of the Blood it self, and on the various Ferments, which are breathed into the mass of the Blood from the Bowels.

As to the first: those things which have altogether like Particles, do not ferment, where∣fore neither distilled Waters, Chymical Oyls, Spirits of Wine, or other simple Liquors are moved, as hath been already observed: but I have said, that Blood, according to the Nature of things quickly irritable, doth consist of a proportionate mixture of the Elements; in which Spirits, for that they are very nimble, continually strive to expand themselves and to fly away: but being entangled by the more thick Particles of the rest, they are detained in their flight. And being detained after this manner, they toss about, break to pieces, and very much subti∣lize the more thick little Bodies, by which they are hindred; they volatilize the Salt, otherwise fixed; by a most minute kneading, and by the adhesion of it, they perfectly dissolve the Sul∣phur, compacted in it self, and not miscible with the rest, and boil it in the Serum. They break the Earth, even to its smallest parts, and mingle it with the rest. But in the mean time, by the striking and molding the Salt and the Sulphur, Esfluvia's of heat plentifully proceed, which being mixed with the rest, and on every side diffused, increase the motion of the Fermentation. And after this manner all being most minutely broken and diluted with watery Particles, they constitute the Liquor of the Blood,, which whilst in the Vessels, as Wine shut up in a Pipe, continually ferments, and according to all its Particles is in perpetual motion.

But the Fermentation of Wine and of Blood, differs in this; that in Wine there is no wast∣ing of the old parts, and a coming again of new; but the Liquor being shut up in the Vessel, remains still the same: but'tis otherwise in Blood, in which some parts are continually destroyed, and in their place others are always generated anew. In Wine, the times of crudity, matura∣tion, and defection, are distinct, and are successively performed in the whole: In Blood, that threefold state is celebrated at the same time and by parts: Fermentation being once begun in Wine, is continued even to the end; but in Blood, because it is washed still with crude Juices, it ought still to be renewed; by which means, the Nutritious Particles, not of kin, are assi∣milated to the rest of the Latex; wherefore, for this work, besides the Fermentation once be∣gun in the Blood, there is need of some Ferments, which may continue the same, otherwise about to leave off.

That Ferments are required for the making of Blood, this is an Argument; that when they are wanting by Nature, they are with good success supplied by the work of Art: for fixed Salts, Alkali Salt, Extracts, Digestives, Openers, and especially Chalybeat Remedies, help for this reason, that, as it were by a certain Ferment, they restore anew, the weak, or almost extinct Ebullition, or boyling of the Blood.

As to what respects the Natural Ferments, very many may certainly be formed, and in divers parts, or hid in the Bowels; for any Humor in which the Particles of Salt, Sulphur or Spi∣rit, being much exalted, are contained, puts on the Nature of a Ferment: after this manner, the flowring or dregs of Beer or new Wine, being kneaded with Meal, and the Mass kept to sowrness, come under this rank, by which new Beer, and the like Liquors, as also the Mass of Bread, are more excellently fermented. In like manner in the Ventricle, a sowrish Humor parti∣cipating of exalted Salt, there helps Concoction: and in the Spleen, the feculeneies of the Blood from Salt and Earth being exalted, go into a Ferment-

How much vigor comes to the Blood from the Womb and Genital Parts, appears from hence, because by the privation, or evil disposition of them, follow, in Maids the Green-sickness, in Men, Barrenness or loss of Virility, want of Beard, and a shrill Voice. But the chief Ferment, that serves for sanguification, is established in the Heart; for this is the chief fire-place, in which the cruder Particles of the Chyme, are as it were inkindled, and acquire a volatileness: which thing may be confirmed by many reasons, but especially by its effects, which we suffer in the Precordia, as often as the Blood ferments more or less than it ought to do: for when it is too much inkindled in the Heart, it is agitated impetuously, as it were by fires put under it; the signs of whose immoderate Ebullition are, a deep pulse and vehement, then almost an intole∣rable heat in the Precordia, with a vehement thirst; on the other side, when the Fermentation of the Blood is lessened in the Heart, we are affected with an anhelous, and difficult respiration upon any motion; as may be perceived in the Dropsie, Cachexia, and Yellow Jaundice: the rea∣son of which is, not because the Lungs are stuffed, or filled full of a tough or clammy matter; but because the Blood doth not rightly ferment, in that Repository of Fermentation; wherefore, being fallen into its Bosom, it is not presently Rarified; nor doth it soon leap forth into the Lungs, but being apt to stagnate, and remain there, causes an oppression of the Heart it self; for the helping of which, frequent breathing is made, that the Blood being let forth into the Lungs, succour might be brought to it: but if by motion or exercise, the Blood be more pro∣voked into its Ventricle, than can be derived by respiration, or the pulse, into the Pneumonic Vessels, there is danger of choaking. The like happens in those that are dying: when the pulse is very small, and the Blood being heaped up in the Heart for want of Fermentation, begins to stagnate and to clodder, we then breath deeply, with a no•…•…se and elevation of the breast; to wit, the Blood with the ultimate endeavour of Nature, and the whole force of the Lungs, as long as it is able to be done, is emptied forth into the Lungs, lest residing in the Heart, it should wholly choak it.

Therefore, Motion and Heat, in the Blood, depend thiefly on two things, viz. partly on its own proper disposition and constitution, by which, it being forged very greatly with active Principles of Spirits, Salt, and Sulphur, of its own accord swells up, or grows turgid in the Vessels, even as Wine in the Ton: and partly on the Ferment implanted in the Heart, which very much rarifies the Liquor passing through its Bosom, and makes it to leap forth with a frothy heat: that the Blood, which is quietly instilled to the Heart through the Veins, running gently like a River, from thence leaping forth through the Arteries, (like a Torrent) with noise and rage, might be carried forward, to all the parts of the whole Body. By what means this is done, though it is not easie to explicate Mechanically, yet the manner, and some not improbable reasons of this thing, are delivered by most Learned men, Ent, Cartes, and others. They sup∣pose indeed, as it were a fire to be set in the Chimny of the Heart, which presently inkindles the Blood infused through the Veins, (even as a flame put to Wine burns it) which being so inkindled, by its deflagration (like lightning) passes most swiftly through the Arteries: so that heat, a most rapid motion, and Effluvia sent by Perspiration, are wont to proceed from the accension of the Blood in the Heart only. Hogelandus affirms, that there is a Ferment hid in the Bosom of the Heart, that compels the Liquor of the Blood to boil up, and to grow hot, with heat, and a plentiful emission of Soot, just like Spirit of Nitre, when it is poured on the Butter of Antimony: so that the Blood, flowing in gently through the Veins, being forthwith Rarified into spume and vapour by the ferment of the Heart, runs very impetuously through the passages of the Arteries. 'Tis almost the same thing, whether it be said to be done, either by this, or by that way: for the alteration which the Blood receives in the Heart, may be equally deduced from a flame, or a Nitrous Sulphureous ferment, there supposed to be placed. Because, whilst the Blood slides into the Ventricles of the Heart, presently the frame of the Liquor is loosned, and the active Particles, especially the Spirituous and Sulphureous, the bond of the mixture being broke, do leap forth from the rest, and strive to expand themselves on every side; but being kept in by the Vessels, and being forced together with the remaining Liquor, through the open passages of the Arteries, they rush with violence, and swelling up by the way they can find, and by that means, diffuse Effluvia of heat, through the whole body: there is little difference, whether the expansion of the Particles of the Blood, and exertion into the liberty of motion, be said to be done by Accension, or by Fermentation, forasmuch as by either way, the frame of the Blood may be so unlocked, that from thence the Particles of Spirit, Salt, and especially of Sulphur, being incited into motion, (as it were by an inkindled fire) may impart heat to the whole Body.

But this Rarefaction, or Accension of the Blood in the Heart, very much depends upon the disposition and constitution of the Blood it self: for if its Liquor be rightly cocted, being made volatile, and (like rich Wine) brought to maturity, it then Ferments there after its due man∣ner, whereby the soluted Particles of the Spirits and Sulphur, diffuse an equal, and moderate heat to all parts. But if the blood, by reason of an ill manner of feeding, and want of Con∣coction, be crude and watry, then it is less inkindled in the Heart; and from thence follow a

frigid intemperance of the whole, difficult breathing and wheesing, with a weak pulse, and lan∣guishing; as in Cachectical people, those distempered with the Green-sickness, and such as are about to die, may be perceived: but if the Blood becomes too luxuriant, and apt to grow tur∣gid, by reason of plenty of Sulphur being carried forth, or of its Effluvia being restrained, or of eating hot things; either its Accension or Fermentation in the Heart, is very much increased, so that from thence a Feaverish heat, and greater effervescencies than usual, are stirred up in the whole. This various Fermentation of the Blood in the Heart, according to the various temper of the same, may be illustrated by the example of Wine: fresh Must, that is yet crude, though it be boiled, or put on the fire, will not burn; but this being purified and brought to maturity, is easily inkindled, but sends forth a small flame, and quickly out. The same at first growing hot, or otherwise warmed, if inkindled, is greatly inflamed, and for the most part is consumed by its burning.

Whilst the Blood, after this manner being rarified, or inkindled in the Heart, and from thence growing hot, through the passages of the Vessels, is resolved into minute parts, some little bodies depart from its loosned frame, which refuse at last to be united, and fitted with the rest of the Liquor: but these are of a twofold Nature; either thin, which like smoke from the burning fire, or Effluvia from a Fermenting Liquor, do evaporate from the Liquor of the Blood, by a constant Diaphoresis, through the breathing holes of the Body; or more thick, which like ashes left after burning, or the settling dregs after Fermentation, ought to be soon strained from the mass of Blood, and to be carried forth of dores: for otherwise, by their confusion, they produce notable perturbations in the Blood. Whereby the Blood growing more hot, is dis∣solved in the Heart, therefore these Recrements, both Fuliginous and Earthy, are more plenti∣fully heaped together; and when by reason of too great congestion, they cannot be presently subdued and secluded from the mass of Blood, they bring forth a swelling up of the Blood and Fea∣verish Heats.

Concerning the Motion, Heat, and Natural Fermentation of the Blood, in the equal tenor of which, the means of our Health consists, what hath hitherto been spoken, shall suffice. We will treat a little more largely of the preternatural, or too great effervescency, on which the Types, and Paroxysms of Feavers depend: I call that too much, or Preternatural Fermentation, when the Blood, (like a Pot boiling over the fire) grows hot above measure, and being rarified with a swelling spume, distends the Vessels, excites a more quick pulse, and like a sulphureous Liquor, having taken fire, diffuses a burning heat on every side.

This kind of motion or Fermentation of the Blood, will be best of all illustrated by an example of Wines growing hot. For Wines, besides the gentle and equal Fermentation, by which they are at first purified, at some times do so remarkably grow hot, and boil up, that they fly out of the mouth of the Vessel, and if they are closely stopped up, cause it to burst in pieces. After this man∣ner, as if struck with fury, unless they are immediately drawn away from the Tartar; or their Lees into another Vessel, they will not cease from growing hot, until the Spirit being very much loosned, and the Sulphur or Salt too much exalted, they are either made unsavory, or degenerate into a sowrness.

Such an Effervescency is wont to be stirred up for two causes chiefly: First, When any extra∣neous thing, and not miscible, is poured into the Ton, (so some drops of Tallow, or Fat, being dropped into the Cask, will produce this motion) or secondly, when Wines being enriched with too rich a Lee or Tartar (by reason of the sulphureous parts being above measure exalted) con∣ceive heats of their own accord, and exceedingly boil up. For in whatsoever substance Sulphur abounds, and its Particles being loosned from the mixture, consociate together, and are bound close in one, there such immoderate heats are procured.

After a like (tho' not wholly the same) manner, whereby Wines grow hot, the boiling up of the Blood is induced; to wit, either what is forein, and not akin to the Blood, is mixed with it, that when it is not assimilated, is wont to cause a Perturbation, and growing hot, until that Heterogeneous thing, is either subdued or cast forth of dores; and the Particles of the Blood being confused and troubled, are at last shaken forth, and that they get again their former place and position in the mixture. Or, Secondly, the Blood grows hot above measure, because some Principle, or its constitutive Element, (viz. Spirit or Sulphur) is carried forth beyond its Na∣tural temper, and becomes enraged; whereby indeed the Particles of this or that, being not agreeable to the rest, are loosned from the mixture; being loosned, they become more violent than they ought, shake much the Liquor of the Blood, and bring forth a heat, which is not al∣layed, till the Blood being as it were inflamed, burns forth with the long fire of a Feaver. By either way, whether the Blood grows hot in the Vessels, by reason of the pouring in of a thing not miscible, or by reason of the rage of the Spirit, or Sulphur being carried forth, because from thence its frame is more loosned, therefore it is more inkindled in the Heart; and the active Particles first loosned from the Ferment there implanted, do grow exceeding hot, leap forth from the mixture, and disperse on every side by their motion, a strong heat, and as it were fiery: but yet with this difference, that the Effervescency, which depends upon the

mingling of some extraneous thing with the Blood, is for the most part short, or renewed, which, when what was Heterogeneous is separated or subdued, is quieted of its own accord, and the shaken parts of the Blood, and put out of order, easily return to their Natural site and dispo∣tion. But the Ebullition which arises from the inordination of the Spirit or Sulphur being enra∣ged, is continual; to wit, here the whole mass of the Blood is so loosned, and dissolved from the strict bond of the mixture, that as an Oily Liquor having taken fire, it ceases not to grow hot, or to be inflamed, till the Particles of Spirit, or Sulphur, or the combustible matter, be for the most part burnt out.

There remains yet a third manner of Preternatural Fervency, whereby the Blood is subject to alteration, which happens not to Wine, but most often to Milk; viz. when at any time, from a Morbific cause, a coagulation of its Liquor is induced, so that its substance is poured forth, and goes into parts, and there is a separation made of the thick and earthy from the thin; by which means the Blood is not fitly circulated in the Vessels, but that its congealed portions, being apt to be fixed in the extream parts, or to stand still in the Heart, do interrupt the equal motion, or grievously hinder it: For the sake of the restoring of which Effervency, greater are wont to be stirred up in the Blood, to wit, such as happen ordinarily in a Plurisie, the Plague, Small Pox, or the Venereal Disease.

CHAP. III. Of Intermitting Feavers or Agues.

BY the Premises which we have spoken of already, concerning the Anatomy, Motion, and Heats of the Blood, there now lies open an easie passage to the handling of Feavers. The Notions which are commonly set forth, concerning a Feaver, out of the force and Etymology of the word, I here purposely omit: It may be described after this manner, that it is, An inordinate motion of the Blood, and a too great Heat of it, with burning and thirst, and other Symptoms besides, whereby the Natural oeconomy or Government, is variously disturbed. As we have remarked already, concerning the growing hot of the Blood, so now we do of a Feaver, that indeed, its accession is either short, and by fits, which is therefore termed Intermitting; or else great, and long protracted, which is called a continual Feaver. We will first speak of the Intermitting Feaver.

Tho' an Intermitting Feaver, in our Popular Idiom, is known by a proper Name, and is di∣stinguished contrary to a Feaver commonly taken, yet because it hath too great Effervency of the Blood joyned to it, it is to be called a Feaver. It is peculiar to this, from a continual Feaver, that it hath certain remissions, or times of intermission; that every fit begins with cold or shaking, for the most part, and ends in sweat; that the accessions or coming of the fits, return at set Pe∣riods, and certain intervals of times, that a Clock is not more exact. Wherefore, we will first, discourse concerning this Feaver in general, what sort of heat of the Blood it is which continues its fit, and from whence it is raised up. Secondly, Wherefore the fit appears equally with cold and shaking, as with sweat following. Thirdly, What may be the cause of the Intermission, as also of its certain set Periods. Fourthly and Lastly, Are added some irregularities of Intermitting Feavers, as when now cold, now heat or sweat is wanting; or when the Periods are wandring and and uncertain, when the Remission or space of Intermission, is not equal, but now comes sooner, now later, and sometimes redoubled: and I will endeavor to shew the reasons of these, and of other Phenomena or appearances, which variously happen in this Distemper. These being laid open, we will go on to unfold in the next Chapter, the division of an Intermitting Feaver, and the kinds of it.

As to the first: The Effervency of the Blood in an Intermitting Feaver, (or Ague) for the time of the fit, is as violent and strong as in a continual Feaver: wherefore, it is concluded, that the parts of the Blood, among themselves, or some heterogeneous thing being mixed with it, do strive together, and ferment above measure. But there is required, that they may ferment, or too greatly boil up among themselves, that some Principle, as chiefly Spirit or Sulphur, being too much exalted and enraged, do appear above the rest; which, when it cannot be yoaked with them, brings in a continual strife and heat: but from this cause, a continual Feaver draws its rise, because such an Ebullition of the Blood, being once begun, is not suddenly allayed, and when it is appeased, it does not afterwards presently return. Wherefore for an Intermitting Feaver, 'tis to be supposed, that some heterogeneous thing is mingled with the Blood, whose Particles, when they are not assi∣milated, make so long an Ebullition of the same, till either being kneaded, they are rendred miscible, or being subtilised, are shut forth of dores. Wherefore, such a matter being brought under, or

shut forth of dores, the fit ceases, and when this matter springs again, it stirs up a new Ebullition, and so a new fit is brought on.

Concerning this Matter, which being mixed with the Blood, induces the periodical Heats, and the other Symptoms of an Intermitting Feaver, 'tis very ambiguously, and diversly disputed among Physicians, where it is generated, in what seat or place it lodges, and by what means it so exactly observes the times of its Motion, and Ebullition. But it would be a work of too much labour and tediousness, to recount here all the Arguments, of the Ancients, and Moderns, to reduce them into order, and to weigh their reasons; Wherefore, doubting, I propose what has come into my mind, when I thought deeply of the matter, and submit to the Judgment of others.

Of necessity there is something, which brings in the Heat of the Bloud exactly periodical, that is generated in our Body at the several periods, or accessions of the Feaver, always in a set measure, and equal proportion, and is communicated to the mass of Bloud; with which when the Bloud is filled to a plenitude, it forthwith grows turgid, and conceives an heat: But this is supposed to be either an Excrementitious humor, sliding down into some Mines, which by de∣degrees, and at a set time, being brought to an increase, and moved, Ferments with the Bloud: or it is the nutritious Juice, supplied from the matter of Food, and delated in weight and mea∣sure, which, when it is not assimilated, by reason of a defect in sanguification, being heaped up to a fulness, for its own expulsion, induces a turgency in the Bloud. The reason of Intermitting Feavers, is commonly explicated by the former way, and the causes of the Intermission, and set times of approach, are fetcht from the nature of the Humor, and the seat, or place where it is cherished. The Nest, or Mine of this Disease, almost by an unanimous consent, is fixed on the first shop of the Body, and from hence the reason of the Intermission is fetched, and the conti∣nual difference of an Intermitting Feaver: but they affirm the matter to be Choler, Phlegm, and Melancholy; and as these humors are said to putrifie slower, or sooner, so the Feaverish courses, are said to be absolved, in the space of one or more days. But this Opinion, after the Circulation of the Bloud hath been made plainly known to all, is deservedly rejected. For when the Bloud never stagnates in the Vessels, but washes every place with a perpetual motion, and continually carries away their filth, it is impossible that the Mine of this Disease should subsist in the Mesa∣raick, where it is commonly asserted to be: as to what belongs to the cavities or dens, for the heaping up of the humors in the Viscera, it neither appears, by what means such should be formed without a Tumor or Imposthume; nor by what instinct, such humors, shut up in their Nest, do increase, are consumed, and lastly spring forth again, at so exact intervals of times. Be∣sides, what is affirmed concerning Bile, Phlegm, and Melancholy, and of their periodical mo∣tions, we hold wholly suspected; because these sort of humors, are not afforded sincere, such as are described in the Schools: but the Bloud, having gotten a various disposition, now being hot∣ter, now colder, its nature imitates the qualities of such humors; or in its Circulating, it lays aside its Recrements, which being deposited in little Chests or Vessels, are falsely believed to be Morbific, and Preternatural humors. Wherefore, as the nutritious Juice, is the only humor where∣with the mass of Bloud is daily refreshed, and its supplements are made still in measure, and pro∣portion, without doubt, the periodical heats of the Bloud, are to be drawn from the accession and commixtion of this.

I have already remarked concerning the Particles of the Bloud, a triple state of crudity, matu∣ration, and defection: to wit, the nourishing Juice, supplied from the daily Food, comes crude, is mixed with the Bloud, and being for some time Circulated, is assimilated to it, and is ripened into a perfect humor: afterwards growing stale, it goes into parts and is laid aside. Whilst after this equal manner, the Bloud is continually restored, and its losses repaired, it very quietly Ferments, without any trouble, or immoderate heat, and is Circulated within the Vessels; but if the supplement of the nourishing Juice, is not (as before) ripened, nor goes into Bloud, by a perfect digestion, its Particles being confused with the Bloud, remain as it were some Heterogeneous thing, and not exactly akin, in the mass of Bloud; with which, when it is filled to a plentitude, the Bloud forthwith grows troubled, and conceives a Fea∣verish heat, whereby the fresh supply of this depraved Juice, is either overcome, or cast forth of dores. I say, therefore, from the first instant, in which the nourishing Juice is not assimilated with the Blood, its Particles, though mixed with it, are as yet Circula∣ted with it, without any great tumult or perturbation, and so afterwards, till the mass of the Bloud is filled with them to a turgency: but then it quickly boils up, and conceives a heat: almost after the same manner, as new Beer put into Bottles, which, if they are clos•…•…ly stopped, that nothing may evaporate, is at first contained in those Vessels, without heat, or force; afterwards, when the Effluvia being still restrained, the mass of the Li∣quor swells up, notably Ferments, and by reason of the force of Fermentation, often∣times makes the Bottles fly in pieces: also this happens at a set time, and in the space of so many hours, as in an Intermitting Feaver, the Liquor arises to its height of tur∣gescency.

There yet remains a difficulty, for what cause the Nutritious Juice, being confused with the Bloud, is not assimilated, but degenerates into an Heterogeneous, and Fermentative Matter: I suppose this to be done, for the most part, not by the default of the Aliments, nor yet of the Bowels, but by the vice of the Bloud it self. For the Bloud, even as Wine, sometimes passes from its native and genuine disposition, into an acid, sowr, or austere disposition; and because the Bloud makes Bloud, it comes to pass, that w•…•…en it is de∣parted from its due temper, it easily perverts the provision of the Nutritious Juice, by which it should be repaired. What that disposition of the Bloud is, and by what means contracted, shall be told hereafter, when we speak of the kinds of Intermitting Feavers, and of their evident, and Procatarctick Causes. The Heat, or Effervescency therefore of the Bloud, which constitutes the fit of an Intermitting Feaver, depends only upon the as∣similation of the nourishing Juice being hindered; the Particles of this being commixed with the Bloud, are not (as before) ripened, nor are made into perfect Bloud; but by the mixture of these, the mass of Bloud (as it were new Drink) is imbued with little bodies greatly Fermentative; when the which are more thickly heaped together, and the Bloud is filled with them to a swelling up, it presently grows hot, and a mighty agitation, and strife of the Particles is made, by which, they break, and subtilise one another, till at length the Vita•…•… Spirit getting the dominion, and the rest being brought under, what is extraneous is thrust forth of dores, from the company of which, the Bloud being freed, the remission, and inter∣mission of the aguish fit follows; but afterwards from a new supply of this Juice, a new fit is brought on.

Secondly, As to the shaking, or cold preceding the heat, in this Distemper, I say, when the Particles of the nourishing Juice, do proceed from a state of crudity, towards matu∣rity, but do not attain it, they contract a notable sowrishness, with which they greatly prick, and haule the nervous parts, and cause the sense of cold: even as new Beer, which being stopped close in Bottles, passes from a sweet into an acid and nitrous taste, that for the cuttingness and cold, can scarce be swallowed. When therefore, the Particles of this sort of crude Juice, being indued with a Nitrous sowrness, do fill the mass of the Bloud to a fulness, or to a swelling up, and when they being more thickly heaped together, begin to enter into a Flux, they first of all strike down the Vital Spirits, with their sharp∣ness, and somewhat overthrow their heat; wherefore the Bloud becomes colder, and is more slowly circulated: yea, and by reason of the defect of heat, the sense of cold is per∣ceived in the whole body, and a pulse very rare exists. Moreover, When the nervous and solid parts, are watered with this sort of acetous Juice, for their last nourishment, by the Flux of this, which happens together with the turgescency of the Bloud, these sensible parts are pulled, and irritated into Tremblings, and Convulsions. And this, without doubt, is the true and genuine Cause of the cold and shaking, which are exci∣ted in a fit of the Intermitting Feaver; to wit, the Flux, and swelling up of the nou∣rishing Juice, degenerated into a Nitrous Matter, with which the Spirits and heat being suf∣fused, are blunted, and the Nervous Bodies, being provoked, are moved into Trem∣blings. But afterwards, when these Nitrous Particles being thrust forth, from some part, into the Superficies of the body, the Bloud is somewhat freed from their weight and op∣pression, the Vital Spirits recollect themselves, and begin to shine forth; but from thence a most intense heat succeeds; because, both the mass of Bloud, by reason of the growing hot with the Feaverish Matter, being loosened, and also it mixture being laxed, the Sul∣phureous Particles are more plentifully inkindled in the Heart; and because (the Pores of the Skin, being possessed by the same Matter, thrust forth towards the circumference of the body) the vaporous Effluvia are restrained within, which do more shake, and make hot the the Bloud; that heat persists still in the Bloud, until that Fermentative Matter being wholly burnt out, and together with the adust recrements, remaining after the burning, being fully brought under, and subtilised, and involved with the Serum, insensibly evaporates by sweat, or transpiration.

Thirdly, These things being premised, it will not be hard to shew the Reasons and Causes of the Intermission, as also of the set Periods, viz. the Intermission follows, because all the Mor∣bific Matter is dispersed in one fit, and so till new be substituted, there is a necessity that a remis∣sion follow. But new Matter begins to be begot, of which the last fit failed; to wit, the mass of Bloud being now emptied, receives the nourishing Juice, and perverts it (as before) by rea∣son of its defect of due making of Bloud, and of Concoction, into a Fermentative Matter; but its little plenty stirs up little or no trouble, or Fermentation; but when the Bloud is filled to a swelling up, it presently Ferments, and is in Flux, even as when new Beer, or new Wine, shut up a long while in a Vessel, at length, at a certain time, boils up, and leaps forth at the mouth of the Vessel.

But that the Fits, or Accessions, do for the most part come again, at set intervals of times, and that so certainly, that a Clock is not more exact; the reason is, because the nourishable Juice, is

for the most part supplied from the Viscera, to the Blood flowing in the Vessels, in an equal mea∣sure and manner; for though we do not daily take exactly so much meat and drink in weight and dimension, yet, because we for the most part eat at set hours, for the satisfying the Appetite, from the things eaten, and the mass of the Chyme heaped up in the Bowels, an equal portion of the nutritious Juice is conveyed to the Blood through the Milky Vessels; wherefore, if at such hours, so much of the nutritious humor is poured into the Blood, which encreasing to a fulness, and swelling up, it brings on the Fit that day: certainly, this being finished, in the space of the same time, sufficient matter is laid up, for the following fit: But if Errors in feeding be com∣mitted, and that the sick indulging their Appetite, eat more plentifully or inordinately, the approach of the fit anticipates the wonted hour, by reason of the Bloods being filled sooner with the Feaverish Matter; if that the sick are abstemious, and more sparingly take their food, the intermission is drawn out longer.

If it be yet asked, wherefore the periods of intermitting Feavers be not of one kind, and of the same distance, but that some repeat, and come again daily, others on the third and fourth day? The cause is the diverse constitution of the Blood, to wit, whereby it is perverted from its due temper, now into a sowrish, now into an acid or sharp,, or into an austere or harsh disposition. By reason of the diverse evil conshitution of this, the alible Juice, being fresh carried, departs more or less from maturation, and is perverted into matter, apt sooner or later to fer∣ment. When the Blood has acquired a sowr, hot, and bilous disposition, I suppose that some part of the nourishing Juice is ripened into perfect humor, and is assimilated with the Blood, and so goes into food, to be carried to the solid parts, and is affixed to them; but the other part of it, from the Blood being too much cocted, and depraved, is changed into a feaverish matter, and supposing that half of the nutritious Juice is after this manner perverted, in dou∣ble the time, in which it is said to have a full concoction in our Body (that is, after eight and forty hours) this kind of fermentative matter rises to a plenitude and turgescency, and then induces the fit of a Tertian Feaver. If that, by reason of the austere, and pontic nature of the degenerated Blood (in which a fixed Salt, with an earthy Faeces is exalted too much) and therefore apt to ferment more slowly, only a third part of the nutricious Juice is corrupted, then in three times the space of the aforesaid time, the fit is induced; that is, after seventy two hours, in which, the period of a Quartan is wont to be concluded. But, if by reason of a greater infection of the Blood, almost the whole supplement of the nutricious Juice is per∣verted into a Feaverish matter; then in the space of that time, in which the plenary coction ought to be absolved in the Vessels and habit of the body (that is, after twenty four hours) this matter arises up to the motion of turgescency, and brings on the quotidian fit. And hence it comes to pass, that in a Quartan Feaver, strength and courage do not presently fail, whilst in a Tertian, the sick are wont to become more weak; but in a Quotidian Feaver, they are sooner brought into languishing, and greatest weakness: to wit, in each, as more or less of the nutricious Juice goes into the food of the Disease, so much also is drawn away from the strength and firmness of the Body. But more fully of these, when we treat of the several kinds of Intermitting Feavers, and the Causes of them.

Against the equal Circuits of these Feavers, it is argued, that for the most part, the fits do anticipate the set time of the day, by the space of some hours, and sometimes also come after it. But in truth this Objection is taken away, if the times of Intermission be computed, not by days, but by hours; for so the intervals which but now seemed to be now sooner, now longer protracted, will appear for the most part equal, by this Rule; forasmuch as in respect of the day, it is said a Tertian Feaver, sometimes prevents the wonted time of its accession, two, three, or more hours, or comes after it; in the mean time, every Circuit exactly repeats or comes again, every time after so many hours. Wherefore the chief differences of Intermitting Feavers consists in this only, that the time of the accession in one Feaver, comes more swift∣ly, and in another more slowly, viz. now at twenty four hours distance, now at thirty four, now at seventy, or the like.

From what hath been said (unless I am deceived) it clearly appears, what the Efferves∣cency of the Blood is, which constitutes the fit of an Intermitting Feaver, from whence the fore-runners of cold and shaking, and lastly, what may be the reason of the Intermission, and of the set periods. But that these, and many other Appearances of this Distemper, depend upon the evil disposition of the Blood, and because of the depravation of the nutricious Juice, and not from humor, lurking in some Mine, will yet more manifestly appear from the collation of the Signs and Symptoms, which are to be met with, worthy of note, in this Distemper: then secondly, from the Procatartic, or more remote causes being truly weighed, which are wont to induce this Distemper: And thirdly, and lastly, from the ways of the Crisis, and Cures, by which this Disease either ceases of its own accord, or is driven away, by the help of Medecines.

First, Among the Signs, the Pulse and Urine deserve the chief consideration: The Pulse, the cold fit coming on, is very rare and low; which clearly argues, the Heat, and Vital Spirits

in the Blood, to be as it were overwhelmed by some crude matter, not easily combustible; just as a fire enkindled on the Hearth, and then covered with green wood, glows very slowly, and flames forth very little, which afterwards, the crude humor being blown away, breaks forth into an open and very strong flame; so also, the Blood, the crude matter, which is in Flux, being something overcome or dispersed, is very much enkindled; and what remains in the Blood is burnt up, when fermenting with the Particles of it, and induces a most violent heat, with thirst; wherefore the Blood growing impetuously hot, is urged with a vehement, and most swift Pulse; otherwise it being too much heaped together in the Heart, might cause the danger of choaking.

As to the Urine; that is imbued (especially, in a Tertian Feaver) with a deep colour, and as it were enflamed, also when the contents are wanting; which seems to denote a scorching of the Blood, and too adust temper: moreover, in this Distemper, different from others, the U∣rine, for the most part is ill, when the Patient is pretty well, and on the contrary; forasmuch as all the time of the Intermission, it is at a great distance from its natural state, it becomes filled with a red colour, and thick, being exposed to the cold, and lays down a plentiful sedi∣ment, like to Bole-Armoniack; which is of necessity to be so done, because in the whole inter∣val of the remission, the Feaverish matter is circulated with the Blood, and there rises to matu∣rity, with a secret increase. But in the middle of the fit, when the heat and burning are at the greatest, the Urine is laudable, and comes more near to the natural, viz. the fermentative mat∣ter, being sent to the circumference of the Body.

The Symptoms preceding the fit, confirm the same thing; for many hours before the fit be∣gins, a perturbation of the humors, and blood, is perceived; an Head-ach, Vertigo, spark∣ling of the Eyes, unquiet Sleep, &c. which plainly shew the Blood first infected with the fer∣menting matter, and the assault of the fit to be only so long deferred, until the mass of the Blood is filled to a swelling up, with the same kind of matter: the fore runners of the ap∣proach of the fit, are, now a paleness at the ends of the Fingers, or Toes, or in the Nails, sometimes a convulsion or numness; now a coldness, and pain in the Loins and Thighs, and sometimes a shivering and trembling invade the Body, which clearly shew, the Blood in the Arteries and Veins, and also the thin Liquor in the Nervous parts, first to conceive the motion of Fermentation, and this Effervency not to be excited from any other Fire-place, or Mine. If it be objected, thatthe sick are most often infested with Vomiting, about the time of the fit; from whence it may seem to be concluded, that the chiefest hurtful matter is established in the Ventricle, and in the first passages, especially when this Distemper is chiefly cured, by the time∣ly taking of a Vomit; I confess, very great Vomitings are sometimes stirred up in the fit of an Intermitting Feaver; but this more often happens, because in the Feaverish shivering, the membranes of the whole body are pulled; wherefore the Ventricle also. as it is a very Nervous part, is distempered with a Convulsion, and having from thence contracted a Spasm, casts forth upwards whatsoever lurks in its bosom. Besides, if that the choler-bearing Vessels swell up with Bile or Choler, by the same Convulsion also of the Viscera, the Bile is pressed forth into the Duodenum by the gallish passage, and is emptied into the Ventricle, and there by its fierceness, pro∣vokes yet to a more cruel vomiting, wherefore for the most part, the vomiting which is excited for this reason, follows the shaking only. But that the Choler was not in the Stomach before the fit troubled it, but only pressed forth from the Choleduct passage, by the Spasm and convulsive motions of the Viscera, and poured sorth into the Ventricle, appears from hence, because if a Vomit be given in the midst of the interval, between the two fits, little or nothing of bilous matter will be drawn forth; besides this bitter humor is of that fierceness, that it cannot be long contained in the Ventricle, but presently it will procure the pain of the Heart, and Vo∣miting. Besides this sort of Vomiting, excited in the shaking fit, sometimes a Vomiting is pro∣voked in the midst of the burning fit, or in the sweat, the cause of which is the redundancy of the bilish humor in the Blood; of which if there be greater plenty, than what diluted with Se∣rum may be sent forth by Sweat, a great part of it, whilst the Blood is circulated about the Crevises of the Liver, is laid aside in the Choleduct Vessels; which, when being filled to a disten∣tion, exonerate themselves, and send away the Choler to the Intestines and Ventricle, and there a Convulsion being presently stirred up, sometimes Vomiting is provoked, and sometimes the belly becomes loose, and the Stools liquid. In this Year 1657. I observed very many affected after this manner, for when after an hot and dry Summer, about the middle of Autumn, an Intermitting Feaver generally raged, the sick were wont suddenly to grow very ill, in the mid∣dle of their hot fit, and sometimes also in their Sweating, and the Sweat being struck in, to be taken with Swooning; but shortly after, when a Choleric Vomiting followed, they were eased.

Not only the signs and symptoms, but the Procatartic or more remote Casues of this Disease, clearly indicate, that it takes its rise from the temper of the Blood being changed; because In∣termitting Feavers are most frequent in the season, and places, in which the Blood receives the greatest alteration from the Air, viz. either in the Spring, when the Vernal heat shutting out the Winters Cold, causes the Blood, before benummed, and apt to be more slowly moved, to begin

to flourish, and luxuriate in the Vessels, and from thence, to get a bilous and hot temper: or in the Autumn, when the Blood being torrified, or rosted by the Summers heat, and therefore its Spirits very much depressed, and Salt and Sulphur exalted, acquires now a sharp and Choleric, now a binding and austere disposition; wherefore, at this season, Feavers, now Tertian, now Quartan, are frequent; besides, in some places, there is that constitution of the Heaven, that on all men whatsoever, there comes either a Tertian or (more frequently) a Quartan Feaver; although in the first Offices, where the Mine of the Disease is commonly believed to be lodged, there be no congestion of humors, by reason of an ill manner of living, or sickly disposition. Yea, they most easily fall into this Disease, who have their Inwards firm and strong, and who abound with a lively heat: on the contrary, those who by reason of a weak concoction, heap up Crudities in the first passages continually, that they are prone to the Dropsie, or Cachexia, re∣main free, for the most part, from this Distemper, to wit, the Blood being made more watery, (like Wine degenerated into a tasteless substance) is altogether unapt to be fermented.

No less doth the Cure of Intermitting Feavers seem to prove this our Assertion, whether it be Natural and Critical, or Artificial, and performed by the help of Medecines. As to the first, Intermitting Feavers are wont to be terminated after a twofold manner. The first is, when from the fits themselves the temper of the Blood is altered, and oft-times is reduced into its natural disposition. For when in every coming of the fit, very much of Sulphur, and adust Salt is burnt out, and exhaled by Sweat, the Liquor of the Blood, by that means becomes more tem∣perate, and less torrid: wherefore, oftentimes this Disease is cured, at six or seven periods, and of its own accord ceases; but if it be longer protracted, and that the Blood being somewhat changed from the sharp and bilous temper or disposition, is not restored to its natural temper, sometimes it degenerates into an acid, watery, and also pontic or saltish temper, from whence a long Tertian Feaver passes into a Quotidian, or a Quartan; also oftentimes, because the Blood is greatly depraved, by the long continuance of this Feaver, the Jaundies, or the Scurvy, or the Cachexia follow. The other manner, whereby this Disease is terminated, is, when the change of the Air, or the Country, brings a notable alteration of the Blood; for so Feavers begun at the times of the Equinoxes, are ended about the time of the Solstices; also the sick▪ travelling into another Region, often grow well.

As to the Cure of it, by the Institutions of the Medecines, it uses to be done two ways, viz. Empirically, and Dogmatically; and in this Disease, Empirical Remedies, sought from Quack∣salvers, and old Women, are more esteemed, and oftentimes do more than the Prescriptions of Physicians, administred after the exact method of Curing.

Empirical Remedies, which are said to cure Intermitting Feavers or Agues, are of that sort, which drive away the approaching fit, without any Evacuation, and are either taken inwardly, or are outwardly applied, where the Pulses chiefly beat, viz. For the most part, they are bound either to the region of the Heart, or to the Hand-wrists, or to the Soles of the Feet; these sometimes are so commonly known to help, that some have warranted the sudden Cure of this Disease, by these Remedies, under the pain of some forfeiture: Wherefore it is worth our en∣quiry, how these operate, and by what way or means they stop the Feaverish accessions. It is clear, First, that those which are outwardly applied, do immediately impart force and action to the Blood and Spirits; and when they drive away the fit, by preventing, without the evacua∣tion of humor, or any matter of necessity, the reason of this effect consists only in this, that by the use of these sort of Medecines, the turgescency or swelling up of the Blood, with the feaverish matter, and Fermentation are stopp'd; to wit, from the Medecine tied about the Bo∣dy, certain little Bodies or Effluvia are communicated to the Blood, which do very much fix and bind together the particles of it, or also, as it were precipitate them, by fusing and shaking them; and by either way, the spontaneous growing hot of the Blood, is hindred; as when cold water is put into a boiling Pot, or as when Vinegar, or Alum is flung into new and working Beer, presently Fermention ceases. and the Liquor acquires a new taste and consistency, whereby it becomes fit to be drunk, as if it had been kept to ripen along time. But that these Ague-stoppers do work after this manner, it is plainly seen, because those which are of principal note, do ex∣cel in a Styptic, and binding force, or else with a precipitating virtue; hence Sea-salt, Nitre, Sal-gemmae, the Juice of Plantane, Shepherds-burse, any binding herbs pounded with Vinegar, and the like, bound to the wrists, the root of Yarrow, Tormentil, also Camphire hung about the neck, are said to take away this Disease: yea, those also which are taken inwardly, are of the same rank; the Juice of Plantan, Red-Rose water, Alum, for that they fix, and constrain the Blood, a decocti∣on of Piper, Sal Armoniac, or of Wormwood, Spirit of Vitriol, also a sudden passion of anger, or fear, forasmuch as they precipitate the Blood, by fusing and shaking it, do oftentimes hinder the Agues approach: even as the concussion, and shaking much any Liquor, or the infusion of a∣stringent things into it, hinder its spontaneous effervescency and rage. It is usual with some Empi∣ricks, for the cure of Agues, to tie a little knot in a Linnen Rag, or a piece of Paper rolled up, so strictly to the wrists, pressing hard upon the beating of the Pulse, that the circulation of the Blood is somewhat hindred, and by this means, the Aguish fit coming on, is

driven away. Very many by this way, I have known to be cured of a tedious sickness; the reason of which seems to be, that whilst the Blood is hindred from its motion in any part, it grows more tumultuous in the other parts; and so by this perturbation, stirred up in the whole Blood, the spontaneous Effervency of the Liquor, being about to follow, is hindred. But that the fit, by this, or any other means, being once hindred, does not afterwards easily return, the reason is, because, if this feaverish and depraved matter be contained longer in the Blood, it is afterwards cocted, and in some measure ripened; and therefore the Blood does not (as be∣fore) altogether pervert, either this, or the provision coming to it anew, but begins to digest and assimilate it; besides, when the fit is once stopp'd, its custom is broke, by the instinct of which alone, Nature oftentimes repeats those her Errors: for, as when it has once made a fault, it is wont more readily to do ill after the same way; so when it once omits its fault, it more easily accustoms it self to do better.

The dogmatical Cure is instituted for the most part, by Vomitory and Purging Medicines, also with the letting of Blood; with which the sick are miserably tormented, and the Disease seldom profligated or driven away, that deservedly, this Distemper is called the Shame of Phy∣sicians; but Tertian Feavers are sometimes carried away by a Vomit given just before the com∣ing of the fit, which indeed happens (as I think) for the reason before mentioned. For I have said, That the cause of a Tertian Feaver, is an evil disposition of the Blood, whereby it passes into a sowr and bilous Nature; and therefore it doth not rightly assimilate the nutritious Juice brought to it, but changes it into a fermentative Matter; wherefore, if the Bile or Choler be copiously drawn forth of the Blood, that Choleric and hot Intemperance is very much taken away, and that fermentative power ceases of it self; But Emetick Medecines do chiefly perform this; for if they operate strongly, a Convulsion is not only brought to the bottom of the Ven∣tricle, but also the Duo denum, with an inverse motion, isdrawn together towards the Pylorus, and the Choler by a continual thrusting forward, being squeez'd forth from the Choleduct pas∣sage, is poured into the Ventricle, which is presently cast out by Vomit; which being copiously performed, the gallish Bladder is almost emptied, and after that, it becomes a receptacle, that draws forth, and separates the bilous humor, or the Particles of adust Sulphur and Salt plenti∣fully poured into the Blood; the next fit sometimes is by this means prevented, not because the Mine of the Disease is extirpated by Vomit, but because an Evacuation and Motion is excited, contrary to the Feaverish motion, and for that reason, the spontaneous Effervescency of the Blood is prevented. Also by this means, sometimes the Disease is taken away after the Fit, because this way, the Blood is fully cleared from the bilous humor. It is worthy observation, that in a Quartan Feaver, Vomits profit nothing, and seldom in a Tertian, unless administred presently at the beginning, whilst the Feaverish disposition is yet light, and not fully con∣firmed.

Concerning Intermitting Feavers in g•…•…neral, there yet remain some Irregulars of them, to be explicated, which vary from the wonted manner: for unless these unusual appearances be solved, this our Hypothesis will seem to be defective, and to halt in one part. First therefore, they are wont sometimes to lack the cold or shaking fit. This intermitting Feaver is frequent in Autumn, whose fits are wont to exercise the sick only with heat. and that most violent, and in many they come with great Vomiting, but no Sweat or Cold; then after four or five periods, upon the coming on of the fit, the sick are wont to be chill, and presently after to quake, and in the de∣clination to sweat: The reason of this was, because, from the very hot Summer, the constitution of the Blood was become sharp, and very much burnt; wherefore the Particles of the crude Juice, being commixed with it, were presently torrified, or made hot, and scorched; that they did not at first, like (new Beer) grow hot with an Acrimony, and then afterwards blaze forth; but a turgescency being stirred up (like dry wood laid upon a fire) presently took fire, and broke forth into flames; but afterwards, the Liquor of the Blood being fired by several fits, became less torrid, that the depraved alible Juice was not presently torrif•…•…ed, but passed into a Nitrous matter, and fermenting with sharpness, which at first swelling up, induced the sense of Cold to the whole Body. When the cold fit was begun, for the most part Sweat concluded it: which indeed hapned, because the Blood being made more watery, is more easily resolved into vapour, with the Feaverish matter, even as a watery Liquor is more easily drawn forth by distil∣lation, than what is Oily, or of a more thick consistency.

It often happens, in the declination of this Disease, when the Fits begin to lessen, that the sense of Cold and shaking, by litle and little are diminished, and at length vanish, and the Fit only troubles the sick with a light burning: The reason of which is, because at this time, the Blood being somewhat restored towards its natural state, begins to concoct and ripen the crude Juice; so that a great part of it is assimilated: but some Excrements being heaped together in the Blood, bring forth as yet a light burning: but when the Feaverish Particles do not parti∣cipate of the Nitrous Acrimony, the Fermentation of the Blood is induced without any shiver∣ing, by which, what was extraneous, burns forth, is either subdued, or carried forth of doors. Sometimes also, in the declination of this Disease, the Fits appear without any burning, only

with a light cold: The reason of which is, because the Morbifick matter, being rather Nitrons, than Sulphureous, when it is in Flux, does somewhat blunt the Natural Heat; and by that means is dissipated, and vanishes, without any great deflagration.

There is yet a great doubt concerning the intervals of the periods, which sometimes seem to be double in the same Feaver, that the first Accession answers to the third, and either perhaps comes in the morning; and again the second to the fourth, and both happen in the Evening; and so forward: wherefore, the Feaver bearing this figure, is wont to be named a double Ter∣tian, or Quartan, of which it doth not easily appear, how they should be done, if the fits de∣pend upon the evil disposition of the Bloud, and from thence on a Congestion to a Turgescency of the depraved nourishing Juice: for which cause, they commonly affirm, that this double figure is stirred up, or draws its original from a double Nest, or Mine; but to me it seems most likely, that in this case, sometimes it happens for the Feaver to be simple, and of one kind, also its types or figures to be alike, and all congruous one to another, but the error to arise, because the interstitia of the periods, are not computed by hours, but days: For when as, the begin∣nings of the fits are distant one from another, not exactly twenty four hours, but either sixteen, or thirty hours, in a Quotidian; and in a Tertian, not forty eight, but forty, or fifty six, more or less, or thereabouts; it comes to pass, that every other fit, happens before, and the others after Noon. To which also may be added, that the different manner of eating, which the sick use very often, produces great inequalities of figures: that sometimes the fit is re∣doubled twice in a day, as I have often observed in Cachectical men, or full of ill humors, and living disorderly: but it doth not seldom happen, that Intermitting Feavers, repeat fits, which do neither observe the same distance, nor bear altogether the figure of the same mode. I have many times observed in a Quartan Feaver, that besides the set comings or Accessions, returning on the fourth day, about the same hour; some wandring and uncertain fits, did infest the sick; that sometimes on the day preceding, the wonted fit, sometimes on that following it, another fit (tho' lighter) was excited anew, with Shivering, Heat, and Sweat, exactly like the figure of an Intermitting Feaver; and nevertheless, the primary Accession returned at its accustomed time. This, for the most part, is wont to happen, either from Diet evilly instituted, chiefly from surfeit, and drinking of Wine; or else from Medicines wrongfully administred: The reason of which (unless I am deceived) consists in this: The Mass of Bloud, being wont to be filled to a swelling up, with the Fermentative matter, at a set time, often, by reason of some errors in eating and drinking, heaps up more matter, than can be easily dissipated in one fit; and when it unequally Cooks the same Fermentative matter, it often happens, that it first shakes off its superfluous, or more thin part, as it were by a certain skirmish, in a more light fit, but dispels the more thick, (after the primary Accession) as yet remaining in the Bloud, by a Fea∣verish Fermentation arising anew. And when the fits, in an Intermitting Feaver, redouble after this manner, either become more remiss, for that t•…•…e same matter in either, is only divided; and eventilated by two accessions. Besides, when this Fermentative Matter, or Nutritious Juice, depraved in its circulation, is continued, partly in the Arteries and Veins, with the Bloud, and partly in the Nervous stock, and solid parts, it may happen, that both humors do not ferment at once, but a great part of one may be dispersed in one fit, and then a great part of the other, in another fit.

CHAP. IV. Of the kinds of Intermitting Feavers; and first of a Tertian.

WE shall easily accommodate to our Hypothesis, delivered in the former Chapter, concerning the nature and beginning of Intermitting Feavers, all the Phaenomena which belong to it, and the reasons of them. But as those which are of this sort, do not observe the same space of Intermission, or of return, and their figures, as to the appearances of their signs and symptoms, do not altogether happen after the same manner; therefore according to the diversities of these, and especially from the distance of the fits, the va∣rious species and differences of Intermitting Feavers, are assigned. The chiefest division of them is, into Tertian, Quotidian, and Quartan: We shall here remark the chief things worthy of note concerning each of them.

It is called a Tertian Feaver, not which is accomplished at the distance of three days; but in∣clusively from the day in which one Fit begins, from thence the other returns on the third. In the mean time, if the Fits be sometimes longer, viz. protracted almost to twenty four hours, and the Remissions anticipated also by their accessions, or comings of the Fits, the space is often∣times

less by a nîght and a day. This Disease is commonly distinguished into exquisite and spu∣rious; The exquisite or exact Tertian Feaver is, which begins with a vehement shaking, to wh•…•…ch succeeds a sharp and biting heat, which goes off in sweat, and its Fit is finished in twelve hours, and that the perfect intermission follows; In the spurious or bastard Tertain, the cold and heat are more remiss, but the Fit is often extended beyond twelve hours, yea, often to eighteen or twenty. These differ as to the various disposition of the Bloud, which is in the former more torrid and sharp; therefore perverts the alible Juice from Crudity, towards an adustion, where∣fore a more vehement Effervescency is stirred up; but as the matter more equally burns forth, it is sooner finished. In the latter, besides the adustion, the Blood abounds with too much serous humidity, wherefore, the nourishing Juice degenerates into a Crude matter, and therefore less apt to be overcome, and to burn forth; wherefore, its Fit is gentler, and more unequal, but is not finished but in a longer space.

The Essence therefore of a Tertian Feaver consists in this; That the Bloud (like Beer brew'd with too high dry'd Mault) being too sharp, and torrid, does not rightly subdue, and ripen the alible Juice, which is taken in from crude things eaten, but very much perverts it into a nitrous, sulphureous matter; with which, when the mass of Bloud is filled to a swelling up, like new B•…•…er stopp'd up in Bottles, it conceives an heat: From the flux of this nitrous matter, which blunts the heat, and vital spirits, and pulls the nervous parts, first the cold, with shaking is excited; then the vital spirit getting strength again, this matter growing hot in the Blood, begins to be subdued, and inkindled in the heart; from whose deflagration, an intense heat is diffused through the whole body; then its reliques being separated, and involved with serum, are sent away by sweat.

This torrid Constitution of the Bloud, consists in this, That 'tis impregnated more than it ought, with Particles of Sulphur and Salt; wherefore, the Procatartick Causes, which dispose to this Disease, are an hot and bilous temperament, a youthful age, hot diet, as an immoderate use of Wine and spiced Meats, but especiall•…•… in the Spring, and autumnal seasons of the year, when the Bloud (as all Vegetables) is apt to flower, and to ferment of its own accord. By rea∣son of these occasions, the Liquor of the Bloud, is wont to be throughly roasted, and to be changed into a cholerick temper: and when it departs from its natural Disposition, so much, that it perverts the nutritious Juice, into a matter plainly Fermentative, the beginning of this Fea∣ver is induced; which sometimes happens from this intemperance, being leisurely increased and brought to the height; but more frequently, an evident cause raises up this •…•…isposition into act, and we ascribe the origine of this Disease to some notable Accident. Wherefore, lying on the Ground, or taking cold after sweating, or transpiration being any ways hindred; also a Surfit, or a perturbation of the Stomach, from any thing inordinately eaten; and lastly, What things soever stir up an immoderate heat in the Bloud, bring the lurking disposition of this Disease into act: for that, from every such occasion, the nutritious Juice, being heaped in the Blood, and somewhat depraved, conceives a Flux, and departing from the rest of the Bloud, ferments with a nitrous sharpness, then being inkindled and shaken by the Spirit, and vital heat, it induces the Fit, with a very strong burning.

A Tertian Feaver, is wont to be more frequent in the Spring, at which time, the Bloud is live∣lier and richer, and therefore more fitted for this kind of Feaverish distemper. If this Feaver being taken, be ended within a moderate time, 'tis commonly said to be a Medicine, rather than a Disease; which is partly true, because, by this means, the impurities of the Bloud burn out, the obstructions of the Viscera are discharged, and in truth the whole Body is ventilated, so that 'tis wholly freed from every excrementitious matter, and the seminary of growing Diseases. But if this Disease be long protracted, it becomes the cause of many Sicknesses, and of a long want of Health. For from hence the mass of the Bloud is very much deprived of the vital Spi∣rit, and (like Wine too much fermented) in a manner grows lifeless: wherefore the Jaundice, Scurvy, or Cachexia, follow this Feaver, being long e'er it be cured. For by its frequent fits, the vital spirit very much evaporates, and because it is but little restored by things eaten, the Bloud therefore becomes weaker, and almost without life: In the mean time, the particles of Salt and Sulphur, are carried forth more, and exalted; from whence, the Bloud is made sharp, and salt, and so more unfit for Circulation and Transpiration.

Moreover, This Disease being long protracted, oftentimes changes its Figure, and from a Tertian Feaver, becomes either a Quotidian, or sometimes a Quartan: then sometimes from either, it returns into a Tertian. The reason of this is, the disposition of the Bloud being variously changed: which at first being sharp, and bilous, had perverted the nutritious Juice, by that means, that it arise to a fulness of swelling up on the third day; afterwards, by the fre∣quent Deflagration, becoming less sharp, or in truth more waterish, it grows far weaker as to its Constitution, so that it doth very little, or not at all assimulate the nourishable humor, and ripe•…•… it, and by that means, the increase of the Fermentative Matter is made sooner, and the Fits return daily: or else, the Bloud from a sharp and bilous intemperance, (the constit•…•…tion of the He•…•…ven, or the Year, bringing on this alteration) is changed into an austere, or saltish,

and therefore more slowly perverts the nourishing Juice, and the increase of the Feaverish Matter, gathering together more slowly, it doth not conceive the Fits till on the fourth day: but if either, by the means of Physick or Dyet, the temper of the Bloud is reduced from either Dyscrasie, towards a bilous, the periods also are altered, and they resume the figure of a Tertian.

Certain Symptoms are wont to come upon a Tertian Feaver, which are commonly esteemed for the Crisis of this Disease; and in truth sometimes, these appearing, the Distemper either clearly ceases, or begins to abate of its wonted fierceness. But these kind of signs, are chiefly these three, viz. The Erysipelas, or an Eruption of Pimples in the Lips, the Yellow Jaundice, and an Inflammation, or swelling suddenly excited, in this or that part of the Body: very often there happens after three or four Fits to the sick, little Ulcers with a crusty Scab, to break forth about the Lips, and altho' there be no coming away of any Matter, in all the Body beside, yet from hence they presage, that the Feaver is about to depart, which sometimes the event proves true. But indeed sometimes, I have observed, that the hoped for effect has not succeeded, but that the Feaver pertinaciously, and for a long while hath afflicted them, when their Lips have been broken out. But as to what respects this Symptom, it seems to arise, for that the Bloud having got a more free Diaphoresis, it not only thrusts forth adoors, the more thin and smoaky Recrements, but also the more thick; and when the same, in other parts more easily exhale through the more open Pores, they stick in their passage about the Lips, by reason of the skin being more strictly bound together; and because the vaporous matter abounds in particles of adust Salt, and Sulphur, being fixed in the skin, it there hinders Circulation, and therefore induces Pustles, and little Ulcers; perhaps the more hot breath, which is breathed forth from the mouth, and nostrils, may contribute something to this Distemper, forasmuch as it scorches, and burns the Blood, and Juices flowing thither: wherefore, it may be said, That this eruption of Pustles, denotes only a more full Diaphoresis in the whole, by which, the more thick, as well as the thin Recrements of the adust Bloud, evaporate forth of dores. For I have known in some, from a Tertian Feaver, little welks like the small Pox to break out in their whole body, that if by this more plentiful Ventilation, as it were a purging, the Blood be so freed, that it recovers its pri∣stine disposition, the Feaver is cured: But if (as sometimes it happens) some Recrements, tho' more thick, break forth, yet others stay within, and still cherish the Feaverish disposition, those little Uleers, argue only a greater taint of the Bloud, and pertinacy of the Disease, therefore it may be observed, when that scabs break out in the lips, if the Feaver does not presently abate, that it will be more grievous and tedious for the future.

Sometimes the yellow Jaundice comes upon a Tertian Feaver, and cures it; (which Hippocra∣tes has also taken notice of) the reason of which is, because, when the Bloud has got a sharp or bilous disposition; that therefore it had perverted the alible Juice, and from thence had heaped together excrementitious matter, it is oftentimes freed by that Dyscrasie, when by a sud∣den Secretion, the recrements of adust Salt and Sulphur, are more plentiful purged forth. This the Choleduct Vessels being irritated by Physick, or of their own accord, and so pouring out plentifully the Bile, from the Bloud, do often perform: because Vomiting, Purging, and espe∣cially a Diarrhea or Lask, very much conduce to the Cure of this Disease, yea sometimes, the Bloud it self, putting forth of its own accord, thrusts forth the bilous recrements, at its off-scour∣ings, and in the circulating puts them forth in the skin, and so inducing the yellow Jaundice, cures this Feaver.

When an Inflammation, (as sometimes 'tis wont) comes upon this Distemper, the Ague is commonly said to fall down into the part distempered with the Tumor. But that by such a breaking forth, this Disease is cured, 'tis no wonder; because the Bloud by this means conti∣nually lays aside out of his bosom, the provision of the degenerate nutritious Juice, and transfers it to the distempered part; and therefore, the degenerate and fermentative matter in the mass of Blood, does not easily arise to a fulness of swelling up: wherefore, the Belly being perpe∣tually loose, hath by degrees helped some, for that the Blood by this means, readily casts forth its burthen, now growing low, and not having a more full increase yielded to it: sometimes also, a Deafness suddenly arising, the Tertian Feaver has presently ceased, to wit, by reason of a continual translation of the Feaverish Matter, from the bosom of the Bloud, into the head.

If that the Tertian Feaver, within a short time, neither by the free accord of Nature, de∣clines by degrees, that it doth clearly cease within seven or ten periods, nor is cured by any of the aforesaid means, nor is removed by the help of Medicine, but that after ten or twelve fits, the sick are still grievously afflicted, it will be a very hard task to cure it: because the Bloud, from the continual heaping of the Feaverish matter, and by the frequent burnings, becomes at length so depraved, that it concocts nothing truly for the nourishment of the body, and for the sustaining its strength; neither is it able to shake throughly out of its bosom, the impurities and excrements, whereby the Disease may make a Crisis or separation, but in truth, the same growing in strength every day, the Blood, besides its Dyscrasie or evil disposition, begins to be

hurt somewhat in its mixture; wherefore, more frequent fits infest them, nor does a perfect Re∣mission come between, but that the sick being very weak and languishing, are almost continually Feaverish, with thirst and heat: when it is come to this pass, unless they are succour'd by reme∣dies from Art, or that the change of the Place, and Air, bring timely help, this Disease often ends in death.

As to its Cure: the method of healing is commonly directed to this one scope, to wit, that the mine of the Disease may be extirpated, and that the Feaverish matter may be eradicated out of our Body, without any cherisher remaining, or fear of relapsing; wherefore Vomits and Pur∣ges are diligently instituted, which when profiting nothing to the cure, but that the Patients strength is very much broken, the sick are left by the Physicians, and the business is wholly com∣mitted to Nature. The Intentions (as it seems to me) ought to be of this sort: First, a restitu∣tion of the Bloud, to its natural Temper. Secondly, a prevention of the depravation of the nourishing Juice, as much as may be. Thirdly, an Inhibition of the Feaverish Fermentation, that the fit may not be excited. And these Indications take place, not only in a Tertian Feaver, but in any other intermitting Feaver besides: which yet are to be performed, not by the same ways and remedies, but by several, according to the diversity of the Disease, of the condition of the sick, and of the symptoms chiefly urging. However in the curing of this Disease, there is more to be attributed to Nature, and to a good order of Diet, or way of Living, than to Physick.

1. Concerning the first Intention; to wit, that the Bloud may be reduced to its natural Tem∣per, Vomits, letting of Bloud, and Purging are of great use: especially, if they be celebrated in the beginning of the Disease. Vomitories help, both for that they purge the Ventricle, that the first Concoction may be better performed, and by that means the nourishing Chyme may be more purely supplied, for matter of the Bloud; but chiefly, for that by plentifully pressing forth the Bile, from the Choleduct passage, they empty the Gallish bag, as by that means, the Bile is poured forth more full from the mass of Bloud; and so the Bloud is purified, from the recrements of adust Salt and Sulphur. The opening of a Vein, cools and ventilates the Blood, as by that means, 'tis less torrified, or scorched, and is circulated more freely in the Vessels, without danger of burning. Also Purging plentifully draws forth, and by provoking expresses, or squeezes out, the Bile, from the gallish Vessels, and consequently from the mass of Blood. For this end, (to wit, the reduction of the Bloud) Digestives bring help, the more temperate Vinegars, or Acetous things, forasmuch as they fuse, and alter the Bloud, and do attemper its fervor. Sometimes also, the change of the Soil, and Air, notably amends the evil constitution of the Blood, before all other Remedies whatsoever.

The second Intention, is excellently performed, by Diet, and an exact manner of living; which in this Disease ought to be slender and sparing: wherefore it is commonly said, Starving is the best Remedy for this Disease: and it appears by common exp•…•…rience, that by a more spare eating, the coming of the Ague fit, is very often prolonged, beyond its wonted custom. There are especially two things to be observed, concerning Eating and Drinking: The first, that the food be slender, that nothing Sulphureous or Spirituous be given, for so the Conflagration of the Bloud will be lessened; then secondly, that the fit approaching, or urging, nothing of Aliment be taken, where∣fore, in fasting the fit is lighter, and sooner finished.

As to the third thing proposed; the Inhibition of the Feaverish fit, is instituted by Remedies, which stay the Fermentation of the Bloud. But tho' this Remedy seems Empirical, and unme∣thodical, and very failable to Physicians, yet I have found these Feavers to be very often cured by this means, when Medicines have profited nothing: What they are, and by what means, with∣out the suspicion of Witchcraft, they afford help, for the curing this Disease, is before noted. We shall here only advertise you, that the use of these is most profitable after Physick, and open∣ing a Vein, if there be need of it; and unless these be rightly performed before-hand, those other rarely stop the fit. But Vomiting, Purging, and breathing a Vein, unless they be presently celebrated after the beginning, yield little help, yea, more often are wont to hinder: For whilst the Bloud is strong in vital spirit, its evil disposition, may with easie labour be corrected, or amended: wherefore if the Bile, about the beginning, be copiously drawn forth, or the Bloud eventilated, it is reduced to its natural Complexion; but afterwards, in the progress of this Disease (the Spirit being now very much exhausted, and the Salt and Sulphur too much exalted) if these kind of Evacuations be administred, they do more debilitate the disposition of the Blood: and therefore it is clear by observation, that the Tertian Feaver, is rarely or never cured, by these Remedies late administred, and often passes into a Quotidian. I my self have known some, in the Spring time, being strong in very good health, from a more strong Emetick taken for prevention sake, causing a violence by the Evacuation, to have presently fallen into a Tertian Fea∣ver; and others, for some time cured of this Feaver, when they had taken a strong Purge, for the carrying away of the remains of the Feaverish matter, upon it to have fallen into a Relapse. It may be readily said, that the mine of the Disease, being before at quiet, was stirred up, and brought into Act, after this manner by the Medicine: But if you consider this thing

rightly, it may rather be said, that from the strong Medicine, the disposition of the Bloud was very much hurt, and when at first it was prone to a bilous Dyscrasie, that it hardly did assi∣milate the alible Juice, from this evident cause, it forthwith degenerated, that it wholly perverted the Nutriment, into a Fermentative matter, and so conceived the Feaverish disposition. It is a common opinion, that a Tertian Feaver can scarce be cured, without a Vomit, wherefore some Medicasters, are wont under the pretext of the necessity, to give to all whatsoever, labouring with this disease (though languishing and weak) an Emetick Medecine not without great danger of life: and those whom they judge wholly unfit for such a Medecine, they leave as not easily curable, to Nature. But (as I have often found the contrary by experience) this sort of practice is evilly instituted; yea, I rather judge, for the curing of a Tertian Feaver, that Vomits are rarely or never to be required, unless in a strong Body, and very easily prone to vomiting, and when the Ventricle happens to be burdened with excrementitious matter; but instead of it, that a gentle Purge, by which the load of the humors may be pleasantly brought away, may be of better use; because a Purge in this case, doth the same thing as a Vomit, to wit, it evacuates the Choleduct Vessels, that the Bile being plentifully exhausted from the Blood, the Feaverish Dyscrasie is mended. But when the gallish humor, being emptied forth into the Ventricle, is cast out upwards, from thence there is great hurt brought to the Sto∣mach, and a mighty perturbation excited in the whole Body: But if that humor be enticed downwards by a gentle Purge, it is sent forth of doors without any trouble. Then, if to a gentle Purge, once or twice repeated, be added a very slender Diet, without flesh, it often answers the preservatory Indication, that there needs no other Remedies, for the taking away the cause of this Disease; but that these being rightly performed, shall render beneficial those things, which being either inwardly taken, or outwardly applied, stop the Feaverish accessi∣on. By this sort of plain and easie institution of Medicine, viz. A Purge of the infusion of Senna, and Rhubarb, a slender Diet, and a Febrifuge or Ague-resisting Topick, laid either to the Wrists, or the Breast, I have known vey often, and in a very short time, Tertian Fea∣vers cured, without the use of any other destroying Physick; yea, a thin Diet only, with Amu∣lets timely administred, hath very happily cured Big-belli'd women, and also very weak old men, whose strength could not bear Purging. I have so often made trial of this method, with good success, that I doubt not, but that a Tertian Feaver may as easily be cured, as any other Disease, if it be at the beginning handled after this manner, viz. before the temper of the Blood be more hurt, by an evil manner of Diet, or by Medicine untowardly administred. For the truth of this thing I will relate this following History.

A certain Noble young man, indued with a bilous temper, had caught an intermitting Ter∣tian Feaver; upon the approach of the Fit, he vomited forth much yellow and greenish Choler, then he was troubled most grievously, for many hours, with a great pain of the Heart, and most strong Heat and Thirst. On the day of the Intermission there was taken from this per∣son, with whom I was by chance, by my prescription, eight ounces of Blood, and in the Af∣ternoon was given an Emollient Clyster, he also used a most slender Diet (viz. only made of Barly) He took every night going to sleep, this Opiate, viz. Conserve of Roses vitriolated, half a dram, of Diascordium a scruple, also every morning of the Salt of Wormwood a scru∣ple, in a spoonful of the Juice of Orange; but when these did not succeed (for the fit re∣turned somewhat more remiss, but with cruel Vomiting, as at first,) besides, for that this sick person extreamly abhorr'd a Vomitory Medecine (because not long before this, from a very gentle Emetick, he had vomited almost thirty times, until being distempered with the Cramp and Convulsions, he was brought into great weakness, with hazard of his Life) therefore, the day following the aforesaid Fit, I gave him a Potion of an infusion of Senna, Rhubarb, and yel∣low Sanders, with Sa•…•…t of Wormwood, in Spring-water, by which he was purged ten times with ease: In the Morning after, and three hours before he expected the Fit, I put to his wrists an Ague-resisting Medecine, and took from him six ounces of Blood, by which means he mist his Feaverish Fit, and then being again purged after the same manner, became perfectly well.

If that the Tertian Feaver, by reason of the evil Constitution of the sick, or because of Er∣rors in Diet, or committed by Physick, hath more deeply rooted it self, that after a long Sick∣ness, the Fits still grow worse, and the sick extreamly languish, with want of Strength, Thirst, and almost continual Heat, want of Appetite, Wakings, weak Pulse, high coloured Urine, and very full of Contents, the Curatory Method ought to be a little otherwise instituted; In this case, first it is to be endeavoured, that the Dyscrasie of the Blood may be taken away; wherefore the sick are to be fed with slender Aliments only, as Barly-Broth, or Grewel, with opening Roots boiled in it (flesh-Broth being wholly laid aside) the Belly is to be kept loose (if need be) with the use of emollient Clysters, besides (Purges being omitted) only Di∣gestive Medecines, which fuse the Blood, and bring away gently the serous Impurities by U∣rine, also comforting Remedies, which corroborate the Viscera, and cherish the Spirits, are chiefly to be insisted on. To this end, Apozems are fitly to be prepared, of Herbs, and Roots gently Diuretic; also Opiats help very much, of temperate Conserves, with Sal Nitre, or

the fixed Salt of Herbs, with shelly Powders, and the Spirit of Vitriol mixed together. When the disposition of the Blood is somewhat mended, that the Urine is clearer, and less coloured, also sleep quieter, with a remission of thirst, and heat following, then may be profitably ad∣ministred Remedies to stop the Feaverish Fit: wherefore-Ague-resisting Amulets may be applied to the Wrists or to the Soles of the Feet; also the Powder of Peruvian Bark, or of something instead of it, or also of the Barks of the Ash-Tree, Tamarisk, or Gentian, with Salts mixed with them, and drunk in white Wine; after the comings of the Fits are taken away, and the sick begin to get strength, and desire food, and in some measure to digest it, gentle Purges may be of use; but let the sick still abstain from a more plentiful Diet, or participating of Flesh, and they will shortly after recover perfect Health without any violent Purge or Phlebotomy.

CHAP. V. Of the Quotidian Intermitting Feaver.

BEcause of its Affinity to the Tertian Feaver, and likeness of Fits, the Quotidian (or daily) Feaver comes next, viz. whose Accession is wont to return every day. It is the Opinion of some, that this sort of Feaver is only a double Tertian, and doth arise from a dispersed matter, having gotten a twofold Nest; to which I cannot assent; and I sup∣pose its beginning is to be attributed to a peculiar Dyscrasie of the Blood. In this the Symp∣toms of Cold and Heat are more remiss, but its fit is longer continued, and oftentimes it is wont to last eighteen or twenty hours: This Feaver for the most part follows a Tertian; for when the Vital Spirit is very much flown away, by the frequent deflagration of the Blood, and (the Feaverish disposition still remaining) the Blood is made weaker, it doth not concoct the nou∣rishing Juice, or ripen it, but perverts almost the whole into a fermentative matter; wherefore its comes sooner to its increase, and is gathered together to a plenitude of swelling up, with∣in double the time, than at first. But because the congested matter participates equally of crudity and adustion, therefore the heat of the burning is lesser, and more unequal, and (like green wood laid on the fire) slowly burns; for which reason the Fit endures longer.

Sometimes it happens, that a Quotidian Feaver, doth arise without a Tertian going before, viz. when a Feaverish disposition falls upon a Cacochymic Body, or full of evil humors, and stuffed with depraved Juices; for then the Blood, being poor in Spirits, perverts in a greater measure the nutritious Juice, and in a shorter time gathers to a fulness of swelling up: But that which begins an every days Ague, oftentimes changes its figure, and becomes a Tertian; just as a Tertian often goes into a Quotidian, because between these Feavers, and their Causes, there is a great vicinity; and the constitution of the Blood being a little changed, it makes a transi∣tion from one to another. A Quotidian Intermitting Feaver is not so easily cured as a Tertian: For whether it comes at first simple, or follows upon another intermitting Feaver, it is still ex∣cited from a stronger cause, and argues a greater dyscrasie of the Blood, which will not pre∣sently give way to Remedies. But also, if this Feaver be of long continuance, or comes upon another Chronical Disease, it has most often adjoyned to it, besides the taint of the Blood, the infirmities of the Inwards: to wit, the Blood being spoiled, easily affixeth its impurities by de∣grees heaped up, on the Viscera, whilst it passes through their Meanders: from hence it is, that in a Quotidian Feaver, the weight of the Ventricle, an extension of the Hyponchondria, Ob∣structions, or Tumors, now of the Liver, now of the Spleen, or Mesentery, are joyned toge∣ther; but these kind of Distempers, are not the cause of the Feaver (as is commonly believed) but only its product. Wherefore, in this Feaver, besides the simple method of Cure, which is shewn in the Tertian, many other intentions or coindications, come under consideration: to wit, that the Ventricle be cleansed from its load of humors, the stuffings of the Inwards freed, Infirmities corroborated; and that together with these, the Dyscrasie of the Blood may be mended, and the Accessions of the Feaver may be restrained, must by all means be endeavoured; from whence, by reason of these kind of various intentions, we come to the Cure by a longer way: In this case, Vomits (if strength will bear them) are of benefit before all other Mede∣cines: also Purges, whereby the assiduous supply of Excrementitious matter may be drawn forth, are often to be repeated: Besides these, Digestive Remedies, Openers of Obstructions, such as restore the Ferment of the Viscera and Blood, and correct their evil dispositions, are frequently to be administred. Wherefore, the fixed Salts of Herbs, and their Extracts, Acid Spirits of Minerals, and sometimes Preparations of Steel, do very much help: concerning these

main things, the Task will be hard, when by reason of the manifold evil, many things are to be done together, yet by reason of the assiduity of the Feaverish fit, there is leisure for the sick to use few only. In Distempers so complicated, though the reason of the Method requires the impediments to be first removed, and then to cure the Disease, yet I have known this kind of Feaver, beset with many other Distempers, in a Body full of Humors, often cured, without Me∣thod, and by an Empirical way, viz. after a light provision of the whole, Ague-resisting Reme∣dies being outwardly applied, have at first stopped the Feaverish Fit, that then there was time, for the curing the other Distempers, and more happy occasions of healing were granted. I lately visited a Noble Lady, who being long indued with a Cachectical habit of Body, a Month after her Lying in, being weak and languishing, was taken with a Quotidian Intermitting Fea∣ver; after six or seven fits of it, her strength was so much cast down, that she could scarce rise out of, or sit up in her Bed; nor able to take never so little Food, though very slender, but up∣on it, most grievous molestations were raised up in her Stomach; besides, the Region of her Ventricle, and left Hypochondrium, was wholly beset, with a hard shining tumor, and cruelly painful, by reason of her strength being mightily cast down, there was no place left for Evacu∣ation, but the use of Clysters; also her Stomach being very weak, loathed all other Remedies, unless very grateful, and only in a very small quantity. In this difficult case, circumscribed be∣tween narrow limits of Curing, I counselled these few things, to wit, that twice in day, she should take this mixture, viz. The Magisterial Water of Earth-worms two ounces, of Elixir Proprietatis twelve drops. Moreover, I ordered to be applied to her Ventricle, a Fomenta∣tion, of the Leaves of Sea-Wormwood, Centaury, Southernwood, with the Roots of Genti∣an, boiled in White-Wine, in an open Vessel: also, that after the Fomentation, a Cake of To∣sted Bread, and dipped in the same Liquor, should be worn upon her Stomach; besides, Ague∣resisting Medicines were ordered for her wrists; and with these Remedies only, she mist her Ague-Fit, on the third day, and remained free from it afterwards; then by the Use of Chalybeat Remedies, she became perfectly well, within a short time.

CHAP. VI. Of a Quartan Feaver.

IN a Quartan Feaver, the period is longer than in the rest; to wit, which is extended to the fourth day inclusively; also its continuance uses to be longer, and its cure harder: be∣cause this Disease is protracted for many Months, yea, oftentimes for years, and seldom, or scarce at all, is cured by Medecines.

The Fit, for the most part, begins with cold and shaking, to which a very troublesom heat succeeds, but more remiss than in a Tertian: Sweat for the most part concludes the Fit. At the first coming of the Disease, the Fits are more grievous, and very infestous, and keep the sick in their Beds; yea, they make them lose their strength, and vigor of Body: But afterwards, the trouble is more easily born, so that the fits are suffered out of bed, and sometimes in a Jour∣ney, or being about any business. If it continue long, it induces the Scurvy, or Hypochondriac Distemper, and involves men in an unhealthful condition.

The Causes which dispose to this Disease, are first, the Constitution of the Soil and Air, be∣cause this Distemper is proper to the Fall of the Leaf, or Autumn, that you rarely find this Fea∣ver to begin but about that time: also in some places, especially about the Sea-coasts, this uses to be general, or common to the Region, and to come upon those living there, or Strangers com∣ing thither from elsewhere. A declining Age, which is past its Achme or height, also a Melancho∣lick Temper, and which, by reason of an ill manner of living, is obnoxious to the Hypochon∣driac Distemper, cause this: besides, long Feavers of another kind, and Chronical Diseases, often pass into a Quartan Feaver.

According to these Positions, and rightly weighed, it may be said, that a Quartan Feaver, even as the other intermitting Feavers, depends upon a vicious disposition of the Blood; to wit, because the nutritious Juice, being by degrees dilated into the Vessels, is perverted into a a fermentative matter; and the effervescency of this, heaped up even to fulness of swelling over, constitutes the Fit of the Quartan Feaver. But as in this Feaver, there are some things, which are peculiar from the rest, we will enquire what kind of Dyscrasie of the Blood it is in this Dis∣ease, distinct from the others, and by what means it excites the very remarkable Symptoms.

The Opinion which is commonly had concerning this thing, is very far from Truth; almost by the consent of all, the Essence and beginning of a Quartan Feaver, is ascribed to a Melan∣cholic humor, heaped up somewhere in the first passages, and there periodically putrifying. In∣stead of this, we affirm, that in this Disease, the Liquor of the Blood doth pass from a sweet, spirituous, and balsamick, into an acid, and somewhat austere nature, like Wine growing sowr; to wit, there is too great a want of Spirits, and the Terrestrial, or Tartareous part of the Blood (which consists chiefly of Salt and Earth) is too much exalted, and being carried forth into a Flux, induces the sourness of the mass of Blood. Even as Beer being disturbed by Thunder, and infected with a troubled Lee or Dregs, grow sowr. The Blood, after this man∣ner degenerated from its native disposition, doth not rightly dress the alible Juice, and assimi∣late it to it self, but perverts it into an extraneous matter; with which, when it is satisfied to a fulness, in the Vessels, and the nervous parts are watered by the Juice, from thence arising, a Flux of this matter, and as it were a spontaneous effervescency follows, by which indeed, the Feaverish fit is induced, with shivering and heat, as is wont to be in a Tertian.

In a Quartan Feaver, the periods have longer intervals, because, when the Dyscrasie of the Blood is become sowrish, and therefore less violent and hot, it perverts the alible Juice without strife or tumult: wherefore, it assimilates some of it, and the depravation of the rest, does not so far recede from its natural state, as in a Tertian; and from hence its congestion to a pleni∣tude, is made longer, and almost in another half of that time, in which a Tertian rises up to a Turgescency: And therefore, those taken with this Feaver, are indifferently well, and are strong; which is a sign, that the nutritious Juice is less depraved; also the Fits are made with∣out cruel burning, because the nutritious humor is perverted into a fermentative matter, with∣out great adustion.

But why this Disease is so hard to be cured, and so pertinaciously infests the sick, the cause is, the Melancholic Constitution of the Blood, which is not easily to be taken away, and yields almost to no Remedies. The Cholerick disposition of the Blood is mended by the frequent Deflagration, and ceases often of its own accord, even as too rich Wines are depressed by their own growing hot, and are wont to be reduced into their due state; but this Melancholick Dys∣crasie of the Blood, in which, with a want and defect of Spirits, Salt and Earth are too much exalted (as when Wines grow sowr) is most hard to be restored, and is almost of the same la∣bour and difficulty, as to put again Life, and a Vinous Spirit into Vinegar: For that the Blood, depraved after this manner, may be restored, it will be needful, that its whole mass should be vo∣latilized, and as it were made Spiritual anew: wherefore, in this case, Evacuations profit not a jot; yea, by more depauperating the Blood, oftentimes the strength is cast down, beyond help: but they had need to exalt, and make volatile what is fixed, and to promote a Transpiration, or Spiritualization in the whole Mass of Blood: From hence it is, that in this Disease, the change of the Air and Region, most often brings help, before all other Remedies; for the Spring following oftentimes takes away those Quartan Feavers that had arisen the Autumn before; which without doubt happens, because the changed condition of the Air is wont to alter for the better, the evil disposition of the Blood: also for the same reason, the change of the place, most often cures this Distemper, inexpugnable to all Physick.

If it be demanded, wherefore this Disease chiefly begins in the Autumn, and rarely in the Spring, or Summer time; I say, the Autumnal time doth most fitly produce this kind of Feaver∣ish disposition of the Blood; for when very much of the Spirit and Sulphur hath flown away by the Summers heat, and that what is left begins to be bound up by the Cold; the Liquor of the Blood (as Wine growing sowr by too much heat) easily degenerates into a saltish; and acidulous or sharp Nature: This also, the Sea-Air, by infecting the Blood and Spirits with Sa∣line Vapours falling on them, easily procures: yea, also the affinity of this Disease, with the Scurvy and Hypochondriac Distemper, plainly shews, the evil disposition of the Blood to be in fault, whereby it becomes salt, and earthy, with the want of Spirit.

Concerning Quartan Feavers, the last year was so abundantly fruitful of Observations, that many might collect by ocular inspection, whatever belong to this Disease; for when the most hot Summer was past, about the end of it an Epidemical Feaver (of which in another place you shall have a description) followed; then the Autumn coming on, when that Disease had ceased, a Quartan Feaver began very much to rage; that in very many places the fourth part of the Peo∣ple was taken with it: neither did it only infest old men, splenetick and melancholick men, but of every Age and Temper, also Infants, Children, and young Men ordinarily; which was clear∣ly a sign, that this Distemper had drawn its Rise, not from a Melancholick Humor, heaped up, by the default of the Spleen, but from the Dyscrasie of the Blood, brought in, through the intemperance of the Year; for the Mass of Blood, after too great heats, even as Wines after immoderate effervescencies, was made fit to grow somewhat sowr, or to get an austere disposi∣tion, and so also prone to this sort of Feaver, as is already shewn.

If the Remedies, which for the curing of this, have been made trial of, both by Physicians and Empiricks, were collected together, their description would swell into a great Volume;

but although there is instituted a manifold provision of Medecine, against this Evil, yet very few are cured in the Autumn. In some, about the beginning of their sickness, before the Disease has taken too deep root, a Vomit hath brought help; but in most, all manner of Catharticks, tho' an hundred times repeated, have profited nothing. In whom the evil had deeply im∣planted it self, the sick received no help, from the most studied Medicines made use of all the Autumn. But when at this time, I perceived the ordinary method of Medicine, was admini∣stred in vain, I proposed to a Noble Virgin, requiring a sudden Cure, by any means, to be per∣formed, that if she would indure a Flux at the Mouth, for some days, from a Mineral Medi∣cine, by that means, it might be hoped, that the Disease would be profligated. When she had readily assented to this, I gave her a gentle, and very safe Medicine, by which a light spitting only was provoked, and that finished within twelve days: As soon as the Salivation began, she mist her fits, but at those times they were wont to come, she felt a perturbation in her whole Body, with an oppression of the Heart, and dread of swooning, but after the spitting was finished, she appear'd very well; and when again after two months space, she was troubled with some light fits of this Disease, from an Emetick Powder, twice or thrice taken, she was wholly cured without relapsing.

After the winter Solstice, this Disease began to rage less, and to cease in some of its own accord, and in many others, to be easily expung'd by the use of Physick: because at this time, the Dyscrasie of the Blood, contracted by the Summers heat, is wont to be blotted out leisurely, by reason of the cold of the Winter, and the mass of Bloud growing old, as it were to put off its old spoils, and to be reduced towards its natural state. But those who were of a melancho∣lick temper, or had their Viscera, and especially the Spleen, evilly affected, or that used an ill manner of Diet, received no change at this Tropick, but to the next period of the year, viz. to the vernal Equinox, or the Spring, kept the Disease; and then in most, the Blood being either restored of it self, or its intemperance more easily mended by the use of Remedies, this Distemper was seen to be overcome: But in the mean time, many old men, and such as were full of evil hu∣mors, or otherways unhealthy, ordinarily died, in all that space of time, of this Disease; also some li•…•…'d, who could not shake off its yoak, tho' the Summer Solstice were past. But altho' very many had labour'd with this Feaver, as it were Epidemical, almost through the whole year, yet none (that I know) contracted it first in the Spring, and very few grew well of it during the Au∣tumn, that in truth, I do not doubt, the Dyscrasie of the Bloud, to be the cause of this, and the cure to consist in the change of it.

The Remedies, which most often brought help, (as appeared at least to our observation) were of this sort, which did restrain the Feaverish fit: for the evils of the disposition of the Bloud, being somewhat mended, by the time of the year, being changed, if now the habitual custom of the fits were broken off, Nature recollected her self, and easily recover'd the pristine state of health, by her own endeavour. And this kind of intention, (to wit, the inhibition of the fits) though sometimes performed by Vomits, given a little before the coming of the fit, (for these did not rarely stop the Feaverish motion of the Bloud, by raising up another mo∣tion contrary to this) yet this Indication is far more certainly, and indeed happily effected, by the use of those kind of Medicines, which do not altogether evacuate from the Viscera, but induce, either a certain fixation to the Blood, or a precipitation of the Feaverish matter, for a time. Wherefore, those whom I undertook to cure in the Spring, and afterwards; I handled (and in most with good success) with this method; a provision being made of the whole, some∣times with an Emetic Medicine, sometimes with a Solutive; I was wont three hours before the fit, to lay a peculiar Ague-Medicine to the wrists, and together, to give them to drink in Sack, an Ague-resisting Powder, and to order the sick to be kept in a Bed in a gentle sweat: It seldom hapned, but at the first, or second time, the Feaverish fit, was by this means restrained, and then, by the same Remedy, sometimes reiterated, the Disease at last wholly ceased. To this kind of practice, (besides our experience) the use of the Powder, of a certain Bark, brought of late from the Indies, seems to give some faith, and approbation; which is said, most certainly, to cure this Disease; but the vertue, or operation of this, without any evacuation, consists in this only, that it hinders the coming of the Feaverish fits.

Concerning this Peruvian Bark, because of late it hath begun to be in use, there are some things to be said, which offer themselves to common observation. The common manner of exhi∣biting this is, that two drams of it beaten to powder, be infused in Sack, or White-wine, in an open Glass, for two hours, and then upon the coming of the fit, the Patient being put to Bed, that the Liquor and Powder be drunk up. This Potion often takes away the approaching fit, yet often∣times tho' taken after the wonted manner, it prevents the next, however, either in the first, se∣cond, or third period, the fit is inhibited, and the Disease seems to be cured, it is often wont to return, within twenty or thirty days; then this Powder being again exhibited, the Disease is for a time deferred about the same space, and by this means, I have known many sick of a Quartan, to have suffered some few fits only, a whole Autumn, and Winter, and so to have detained the enemy in his precincts, till the Spring coming on, the disposition of the Bloud is altered for the

better, by the help of the time of year, and of other Physick, and so this distemper vanishes by degrees. Those who by this means, have procured these frequent truces of the Quartan, have liv'd chearful, lively, and ready for any business, when otherwise, being weak, and pale, they were brought into languishment, and a vitious habit of body: scarce one of an hundred, hath tryed this Medicine in vain, yea, if but half, or a lesser quantity, viz. the weight of but one dram, taken, it very often takes away the fits, and suspends the same, a shorter space only; neither is it any mat∣ter, whether it be taken in strong, or small Wine, unless with the respect, to the disposition of the sick: because in a more hot temper, it may be profitably taken in distilled Water, or Whey; also, a clear infusion of it, the more thick substance being cast away, produces the like effect, but of shorter durance: I have taken care to reduce this Powder into Pills, with the Mucilage of Tra∣gacanth, with a little cost to the sick, to be given to some; after what manner soever it is taken, unless to those loathing and abhorring every Medicine, it causes no manifest evacuation, and takes away the fit, almost from all; neither is it only in a Quartan Feaver, but in the other kinds of intermitting Feavers, to wit, in every one where there is any remission coming between, given with good success. It is commonly ordered, that a gentle Purge should be taken before this, but in some who are very weak, and keep their Beds, this Powder being taken carefully, without any previous Medicine, hath procured laudable effects. In the mean time, I will ingeniously confess, that I have not seen an intermitting Feaver quite cured, by this Bark, once taken: nay, rather the fits not only of a Quartan, but of a Tertian, and Quotidian Feaver, wholly overcome easily by other Remedies, seeming to be driven away by this Powder, have constantly return'd after a short time. For this Reason, they who suppress intermitting Feavers, otherways easily curable, no necessity urging them, by this Medicine, for a little while, only seem to institute a deceitful Medicine, and do no more than those, who skin over a rotten Ulcer, which will shortly break out again; in truth, in some cases, the use of this will be requisite, viz. when by the too great assi∣duity of the fits, the spirits of the sick are cast down, truces are by this means procured, by which Nature may recollect her self, and afterwards may be more able to fight against this potent Ene∣my: also, that a Quartan Feaver, during the Autumn and Winter, may pass over with little trouble, this Bark is profitably administred: But those, who expect a longer resting time, from the assaults of this Feaver, are bid to take this Powder in greater quantity, and more often, to wit, that they should take two drams, three several times one after another, whether the fits return or no; by this means, they remain longer free, yet they retain within, the Enemy still, tho' asleep.

If it be demanded, concerning the Nature of this Bark, and the vertue in suppressing the fits of Intermitting Feavers, it is not to be dissembled, that 'tis very difficult to explicate the causes of these kind of effects, and the manner of working; because there is not found as yet in any Subject, besides, the like efficacy; but from a singular Experiment, a general Reason is not to be rightly fitted: however, from the appearances diligently Collated, we will deduce some Theses in order, which may make at least some steps towards, if not obtain the verity of this thing.

It is to be noted therefore, in the first place, that this Medicine, being inwardly taken, espe∣cially exerciseth its force and energy on the Mass of Blood: because, it does not at all irritate the Viscera, neither causes in them any excretion, or trouble; besides, whilst it communicates its vertue to the Blood, it doth not at a•…•…l put forth Anti-feaverish property; wherefore, not always the next following fit, but the second, or the third, is prevented, by the same being taken: and for this reason, that it may sooner affect the Blood, it is a usual thing, to drink the Liquor, very much impregnated with the same Powder, for so its Particles are more easily conveyed into the Mass of Blood. Secondly, The Vertue of this Bark, being impressed on the Blood, stays in it for some time, and that either shorter or longer, according as either a greater or lesser portion of the Medicine was taken inwardly; for the Particles of this, being confused with the Blood, are a long while circulated with it, and by how much the longer they stay, by so much the more they affect its mass, and produce a longer effect: for though Ali∣ments, and some other things taken in, for that they are presently overcome by the native heat, put off whatever they have of vertue, within some few hours, this being then assimi∣lated, or sent forth adoors, they cease to operate: yet some Medicines being taken inwardly, because they are not easily tamed, nor cast forth of doors presently, by an irritation stirred up, they remain for many days very active, and hold a long time the Juices, and the Blood, in this or that manner of Fermentation, this may be observed of some Medicines, also of Poysons, and Counter-poysons, the once or twice taking of which, for some days, is wont to affect our Bodies for a longer time; for 'tis an usual thing which Cathartick Medicines, when they work little by Vomit, or Stool, to break forth after many Weeks outwardly, in Pustles and Welks: yea, if Death be avoided, from the drinking of Poyson, every body knows, that the virulency will lie hid, a long time in the Blood and Juices. In like manner also, this Powder, and perhaps very many other things inwardly taken, altho' they seem asleep, yet continue to act, on the Spi∣rits and Humors.

Thirdly, Altho' this Medicine acts immediately on the Bloud and Humors, yet it takes not wholly away, the Feaverish Dyscrasie, implanted in them: for, as soon as its force is consumed, and all its Particles are flown away, from the mixture of the Bloud, the Distemper being only sup∣pressed for a time, at length rises up, and repeats its fits after its wonted manner, but forasmuch as Nature, by the space of this cessation, becomes stronger, therefore, after the Relapse, the fits (not as before) but on the third or fourth day, according to the first figure of the Disease, are wont to return.

Fourthly, It is remarked, that this Remedy, does not stop the Feaverish accessions, as the ordi∣nary Ague-resisters or Febrifuges, by fixing, or also by fusing the Bloud; for then the next fit al∣ways, and not the second, or third following after, is prevented.

According to which positions, that we may instead of a Corollary, subjoyn some things con∣cerning the manner it self of working, whereby this Medicine seems to act; we say, it is most likely, that when the Particles, proceeding from the same being taken, are throughly mixed with the Bloud, they compel it into a certain new Fermentation, by which, whilst the Particles of the Bloud are continually agitated, they are wholly hindred, that they cannot heap up any Excrementitious matter, or enter into Feaverish turgescencies; for, as after the biting of a mad Dog, or stinging of any venomous Creatures, the Bloud it self, and nervous Juice, are a long while impoysoned, yet lest they should conceive presently great irregularities, Counter-poysons being taken do hinder their Liquors, by retaining them in another Fermentation; the use of which, if so long continued, whilst the virulent little Bodies are quite flown away, no horrid symptom is to be feared, from that evil being contracted; but if the strength of the Remedy, being too sparingly given, be first consumed, forthwith the Venom repullulates, and the old Poyson, thought to have been exploded, is at length brought into act: by the same way, when the Bloud, having gotten a vitious disposition, perverts the Alible Juice, and whereby it might more rightly expel it, heaped together to a fulness, conceives Feaverish swellings up; this Peruvian Bark being beaten, and administred, by the Commerce of its Particles, so agitates the Bloud, tho' distempered with an evil disposition, with a new excited Fermentation, and alters it, that it in some measure concocts the nourishable Juice, and continually evaporates its Recre∣ments, that they are not heaped together as before, into the matter of a fit: But, when the Particles of this Remedy, are wholly flown away, from the company of the Bloud, and the whole virtue consumed, the evil disposition of the Bloud, before contracted, at length rises up, and so the Feaverish fits return, after their wonted manner. Sometimes perhaps it happens, that whilst the Feaverish fits are suppressed, by the use of this Powder, by reason of the season of the Year being changed, or by the help of another Remedy, or by the endeavour of Nature it self, that Dyscrasie of the Bloud may be mended, by degrees, and so the Feaver may at length vanish, of its own accord. This I have known to happen, but very rarely, because almost with the same certainty, by which you expect the Feaverish fits to be suppressed, by that Powder, you may afterwards look for their return.

As to what appertains to the sensible qualities, with which this Bark is noted, it appears to abound with bitterness, and a certain stipticity, that it seems to the taste, to have the likeness of Savor, which is in most Counter-poysons, as the Root of Gentian, Serpentary, Contrayer∣va, &c. for what are bitter in act, are strong in excellent virtue, for the suppressing the force of preternatural Ferments; yea, the Root of Gentian, which is likest to this Bark, was in times past of famous use, for the Curing of Quartan Feavers. But now, altho' this Peruvian Powder, be the only Alexiterion or Counter-poyson, as yet found out against a Quartan Feaver, to wit, that in∣hibits (tho' only for a time) its fits, and of other Intermitting Feavers, yet it is not to be doubted, but that there are in the World, other Medicines extant, which are as good Ague∣resisters; and it is hoped, that led by the example of this new invention, we may be excited, to the finding out the virtues of Herbs, almost as yet unknown: so, which whilst we shall insist on the trial of several, and the Empirical be joyned to the Rational Medicine, without doubt the Cures of the Quartan Ague, and of other invincible Diseases, may more happily be accom∣plished: which therefore I promise more willingly to this Age, or at least to the next, when being led by the Analogy of this Book, I have found out a Medicine, for the profligating of Feavers, of use not contemptible, it not being long since variously tryed, which also I am wont to give to the poorer sort, in•…•…tead of something else, with good success.

CHAP. VII. Of Continual Feavers.

A Continual Feaver is that, whose fit is continued for many days, without intermission: It hath its times of remission, and of more fierceness, but never of intermission; the burning is now more remiss, now more intense, but still the sick are in a Feaver, until by the temperament, or insensible growing well, the Disease is wholly cured. Concerning this, it behoves us to inquire, what Effervescency of the Blood it is, which causes a continual Feaver; then, by what ways, and from what causes, it is wont to be excited: also, how it differs from that, which is in Intermitting Feavers. And these being performed, we will descend to the Spe∣cies of Continual Feavers.

There are many ways, by which the Blood growing hot, induces a continual Feaver, the chief of which may be reduced to these Heads: The first way is, when the more spirituous, and fubtil Portion of the Blood, becomes too hot, and is distempered, with a certain burning, which therefore agitates the other parts of the Blood, and incites it into a certain rage, so that the Sul∣phur, or the Oily part of the Blood, is more dissolved, and more inkindled in the Heart, also, for that cause, there is among all the Particles of the Blood, a certain syncrifis, contrariety, or perturbation, by which in truth, being confused, and put out of order, they are not able quickly to be extri•…•…ated, and reduced into their former posture, wherefore a heat and burn∣ing more than is wont to be, is stirred up in the whole Body: but when the Spirits are only in fault, their heat and disorder, are wont within a short space, to be allayed of their own accord; therefore, this Feaver is often terminated within a day, and is rarely continued beyond three: and therefore, is called and Ephemera, or a Feaver of a day, or Synochus of more days.

2. The second manner, or degree of growing hot, is when the Sulphureous or Oily part of the Blood, being too much heated, conceives a Fervor: for then, it both grows immode∣rately hot in the Vessels, and being very much inkindled in the Heart, produces by its deflagra∣tion, a very strong heat in the whole Body. Indeed the Blood, as to its temper, mostly d•…•…pends on the condition 〈◊〉〈◊〉 the Sulphur; when by reason of Crudity, the Sulphur is less dissolved, the Blood is made w•…•…tery and cold, and is moved slowly in the Vessels: but if the Sulphureous, or Oily part of the Blood, grows hot, beyond its Natural disposition, presently it becomes fierce, and improportionate with the rest, so that, almost the whole being acted, as it were into a flame, by the Ferment of the Heart, compels the mass of Blood to grow immoderately hot, and and to boil up. For as when Wines, indued with a rich Lee, ar•…•… stirred up into an heat, by the too rancid Sulphur; or as Hay, laid up too wet, by reason of the want of Ventilation, conceives of its own accord a burning, the Particles of the Sulphur being loosned from the mixture; in like manner, when the Blood is not rightly ventilated, but being restrained from Evacuation, by reason of the admixtion of some hotthing, or a more plentiful sanguification, or for some other cause, the Particles of the Sulphur begin to be thickly gathered together; presently, all its Liquor, immoderately boils up, by the Sulphurs being loosned, and inflamed in the Heart, and this kind of Feaver is induced, which is called a putrid Synochus; notwithstanding which appellation, tho' of many rejected, for that the Blood so long as it is in motion, doth not putrifie; yet forasmuch, as in this Feaver, the mixture of the Blood, is somewhat loosned, by the Sulphur being too much exalted, and the mass of its Liquor being changed, from its Natural disposition, tends to∣ward putrefaction; therefore, the term of a putrid Feaver, as hath been anciently used, may be still, with good reason, retained.

3. The third degree of growing hot, (and which constitutes a distinct kind of continual Fea∣ver) is excited, from a certain malignant, and invenomed Ferment, by which, when the mass of the Blood is imbued, and the Spirits, and the Sulphureous part together, conceive an heat, and their burning is not sooner appeased, than that either that malignant matter be consumed, and cast forth of doors, or else a certain coagulation, and as it were putrefaction, of the Blood from its corruptive venom is induced, by which, both circulation is hindred, and the Vital Spirit extin∣guished. This malignity is wont to arise, either from a certain contagion received from without, or from some infection begotten within us; according to these ways the malignant Feaver, Small Pox, Measles, and also the Plague, draw their beginnings, and by their contagion, far and near set upon many.

There are therefore three degrees, or manners of growing hot, by which, the kinds of con∣tinual Feavers are determined. From the subtil portion of the Blood made hot, or the Ebulli∣tion

of the Spirits, the Ephemera arises, as also the Synochus of one or more days; by the Sul∣phureous or Oily part of the blood, being too hot and inkindled, the putrid Feaver is stirred up; then thirdly, upon an envenomed taint, infecting the blood, and congealing its Liquor, malignant Feavers depend. In every one of these, by the depravation, or rather corruption of the alible Juice, fresh carried into the blood, the various fits, inequalities, and critical motions arise. But before I enter upon the several kinds of a continued Feaver, it is requisite for me, to consider, how the growing hot of the blood, in a continual Feaver, differs from that other, which constitutes intermitting Feavers.

I say therefore, that the growing hot of the blood, in an intermitting Feaver, depends only, upon the commixtion of acertain fermentative matter, and not rightly miscible, with the blood, and on its growing up, to a fulness of boiling over. Because of this heat, with the blood in the Vessels, and of the deflagration in the Heart, the fit is induced; because of its growing cool, the intermission follows, that in the coming between of the fits, neither the Spirits, nor Sulphur, become outragious, but the bond of the mixture being kept whole, the Liquor is circulated in the Vessels, equally, and without trouble: on the contrary, in a continual Feaver, the disor∣ders of the Spirits, and of Sulphur, of either, or both together, by their proper Ebullition, also without the mixture of any other, stir up the Ebullition of the blood; wherefore there are required, for an intermission, besides the difflation or cooling of the excrementitious matter, a deflagration of the enkindled blood, and a reduction of it to its due temper.

The Constitution of the blood in a continual Feaver, is of the same sort as of Wines, when they grow hot upon too rich a Lee; to wit, are mighty in Spirit, and grow turgid with exal∣ted Sulphur, and therefore they conceive a fervor, and greatly boil up of their own accord, without the mixture of any other thing. In an intermitting Feaver, the blood is moved after that manner, as Wines, when they conceive an heat, because of something poured to them, that is not miscible with them: Moreover, in this Feaver, the disposition of the blood is of that sort, as of Wines, when in their decay and declination, they become ropy, unsavoury, or a∣cid, to wit, in which the Spirit is depressed, that in the mean time, either Salt, or Sulphur, or both together, appear above the rest, and infect the whole Liquor with their disorder. An intermitting Feaver, for the most part is free from danger, because the constitutive parts of the blood, although they should somewhat change their disposition, however, keep the bond of mixtuer, and whilst they are in power, are circulated equally in the Vessels, yea, they pervert the nutritious Juice into a matter, not altogether besides Nature, but rather infesting, with its fulness and turgescency. In a continual Feaver, besides the intemperance, the mixture of the Blood, and constitution of the Liquor are somewhat loosned, and its corruption easily follows; wherefore this Disease often ends in death: further, the nourishing Juice is depraved into a m•…•…tter wholly vicious, and altogether infestous to Nature.

CHAP. VIII. Of the Ephemera, or Feaver for a Day.

I Have said, the least degree of heat, which induces a continual Feaver, is placed in the sub∣til, and spirituous part of the Blood, being too much agitated and heated; for this, like the Spirit of Wine, boils up on every light occasion, and conceives a fervor, by a too great motion of the Body, or perturbation of Mind, by the ambient heat, as of the Sun or Va∣pors, by hot things taken inwardly, as the drinking of Wine, and the eating of Pepper'd meats, and being irritated by such like. For the Spir•…•…ts of the Blood easily take fire, and be∣ing impetuously moved, are not presently appeased, b•…•…t they move throughly other Particles of the Blood, variously confound and snatch them into a rapid and disorderly motion; also from this motion of the Spirits, the Sulphur, or Oily part of the Blood is more boiled forth, somewhat more dissolved, and something more fully enkindled in the Heart, by which means, an intense heat is raised up, in the whole Body. But forasmuch as Sulphur is enkindled, and inflamed only by small parts, and not in the whole, that fervor of the Spirits is quickly appeased, and ceases; wherefore the Feaver which is excited by this means, for the most part is terminated within twenty four hours, and therefore is called an Ephemera, or a Feaver of a day. If that by reason of a greater heat of the Spirituous Blood, it is prolonged further, it rarely ex∣ceeds three days, and is called an Ephemera of more days, or a Synochus not putrid; but if it

should happen to be lengthened beyond this time, this Feaver easily passes into a putrid, viz. from the daily ebullition of the Spirituous Blood, the more thick particles of the Sulphur at length begin to take fire, and involve the whole Mass of Blood in its effervescency: even as the Spirit of Turpentine, being shut up in a Cucurbit, and being put into a Sand Furnace, if it be forced with a moderate heat, boils up gently, as the Blood in a Feaver of a day; but if the heat be made more strong, the Liquor grows impetuously hot, till it breaks forth into a flame, to which the inflammation of the Blood, in a putrid Feaver, may be very aptly com∣pared.

The Days Feaver, and Synochus simple, rarely begin without an evident cause: Besides what hath been but now said, immoderate Labour, Watchings, a sudden passion of the mind, a con∣striction of the Pores, a Surfeit, also a Bubo or inflamed Sore, a Wound, the coming down of the Milk in Child-bearing Women, are wont to induce them: The procatartic Causes, which dispose to this, are an hot temper of Body, an active Habit, a sedentary Life, and disuse of ex∣ercise.

The chief beginn ings of this Disease depend upon the presence of the evident Cause; for ei∣ther, little Bodies of extraneous heat, being confused with the Blood, like water boiling over the fire, make it to boil up; or this Feaver is induced, by motion, or by reason of transpiration being stopped; even as Wines made hot by motion, or when too closely stopped in the Ton, are put into a fervor: but what way soever an inflammation is first excited, presently the Spi∣rits become enraged, and being moved hither and thither, compel the Blood to boil up, and to be enlarged into a greater space, with a spumous rarefaction; wherefore the Vessels are distend∣ed, and the membranous parts halled; hence follow pain, chiefly in the Head and Loins, a spon∣taneous weariness, and as it were an inflation of the whole Body. If that, with the Spirit of the Blood, a certain sulphureous part be also in some measure inkindled, a sharp heat is diffused through the whole, the Pulse is vehement and quick, the Urine red, also thirst, watchings, and many other Symptoms infest, the Reasons of which are added hereafter.

Concerning the Solution, or Crisis of the Ephemeran Feaver, and of the not putrid Syno∣chus, three things are chiefly requisite, viz. a removing of the evident cause; secondly, a sepa∣ration, and a scattering of the depraved or excrementitious matter, from the mass of Blood: thirdly, a quieting of the parts of the Blood, and a restitution of them to their natural and equal motion and site. According as these succeed, now more suddenly, now more slowly and difficultly, this Disease is finished in a shorter or longer time.

1. The evident cause, which for the most part is intrinsick, is easily removed, and the sick are wont, presently to avoid the presence or assiduity of that thing, and do perceive a sense of any thing that is hurtful; none taking a Feaver from Wine, will still indulge the drinking of it, assoon as any one grows more than usually hot, in a Bath, or the heat of the Sun, 'tis a trou∣ble to them to stay longer.

2. As to the excrementitious Matter, which ought to be scattered and separated from the Blood; this is either brought from without as when the Blood is infected by surfeit, drinking of Wine, sitting in the Sun, or from too hot a Bath, with Effluvia, or little dry and fermenta∣tive Bodies; or this matter is begotten within, as when its Liquor is stuffed with Recrements, or adust Particles, from the deflagration of the Blood. Either of these matters ought to be sepa∣rated from the Blood, to be dispersed, and either by sweat, or insensible breathing forth, to be thrust out of doors, before the Feaver be appeased: wherefore, whenas the pores are bound up, and transpiration hindred, the Ephemeran Feaver is longer protracted, and sometimes passes, from a simple Synochus, into a putrid.

3. The evident Cause being removed, and this degenerate matter dispersed, there is required for the remission, a quieting, and reducing into order, the parts of the Blood; for divers Par∣ticles of the Blood, being after this manner confused; and by reason of the Feaverish heat car∣ried up and down, they do not presently get again the former order of situation and position; but it is needful that they be by degrees extricated, and by little and little restored, to a just mix∣ture.

Although this Disease, after the rem•…•…ving of the evident Cause, for the most part ceases of its own accord, within a while, yet some Medicinal Remedies may be administred with good success, especially, when there is danger, lest the Ephemeran Feaver, should pass into a putrid. The chief Intentions should be, to suppress the fervor of the Blood, and to procure a more free transpiration; to the which conduce, first, a breathing of a Vein, a slender Diet, or rather Abstinency, cooling Drinks, and a bringing away the filth of the belly, by Clysters: Sleep and rest greatly help, above all the rest; which, if wanting, should be procured in time, by Opiats, and Anodines.

Verily, although the Histories, and Observations of those, distempered with an Ephemeran Feaver, contain in themselves nothing very rare; yet I shall subjoin an example or two in this place, whereby the Delineation or Type of this Disease may be illustrated.

A certain young Gentleman, about twenty years of Age, endued with a strong habit of Bo∣dy, by the immoderate drinking of strong Wine, fell into a Feaverish distemper, with thirst, heat, and with a great burning of his Praecordia; being let Blood, he drank a great quantity of fair water, and upon it presently a plentiful sweat following, he grew shortly well: In this case, the more thin portion of the Blood, being heated by the Spirits of Wine, fell into a rage, caused the whole Mass of Blood to be shaken, and its frame to be loosned more than 'twas wont; and for that reason, that hapned to be more dissolved, by the Ferment of the Heart, and to be as it were enkindled by the active Particles, loosned from the mixture; until the Vessels being emptied by Phlebotomy, the raging Blood was cooled, and by the drinking of the water, its fervor was attempered; then the hot Fffluvia being involved, together with the adust Matter, with a copious Serum, and sent away by Sweat, the Blood at length recovered its due temper. Moreover an ingenious young man, of a sedentary life, and also very much addicted to the study of Learning, when he had for some time exercised himself beyond his strength, in the hot Sun∣shine, he began to complain of the pain of his head, a want of Appetite, a heat of his Praecor∣dia, and of a Feaverish distemper all over; to whom (for that he was wholly averse to Physick) I ordered an abstinence from all things whatsoever, unless from small Beer and Grewel; on the second day, and so more on the third, the Symptoms remitted, by little and little; on the fourth, he went home freed from the Feaver, without any Medecine.

CHAP. IX. Of a Putrid Feaver.

SO much for a Continual Feaver, which is raised from the most simple heating of the Blood, or its lowest degree of inordinate heat; that which depends on a greater degree of heat follows, viz. when the Oily and Sulphureous part of the Blood, being too much heated, swells up above measure, and as it were forced into a flame; and therefore from the similitude, by which humid things putrifying, conceive an heat, this kind of Ebullition of the Blood, be∣cause it induces an immoderate heat, is called a putrid Feaver: which Name ought to be re∣tained without injury, because that in this Feaver, th•…•… Synthesis of the Blood (as is wont to happen in putrefying Liquors) is very much unlocked. When the Spirits only grow enraged, (as in an Ephemera) the frame of the Blood is somewhat set open, and loosned, that it is more dissolved, by the Ferment of the Heart, than is wont, and more Particles than naturally use to do, leap forth, and diffuse a more intense heat; but yet the mixture of the Liquor, as to its chief parts, is conserved. But when the Sulphureous matter taking fire, grows hot above mea∣sure, the bond of the mixture, for the greatest part, is loosed, that its Principles are almost wholly drawn away, by the Ferment of the Heart, and the active Particles, being loosned from the mixture, break forth as it were into a flame. Wherefore, the Liquor of the Blood being after this manner rarified in the Heart, and as it were enkindled, is from thence carried through the Vessels, with a most rapid motion, and disperses very many Effluvia of heat, from its deflagration. Hence, the whole mass of Blood (like water put over the fire) continually, boiling, distends the Vessels, pulls the Brain and Nervous parts, raises up Convulsions, and pains in them, very much destroys the Vital Spirits with its heat, wastes the Ferments of the Bowels, hinders the Offices of Concoction and Dispensation, often depraves the nourishing Juice, desti∣nated for the Nervous stock, that from thence exceeding great disorders of the Animal Spirits follow; yea almost perverts the whole oeconomy of Nature.

The course of this Disease shews it self after this manner; It rarely begins without a proca∣tartic cause, or previous disposition: to wit, the Sulphureous or Oily part of the Blood, is first too much carried forth, and exalted beyond its due tenor, which afterwards, either of its own accord (like Hay not eventilated) begins to grow hot, or by the coming of an evident cause, it is forced into a preternatural heat. But when it grows turgid in the first place, by reason of the admixtion of a crude Juice with the Blood, now a shivering, now heat infests, which shew themselves unequally, like Fire which is covered with green wood, sends forth now smoke, now flame: But at length, the fire glowing more largely, as here the victor fire spreads it self abroad, so there (sooner than said) the whole mass of Blood is inflamed, and is urged at once with heat, and a most swift motion; nor is this immoderate heat of the Blood appeased, be∣fore its active Particles being loosned from the mixture, and then successively inkindled in the Heart, are wholly burned out, which doth not happen, but in the space of many days. And then at length this Feaver ceases, when the remaining Liquor of the Blood, the Spirit and Sul∣phur being very much consumed, being made lifeless and poor, is fit only for a weak and small

Fermentation. From this kind of deflagration of the Blood, and also of the alible Juice (by the same fire burnt out) the recrements, or little Bodies of torrifi'd matter, are heaped up in the Blood, which yet do more promote its fervor and ebullition, and for a time increase the Fea∣verish distemper. After the blood hath very much burned forth, and these kind of little bodies are gathered together to a fulness of swelling up, the vital Spirit endeavors a separation, and tries to concoct, and to overcome (what it may) these adust recrements, and then, having put a great many of them into a swelling up, a Flux being risen, strives to shut them wholly out. And indeed, in the subaction and seclusion of this matter, chiefly consists the event of this Dis∣ease; for if the vital Spirit being strong, the bloody Humor (when it hath sufficiently burned forth, and shall be freed from these adust particles) should recover its pristine tenor, whereby it is made fit for motion, and a due fermentation in the heart, the sick tends towards health; but if by a long deflagration, and an inextricable confusion of the morbific matter, the liquor of the Blood, being wanting of Spirits, and more pure Sulphur, or those same (by the impure mix∣ture growing ill) being as it were put under the yoke, is rendred so lifeless, that it is not any longer rarified by the ferment of the Heart, or enkindled, by degrees its heat and motion, to∣gether with Life it self decays.

The procatartick Causes, which dispose to this Disease, are, a hot and humid Temper, an active habit of Body, a youthful Age, the Spring time, or Summer season, a high and rich Diet, besides the often drinking of rich Wines, a sedentary and idle Life, a Body full of gross Hu∣mors, and stuffed with vicious Juices; but above all the rest, it appears by observation, that the frequent letting of Blood, renders men more apt to Feavers; wherefore it is commonly said, from whom blood is once drawn, that unless they do the same every year, they are prone to a Feaver. The reason of this is (unless I am deceived) by the frequent letting of blood, the Sulphur is more copiously gathered together in the Mass of blood; in the mean time, the Salt (which should bridle it, and hinder it from raging) by this means is drawn away; for the blood, the older it grows, becomes so much the more salt, the Salt of all the Elements not evaporating. But by how much the more the Blood abounds in Salt, by so much the less it abounds in Sulphur; for Salt eats and consumes the Sulphur, and makes it evaporate: wherefore they who are lean, and abound with a salt blood, are less prone to Feavers. But when by the letting of blood, the ancient blood is drawn forth, in its stead another more rich, and more impregnated with Sul∣phur, is substituted; so that it becomes less salt, and more sulphureous. Hence it is, that those who often let blood, are not only prone to Feavers, but also are wont to growfat, because of the blood's being more impregnated with sulphureous Juice.

The evident Causes which deduce the latent disposition of this Feaver into act, are of the same sort, which procure an Ephemeran •…•…eaver, and simple Synochus; in this rank chiefly come, Transpiration being hindred, and Surfetting. By reason of the Effluvia being restrained, the Mass of the blood being increased in bulk grows turgid, and conceives a Fervor, as it were from a certain Ferment, inspired anew, and cruelly boils up; from thence, presently the pores are more obstructed, by the infartion of the Effluvia, and the frame of the Liquor being loosned, the particles of the Sulphur exuberating in the blood, leap forth from the mixture, and are in∣flamed by the ferment of the Heart, as it were by fire put to them, and so they enkindle a very intense Feaver. But from a Surfeit, both an immoderate fermentation is induced in the blood, and also a nitrous sulphureous matter, apt for adustion, and an inkindling is conveyed, as it were food, to the burning blood.

In this Feaver, four times or seasons are to be observed, in which, as it were so many posts, or fpaces, its course is performed: These are then, the Beginning, the Augmentation, the Height, and Declination. These are wont to be finished in some sooner, in others more slowly, or in a longer time. The beginning ought to be computed, from the time the blood begins to be made hot, and its Sulphur to conceive a burning, until the ardors and burnings are diffused, through the whole mass of blood. The Increase or Augmentation, is from the time, that the blood being made hot, and inkindled through the whole, burns forth for some time, and its mass is aggravated with the Recrements, or burnt Particles, which increase the fermentation. The state, or standing of the Disease, is, when (after the blood has sufficiently burned forth, and its burning now remits) the long vexed blood, like a noble Wrestler, when his Adversary is a little yielding, recollecting all his strength, endeavors a bringing under, and a separation of that adust matter, with which it is filled to a plenitude, and also a Crisis or separation being once or oftner attempted, an expulsion of it forth of doors. The Declination succeeds after the Crisis or Secretion, in which the blood grows less hot, with a languishing fire, and either (the vital Spirit being as yet strong) overcomes what is left of that adust and extraneous mat∣ter, and by degrees puts it forth, until it is restored to its former vigor; or, whilst the same Spi∣rit is too much depressed, the Liquor of the blood is still stuffed with adust Recrements, and therefore becomes troubled and depauperated, that it neither assimilates the nourishing Juice, nor is made fit for an accension in the heart, for the sustaining the Lamp of Life.

1. When therefore any one is taken with a putrid Feaver, the first assault is for the most part accompanied with a shivering or horror: for when the Bloud begins to grow hot, there is a flux made, and a swelling up of the crude Juice, freshly gathered together in the Vessels, even as in the fit of an intermitting Feaver, heat, and sometimes sweat follow, upon the shivering, by which, the matter of that crude Juice is inkindled, and dispersed: afterwards, a certain remis∣sion of the heat follows, but yet from the fire still glowing in the Bloud, a lassitude, and pertur∣bation with thirst, and waking, continually infest: A pain arises in the Head, or Loins, partly from the ebullition of the Bloud, and partly from the motion of the nervous Juice being hin∣dred; also a nauseousness, or a vomiting offends the Stomach, because the Bile, flowing out of the Choleduct Vessels, is poured into it, and a Convulsion from Vapors, and from the sharp Juice brought through the Arteries, is excited in the Stomach. In the mean time, altho' the heat be more increased, and inequal, it is not yet strong, because the Bloud as yet abounding with crude Juices, is only inkindled by parts: and therefore burns out a little, and then ceases, and at last returns; like a flame that is made by wet and moist straw. In this condition for some days, the Disease remains, the Urin is more red than usual, by reason of the Salt and Sulphur being more dissolved and infected with the serum; It still retains its Hypostasis or substance, be∣cause the Coction and assimilation are not altogether depraved; it appears greater than ordi∣nary in its sediment, which is yet easily separated, and falls to the bottom of its own accord. At this time, they may let Bloud, and administer Physick by Vomit, or Purge, so it be done without any great perturbation of the Bloud: it often happens, from these kinds of evacua∣tions, timely performed, that a greater increase of the Disease is prevented, and the Feaver as it were killed in the shell. The limits of this stadium or space, are variously determined, according to the temper of the sick, and other accidents of the Disease; sometimes, the first ru∣diments of this Feaver, are laid in a day or two; sometimes the beginning of the Disease is ex∣tended to more; if in a corpulent Body full of Spirit, Juice, and hot Bloud, or it happen in a youthful Age, and very hot season, if the disposition to a Feaver be potent, and the evident cause coming thereupon be strong, the Feaverish heat, being once begun, quickly invades all the Bloud, and on the second and third day, having rooted it self, the Disease arises to its increase; but if the Feaverish indisposition, be begun in a less hot Body, a Phlegmatic temper, or a melancholy, and in old age, or a cold season, the entrance is longer, and scarce exceeds the limits of this first sta∣dium or space, before the sixth or seventh day.

2. The increase of this Disease, is computed from what time the burning of the Feaver hath possest the whole mass of Bloud: that is, the Sulphur, or the Oily part of the Bloud, having been long heated, and growing fervent in parts, at length, like Hay laid up wet, breaks forth, after a long heating, all at once into a flame; the Bloud at this time cruelly boils up, and very much inkindled in the Heart, by its deflagration, diffuses as it were a fiery heat through the whole Body, and especially in the Precordia; hence the sick complain of intolerable thirst, be∣sides a pain of the Head, pertinacious wakings, and oftentimes a Delirium, Phrensie, and Con∣vulsive motions infest: all Food whatsoever is loathsom, either it is cast up again by Vomit, or if retained, being baked by too much heat, it goes into a Feaverish matter; besides, there hap∣pens a bitterness of the mouth, an ingrateful savor, a scurfiness of the Tongue, a vehement and quick Pulse, an Urin highly red, and for the most part troubled, full of Contents, without Hypostasis or laudable sediment; when the Bloud is at this time almost wholly inkindled by its deflagration, it begets great plenty of adust matter, (as it were ashes remaining after a Fire) with which the serum being very much stuffed, renders the Urin thick, and big with Contents: Also the Bloud, being filled with a load of this, to a rising up, is irritated into Critical motions, by which this Feaverish matter, (if it may be done) being brought under, and separated, is shut out of doors; and indeed this state of the Feaver induces that, in which a Judgment is discerned, be∣tween Nature and the Disease, the strife being as it were brought to an aequilibrium; and there∣fore the evacuation, which follows from thence, is called the Crisis.

The state therefore, or height of a putrid Feaver, is that time of the Disease, in which Na∣ture endeavors a Crisis, or an expulsion of the adust matter, remaining after the deflagration of the Blood. To this is required, in the first place, that the Bloud hath now for the most part burned forth; because in the midst of its burning, Nature is not at leisure for a Crisis, nor is it ever prosperously endeavored, nor in truth procured by Art with good success. Secondly, That the spirit of the Bloud, doth first, by some means subdue this adust matter, or Caput mortuum, separate it from the profitable, and render a period to the expulsion, for otherways, tho' a co∣pious evacuation happens, Nature will never be free from her burthen. Thirdly, That this matter, be gathered together in such a quantity, that by its turgency, it may irritate Nature to a Critical expulsion. If these rightly concur, a perfect Crisis of the Disease, for the most part succeeds, in which, even as in the Fits of intermitting Feavers, a Flux being arisen, whatsoever extraneous and heterogeneous thing, is contained in the bosom of the Bloud, is exagitated, then being separated, and involved with serum, it is thrust forth of doors; when any thing of these is wanting, the Crisis, for the most part, is in vain, and not to be trusted, and rarely

cures the Disease. For if in the midst o•…•… the burning, before the Bloud hath sufficiently burned forth, an evacuation happens, by Sweat, a Lask, Bleeding, or any other way, the adust matter is not all separated, or else, if for the present, it be drawn away for the greatest part, the Bloud more largely flaming out, presently substitutes new, and will renew the Feaver again, that seemed to be vanquished: If that this matter, not being yet overcome, nor brought to a fulness of rising up, be irritated to an expulsion by Nature, an imperfect, and partial Crisis only follows; and when the first indeavor of excretion shall be in vain, rarely a perfect, and curatory succeeds after that one time.

The Crisis in a continual Feaver, is almost the same thing, as the Fit of the intermit∣ting Feavers. For as in this, when the mass of Bloud, is filled to a fulness of swelling up, with the Particles of depraved alible Juice, and fitted for maturation, there are made a Flux, secretion, and expulsion out of dores of that matter: so in a continual Feaver, from the de∣flagration of the Bloud, and alible Juice, very many little Bodies of adust matter are ga∣thered together, with which, when the Bloud is aggravated, and is at leisure, a little from the burning, it overcomes them, by little and little separates them, and then a Flux being raised up, endeavors to cast them out of dores: wherefore, as the Fits of Intermitting Fea∣vers come not but at a set time, and after so many hours, so also the Critical motions happen from the fourth day to the fourth, or perhaps from the seventh day to the seventh, for in this kind of space, the Bloud being inkindled burns forth, and with its burning makes an heap of adust mat∣ter, as it were ashes, which being troublesom to Nature by their irritation, induces Critical mo∣tions.

Therefore, what some affirm is not true, That the Crises depend altogether on the influen∣ces of the Moon, and Stars, and follow their Aspects, Quadrations, Oppositions, or Con∣junctions: because the Critical evacuations are only determined, by the gathering together, and the swelling up of the adust matter. For, as soon as the Bloud is at leisure, from the deflagra∣tion, and being filled with the particle of that adust matter, is able in some measure to over∣come, and separate them, presently a Flux, or swelling up being risen, it endeavors to thrust them forth by any way; which, for that they are easily to be separated from the Bloud, and the breathing places of the skin are sufficiently open, being involved with serum, are sent away with sweat. And this is the best way of the Crisis, which if it rightly succeeds, very often, wholly, and at one time, perfectly cures the Disease, without danger of relapse. To this next, follows the Crisis, which is endeavoured by the Hemorrhage or bleeding at Nose; for this matter, as it were the flowring, being moved with the Bloud, (if it be not cast forth by sweat, by reason of a less free transpiration) is transferred from the heart, into some remote part, and frequently is cast into the Head, by the impetuous rapture of the Bloud; where, if a passage be open, from the private holes opening into the nostrils, the morbific mat∣ter, leaps forth of dores, with a portion of the Bloud. But otherways being oftentimes fixed in the Brain, brings a phrensie, delirium, or other grievous and tedious Diseases of the Head; yea, 'tis to be observed, that almost in all continual Feavers whatsoever, when they are hardly or im∣perfectly cured, so that the Bloud is infected, for a long time with the Feaverish matter or adust recrements, that from thence, the nervous Juice (as it seems) contracting an Infection, pertinacious Distempers; to wit, Watchings, also Deliriums, Tremblings, Convulsive motions, and long adhering weakness of the nervous parts follow. Also, there are other ways of Crisis, by which Nature endeavors, not at once and wholly, but by little and little, and by parts, to expel the Feaverish matter; now by Urin, now by Vomit, or Stool, now by breakings forth, and buboes, or biles; by what way soever, that it may be done with a good event, it is required, that the de∣flagration of the Blood be past, and that the adust matter be concocted, and rendred fit to be separated.

The state or standing of the Disease, is therefore not one, and simple, nor always hap∣pens after the same manner, but with a various difference of symptoms, and tending to far different events. But by a prudent Physician, a Prognostication is expedient to be given, in what space of time, the Disease will come to its height or standing, and what end it will have.

If the Feav•…•…r be vehement from the beginning, and suddenly invades the whole mass of Bloud with a burning; if it urges constantly, and equally without any remission, with a ferocity of symptoms; for the most part, the Bloud will so much burn forth, in the space of four days, that the adust matter, will arise to a fulness of swelling up, for the making a Crisis. B•…•…t if its beginnings are more slow, and the accension of the Bloud often interrupted, the Fea∣ver will come to its achme or height, about the seventh day. If it should begin yet more remiss, the standing of the Disease is wont to be drawn out, to the Eleventh or Fourteenth day. In the mean time it is to be noted, that as the Fits of Intermitting Feavers return at set times, so the Critical motions in continual Feavers, (but for the most part they observe the fourth day:) for altho' the Crisis may be perfectly prorogued to the fourteenth, seventeenth, or perhaps the twentieth day, because all things, requisite to the full curing of the Disease,

do not sooner concur; yet in the time betwixt, more light motions happen, by which the Fea∣verish matter arising leisurely, to an increase, is a little emptied, and as it were cut off by parts, until Nature may be able to enter upon its more full discussion; but when the great provision of the adust matter, in the burning Bloud, is heaped up in the Vessels, Nature, unless otherways disturbed, on every fourth day, being tyred with the plenty of matter, trys to shake off part of its burthen, by a certain swelling up: wherefore, for the most part, the Critical motions happen on the fourth, seventh, eleventh, and fourteenth days, not by the direction of the Planets, but by reason of the necessity of Nature.

As to the event, whether the Crisis shall be good or not, certain fore-knowledges are taken, from the strength of the sick, the Pulse, Urine, and other signs, and concourse of symptoms: If the sick appear with some strength, the fire of the Feaver urging, hath a strong and equal Pulse, if the Urine be of a moderate consistency with some sediment, with a separation of the Contents, and easily falling to the bottom, if the Disease shall make its progress, without great Vomiting, Watchings, Phrensie, Convulsive motions, and suspition of malignity, the standing will be laudable, and to be expected with a good Crisis: if the contrary to these happen, viz. that presently strength is cast down, and that the sick is obnoxious to frequent Swoonings, Convul∣sions, a delirium, with a weak intermitting or unequal Pulse, if pertinacious watchings, intolle∣rable thirst, and Vomiting continually infest; if the Urine be thick and troubled, without sedi∣ment, or sinking down of the parts, if, the burning yet troubling, Nature is provoked to critical evacuations, a very dangerous state of the Disease is imminent, nor may there be hoped for any thing of good from the Crisis.

Concerning the Crisis of a Putrid Feaver, we will here subjoyn a particular Prognostication, in which, though the things, which from the beginning did appear, might promise a most de∣sired event, a very deadly one is imminent; I have often observed, in a Putrid Feaver, which be∣gins slowly, and with a small burning, if the Urine be red, and when rendred presently troubled, and thick, which is not precipitated, neither by the cold, nor of its own accord, puts down a sediment, and if at the same time, the sick lie for many days without sleep, tho' quiet, and that they toss not themselves up and down, their condition is in danger: and the suspition will be more, if in the mean time, they are neither troubled with a strong Feaver, nor infested with thirst, or with a very troublesom heat; because those distempered after this manner, are incident for the most part, about the state of the Disease, to a Delirium, Convulsive motions, and oftentimes fall into madness, from which they are quickly cast into death; and when these symptoms arise, the Urine is altered, from a thick and red, into a thin and more pale Urine. It seems in this case, the mass of Bloud, being taken with the Feaver, not to grow turgid, so with Sulphur exalted to the height, as Wines or Beer are wont in their Effervescencies; but (the Salt, and the terrestrial Lee or Dregs, being stirred together with the Sulphur) to be affected after the same way, as Wines and Beer, being suddenly disturbed with Thunder, and growing sour; wherefore, altho' the Bloud does not presently conceive an immoderate heat from the Feaver, yet its disposition being changed, it wholly depraves the Juice destinated to the Brain, and Nervous parts, and therefore about the beginning of the Feaver, pertinacious watchings hap∣pen, then the state growing urgent, the oeconomy of the whole Nervous stock is perver∣ted. Melancholick persons are most obnoxious to these sort of Feavers, in whom the unruli∣liness of the Sulphur, are a little restrained, by the Salt, and Earthy dregs being stirred up with it, notwithstanding which, all being leisurely carried forth, break forth afterwards, with a greater slaughter.

When the Disease shall come to the standing, either the business is done at one conflict, and from thence with a manifect declination, there is made a translation to life, or death, or there are made frequent skirmishes, between Nature and the Disease, and critical motions are often attempted, before the victory is yielded to either party.

1. As to the first, If after the Bloud hath sufficiently burned forth, with a good precursion of signs and symptoms, and its burning hath remitted, the adust matter being equally brought under, and subtilated, arises from a full increase, to the motion of boiling up; and Nature being free from any impediment or depression, is strong with able strength enough, for the decertation or strife, the Feaverish matter, for the most part, is exterminated at one motion of its flowring or putting forth, and the Bloud being freed from its fellowship and infection, soon recovers its former vigour.

2. But if Nature is stirred up, to a critical motion, before the Bloud hath perfectly burnt forth, or that adust matter is prepared for excretion, altho', as to the rest, things are in a mo∣derate condition; yet from hence, but an imperfect Crisis follows, by which indeed, some∣thing of the load or burthen, with which the Bloud is oppressed, is drawn away; notwith∣standing presently another springs up afresh, in its place, and then at set times, (perhaps, in four, or seven days space) like the fits of intermitting Feavers, the critical motions are repeated, the second, and perhaps the third time, before the strife being ended, the matter openly inclines to this, or that party.

3. But when, with the preceding evil appearance, of signs and symptoms, the burning of the Bloud yet urging, the critical motion is provoked, without any coction of the Feaverish matter, sometimes Nature is overthrown at the first conflict, nor doth she recollect her self, but yielding her powers overcome by the Disease, is precipitated into death. Nor is the business much better, when the Crisis is at first imperfect, and in vain, celebrated, without any ease to the sick, and from thence, the next to this succeeds worse, and then in another, and perhaps another conflict, the Disease prevails, until the strength being wholly broken, and cast down, there is a plain end of life.

Thus much concerning the state and Crisis of the Disease, on whose good or improsperous suc∣cess, the event of the Disease depends; the declination of the Feaver, takes its period of this, of which we must speak next.

4. Altho' the Declining of the Feaver, for the most part, is taken in the better part, that it denotes the condition of the sick growing well of the Disease, in which the Bloud being almost freed from its Effervency, recovers leisurely, strength and spirits, that were lost, and expels what extraneous thing is left remaining in its bosom; yet, in a genuine enough signification, it may be used for that state, when from an ill Crisis, or in vain, the Bloud being depauperated, and infected with an extraneous and Feaverish mixture, still declines for the worse, until at length (like Wine changed into a lifelessness) being made wholly unable for circulation, and accension in the Heart, it calls on death. Therefore, in this place, the name of declination signifies the condition of sick, and of the Disease, which follows the standing, whether it tends to life, or to death; whether the Feaver, or life it self of the sick, at this time, declines.

As to the times of declination, it will be worth our labour to inquire, what the temper of the Bloud may be, and what turns of alterations it has undergone, as often as from a good, or bad Crisis, there has been made a progress of the Disease, towards Health, or Death. To wit, first, what the disposition, or condition of the Bloud and Spirits may be, from a good Crisis, and with what alterations, its spoiled Liquor recovers its former vigor. Secondly, what their tem∣per is, from an evil Crisis, and by what degrees it still tends to worse; and lastly, how they are, when from a doubtful state, and long weakness, the sick hardly get up at length, and recover their health.

The vice, or depauperation, which the Bloud hath contracted from the Feaverish heat, consists in this: The Spirit very much evaporates, and is lost: the Sulphureous part is too much scorched, and is much wasted by the deflagration, and from its burning, the adust matter (as it were the Caput Mortuum) is left, with the Particles of which, the mass of Bloud is aggravated, and debilitated; in the mean time, the Saline and Earthy parts, are too much exalted, even as is wont to come to pass in Wine, or Beer, by the use of too much Ferment. The Bloud, by these ways being spoiled, evilly assimilates the provision of the Nutritious Juice, yea also, by reason of the roasting of the Sulphur in the Heart, or defect of it, not rightly Fermenting, or inflamed, it untowardly dispenses the Vital Spirit, in the mean time, from the adust matter, and Salt too much exalted, it grows more fervent than it should, and more wasts it self.

1. From a good Crisis, the Spirit, tho' made weaker, yet gets the upper hand, where∣fore, what is left of the Feaverish matter, it by degrees overcomes, and expels; and con∣cocts, and assimilates (so what is brought be thin or slender) the Nutritious Juice: from thence, the mass of Bloud is amended anew, with Spirit and Sulphur; and the Bloud which now being Salt and sharp, did continually grow hot, acquires at length a Sweet and Balsamic Na∣ture, and being quickned with a lively motion and heat, rightly performs the offices of life and sense.

2. From a bad Crisis, the business is otherways, the Liquor of the Bloud (like Wine too much Fermented) degenerates, almost into a vappidness, or lifelesness; its Spirit is greatly diminished; the Reliques which remain, are intricated, and, as it were, over∣whelmed, with the Particles of Adust Matter, from whence there is yet a continual grow∣ing hot remaining in the Bloud, yet without concoction, or assimilation, of the Alible Juice, or separation of the profitable, from the unprofitable: The benign Sulphur, and the Food of the Vital flame, is much consumed, so that the Bloud is less inkindled in the Heart, than it ought to be; in the mean time, from the Adust Recrements, and also the Salt, and Earth being too much carried forth, it perpetually burns in the Vessels, with thirst and heat. And because it is dayly depauperated, the Spirit and benign Sulphur being waste•…•… and more infected, with the Salt, and Earthy dregs being too much exalted, its Liquor in a short time becomes tastless, and is made unfit for circulation, and for the inkindling in the Heart, for the sustaining the Vital fire: wherefore there is a necessity that life be lost, even as the flame of a Lamp is extinguished, when instead of the wasted Oil, a Salt and Muddy Liquor only supplies it.

3. From an imperfect and doubtful Crisis, when the sick being weakned by a long imbeci∣lity, become not well, but of a long time, the business is after this manner; The Spirituous and Sulphureous parts of the blood are very much consumed by the slow deflagration; the re∣maining Liquor, being not purged from the adust recrements and feculencies, is rendred very impure; but when there is yet remaining somthing of Oil for the Vital Lamp, nor Spirits are altogether wanting, for the subduing the Feaverish matter, the blood is still circulated, and (though but smally) is enkindled in the Heart; yea, and by little and little the Spirits recol∣lect themselves, set upon the matter remaining of the Feaver, and what they are able, begin to overcome it: then by a pertinacious assiduity of coction, like a flame, wavering and half ex∣tinct, among green wood, at length rise up victorious, and restoreanew, both with heat and motion, leisurely renewed, a quick and lively Fermentation, in the Heart.

So much in general of the Feaver called Putrid: it remains, before we descend to the kinds, and particular Cases of it, that I recount the symptoms and signs chiefly notable, in the course of this Feaver, and subjoin the Reasons and Causes of them, and their manner of being done.

CHAP. X. Of the Symptoms and Signs chiefly to be noted in a Putrid Feaver.

THE Symptoms, coming upon a Putrid Feaver, although they argue the oeconomy of the whole Body, to be for the most part depraved, and the disposition and Functions of some part, or Member hurt; yet, the Accidents, which a Physician ought chiefly to consider, about the Diagnosis of this Disease, and its Prognosis to be rightly instituted, may be referred to three classes or common places; to wit, they have respect to the Viscera of Concoction, viz. the Ventricle, and Intestines, with their Appendixes: Or secondly, to the Humors, flowing in the Vessels, viz. the blood in the Arteries and Veins, and the thin Li∣quor in the Nervous parts, together with the chief Springs of either, viz. the Heart, and Brain; or lastly, these Symptoms respect the habit of the Body, with the various constitution of the pores, and the extension or emarceration of the solid parts. They, who would exactly observe the course of this Disease, and would fitly draw out Curatory intentions, may take notice of these three heads of Symptoms, and carefully consider what alterations may happen in these; as it were distinct Regions, according to the different times of the Feaver.

1. Troubles and Disorders, such as Nauseousness, Vomiting, want of Appetite, Indigestion, a Looseness, a Scurfiness of the Mouth and Tongue, a bitter Savour, are wont to infest about the Ventricle, and first Passages, in the whole course of this Feaver. These, for the most part, are attributed to the humors, first heaped together in the Stomach, and there putrefying: But besides, that the recrements of the Chyle, being throughly roasted, by too much heat, degene∣rate into an hurtful matter, very often these kind of Accidents happen, for that the Purgings, and the Filth of the Blood and Nervous Juice, while they grow hot, are carried inward, and being deposited in the membranes of the Viscera, provoke Convulsions, and also make a filthy heap of vicious and very infestous humor. I have often observed, that about the beginning of the Feaver, the blood growing hot, laid aside its recrements even inwardly, with a benefit to the sick, where, although great molestations did arise about the firs•…•… passages, yet the burning was therefore more mild, the Pulse moderate, and the Urine laudable, and these being after this manner in a Feaver, quickly grew well, with a slender Diet, and the use of gentle evacua∣tions. But if in this case I should administer a vehement Cathartic, for the extirpating the humors, that natural purging of the Blood being hindred, presently the Feaver became strong, with a red Urine, and troubled, a deep Pulse, Watchings, and other horrid Symptoms; also, oftentimes after the state of the Disease, by this interior kind of Lustration or Purging, the adust matter, and excrementitious, is separated from the Blood. Hence sometimes a Lask, some∣times a scurfie covering of the Mouth and Throat, follow: Wherefore, there is need of cau∣tion, about the Accidents which happen in the first passages, lest that whilst we oppose them, we should p•…•…rvert the motion of Nature; and lest whilst we fortifie these parts against the course of the Morbific matter, we untowardly keep the same shut up in the Mass of Blood.

The Symptom chiefly to be considered, about the bloody Mass, are, an heat diffused through the whole, a burning of the Praecordia, Thirst, a Disorder of the Pulse, a red Urine, a spon∣taneous wearisomness, a loss of all strength, out of which rightly considered, these things fol∣lowing may be known, viz. what the manner of the heat is, or with what tenor the burning blood

flames forth; what time of remi•…•…ion, or of encrease its Effervescency observes in the deflagra∣tion; whether it retains its Crasis or Mixture whole; for the burning of it, and circulation of it enkindled, what strength of the Heart will suffice, and what space the Vessels may require; so long as the blood burns, what plenty of adust recrements it may heap up, by what means it may overcome, separate, or at least endeavour to separate the same, and lastly, what way of a Crisis it endeavors, and with what success.

The Accidents which have a respect to the thin liq•…•…or, with the Brain, and nervous Appen∣dix, are disorders concerning Sleep and waking, a debility of the whole Body, a Trembling, Shivering, Pains, Convulsive Motions, Cramps of the Viscera, Stupefaction, Phrensie; and the observation of which suggests what the temper and constitution of that thin Liquor may be; by what means it waters, and influtes the nervous parts, and performs its Circuits through them; how the Animal Spirits execute the functions of the Viscera; what the state of the Brain may be, whether it remain free from the incursion of the Feaverish matter, or whether it be not in danger of being overwhelmed, by reason of its Critical Metastasis or Translation.

Concerning the habit of the Body, may be observed, what may be the reason of sweating, and the manner of it; whether only by vaporous Effluvia, or by Sweat, or also by little wealks; whether the Flesh falls away on the sudden from its wonted bulk; or whether it retains it self a long while; what the colour of the Face is, and the vigor or habit of the Eyes? From these well laid together, the course of the Feaver may be best of all measured; at what time it will come to its height or standing; whether Nature will prevail over the Disease or not; with what manner of separation, and with what success she will endeavor the expulsion of the Fea∣verish matter; also by these signs may be learned, by what degrees the blood growing hot, and often congealed, doth tend towards Putrefaction or Corruption; whether it does any thing concoct the alible Juice poured to it; or whether or not it presently casts forth of doors all its provision by Sweat, as often happens in the declination of this Disease.

By these Symptoms and Signs, a yet more plentiful Indication may be had, if first it be known upon what Causes the several Species of them depend, and, by what provision they are wont to be raised up in our Body: wherefore I have thought it worth our labour to recount particularly the chief of these; and to explicate the Reasons of them, and their ways of working.

But the Symptoms chiefly to be observed in a putrid Synochus, or continual fervor without intermissions, are, an heat in the whole Body, a spontaneous Weariness, a burning of the Prae∣cordia, intolerable Thirst, an Ardor and Scurfiness of the Tongue, or Jaws, a Pain of the Head and Loins, pertinacious Watchings, Phrensie, convulsive Motions, a Syncope, Heart-burning, Vomiting, Nauseousness, a want of Appetite, a Loosness, a Flux, with which, not all at once, now with these, now with those, this Disease is wont to be beset.

1. Heat, which is felt sharp and biting, in the whole Body, depends upon the too great ef∣fervescency of the Blood, and the accension of it in the Heart; for the Sulphureous or Oily part of the blood being exalted, and taking an heat, is enkindled in the Heart, in a double pro∣portion, more than it was wont; wherefore, it copiously diffuses, by its deflagration, Effluvia of heat through the whole Body. When the Sulphur is less dissolved, and enkindled in the Heart, as in the Green Sickness, or the white Dropsical Disease, &c. Heat is wanting in the whole; but in a Feaver, when the Sulphur too much burns forth, Heat superabounds. For heat depends not only upon the actual inflammation of the Sulphur, or the firing of it, but an in∣tense heat is excited without fire, in many mixtures, where the Particles of Sulphur are dissol∣ved by corrosion, or are more thickly heaped together for want of ventilation; wherefore, when Iron is corroded by an acid mineral Spirit, or when Spirit of Nitre is poured on the Butter of An∣timony, a mighty heat with a Fume is produced; in like manner when Dung, or Hay laid up wet, are kept from ventilation, grow highly hot; it is the same reason, why the Blood burns above measure in Feavers, to wit, the particles of the Sulphur, being too much exalted, and made hot, are more thickly heaped together in the Vessels, and are more dissolved, and as it were enkindled by the ferment of the Heart; wherefore, they every way diffuse heat, being loosned in the bond of the mixture, and every where stretched forth or expansed.

2. A spontaneous Weariness or Lassitude is felt in the whole Body; to wit, by reason of the Vessels being distented with the boiling blood, also the musculous flesh is very much stuffed with blood, and a copious breath, that it is made less fit for motion, as they who are sick of an Ana∣sarca, have their Limbs very unwieldy by reason of the abundance of serous humor; besides, in Feavers, by reason of the inflammation of the blood, the Juice, which is sent for a supply to the nervous stock, departs from its due temper, that it becomes little fit for the actuating the Body.

3. The burning of the Praecordia is made, by reason of the blood being more copiously en∣kindled in the Chimny of the Heart, which from thence boils forth into the Lungs, with great ardency; wherefore by how much the nearer this Region is to that fire-place of Heat, it is pierced therefore with the greater burning.

4. An almost unquenchable Thirst is caused, both from the glowing heat in the Praecordia, also by reason of the sharp and hot particles of the Feaverish Matter, affixed to the Ventri∣cle, in the circulating of the Blood; which indeed desire to be washed, even as salted and spiced Meats, being plentifully eaten, or also strong, or sowr things, rolled in the Mouth or Throat; for this kind of Distemper calls for a more free swallowing down of Drink, as a Member too much heated, the pouring on of cold water.

5. The Ardor and Scurfiness of the Tongue and Jaws, as also oftentimes an accretion of a cer∣tain white, or yellow, or black filth, happen without doubt, because of the Heat and Soot ex∣haled from the Ventricle and Lungs, burning with heat: but the Tongue grows white, as often as that humidity (with which it is naturally much imbued) is dried up, and parched, and so the exterior skin of the Tongue, is as it were rosted, by the burning heat, from hence also it becomes scurfie; which is also seen in healthful people, when it happens that the Tongue is scorched by Broth, or any other very hot Suppings; in like manner, as when the Tongues of Animals are boiled, for the use of the Table, their Skin becomes white and sharp, or rugged. For whether the Spittle is drawn from the maxillary Glandula's (as the Doctrine of the most ingenious Wharton hath first made known) or any other humor from the Gla•…•…dula's of the Jaws, or else∣where; yet because, by reason of the heat and driness, it grows too thick, and becomes clam∣my, also then the outward skin of the Tongue grows nevertheless white; but also it is covered with a certain filthy Glew, to wit, because that humor, by reason of its thickness, may smear the Tongue, but cannot wet or moisten it; but if it happens, that the Tongue is inwardly suf∣fused with a bilous humor, or outwardly tinged (as comes to pass by the use of Choler-abound∣ing Vomits) then its hairy Nap being spongy, imbibing the yellow poyson, exhibits also the like Colour, If that lastly, the heat be so strong, that it burns the Blood, and enkindles a fire, more ardent than usual, it follows, that from the fire-place of the Heart, the breathing places through the Lungs, scarcely sufficing for the ventilating so great fire, soot or smoak is raised up, which being smitten to the furnace of the Palat, strikes against the Tongue, as it were in a Reverberatory, and infects it with Blackness. But this same kind of Blackness (and as other filthinesses of the Tongue) is most conspicuous in its middle parts, because the more ex∣terior compass is cleansed by its frequent rubbing against the Gums and Palat.

6. Sometimes it happens in Feavers, and especially about their declinations, that the Tongue, Palat, Gums, yea the Cavity of the whole Mouth and Throat, are covered over with a cer∣tain viscous matter, as it were a whitish Crust; which being often wiped off, presently new springs again; and unless by rubbing diligently, and washing the Mouth, this crusty matter be frequently wiped away, the sick are in hazard of being choaked. This kind of Distemper is most often excited in Children newly born; for they are wont, for the most part, within fourteen days with an external growing hot, to be sprinkled through the whole skin, with broad and •…•…red spots; if that this suffusion of redness do not freely break forth, or vanishes away sooner than it ought, for the most part, this whitish Crust follows, in the parts of the mouth. This Symptom, when it troubles Infants after this manner, is wont to be ascribed to the fault of the Milk, to wit, that being too sharp, it induces the ulcerous Distemper of the Mouth. In those sick with Feavers, it is commonly attributed to thick Vapors and sooty, ele∣vated from the Ventricle; But to me it seems most likely, that in either, this Distemper arises from the impurities of the whole Bloud (and perhaps in some measure of the Nervous Juice) deposited about these parts: for, as often as in the mass of either humor, any extraneous thing intimately mixed, is contained, that it is not to be dispersed by Sweat, nor easily sent away by Urine, that most often is fixed with the serous filth abont the Mouth; from whence Ca∣tarrhs, Tumors, and troublefom Spittings are caused: For when for the chewing of the meats, the Salival humor in this place ought to be plentifully suffused, Nature very often endeavours to send forth of doors what is superfluous, or otherwise troublesome, by these usual ways of Excretion. Hence from Mercury being taken, when both the Bloud, and nervous Juice are abundantly stuffed, with its most smally divided Particles, and endeavour to thrust them forth, being involved with Serum because they are not able to exterminate those Mercurial little Bodies, being intimately confused, neither by Sweat, Urine, or by any otherways, what is re∣maining, they endeavour to expel through the Arteries and other Passages, which supply the Mouth with Spittle, the same being involved with the serous Latex.

Also in like manner, in Feavers, when from a long deflagration of the Bloud, the adust mat∣ter is very much heaped together, of which no small part remaining, after the Crisis, is yet confounded with the Bloud, and Nervous Juice, being fixed either to the Brain, or to some other place, from them it is at length supped up again, 'tis most probable, that this matter is throughly roasted, by a long Concoction, and so becomes almost like Glew, thick; wherefore being not able to be dispersed, neither by Spittle, or insensible Transpiration, nor to be sepa∣rated by the Urinary Passages, but at length leisurely runs out by the little Arteries, and other Passages of the Spittle, lying open into the Palat, as the most usual way of excretion, and forthwith by reason of its thickness, grows into that Glewiness. The same reason holds

in Infants, whose blood being made impure, by filths contracted in the Womb, presently it endeavors to purifie it self, by that exterior putting forth, which if it do not rightly succeed, by reason of the thickness of the matter, immediately the viscous impurities are exterminated by this way, as the more open. I have known some, in the declination of a Feaver, to whom, not only this kind of Crust of gummy matter has happened in the parts of the mouth, but a co∣pious salivation, as if they had taken Mercury, with a stinking of the breath, also a swelling of the Tongue and Gums, hath been raised up for many days.

7. The pain of the Head, in Feavers is excited, because the Meninges of the Brain, being pulled or hauled with Vapors, and with a sharp Blood, and hot, for the Blood being impetu∣ously moved, by reason of the direction of the great Artery, is carried in a greater plenty to the Head, than to the lower parts; because the passage from the bosom of the Heart to the Head, is straight, from the same, to the inferior members, oblique, and as it were reflected; wherefore, as the membranes are very sensible, and that there the Blood is stopped, and rever∣berated, in its rapid course, it is no wonder, if cruel Head-aches are excited in Feavers. Be∣sides, this impetuous flowing of the Blood, wherewith (as it were by a certain Ramming) the membranes of the Head being distended, ake grievously; also sometime, Head-aches arise, by reason of the Nervous Juice (which is supplied from the burning Blood) being too sharp and pricking; wherefore, when the membranes, and nervous parts are watered with the same they being pulled by its acrimony, are moved into Pains and Convulsions.

8. In like manner also, the other Distempers of the Head, as Watchings, Delirium, Phren∣sie, Convulsion, &c. arise, sometimes from the Blood being in a rage, and so stirring up inor∣dinate motions in the Brain, and sometimes also from the nervous Juice being depraved, and therefore made improportionate, to the regiment of the Animal Spirits: But most often, these kind of Symptoms are frequent in Feavers, by reason of the transsation of the Feaverish matter from the bosom of the Blood, into these parts. For the Blood, being full of the adust Recre∣ments, remaining after the deflagration, endeavours (like the flowring of new Wine) to subdue, and exclude them from its company, by every manner of way; which, a Flux being arisen, when it cannot expel by Sweat, Urine, or Bleeding, it oftentimes transfers to the substance of the Brain, and there fixes them; and from hence chiefly, the aforesaid Distem∣pers, when they are fixed, and firmly rooted, draw their Original, whenas the lighter, and that are easily moved, often proceed from the afore-recited Causes.

9. Convulsive Motions happen in Feavers, for divers causes; sometimes, because of the mat∣ter being heaped together in the first passages, which there hales the membranous parts, with its notable pravity, and then, by the consent of the nervous stock, the Convulsion is presently communicated to the beginning of the Nerves, in the Brain, and by that means draws aside now these, and now those parts: by which means, Worms abounding in the Viscera, sharp Hu∣mors being stirred, and strong Medecines, induce Convulsions: Or secondly, when the Feaver is a partaker of some malignity, so in the Small Pox, Measles, or the Plague, frequently Con∣vulsions happen; to wit, because the Blood is altered from its benign and natural temper, into a destroying and venomous, by which the Nerves, and their beginnings are peirced, and for∣ced into Convulsions. Also, oftentimes without the suspition of malignity, in a putrid Feaver, Convulsive motions are induced by reason of the translation of the Feaverish matter to the Brain, as was but now intimated: so I have often observed, when the Disease is not presently cured with the Crisis, the sick lie by it with a tedious sickness, and are made obnoxious to Tremblings and Convulsive motions. Thirdly, and lastly, for the most part in every Feaver, which ter∣minates in Death, Convulsive motions are the sad fore-runners of it; which I think to happen, not only from the malignity of the Matter, with which the nervous stock is pulled and pierced, but because the Spirits, very much exhausted and debilitated, do not sufficiently blow up, and distend the Bodies of the Nerves; wherefore, being released from their wonted extension, and tonick motion, they are however by a more weak endeavor of the Spirits agitated into a disor∣dered motion.

10. A Syncope or Swooning, is wont to be raised up several ways in Feavers; but chiefly for these three causes, to wit, either from the mouth of the Ventricle being distempered, which part as it is interwoven with a manifold texture of Nerves, is very sensible; and because from the same branch of the sixth part, little shoots of Nerves are equally derived to the Heart, and to the Ventricle, if the Orifice of the Ventricle, so implanted with Nerves, be di∣stempered with any great trouble, it is also communicated to the Heart, and either the motion is stopped in it, or at least an inordinate one is excited, whereby the equal Flux of the Spi∣rits and the Blood is interrupted for a time. I knew one in an acute Feaver, taken with a fre∣quent swooning, which distemper wholly ceased, after he had cast forth by Vomit a long smooth Worm. Secondly, a Syncope also is sometimes induced, because the invenomed matter is circulated with the Blood, which suddenly sixes and extinguishes the vital Spirits, and con∣geals the Blood it self, that it is apt to stagnate in the Heart, as usually happens in the Pest, Small Pox, &c. of which we shall speak particularly hereafter. Thirdly, A Syncope is wont to

happen, by reason of the more rare texture of the Spirits, which as they are very tender and subtil, are easily unbent, by any immoderate motion or pain: so I have known some, who being quiet in bed, have found themselves well enough, but being removed from one place to another, presently have swooned away.

11. The pain of the Heart happens in Feavers, when the Ventricle, and especially its Orifices, by reason of the manifold insertions of Nerves, being very sensible, are beset with a sharp and bitterish humor, or else with an acid, and corrosive; for hence a pain and trouble arises from the acrimony of the humor, after the same manner, as when the sphincter of the fundament is afflicted, in Choleric dejections, with pain and molestation.

12. By reason of the same Cause, Vomiting, and Nauseousness, are wont to be ex∣cited; to wit, by the Ventricles being beset, and irritated to a Convulsion, from an ex∣traneous matter, and not akin to it self: Such an excrementitious matter, may be ga∣thered together in the Ventricle, by three ways; for either the Aliments, partly by rea∣son of a want of an Acid Ferment, by which they should be rightly Cooked, and partly by reason of the burning heat of the Ventricle, are roasted into such a Corruption; or, Secondly, this kind of matter, is laid up in the Ventricle, from the Arteries, terminating in its Cavity, as uses to happen in the Small Pox, the Plague, and malignant Feavers; or, Thirdly, meer Choler, being pressed forth from the Choleduct Vessels, into the empty In∣testine, by reason of an inverse motion, and as it were Convulsive, of that Intestine, it is poured into the Ventricle, want of Appetite, also happens, by reason of the Ventricles abounding with vitious Juices, and because the Acid Ferment, is wholly perverted, by the scorching heat. These kind of Distempers of the Venticle, and Viscera, sometimes arise from an excrementitious matter, (to wit, alimentous, degenerated in the concoction) heaped together, a long while before the Feaver, in the first passages, which not seldom becomes, the occasional cause, of the Feaver it self: but sometimes, nauseousness, want of Appetite, Vomiting, pain of the Heart, &c. are the immediate products of the Feaver; for when the day before the sickness, those distempered, have been well enough in the Stomack, as soon as the immoderate heat of the Bloud was induced, whilst it boiled up above measure, both the Effluvia, and the Recrements, being wonted to be evaporated outwardly, also the bilous humor, flowing out of the Choleduct Vessels, are poured into the Ventricle; by which, its Crisis is overthrown; also the Reliques of the Chyle, and other Contents in the Viscera, are egregiously depraved; from whence, the aforesaid Distempers draw their Original.

14. No less frequent a Symptom in Feavers, is a Diarrhea, or Flux of the Belly, which some∣time happens about the beginning of the Disease, and arises (for the most part) either from the Bile, flowing forth of the Choleduct Vessels, into the Duodenum; or from the Recrements of the Bloud, and Nervous Juice, poured forth from the Arteries, and the passage of the Pan∣creas, into the Intestines. All the aforesaid humors, (but especially the Choleric) when they are supplied in abundance, often Ferment with the mass remaining of the Chyme, that the same swelling up with a spumous rarefaction, irritates the Intestines, and provokes to the motion of excretion: sometimes also, about the standing of the Disease, and in the declination of it, a Lask is excited; and so, either Nature being Conqueress, the more thick purgings of the Bloud, are this way critically sifted forth; or being overcome, the Flux of the Belly, is the effect, and sign, of the Viscera wholly losing their strength, and firm tenour. It sometimes happens in a Feaver, that the Belly is always bound, that it is not at all loosned, but by Phy∣sick, and tho' the sick take nothing but liquid things, for many days, the stools are still of a solid consistence, and hard, this seems for the most part to be done, when the Bloud growing sharply and exceeding hot, like fire, consumes the humidities, wherever they flow, and draws to it self, out of the Bowels, the watery matter, by a Copious emission of vapours, and presently makes it to be evaporated outwardly: wherefore, the thicker part, being left in the Intestines, is made firm, from the scorching heat, as it were a Caput Mortuum, remaining after distillation.

A Dysentery is a Distemper, so frequent in continual Feavers, that some years it becomes Epidemical, and not more mild than the Plague, kills many: The cause of it is wont to be, not any humor produced within the Viscera, that corrodes the Intestines with its Acrimony, (as some affirm) but a certain Infection impressed on the Bloud, and so intimately confused with it, that, under the form of a vapour, or a sincere humor, it cannot be pulled away from the Bloud: wherefore, the thrusting forwards, towards the Intestines, unlocks the little mouths of the Arteries, and makes there little Ulcers, and exudations or flowings forth of the Bloud, like as when from the Feaverish Bloud, Pustles and Inflamations break forth outwardly, with a flowring towards the skin: But it is most likely, these dysenteric distempers, which accompany Malignant or Epidemical Feavers, arise from a certain coagulation of the Bloud, as shall be more fully declared hereafter.

And here also, among the symptoms of Feavers, might be recited, what are wont to appear outwardly, in the superficies of the Body, as are Spots, Whelks, Buboes, Carbuncles, &c. but be∣cause these belong after an especial manner to a Malignant Feaver, therefore we will forbear in this place, from the consideration of them, until we shall speak of the Plague, Small Pox, the Pesti∣lential, and Malignant Feaver.

The Pulse and Urine shall conclude here the troop of symptoms and signs in a Putrid Fea∣ver, which are much heeded, for the finding out, both the state and the strength of the sick: For, as there are two things, by which our life is propped, viz. Heat inkindled in the Heart, and concoction to be made in the Viscera, and Vessels, because the Pulse and Urine, best show the alterations in either, induced in a Feaver, therefore from hence, a most certain judgment is taken of this Disease, about to end, in Death or Health. I think it is not needful, to speak of these at large, or to recount the several causes and differences of either: It will suffice for me to note here, the chiefest things of them, and what are worthy of consideration in the course of Feavers. And first of all the Pulse is consulted, as it were a Thermometer or Weather-Glass, constituted by Nature, that from thence, the heat inkindled, in a Feaver might be meted; which if it should be more strong, stirs up a great ebullition or boiling up of the Bloud, the Ar∣tery beats more strongly and quicker, so long as the Spirits are in strength; then they being a little exhausted, the more strong Pulse is remitted; which however is compensated with swift∣ness, and is made quick, and small. If the Feaver be gentler, and is troubled with a lesser burning, the Pulse also declines less, from its Natural condition, and the moderation of this, in the whole course of the Disease, denotes the truces of Nature. Neither doth the Pulse only, betray the forces of the Feaver, as of an Enemy, but shews also plainly the strength of Nature, and her ability of resisting. So long as the Pulse is laudable, the matter goes well, and it shews good hopes; but from the evil state of this, a bad omen is shewn, and a despair of Health. So without a frequent, and diligent examination of the Pulse, a Physician cannot make a right Judg∣ment or Prognostication, or safely prescribe Physick.

1. As to the first thing, it ought to be known (as much as may be) what every ones Pulse is, according to its Natural Constitution; for it is in these stronger, in those weaker: then it is to be considered, in every moment of the Feavers, by what degrees it is distant from its Natural state: for now it is sometimes more vehement, and argues the Feaver to grow stronger; now it is depressed, below its wont, and denotes the Spirits and Strength dejected.

Those whose Pulse in Health beats weakly and languishing, when taken with a Feaver, if they have a small and weak Pulse, it is not so evil a sign, that we should presently despair of their Health: In whom the Pulse is by Nature strong and vehement, if after the Crisis of the Disease, it hath scarce a moderate vigour, tho' it be not wholly weak, it argues the condition of the sick to be su∣spected, and not safe.

If from the beginning of the Feaver, before the Bloud has flamed out, or if a Crisis being made, when part of the burthen is drawn away, or at another time, without an evi∣dent cause, the Pulse becomes weak, it portends evilly: but if after long watchings, or great evacuations, the Pulse is made a little weaker, Health is not therefore to be despaired of, because the strength cast down by these means, or overwhelmed, may be restored, and the Spirits renewed.

When the Pulse is suddenly altered for the worse, tho' the sick seem to be better, as to the rest of the symptoms, you may forespeak the sad prognostication of Death; and so contrariwise, altho' most horrid symptoms urge, and yet the Pulse is laudable, Health may be yet hoped for. If in a strong man, that hath a Feaver, the Pulse is very small, and creepingly, or becomes like the motion of Ants, death is at hand.

2. In the exhibiting of Medicines, cautions and rules of no small moment are taken; Purging and Vomiting are forbid, by the pulse being too quick and violent; also by being low and depressed; be∣cause, whilst the Bloud is too fervent, evacuation helps little, because both what is hurtful is not se∣parated, also for that by the perturbation, the strength or spirits, are more debilitated. But when the spirits are broken, and strength cast down, Medicines cast them more down, and sometimes wholly overthrows them. Wherefore, when a Physician thinks of evacuation, upwards or downwards, he first examines the pulse, and goes about this work only, when Nature is strong and quiet; that she may at once be at leisure, for the operation of the Medicine, and may have sufficient strength.

Nor is there less need of circumspection, in sweating Medicines and Cordials: which, if admini∣stred in the Feaverish fit, do too much strengthen, the former violent motion of the Heart, and oftentimes break its strength; also, when the Pulse is very languid, if hot and strong Cordials are administred, (as when a small flame is troubled with a more strong blast of wind) life is easily ex∣tinguished; wherefore, 'tis a vulgar observation, that Cordials often accelerate death, for that by too much troubling the Bloud, they sooner beat down strength.

There is yet the most need of the caution, and direction of the Pulse, in exhibiting Narco∣ticks; for these, (because they perform their work by extinguishing, and fixing the too fierce vital spirits) if used in a weak or inconstant Pulse, either by dimi•…•…ishing the vital spirits, render

them wholly insufficient for the Disease, or by suffocating them too much, cause a perpetual sleep: wherefore, in a languid, unequal, or formicating, or creeping Pulse, Opiats are to be shunned, more than a mad Dog or Snake.

An unequal and intermitting Pulse has a most evil Report from the Writings of Physitians; yet, although of an ill note, does not so certainly portend Death, as a Weak Pulse; for I have known many to have recovered, though, by those kind of signs condemned to the grave; because the inordination of the Spirits and the Blood, may be more certainly and easily compo∣sed, or allayed, than their dejection restored.

2. The Inspection of Urines in Feavers, before all other Diseases whatsoever, hath more of certainty, and is of greatest use, for from hence, the conditions of the sick, and of the Dis∣ease are best known, and the Medical intentions, concerning what is to be done, are better di∣rected; what Observations and Rules concerning this thing, are vulgarly set forth, are so many, that it would be almost an infinite labour and tediousness, to recount them all: it will be sufficient here to note the chief of them.

Concerning the Urines of persons in Feavers, there are chiefly to be considered, the Colour, Consistency, Contents, and Subsidency or Setling. The Colour of the Urine shews the mea∣sure or excess of heat in the Blood; which, as it is increased, and becomes more remiss, the Urine also is more or less red; the cause of which is, the ebullition of the Blood, or the Ef∣fervescency induced from the Feaver, to the Blood; by reason of which, the particles of Salt and Sulphur, implanted in the Blood, Humors, and solid Parts, are more dissolved, and in∣cocted with the Serum, and impart to it a redness; even as, when Salt of Tartar, and com∣mon Sulphur being mixed one with another, and boiled in water, impart a deep red colour to the Liquor.

The Urines of some are highly red, when they are but a little or lightly Feaverish: and on the contrary, the Urines of others, labouring with a Feaverish Burning, are less coloured. Who abound with lively heat, and a very hot Blood, or are obnoxious to the Scurvy, Phthisis, or Hypochondriack Distemper, when by taking Cold, Condensation, Surfeit, or Drinking of Wine, they are troubled by any little Feaver, they render a Urine strongly red; for that the Particles of Salt and Sulphur remain exalted in their Blood, and before half loosned; where∣fore there is a necessity, that the Feaver urging, they are more boiled in the Serum; on the con∣trary, they who are endued with a cold temper, with a faint and weak Pulse, being taken with a Feaver, with a greater effervescency of the Blood, render their Urine less coloured.

The Consistency, Contents, and Subsidency of Urines, being put, as it were, upon the same Thred, depend all of them, on the adust and recrementitious matter, which is remaining in the Blood, after the Feaverish deflagration: if there shall be plenty of this, the consistency of the Urine becomes somewhat thicker, and after it has stood, it is troubled by the Cold; but if there be a lesser quantity of this, or otherwise derived than to the Reins (to wit, by Sweat, or is called away by a critical Translation, to this or that part) the Consistency is made thin∣ner, and the Liquor remains clear. Also the Particles of this Matter do enlarge the Contents of the Urine, which shew themselves diversly, according as the nutricious Juice, is now some∣what cooked, and assimilated by the Blood, now altogether perverted, and carried into a pu∣trefaction, some signs of Concoction and Assimilation shew themselves in the Urines of Feaverish persons, now a laudable Hypostasis, now some Marks and Rudiments of the same. A want of Hypostasis, and the Confusion, and Perturbation of the Urine, denote the Con∣coction vitiated. But as this Matter is more or less roasted in the Blood, the Contents are now of a pale, now of a red Colour, like Oker. By reason that the recrements, confoun∣ded with the Blood, either the Spirit being strong, begin to be overcome, and separated, or the same being depressed too much, they are less able to be separated: also the Contents of the Urine are wont to be more or less, sooner or slower separated from the rest of the Liquor, and to sink down towards the bottom.

As to the Prognosticks, to be taken from the Urine, we may take notice, that the Colour of the Urine being somewhat more remiss, the Consistency mean, the Contents few, the Subsi∣ding free, or easily collected into a Cloud, portend good: on the contrary, a deep red, a thick and troubled Consistency, thick and cloudy Contents, which slowly or scarce at all sink to the bottom, denote a very great Heat, plenty of adust Matter, and its being brought under, and secretion, difficult, or frustrated.

As to the Medicinal Directions, the business depends on this, that we attend, by the frequent inspection of the Urine, the motion of Nature, and be helpful to the same; neither is it to be moved by Purge or Sweat, but when a certain Hypostasis of the Urine shews signs of Conco∣ction and Separation. I thought it needless to say any more here concerning this Matter, be∣cause those things are more largely handled elsewhere, in a proper place, which belongs to U∣rines.

CHAP. XI. Of the Kinds, and Cure of a Putrid Synochus, or Continual Feaver.

AND thus much for a Putrid Synochus in general, in which is described its formal rea∣son, according to the Accidents and Symptoms which are commonly observed in its Figure; there are besides (I shall not say Species, but) but some Varieties or Irregu∣larities of this Disease, in which this Feaver sometimes declines from this common Rule, and by reason of some accidental Distempers, gets new Names and Distinctions.

In the first place therefore, a Putrid Synochus is wont to be divided into Symptomatick, and Essential; It is called Symptomatick, which draws its beginning from some other Distemper, or Disease before excited in the Body, so that the Feaver is only a Symptom, coming upon that other Disease: of which sort is accounted, what depends upon the Squinancy, Plurisie, the In∣flammation, or Imposthume of the Lungs, or any Imposthume from a wound, or Ulcer in a prin∣cipal part, or its Neighborhood, of which we think a little otherwise, viz. That truly no pu∣trid Feaver is meerly Symptomatical; perhaps it may arise occasionally, from some other Di∣stemper; but it is founded immediatly, in the Sulphureous part of the Blood being made too hot, and as it were enkindled: for without a Procatarsis, or preceding indisposition of the Blood, the aforesaid Distempers, rarely, or not at all, cause a Putrid Feaver.

As to what respects the Squinancy, Plurisie, the Inflammation, or Imposthume of the Lungs, and the like; I say, that these are the products of the Feaver, or Distempers following it; but by no means the cause of it: for most often the evident Cause, went before, which produced the feaverish Effervescency of the Blood, as a taking of cold, evacuation being hindred, &c. then, although the sick do not openly grow presently into a Feaver, yet a greater ebullition of the Blood, than was wont, is stirred up, as may be easily conjectured from the Urine, Pulse, and inquietude of the whole Body. After some days (now sooner, now later) an Inflammation is brought forth in one part or other; the reason of which, may probable enough be said to be of this sort: The Blood, by reason of the Effluvia being retained (which are like ferment) is in∣creased in its bulk, and grows more turgid than its wont, in the Vessels; and when for want of Ventilation, it is streightned in the space of its Circulation, it easily springs forth, where it can find a passage, through the Arteries, and being extravasated from the broken Thred of Cir∣culation, it gathers together into a Tumor; and because from this kind of tumor an heat and pain are increased in the part, the Blood is more disturbed in its motion, and so the Fea∣ver, at first inkindled, is more aggravated.

Further, in these kind of Distempers, we may take notice of a certain aptitude of the Blood to be coagulated, whereby it is made less fluid, so that it is apt to be congealed in the lesser Vessels, even as it is to be perceived in Milk, when it begins to sowr, for then it will not be boiled, nor heated over the fire, without coagulation: and in like manner, there is to be suspected in the Blood, a certain disposition to growing sowr, by reason of which, it is made more obnoxi∣ous to coagulation; for it easily appears, that in a Plurisie, a Peripneumonia, the Squinancy, and the like Diseases, the Inflammation, or Extravasation of the Blood, does not always depend on the exuberancy of the Blood, and plenitude of the Vessels; for oftentimes the Blood is stop∣ped in its motion, with a weak Pulse, and a sinking down of the Vessels, and being extravasated in the side, or elsewhere, causes a most acute pain, yea being driven from one part, by and by it is fixed in another; and sometimes it begins to stagnate in the Heart it self, and there often∣times induces a deadly oppression: wherefore, some pluritical people, are wont, when the pains are gone, to complain of a great burden, and as it were weight, fixed about the Region of the Heart: And when we have opened the dead Bodies of such as have died of these kind of Diseases, we have seen the Blood to be gathered together, in little bits, or oblong gobbets, in the secret parts of the Heart, and round about the cavities of the Vessels. But for that these Diseases are wont to be handled apart from the Feaver, therefore we shall say no more of them here.

It only remains, that we enquire, whether the Feaver which accompanies these Distempers, is to be esteemed in the rank of those that are called putrid, or not? To which we reply, that most often they are simple Feavers, in which only a subtil and spirituous part of the Blood is inflamed; and therefore if the extravasated Blood may be restored to Circulation, by a plenti∣ful detraction of the Blood, or an emptying the Vessels by Sweat, presently the growing hot of the Blood is appeased, and the Feaver shortly allayed. But sometimes, when a predisposition, as in a Plethora, or fulness of good humor, or in a great Cacochymy, or fulness of evil Juices, brings it on, together with the same kind of Distempers, a putrid •…•…eaver is inkindled, wholly from the same Cause.

Among the Symptomatick Feavers, is reckoned that which is commonly called the slow Fea∣ver; they who are sick of this, are more than usually hot, especially after eating, any motion, or exercise; the Urine for the most part is red, the Spirits are feeble, and strength cast down; as to their Appetite and Rest, they are indifferently well, they have neither Cough, nor much Spitting, but they daily (like those in Consumptions) grow lean without any evident cause. The fault for the most part is ascribed to Obstructions in some Inward (as the Liver, Spleen, or Mesentery) by whose default the Aliment is not well Cooked, nor rightly dispensed. But it seems to me, that this sort of distemper is immediately founded in the evil disposition of the Blood, by which it is inclined into a too salt and sowr temper, and therefore is rendred less apt for nutrition and an equal Circulation. For the Blood in the Heart, just like Oil in a Lamp, if it redounds too much with saline Particles, is enkindled not pleasantly and equally, but with a noise, and greát evaporation of the parts; whereby indeed, it is sooner wasted, and exhibits but a languishing and weak flame. I opened one, sometime since dead of this Disease, in whom the Viscera destinated to Concoction, were well enough, but the Lungs were without moisture, and dry, and beset throughout with a sandy matter like Chalk. Also oftentimes, in this Dis∣ease, the Mesentery is beset, the Glandules being filled with such a Chalky matter: but whether the Blood being made more saltish, doth first bring in these kind of Distempers of the Viscera, or whether the Dyscrasie, or evil disposition of the Viscera, first brings it upon the Blood, is uncertain: it seems probable, that either Distemper depends upon the other, and that the causes of either evil are reciprocal.

But the Feaver, which chiefly deserves to be called Symptomatic, is that which is excited in Phthisical persons, from an Ulcer or Consumption of the Lungs. For the whole Blood, whilst it passes through the Lungs, in its Circulation, often impresses on this Inward, the Idea's of very many Diseases; and on the other side, receives the same from it, being evilly affected, whatsoever impure thing is contained in the Mass of the Blood, as the flowring of new Wine, is cast forth by extremities of the Arteries; wherefore, when Nature being made more weak, it cannot transfer its recrements into the superficies of the Body, it deposes them by a more near Purgation into the Lungs. From hence a Cacochymia, or fulness of ill Juices, and many Chro∣nical Diseases end in a Consumption: in like manner, when the flesh of the Lungs wastes, or abounding with an ulcerous Matter, becomes palf putrid, the Blood passing through it, is in∣fected with the purulent matter, or tabid infection, and for that cause, is stirred up into a con∣tinual Effervescency, by reason of the confusion of something not miscible, and wherefore it induces an assiduous Feaver, and wholly perverts the Alible Juice. The same reason is of Fea∣vers, from an Ulcer or Imposthume, oftentimes raised up in other parts; for these, even as the tabid constitution of the Lungs, cause oftentimes a Consumption and Hectick Feaver. The full consideration of these are not for this place; wherefore we will return whence we have di∣gressed, to a Putrid Feaver properly called, or essential,

The Essential putrid Synochus is wont to be divided into a putrid (such as is already descri∣bed) into a Causon, or hot burning Feaver; and besides into a Quotidian, Tertian, and Quar∣tan: The putrid Synochus, but now delineated, ought to be the rule or square of the rest, to whose Type most Feavers, which are of this kind, are to be composed. As to the rest, but now mentioned, according as they vary their kind, I shall briefly subjoin.

The Causon, or burning Feaver, is that which performs its course with a greater heat, al∣most intolerable thirst, and other Symptoms, arguing a greater inflammation of the Blood: The formal reason of it, by which it is differenced from the rest, consists in this; that the temper of the Blood is hotter, that is, abounds more with fireable Sulphur; therefore, when it grows fer∣vent, it is enkindled in a greater plenty; and with its deflagration, diffuses the Effluvia of a most intense heat, through the whole Body: its motion is acute, and quickly comes to its stand∣ing; it is co•…•…passed about with more horrid Symptoms, hath a difficult Crisis, and an even full of danger.

But as to what respects those periods or fits, in which a putrid Feaver sometimes is wont to be more cruel at a set time; and (as if intermitting) now every day, now every third or fourth day, repeats as it were the Feaverish fit; the reason of this seems not easily to be explicated; especially if we reject from this cense the fewer humors, to the spontaneous motion of which, this Distemper is commonly ascribed, concerning this matter, what seems most likely to me, I shall doubtingly propose. In a continual Feaver there are two chief things (as we have al∣ready noted) which for the most part induce the Effervescency of the Blood, to wit, the exaltation and enkindling of the Sulphureous part of the Blood; then consequently an heaping together of the adust matter, and remaining after the burning of the Blood, to a swelling up: upon the former a continuance of the Feaver, upon the other, its standing, and critical perturbations depend: To these sometimes, a certain third thing happens, to wit, a fulness, and swelling up of the crude Juice, from the Aliments newly taken, which in a continual Feaver (as in the fits of intermitting Feavers) induces a great Effervescency at set intervals of times. But why this does not always happen, nor wholly after the same manner,

the reason is this; when the putrid Synochus is very acute, and the whole Blood almost is quick∣ly inflamed, and highly rages, whatsoever of nutricious Juice is poured to the blood, is pre∣sently burnt and consumed by the fire; wherefore little or nothing of it is contained in the mass of blood, for the matter of a fit. But if this Feaver be less acute, and the blood only slames forth moderately, and in parts, the supplement of the crude Juice is not wholly consumed by the burning; but is perverted by a more gentle fire, into a fermentative matter, which, when it arises in the Vessels to a fulness of swelling up, conceives a Flux, and by its Effervescency, makes stronger the Feaverish heat, before glowing in the bloud, as it were by the coming of new Few∣el. The flowring of this matter doth not seldom begin with a light shivering, or cold, and sometimes end with sweat; but for the most part, it is exhaled by insensible transpiration. In every fit, besides the provision of the degenerate nutricious Juice, something from the adust, and burnt matter of the blood, evaporates; wherefore the •…•…risis of the Disease is drawn forth longer, that 'tis hardly cured, under eleven or fourteen days; yea (for the most part) in this sort of Feaver, with fits and remissions coming between, the perfect Cure of the Disease happens scarcely within twenty days; and sometimes leisurely, without any through Crisis, it remits, and then by a long declination, it is ended in Death, or Health.

But that this kind of remission and acerbation or growing more violent, are varied, accord∣ing to the type of an Intermitting Feaver, that they repeat their turns now every day, now every other day, and sometimes not but within four days, the reason of this is to be sought, from the Doctrine before delivered, of Intermitting Feavers; to wit, that according as the Dys∣crasie of the Blood diversly appears, the supplement of the degenerate nutritious Juice, arises to the fulness of swelling up, either sooner or later; and for that reason, its Effervescency causes now more frequent, now more rare fits in this Feaver.

Concerning the Cure of putrid Feavers, of every kind, there are four general intentions, on which the whole stress of the matter depends.

First, That the Blood (if it may be done) may be defended from burning, and the flame, or fire enkindled in its Sulphureous part, be wholly suppressed; which about the first beginning of this Disease, happens to be brought often about.

Secondly, That when the Blood having taken fire, cannot be presently extinguished, that at least it may perform its burning more mildly, and with lesser hurt.

Thirdly, The deflagration being ended, that the Liquor of the Blood be freed from the re∣crements of the adust and burnt matter, and afterwards restored to its natural Temper and Vigor.

Fourthly, That the Symptoms chiefly troubling may be timely helped, the which, unless ta∣ken away, will frustrate the work both of Nature and Medecine.

As to particular Remedies, with which these intentions may be served, there are various prescriptions, and forms of Medecines, not only among Physicians, but also among old women and Emperics, ordinarily in use; from which, however, like a Sword in a blind mans hand, used without difference, and exact method of healing, more hurt than good, most often accrues to the sick. There will be no need here to repeat the forms of Purges, Cordials, and of other Medecines, elegantly enough delivered among many Authors: I will add in few words, some chief indications, and Medical Cautions, which ought to be observed in the course of this Feaver, according to its various times, and divers symptoms.

1. At the first beginning of this Disease, the business will be, that the Feaver may be pre∣sently suppressed; and the inflammation of the heated Sulphur may be inhibited; to which, the opening of a vein doth chiefly conduce; for by this means, the Blood is eventilated, and the heated Particles, too much heaped together, and almost ready to be sired, are dissipated one from another: as when Hay, apt to burn, if exposed to the open Air, its firing is prevented. Besides, let a slender Diet be instituted, in which nothing Spirituous or Sulphureous ought to be administred: The Viscera, and first Passages should be freed from the load of excrementitious matter; wherefore Clysters are of necessary use; sometimes also Vomits and gentle Purges; by which, sometimes timely and with Judgment administred, the Feaver presently after the begin∣ning, is extinguished, the food of the fire being drawn away. If that notwithstanding this method the burning spreads more abroad, and more and more, daily snatches hold of the Sul∣phureous Particles of the Blood; it must be endeavoured (as much as may be) that the deflagra∣tion proceed gently, without great tumult.

2. When the Feaver is augmented, if the Blood be too hot, and distends the Vessels very much, with a vehement and strong Pulse; if Watchings, a Phrensie, or a pain of the Head cru∣elly urge, the letting of Blood may be again repeated; Transpiration (as much as may be) should be freely procured; wherefore let the sick keep in bed for the most part; let the Diet be fparing, of the most slender Aliments, also Drink small, and plentiful, that the burning blood may be diluted with a more plentiful Serum: Clysters are administred safe enough, and in truth commodiously; but Medecines, whether Catharticks, or Diaphoreticks, and which too much exagitate the Blood, are to be shunned, with the same industry, as Blasts of Wind to burning

Houses; but rather Opiats, and Anodines which fix and bind up the Blood and Spirits, are to be made use of; also Juleps and Decoctions, which refrigerate the burning Vi•…•…cera, attemper the Blood, and cherish the Spirits, are often to be exhibited; acetous Liquors of Vegetables, or Minerals, also putrified Nitre, because they restrain the rage of the Blood, and extinguish Thirst, are truly convenient. Hot Waters, and Spirits, Cordial, and Bezoartick Powders (so long as the Disease is not malignant) are not to be medled with. If that the Blood be unequally circulated, and is carried more towards the Head, than the Feet, Epithema's are Profitable, of the warm Flesh, or Inwards of Animals, applied to the Soles of the Feet.

3. When the Feaver is at its standing, the motion of Nature is diligently to be attended, whether it will make a Crisis or not; wherefore nothing rashly is to be attempted by the Physi∣tian; the opening a Vein, or strong Purgation, is wholly to be forbid; but after that the Feaver∣ish burning is somewhat remitted, from the deflagration of the Blood, a•…•…d signs of Concoction appear in the Urine, if that the motion of Nature be slow, a Sweat, or gentle Purge may be admittted; which however, are better and safer done by the Physician, when Nature first, by a critical motion, hath entred upon the seclusion of the Morbifick matter. If that all things are crude, and troubled, the Urine yet turbid, without sediment, or separation of parts, if the strength be languishing, the Pulse weak, if there be no Crisis going before, or only in vain, any evacuation, either by sweat or Purge, is not to be attempted, without manifest danger of Life, but it must be longer staid for, that the Spirits of the Blood may recover themselves, may by some means overcome the excrementitious and adust matter, and then by degrees may separate it, and put it forth; in the mean time, the Spirits are to be cherished, with temperate Cordials, the immoderate Effervescency of the Blood (if it still be) is to be stopped, and its due fer∣mentation sustained, which in truth is best performed by Corals, Pearls, and such kind of Pow∣ders; which indeed are dissolved by the Ferments of the Viscera, and then ferment with the Blood, and greatly restore its weak and wavering motion. In the mean time (whilst Nature is labouring) all obstacles and impediments are to be removed, and especially the provision of Excrements, heaped up in the first passages, is to be brought away, by the frequent use of Clysters.

4. By what way or method, the Symptoms chiefly urging, ought to be handled, will not be ea∣sily prescribed by certain Rules; because they themselves require sometimes to be presently ap∣peased and qtieted, and sometimes to be quickned forward: and what is something more; perhaps at another time, they are to be left wholly to Nature. Some of these are to be opposed with gentle and lenitive Remedies, but others with more sharp and irritative Physick: yet in the mean time it is a precept to be held in all, that you diligently wait upon the footsteps of Nature; which if it works wrongfully, its disorder is to be reduced; if rightly, yet too ve∣hemently, to be bridled: If she works rightly, yet too slowly, or more weakly than she should, the business will be, that her endeavour may be incited, and helped, by the help of Mede∣cine.

5. In the declination of the Feaver, when after a perfect Crisis, Nature is stronger than the Disease, the business goes well, nor is there much business left for a Physician: It only remains to propose an exact manner of Diet, that the sick may soon recover strength, without fear of relapsing: also it is requisite to exterminate the Reliques of the feaverish matter, with a light Purgation. About Diet, they often fall on the Rock of Relapsing, viz, by the too hasty eating of flesh-meats, or more strong food, the sick relapse into the Feaver; for when the Viscera are weak, and the Aliments (unless very slender) not easily digested, and when also the disposition of the Blood is weaker, that it does not assimilate the more strong nourishing Juice, if any thing improportionate is brought to either, the Regiment of Nature is again perverted, and all goes ill. Wherefore, those growing well, should for a long time refrain from flesh, and when at length they use it, it should not be unless the Urine shall be like that of healthful people, and no more troubled by the cold; and then indeed it will be safest to begin with Broths made of Flesh, and then by degrees, to proceed to more strong Aliments.

6. When from an imperfect Crisis, things are grown doubtful, and remain yet undetermined; then is the Physicians most difficult Task: The motions and strength of Nature are carefully to be waited on, whether it begins to prevail on the Disease, or to yield to it: If signs of conco∣ction appear, and that there is strength, a gentle evacuation, and only by leisure, is to be ce∣lebrated. In the mean time, the Symptoms most urging are to be succoured with convenient Remedies, all impediments to be taken away, and strength is to be sustained (as much as may be) with Cordials, and a right manner of Living or Diet.

7. When from an Evil, or no Crisis, all things turn to the worse, and when the Physician al∣most despairs of curing the Disease, he may predict its event suspected, and much to be feared. But yet, he ought not to trust to a naked Prognostication, to hinder all things else, but that as yet, what is in the Medical Art, should be consulted for health, though desperate: Remedies may be administred to the Symptoms most infesting; the Spirits of the Blood almost extinct, may be restored by Cordials. When we despond of Health, Life should be prolonged as long as tmay, and at least a fair Exit procured.

According to the various types but now described, of a Putrid Feaver, I might readily add very many Histories of sick people, and particular observations, made about their Cure; for for these kind of Examples are usually met with in our daily practice, so that they are sufficient to fill a great Volume; out of these however, with the good leave of the honest Reader, I will briefly propose some few, respecting the several kinds of the aforesaid Feaver, by which their Doctrine, and Method of healing them, above delivered, may be illustrated.

A Noble Matron, about fifty years of Age, of a slender habit of Body, litlte stature, indued with a ruddy complexion, when on the fifteenth day of June, by reason of the Summers heat, she had put on more thin Garments than she was wont, felt her self ill in the Evening; from thence she was distempered with a nauseousness, and oppression of her stomach, she felt wan∣dring pains, troubling her now in her shoulders, now in her back, very thirsty, yet without any immoderate heat: on the second, and third day, almost after the same manner, on the fourth day after a Vomit, viz. of the infusion of Crocus Metallorum, one Ounce given, she cast forth yel∣low bile four times, and had three Stools, and seemed to be eased, the night following, she slept something better: but on the next day, the Feaver being throughly inkindled, she com∣plained of thirst, a burning of the Praecordia, and of a pain, now in her side, now in her back; presently blood was taken to eight Ounces, her Urine was of a very deep red, thick, and trou∣bled without any Hypostasis, or setling of the Contents, her Pulse unequal, and often intermit∣ting, the following night without sleep: on the sixth day of the Disease, early in the Morning, a small Sweat broke forth, from whence the heat something abated, which in the Evening again grew stronger: on the seventh day, a very acute heat, with thirst, burning, an inordinate and intermitting Pulse, as also with a mighty restlesness, and tossing of the whole Body troubled her, on the eighth the symptoms were somewhat more remiss; also in the Urine, some marks of an Hypostasis: she took that day Posset-drink, with Meadow-sweet boiled in it, and sweated plentifully; and was cured of her Feaver. All the time of her sickness, for Food they gave on∣ly small Beer, Posset-drink, Barly-Broth, or Grewel, also frequently Clysters; Drink, and a cool∣ing Julep, they gave her at her pleasure.

This Noble Lady, through transpiration being hindred, fell into a putrid Synochus: the Ef∣fluvia, wont to be evaporated through the Skin, being retained within (together with the Cho∣ler flowing out of the Choleric Vessels) and fixed to the Viscera, did overthrow the dispositions of their parts, and especially gave trouble to the Stomach, and raised up pains and Convulsions in the parts filled with Muscles and Membranes: the Pulse was unequal, and intermitting, not because of the malignity of the Disease, as in the Plague, but by reason a certain proper dispo∣sition of the Heart, by which indeed, its ferment being not well constituted, the Blood growing fervent, is not presently equally enkindled, and wholly leaps forth, but a part of the Blood, in flowing in a small, then a greater, and after some turns, the greatest proportion, stopping for a moment of time, in the bosoms of the Heart, produces the unequal or intermitting Pulse. I have known in many others, clearly, the like Distemper of the Pulse; to wit, so long as they were free from intemperance, the Pulse was altogether equal and orderly, but if they were more strongly heated than usually, by any sudden passion of the mind, or too great agitation of the Body,, presently they were affected with an unequal Pulse, and between the vibrations or strikings, intermitting perhaps 4, 7, 10, or 20. and as often as they fell into a Feaver, the Pulse shewed it self after this irregular manner. When this habitual irregularity concerning the Pulse, was not yet made known to me, by frequent experience, I was wont to suspect still a ma∣lignity in the Disease, and to foretel a fatal event, which happened otherwise.

On the fifth day, in this sick person, the Feaver, although slowly enkindled, came to an aug∣mentation, and from thence pass'd through the rest of the stations with a swift motion; on the sixth light emptying of the adust matter, arising to a fulness, a Sweat being risen, and so a certain remission of the Feaverish heat followed: on the seventh day, this adust matter arising to its height of increase, made the standing of the Disease, to which, at length on the eighth day, a plentiful Sweat, with all things requisite to a good Crisis, followed, and perfectly cured the Feaver: because (as it ought to be) those three things went before this critical evacuation, viz. first a full and sufficient deflagration of the Blood, as appeared by the very strong heat, and plainly fiery, continued for three days before; also secondly, a congestion of the adust matter to a plenitude, as was collected by the high disquiet and tossing about the preceding night: and then a certain Pepasmus or Concoction of the same matter, and a begun secretion in the Blood, which a ceasing of the Symptoms and Signs of Concoction in the Urine, shewed; wherefore, the copious Sweat, coming upon so laudable a sign, so long as there was no suspition of malig∣nity, portended nothing but good.

About the beginning of the year 1656, a Gentleman endued with an active habit of Body, without any manifest cause (unless that being much addicted to study, he used no exercise after it) became ill; at first he complained of a nauseousness and want of Appetite, with a great Head-Ach, on the second day he was affected, now with a shivering, now with heat, several times reciprocating, besides, with thirst, and burning of the Praecordia, with a scurfiness of the

Tongue, and an ingrateful savour. On that day, he took ten drams of an Emetick Liquor, by which he vomited seven times and cast up a great quantity of yellow bile, and had four Stools; the night following he was unquiet, and almost wholly without sleep, and in which the sick person grew more Feaverish, with an increased heat: on the third day, when the aforesaid Symptoms were grown worse, he was let blood to ten ounces; his Urine was red, thick, and with a copious sediment; his Pulse quick, and vehement; at night he sweat a little with a short sleep, but disturbed: on the following morning, he seemed to be a little eased; yet in the even∣ing all things grew worse, with most strong wakings, heat, and thirst: on the fifth day, by a light Sweat, the heat somewhat remitted, which yet a little before the Evening, returned with its wonted fierceness. The Night again was wholly without sleep, with a continual tossing up and down of his Body. In the Morning, by a little gentle Sweating, he felt a little ease; in the Evening an increase again of all things more cruelly; the night also was very unquiet: about the beginning of the next day, a Sweat, as before succeeded, and a little more plentifully: on this day was a manifest change towards Health; the heat and thirst was a little less vehement, his Urine was less red, with some Hypostasis; thence, for three days, the Feaver leisurely de∣clined; yet every night he had a certain fit, but more remiss than before; on the eleventh day, he sweated more plentifully, and was perfectly cured: all the time of his Sickness, he used a most spare diet, taking truly nothing of Aliment, beside small Beer, and Posset-drink made of it; he sometimes took Drink and cooling Juleps of boiled Barly, and distilled wa∣ters; daily, if his Belly was not loose of it self, an emollient Clyster was administred: he used no other Physick besides, no wit, neither Purge nor Cordial. But the Feaver being allayed, he was twice Purged, and from thence quickly well.

This Feaver was a putrid Synochus, as may be conjectured by the shivering about the begin∣ning, and then with continual heat, thirst, watchings, and other Symptoms grievously infest∣ing for many days: but forasmuch as its intemperature was exasperated every night, it might be called a continued Quotidian This Disease made its first assault without any evident cause, because the Blood being little ventilated, like Wine growing hot of it self, had conceived an ardour, from the exalted Sulphur; the Choler flowing forth from the Choleduct Vessels, and likewise the Purgings of the raging Blood, being poured about inwardly (as it is wont to do for the most part in Feavers) presently stirred up troubles and disorders in the first passages; therefore by reason of the excrementitious matter there heaped up, there was procured a de∣pletion, and soon after the beginning, a Vomiting: notwithstanding which Evacuation, and likewise a more strong purging of the Belly by Stool, if administred, the Feaver being wholly inkindled, because they too much agitate the Blood, and disturb greatly the Concoction of the adust feaverish matter, for that reason bring more dammage for the most part, than benefit to the sick: The first station of this Disease, viz. until the whole Blood was fired, was ex∣tended to the third day; and then from thence, when the Blood flaming forth, was burdened with adust recrements, its greater ebullition, with a frequent endeavor of expulsion by Sweat, followed, on the seventh day, when the Blood for the greatest part had flamed forth, and the adust recrements, heaped up in its bosom to a fulness of swelling up, began to be troublesom, the critical motion was stirred up; by which nevertheless, that matter not being as yet wholly subdued, nor ready for separation, the Disease was not perfectly cured; but after another period, the same increasing, at last being stirred up, on the eleventh day, brought on that other, and perfectly curing swelling up: in the days between, because, besides the recrements remaining after the deflagration of the Blood, and received for a Crisis, also from the Nutritious Juice not presently taking fire, but after a peculiar manner depravcd, other matter in the bosom of the Blood, apt to a swelling up, was gathered together; therefore, from the continual in∣crease, and Flux of this, there hapned to this Feaver continual fits (such as are wont in inter∣mitting Feavers) on set days and hours.

A studious young man, about twenty five years of Age, of a dark Countenance, and Me∣lancholic temper, without any manifest occasion, began to be sick, in the Year 1656. At first he complained of a Feaverish Distemper with thirst, a spontaneous weariness, and want of Ap∣petite; moreover, on the second day, of a pain in his right side, and a distention of either Hy∣pochondrium, also with almost continual Vomiting, Wakings, and very great pain of the Head; a Physician being sent for, he was presently let Blood to twelve ounces. In the Even∣ing he grew more hot, and was light-headed; afterwards, a Sweat, though small succeeding, he was better the next Morning: on the fourth day again, he cast up whatever he took pre∣sently; also he was troubled with an almost continual endeavour of Vomiting. The exhibi∣bition of a Vomitory Medicine, proposed by the Physician, both the sick person, and also his Friends, taught by the danger of it before, rejected. From a Clyster given him, he had six Stools, and seemed to be a little alleviated; also the night following he slept somewhat: on the fifth day he again fell into frequent Vomiting, with intolerable Thirst; he burnt in∣wardly, but outwardly could not be felt any immoderate heat; because the recrements of the effervent Blood, which ought to exhale through the Skin, seemed to stagnate within, and to

flow forth into the Viscera. Therefore in the evening this Bolus was given him, to provoke Sweat. Of Conserves of Roses Vitriolate one Dram, of Gascon's Powder one Scruple, of Lau∣danum soluted in Balm-Water one Grain: that night he slept moderately, and by a copious sweat following, the Symptoms seemed to be mitigated: nevertheless on the sixth day, all things again were imbittered, and a through heat, thirst, and burning of the Praecordia, cruelly tormented him; on the seventh and eighth day, the Puse was unequal and disordered; for the most part he talked idly, and if moved in his Bed, he fell often into a Swoon. On the ninth day, the same Symptoms stopped, also he was troubled with a contraction of the Tendo•…•…s in his wrists, and convulsive motions of other parts, that we almost despaired of Life. Because that mor∣ning Nature seemed to be given over as conquered, she was now to be succoured, with what∣ever remained of Art: Wherefore intending a more copious Sweat, as the last Refuge, I gave him a Dram of Spirit of Harts-horn, at one time, in a small draught of Cordial Julep; upon which, being for four hours very unquiet, and furious, he could scarce be held in his Bed: but afterwards Sleep creeping upon him, he sweat very much, and the business suddenly came to be out of all danger, On the following night, for the continuing of the Sweat, I ordered to be given him, every six hours, a dose of the Powder of Contrayerva, the Feaver, and the Di∣stempers of the Nerves shortly ceased, and the sick person became well.

This Feaver, as to the manner of its Figure, may be called a putrid Synochus; which, in this sick person, from the Blood being made hot of its own accord, like Hay heating, and so conceiving an immoderate Fermentation, took its original: by reason of the Melancholick tem∣per of the Blood, the heat was less strong, although the Symptoms were otherwise worse, and happened to be chiefly inimical to the nervous stock; for the Blood burning forth, as Fire in a Furnace, covered with Chips, glowed with a most intestine burning; therefore the sick com∣plained of the heat of the Praecordia, with an intolerable thirst, when in the mean time, the exterior parts were bu little heated: for this reason, and because the Body was less perspirable, the adust recrements of the Blood being about to make a Crisis, and which were wont to be dispersed outwardly, at set times, being suffused inwardly (Nature being very much oppressed, and perpetually provoked) brought on cruel, and almost continual Vomitings; wherefore, when the Feaverish matter was derived to the first passages, by so frequent an endeavour of its expulsion, before the fulness, or concoction, no Crisis followed thereupon. Nor was the sick man the better for that irregular evacuation; yea, the Blood being still made worse in its mix∣ture, began to be corrupted in it self, and wholly to pervert the Nervous Liquor; from whence, besides the assiduous Vomitings, frequent Swoonings, inequal Pulse, also Deliriums, and Con∣vulsive Motions did arise; but forasmuch as the mixtion of either humor and disposition, being not yet wholly loosned, or overturned, the Diaphoretick was administred, which by reason of its great agility, quickly pass'd through both the Blood, and the Nervous Liquor, and a lively and hasty Fermentation being raised up anew, carried forth of doors their impurities and extraneous mixtures; the state of the [Disease tending towards Death, was reduced to Health, and by this means, instead of a Natural Crisis, by the help of a supplying Medecine, the sick man, as it were recalled from the dead, quickly recovered Health.

A Woman, being about thirty years old, of a strong Body, and Melancholick temper, (as might be gathered by her very austere manners) in the third month after her lying in, got cold in giving her Child suck, and uncovering her self, and upon it fell presently into a shivering. To this, a heat more increased than usual, followed, which afterwards (a light Sweat arising) quick∣ly remitted. On the second and third day, she was very thirsty, and without appetite to Food, yet without immoderate heat, that she could scarce believe her self in a Feaver: She lay quiet every night, but wholly without sleep; her Urine was highly red, and with the multi∣tude of Contents, thick and cloudy, which however not troubled by the Cold, remained still after the same manner, without Hypostasis, or sinking down of the parts▪ On the fourth day, the heat was inkindled throughout the whole; wherefore a Physician being then first sent for, about 12 ounces of Blood was taken from her Arm; after the letting of blood, and her Belly the same day copiously emptied, by a Clyster, in the evening she fell into a Sweat, by which neverthe∣less she was nothing •…•…ased, and (though an Anodine Medecine was given her) she wore out the whole night (as before) without sleep. On the fifth day, from a Clyster being given, she had three Stools, and felt some ease: her Urine still remained red and troubled; when Blood was prescri∣bed to be taken from her Ham, the sick obstinately refused, esteeming her self to grow well: on the following night, when she had lain long without sleep, and unquiet, she at length was troubled with a fit, such as is commonly called Hysterical, after a grievous manner; and at first, with a certain numness or sense of pricking possessing the extream parts of her body (especially her feet, thighs and legs) she was affected; and together with a Wind cruelly distending the Intestines, Ventricle and Hypochondria; she felt in the bottom of her Belly, as it were a certain bulk to creep upwards, which when it had ascended to the Heart, and thence to the Brain, the sick Woman pre∣sently was weakned in her Intellectuals, and all the night lay talking extravagantly and idly. On the sixth day, after her Belly was taken down by a Clyster, she returned to her self, and

remained in her right mind, and seemed to be indifferently well. But in the Evening when she was moved in her bed, she began to feel the same kind of fit as before, to wit, she had a sense of pricking, as if stung with Nettles, in all her body, together as it were a round thing roul∣ing about in her belly, which creeping upwards, distended the Intestines and Ventricle, that she emitted by means of it blasts, and belchings: for ease sake, she required a draught of cold Water. Moreover, the Remedies usual in hysterical Distempers, as Castor, the smell of Assa foetida, the fume of burnt Feathers, Ligatures, and Frictions of the Legs, and the like were administred, by the use of which, she seemed for the present, free from the aforesaid Distemper, and was wholly without it for four hours: but when she lay upon her back in her bed, as she had setled her self to sleep, on a sudden she complained, that the same Symptoms, did at once run through her whole Body, and by and by, she fell upon it into a Delirium; houling and crying out, she talked idely the whole night; the day following, her eyes being open, she lay without speech or motion: again in the Evening, when her Feaver being increased, she grew furious, that she could scarce be held in her bed: and so she remained for three days, now delirious, crying out, and wailing, now as it were stupid, without motion, or voice; yet still she was tormented with Convulsive motions, about the tendons of the muscles: on the tenth day, she drew her breath deep, and difficultly, with a weak, and as it were a creeping pulse, and about the middle of the night died.

This Feaver was of the rank of the Putrid Feavers, which nevertheless, by reason of the melancholic disposition of the Bloud, (as we before intimated) was not very grievous, with heat or burning; but yet being very much infestous to the Brain, and nervous stock, was more difficult to be cured: The Bloud being predisposed to a growing hot, easily contracted the Di∣stemper by taking cold, but yet, from the salt, and earthy feculencies, together with the Sul∣phur being moved, it was not openly inflamed; nevertheless, burning with an intestine, and as it were shut up fire, it was more notably depraved: Hence, presently from the beginning, the Urine was highly red, and troubled, also she continued wholly without sleep: on the fifth day, the Bloud burning forth, and being filled with the recrements, or adust matter, was irritated by its plenitude to an endeavor of excretion; wherefore, this night, a swelling up being arisen, it transferred its load, not dispersable by sweat, into the head, and there affixed it to the Brain, and nervous stock: From thence, presently, the wonted irradiation of the animal Spirits, being disturbed in the fountain it self, their inordinations first hapned to be felt in the extream parts; wherefore, there was a pricking in the whole Body, the Belly inflated, the Hypochon∣dria distended, and as it were a certain substance, or live thing, ascending upwards, and suc∣cessively running through the Belly, Precordia, and at length the Head: For these kind of Symptoms, arise not (as it is commonly believed) always from Vapors, lifted up from the Womb, and striving or thrusting upwards: but, not seldom, from the Brain, and the begin∣ning of the Nerves being distempered: for, when the evil is there infli•…•…ed, that the animal Spirits nigh their origine, are disturbed in their motion, neither (as before) blow up, and distend the nervous Bodies, presently the other Spirits, implanted in the extremities of the Nerves, being deprived of their wonted influence, begin to tumultuate, and being moved in∣ordinately, and towards their beginnings, cause Convulsions in those parts in which they dwell. This irregular, and Convulsive motion, begun in the extremities, by the continued passage of the Spirits, and of the nervous parts, creeps by and by into other parts, and then to others, still to those nearer to the Brain, till at length, (the whole series of Spirits, like Souldiers, being carried successively backwards) the Convulsions are continued, into the foun∣tain it self of motion; So as in truth, by this means, the Convulsive motions, are sometimes begun, a most long way, from the cause, or place of the Distemper, as by this only argument plainly appears: to wit, as often as the influx of the animal Spirits, is inhibited in the Leg, or Arms, by a strict Ligature, or by leaning hard on them, a sense of pricking, or a cramp, with a numness, is felt, first in the Foot or Hand, which afterwards successively ascends towards the affected part: wherefore, in this sick Woman, by reason of the Feaverish matter, (to wit, the adust recrements) fixed on the Brain, by a critical translation from the bosom of the Bloud; and there besetting the beginnings of the Nerves, those Symptoms, imitating the histerical distem∣per were stirred up: by reason of the Nerves, (which are dispersed through the whole Body, by means of the Spinal Marrow) being distempered near their original, the sense of pricking begun in the extream parts, by and by is perceived in the whole. By reason of a like hurt, of the sixth pare in the fountain, Convulsions and Distentions arise, first in its little branches, most thickly set about the Abdomen: That ascent, as it were of a certain substance, was only a tume∣faction of the Viscera, and Muscles, successively inflated or blown up, by the Convulsion; from thence, the same Distemper (by the mediation or coming between of the branch of the same sixth pare) creeping along more upward, and still more near the Brain, the Precordia, and then the Head it self, (as by a certain Vapor raised up from beneath) seemed to be taken; on the next day, when this Feaverish matter, at first lightly fixed in the Brain, was at length again amended by the Bloud, the aforesaid Symptoms ceased for a time: Then soon after (the Bloud

again flowing, and deposing its Recrements again in the Brain) the same kind of Distemper as before, this sick Woman felt to come upon her; which however, with rubbings, the smell of stinking things, and other Remedies used in the histerical passion, was retarded for four hours, from its assault; to wit, forasmuch as the animal Spirits, being tyred out by the external object, and irritated into a violent motion, were hindred, that they could not so suddenly conceive Con∣vulsive motions: but afterwards, when that incitation of the Spirits, outwardly exhibited, did cease, the morbific cause still troubling, those Spirits being grievously beset, not succcessively (as before) beginning at the extremities, but on a sudden, all, both in the Brain, and the nervous appendix, were at once acted into confusion. The Crisis being after this manner attempted, viz. By the translation of the Feaverish matter to the Brain, the event of the Disease, both in this sick Woman, and also in others, whose sicknesses I have diligently observed, for the most part hath a mortal success. For the Bloud, unless extreamly depraved, and hindred, scarce ever endeavors to purifie it self, by such a Crisis: and as often as it endeavors an excretion by this means, it inflicts on the Brain, and nervous stock, an evil, not quickly, nor easily to be blotted out: also, the mass it self of the Bloud, very rarely, by the motion of such a flowring, is rendred free, from the impure mixture of the Feaverish matter.

A learned young man, of a lean habit, and pale countenance, in the coming in of the Spring, being conscious of no error as to his dyet, began to complain of a weariness, and impotency in walking, also of a drousiness, and sleepiness of his head: on the second day also, he was tor∣mented with thirst, want of appetite, and an heat of his Precordia: on the third day, the Phy∣sician being sent for, he took a Vomit, by which, when he had Vomited three times, and cast downwards five times, cholerick and hot matter, he became somewhat chearfuller, and the night following slept indifferently well: on the fourth day, he bled a small quantity; then his thirst, and heat very much increased: his Urine was red, with a copious sediment, and a little hypostasis. But because, after the signs of concoction in the Urine, the endeavour of Nature, as it were oppressed, appeared for separation, without sufficient evacuation, therefore he was let Bloud to seven Ounces, and he seemed thereby to be very much eased, yet in the evening, all things grew worse, and then for three days, the Feaver seemed still to be increased: on the se∣venth day, he complained of a great heaviness in his head, and of a darkness, turning about in his eyes: after noon, an hemorrhage or bleeding copiously followed, that for the great loss of Bloud, the sick person had almost lost all his strength, and there was a very great necessity of medicinal help to stop the Bloud: For this end, when a Vein in his Arm was opened, Ligatures, and proper Medicines were applied, both to his Head and Belly, and very many other Remedies (the occasion of hasty curing urging) prescribed by every body, were tryed in vain; at length, by the persuasion of a Woman, coming there by chance, a red hot Iron was held to his bleeding Nose, and on a sudden, from the Vapour of the burnt Bloud, received into the Nostrils, its Flux was stayed. This Remedy, I afterwards knew used to many, with very good success. This great Hemorrhage cured the continual Feaver, to which nevertheless, an in∣termitting Quotidian followed, which afterward was quickly cured, by the method of curing already delivered.

This Feaver, beginning without any manifest occasion, and continued for many days with thirst, and heat, may be called a Putrid Synochus; which yet without any horrid Symptom, about the beginning or standing, was cured by an easie course, tho' at length by a dangerous and difficult Crisis: The turgescency of the Bloud in the Spring-time, and together the defect of ven∣tilation in the same, gave the beginning to this: The Bloud burning out, with a Feaverish fire, about the fourth day, had heaped up something of adust matter; that flowring it attempted a critical motion, tho' with a small hemorrhage: The defect of a more full evacuation, the opening of the Vein supplied for a time, afterwards, the adust Recrements being heaped together, in great plenty, the same being not apt to be dissipated by sweat, in a body not rightly perspirable, at the time nature was about to endeavour a Crisis, a mighty bleeding followed. For when the Bloud, by reason of the seclusion of the Feaverish matter, is agitated with a critical motion, very many of its Particles are loosned from the mixture, so that a greater swelling up being provoked, they carry forth every extraneous thing confused with them: if at this time, the breathing places of the skin, be but little open, the mass of the Bloud (as new Wine stopped up in a bottle of a small mouth) even more notably grows turgid, and because it cannot shake off the Feaverish mat∣ter, by sweat, it carries it self forth of dores, together with it, any way it can find; wherefore, when there lies a most easie passage, for the boiling Bloud, through the vessels opening into aper∣tures of the Nostrils, from that Port (like the same new Wine when the vessel is opened) being inlarged by a spumous refraction, it abundantly leaps forth. The continual Feaver being cured, by this means, an intermitting Quotidian followed, because after a long deflagration of the Bloud, and great loss of it, what Bloud was remaining, being very much deprived of Spirit, and the Salt, with the left Sulphur being throughly roasted, easily contracted that kind of disposition, whereby it was apt, not rightly to concoct the alible juice, but to pervert it into a matter very fermen∣tative.

A Matron, about sixty years of age, when she had sat up a certain night, going to bed in sheets, not throughly dry, began to be ill; at first she was troubled with a suffocating Catarrh, that by reason of the serous deluge, falling on the Sarynx, she could hardly breath; neither could she sleep; the next day with a nauseousness, and want of Appetite, with some little ex∣cess of thirst and heat: on the third day, an acute pain invaded her in her side, with a Cough, and the Feaver increased: her Urine was red, and clear, with a laudable Hypostasis, an unequal, and an intermitting pulse. A Physician being sent for, she was let Bloud to ten ounces, also that day, her belly was copiously loosned by a Clyster: About night the pain vanished, and she slept indifferently: her Urine was then red, troubled, and full of contents: on the fourth day, the Feaver was somewhat increased: In the evening troubled with a Cough very much, and by and by following thereupon the acute pain (as before) in the same side; her Urine being again clear, with an Hypostasis: Her pain, from her being let Bloud again ceased; on the fifth day, the Feaver was more remiss, but at night she was unquiet with heat, and a tossing up and down of her body, but without pain. The next morning she sweated plentifully, and was eased; then using still a slender dyet for some days, and being once purged, she grew well without relapsing. It is worth observation, that whilst the pain troubled her, the Urine was clear, and with an Hy∣postasis, nor troubled by the cold; which however, the same being allayed, became presently thick, more red, and filled with contents.

This Disease, because of the acute pain in the fide, as it were a Pathognomic sign, might be called a Plurisie: but we have here a Feaver, preceding the pain, and not the product of it; The evident cause of the sickness was Transpiration being hindred by the constriction of the pores; The Bloud growing hot, by reason of the Effluvia being retained, and also too much abounding with a serous latex, as it were vomiting very much of it, from the Arteries termina∣ting in the Larynx, caused the sense of the suffocating Catarrh: For this kind of Distemper (as also the Cough with great spitting) arises not, for that the watery humor (as is commonly said) falls from the head, into the throat, and lungs; but because the serous Latex is poured forth, now from the pneumonic vessels, immediately into the lungs, now dropping forth from the Arteries opening into the Larynx, falls down on the breast; on the third day, from the same serous humour, with a portion of the Bloud, being fixed in the side, the acute pain arose; for the Bloud beginning to grow fervent, when as yet it did contain in it self a crude matter, and (as it should seem) something sour, from the degenerate alible juice, deposed the same, (because it could not cast it forth of doors by sweat) by a proper lustration or purging through the intercostal Arteries, into the Membrane surrounding the Ribs; and there (as it is always wont in a Plurisie) either by coagulation, (which may be lawfully suspected) or by the shutting up of the vessels, the Bloud being intangled with the same matter, is stopped in its motion; then being increased in its bulk, by a new coming still of the Bloud, it causes a break of the union, and so an acute pain. That in this sick Woman, the same kind of matter, disturbing the mass of Bloud, with a portion of it extravasated, was fixed about the Pleura, it from thence hapned, because the pain urging, the Urine was clear, and not full of contents: then when the vessels, by reason of Phlebotomy, being emptied, they supped up again that matter, into its mass, before exterminated from the Bloud, the Urine presently became troubled, and again big with contents: The pulse was unequal, and intermitting, because of the idiocrasie or proper disposition, which she was wont to have in every intemperature: for when I cured this Woman of a Feaver, many years before, her pulse being unequal, and intermitting, had struck a fear in me, and others, of a sad presage, concerning the event of the Disease, which however at that time, (as also in this sickness) ceased, prosperously, and without any horrid Symptom.

A strong young man, and corpulent, after immoderate Exercise, about the Summer solstice, and then a sudden cold coming upon the heat, found himself ill: At first, a want of Appetite, nauseousness, and cruel pain of the head, as also thirst, and a more intense heat than usual trou∣bled him; on the second day, an acute pain invaded him on his right side with a Cough, and difficult breathing; Bloud being presently taken plentifully from the Arm of the same side, that pain remitted somewhat, which yet in the evening returned, being made more cruel by a Cough, and bloudy Spittle. The night followed, without sleep, and very unquiet: on the third day, he was again let bloud, besides Liniments and Fomentations were applied to his side; Moreover, Pouders, Juleps, and anti-pleuretick Decoctions, being taken inwardly, about night the pain almost wholly ceased. Then by and by, he was afflicted with a cruel Head-ach, and a Vertigo: on the fourth day, a stream of Bloud fell from his right nostril, about two ounces, by which the pain of his Head clearly ceased, and the Vertigo; but in the Evening, the pain in the side before distempered, returned with greater fierceness: In the mean time his Pulse was small, and weak, that when it was consulted upon, for the letting him bloud again, 'twas thought dangerous, lest his dejected strength would not admit of such Remedy: wherefore, Phlebotomy was performed only, in a very small quantity, and a Fomentation, and a Cataplasm was prescribed to be dili∣gently applied to his side; besides twenty drops of the Spirit of Harts-horn, to be taken in a

spoonful of Cordial Julep, and the same to be repeated continually, within the space of six hours: He sweat that night very much, and the pain much remitted, his spitting was but little, interspersed with Bloud, which, within a day wholly ceased, and the pain also leisurely vanished. The sick man took twice a day, a scruple of the same Spirit of Harts-horn, and within a few days, he grew perfectly well, without relapsing.

This Feaver was a simple Synochus, stirr'd up from the evident cause, viz. a Constriction of the Pores: as soon as the Bloud began to be somewhat filled with the adust Recrements, and so to swell up more, the matter, which should have been separated, by reason of its peculiar evil, was tranferred into the Pleura, and being there fixed, compelled the Bloud coming to it, to be coagulated, and therefore to be stopped in its circulation, and (when it could not be received by the Veins) presently to be extravasated: from hence hapned the acute pain in the side, and bloudy Spittle, by and by, after the beginning of this Disease; then afterwards, the same mat∣ter being thrust out of that nest, which it had got, and being supped up again into the mass of Bloud, was fixed in the head; and there inducing the like stagnation of the Bloud, and (as it is probable) coagulation, caused the Vertigo, and cruel pain; which nevertheless was quickly cured, by the hemorrhage being arisen, by reason of the extravasated Bloud. A part of the morbifick matter, being after this manner drawn away, the other part resumed by the Bloud, was again conveyed to its usual nest, to wit, the side before distempered; where depositing its Latex, (to wit, a portion of the Bloud) it did coagulate it again, and compelled it to be ex∣travasated, or to flow out of the Vessels: For that pain being renewed on the fourth day, with the bloudy Spittle, from the ebullition of the Bloud, too extreamly, and therefore flowing out of the Vessels, would not be brought away; because at that time, the Pulse was small and weak, with a falling down of the Vessels, that indeed the Bloud was thought to have been run all out of the Vessels, for that being coagulated by the morbific matter, (and therefore tho' ex∣pulsed the Arteries, yet not being able to be carried back by the Veins) it was stopped in its cir∣culation. Upon this, an acute pain followed, because the Bloud being heaped together by its frequent approach, and elevated into a Tumor, made a dissolution of the union; also, by and by from the beginning, a bloudy Spittle came upon it, because the Bloud being restrained within, in the Body, somewhere in its motion, by reason of the most tender, and easily opening little mouths of the Vessels, ran forth into the Cavities; when to the same outwardly extrava∣sated, by reason of a more thick skin, and the mouths of the little Vessels being locked up, no way lay open, unless by its being made and ripened into an Imposthume. The opening of a Vein profited in the beginning of the Pleurisie, because it restrained the Bloud, somewhere hin∣dred in its circuit, from too great effervescency; but especially, for that, when the Vessels were by that means greatly emptied, they did again receive, and render fluent, whatsoever humors were before exterminated, and also the Bloud beginning to stagnate in the distempered part. Also, the Remedies helping most, about the beginning of this Disease, were of that sort, which hinder the coagulation of the Bloud, or dissolve it in the coagulating; such they are, which abound very much with a volatile, or an alchalisate Salt: to wit, Spirit of Soot, of Bloud, Harts-horn, also Spirit and Salt of Urine, the Pouder of the Claws and Eyes of Crabs, of a Boars Tooth, or the Jaw of a Pike, are of known use. Among the Common People, it is a custom to drink an Infusion of Horse-Dung; which Medicine indeed, I have known often to have brought help, in deplorable cases. In the mean time, all acid things whatsoever, because they more coagulate the Bloud, and hinder expectoration, are highly hurtful in this Disease.

CHAP. XII. Of a Malignant or Pestilential Feaver in general.

BEsides the continual Feaver, which is already described, and which arises from some prin∣ciple of the Blood being too much carried forth, there is another species of this, which is stirred up, by reason of the Bloud being touched with some invenomed Infection, and therefore liable to enter into various coagulations, and corruptions: In which, not only the Spi∣rit and the Sulphur, as in a Putrid Feaver, rage, and compel the Bloud to grow immoderately hot, but besides, the mixture of the Bloud is presently dissolved, and its liquor goes into parts; and so most horrid Symptoms, with manifest danger of life, are induced in this sort of distemper. Under this rank, we comprehend Malignant, and Pestilential Feavers, the Plague, Small Pox, and Measles: of which we shall speak presently.

Pestilential Diseases, wander so in the dark, and have an unknown original, that their causes, and beings are seldom explicated, without having a recourse to occult qualities. By the unani∣mous consent of all, the strength, and power of these are placed in an invenomed matter; because we perceive, from a pestilent distemper, strength suddenly to be overthrown, and life quickly destroyed, no otherwise than from the drinking of Poyson. And therefore, for the explicating the nature of the pestilence, it will not be besides the matter, first, to enquire concerning Poyson in general, and by what means it distempers our Bodies, then to shew what sort of Poyson is sprinkled in the Plague, and contagious Diseases: which being performed, we will treat particu∣larly of the Diseases but now recited.

Every thing deserves the name of Poyson, which striking into our Body, after an occult man∣ner vehemently hurts the temper, and actions of any part, or of the whole, profligates the Spirits, or perverts their motions, solves the mixtures of the Liquors, and induces Coagulations and Corruptions, destroys the functions and ferments of the Viscera, and so suddenly and hid∣denly brings life into danger. Of these, which after this manner lie in wait for us, there is a mighty plenty, and very rich provision in the nature of things: oftentimes they are inwardly be∣gotten within our body; outwardly they are abundantly supplied from every Coast, and out of every tract of Earth, Water and Air, these daily arise out of the distinct families of Minerals, Vegetables, and Animals, and so mingle themselves with our Food, yea, with our Medicine, that we may complain with Pliny, Quod non sit fateri, an rerum natura largius mala, an remedia genuerit. That it was not known, whether Nature had begot greater Evils, or Remedies.

As there is great varieties of Poysons, so, as to their Subjects, and ways of hurting, there is no less diversity of them: for the most Poysons, in their whole substance are said to be contrary to us, that whatsoever they come to, with a burning force, and like fierce fire, they reduce into ashes, yet out of these, some being noted for a peculiar raising of hurt, do more endammage one one part or substance than another. The Subjects, on which the taint of Poyson, is next and more immediately inflicted, are twofold; to wit, the animal Spirits, or the spirituous subtil Li∣quor flowing in the Brain, and nervous stock; and the Bloud flowing in the Vessels, and Heart, when the object is carried only to one, or being improportionate, at one to either, that from thence, the disposition of the Liquors, or of the containing parts, is overthrown, whereby the necessary functions, for the performing of life and sense, are restrained, and this done latently, and as it were unforeseen, these kind of Distempers, we ascribe to Poyson.

The nervous Bodies, with the animal Spirit, are not invaded wholly after the same manner, by every sort of Poysons; for they are tormented, now with a Stupor, now with Convulsions, and those of divers kinds and manners: The Bile of a Tarantula, causes dancing: A Power sent from the Torpedo, by the Angle, or lines of the Net, stupifies the hand of the Fisher. The Roots of the Wild Parsnip, or the Seeds of Lolium or Darnel, being eaten, make men mad: Opium, Mandrakes, Henbane, and the like, cause deep, and sometimes deadly sleep. These and many others, chiefly impre•…•…s their Poyson, on the spirituous or animal faculty, without any great per∣turbation of the Bloud, or hurt brought to the heart.

There are also some Poysons, which most of all insinuate their malignity, to the mass of Bloud; wherefore, from some Medicines, there have been produced, a yellow or black Jaundice, sometimes a Leprosie, or leprous distempers, and swellings of the whole body, vapours breaking forth from secret hollows of the Earth, also from Coals newly inkindled, often suffocating the vital Spirits, at once congeal the Bloud, and stop it in its motion, whereby the flame of life in the heart, could not be continued. How much corruption of the mass of Bloud is imparted from the pestilent Infection, is perspicuous to every one, from the Spots and Whelks, which are as it were the marks of the blasted Bloud.

If the hurt, being first inflicted to either, viz. The regiment of the Heart, or Brain, be more lightly made, it is for the most part cured, without any great offence to either; wherefore, Convulsive Motions, Stupefaction, Lethargy, Melancholy, Paralytick Distempers, do not sel∣dom begin with a laudable Pulse, and without an immoderate effervescency of the Bloud; and then, if the distemper does not get strength, leisurely end, and cease. There are other Poysons, which often deprave the Bloud, and by dissolving its mixture, corrupt it, in the mean time the animal functions remain whole enough. But if the ferment of the Poyson be stronger, and hath more deeply fixed its roots, presently the Poyson is dispersed, from one Province to the other: for when the nervous parts swell up, with a virulent juice, a portion of the Poyson, is carried with the nervous Latex returning through the Lymphatick Vessels, into the Veins, easily into the bosom of the Bloud, and infects its mass, with the evil with which it was big: also, from the Bloud being grievously impoysoned, the juice, by which the Nerves are watered, quickly con∣tract the infection; hence mad men are in a Feaver, and those taken with a pestilent Feaver, are most often tormented with a Delirium, or Phrensie. Concerning these things, we must consider, what the alteration is, or the impression of hurt, which is inflicted from the Poyson, to the animal Spirit, with the brain and nervous appendix; and what also, to the Bloud, with the Heart and the annexed Vessels: tho' here, it is not in the power of humane skill or wit, plainly to shew, or

as it were point out with the finger the manner of its being done; yet we may be able to attain to some little knowledge of this thing, by reasoning, and by comparing it, with other di∣stempers.

Concerning the former, we shall observe, that the subtil Liquor, or animal Spirits, where∣with the Nervous Bodies are blown up, and by whose expansion, sense and motion perform their reciprocal actions, are easily perverted from their tensity, and equal expansion: for as the Nerves are of a soft texture, and the Spirits which abound in them of a very subtil substance, they can∣not endure any strong or vehement objects; wherefore when any violent or improportionate thing falls on them, they are often compelled from their expansion, and excursion into sl•…•…ght, and a running backward, and not seldom into irregularities of motions: wherefore sudden passions of the mind distract them, and drive them into Spasms, and Convulsions; when the Alible Juice, by which they are repaired, is supplied too sharp, four or austere, they suffer now Palsies, and now Contractures: If that some object more incongruous, (such as we have affirmed Poyson to be) should be offered, whose Particles are indued with such fierceness, or are of such a kind of con∣figuration, that when they grow impetuously hot with the Nervous Liquor, they shake or lose here and there its more subtil or spirituous part, or wholly drive it away, and fix the remaining Liquor either with a styptic force, or by ebullition, force it into inordinate motions; hence of necessity, evil distempers of the Brain, and Nervous parts arise, viz. sometimes a Convulsion, Trembling, Shivering, sometimes loosnings, or a stupefaction, and other symptoms of more grievous note. What things after this manner infect the Nervous Juice with Poyson, are now more thick, and only when they are applied in a very Corporeal substance, do inflict their hurt; now they are thin, and being resolved, even into a vapour or breath, pour forth from a certain little prick, the ferment of Poyson, through the whole Nervous stock. Sometimes the Poyson of some hurtful thing, being eaten, first begins its Tragedy in the Ventricle; more often by a naked touch, leaves on the superficies of the Body, a virulent taint, which easily and quickly with its ferment, contaminates the Spirits, dispersed through the whole. The •…•…nfection, whereever in∣flicted, either within or without, is more largely dispersed from the extremities of the Nerves, by their easie passage, being from thence brought into consent of the evil, by the very many little shoots of the same branch. Often a more light touch of an invenomed thing, by the finger, or extremity of any other member, presently communicates to the Brain, the received infection, and from thence it is retorted into the whole Body, and the farthest members; the reason of this is, that both the Particles of the Nervous Juice, and of the same invenomed infection, are so light, and ready for motion, that they pass through most swiftly, as the Rays of light through a Diaphanous medium, the whole mass of one another.

2. As often as the Bloud contracts hurt from some Poysonous thing, the Poyson is fixed within; either slow, and of lesser activity, which does not presently betray it self, nor break forth into cruel symptoms, till of a long time after, it is ripened by a silent fermentation, and hath first infected the whole mass of Bloud, as may be observed in some Poysons, which are said to kill at a distance, and not till after some months or years. Or the Poysons inspired into the Bloud, are imbued with a much more acute sting, that from their Contagion, the Infection con∣tracted, presently breaks forth into cruel symptoms, and thereupon follows now a Feaverish effer∣vency with Vomiting, Thirst, and burning of the Precordia, now a swelling up of the whole Body, a discoloration of the Skin, oftentimes a breaking forth of Whelks, and Bu∣boes, and frequently also a sudden loss of all strength, so that sudden death, without tumult, and almost insensibly steals upon one: where by the way it is to be noted, If the Spirits of the Bloud, provoked by the enemy, are able to encounter him, and to •…•…trive for the victory, this Feaverish ebullition of the Bloud is stirred up from the conflict; but if the Particles of the Poyson, being far stronger, suddenly profligate the Spirits of the Bloud, and extinguish life, presently the bloudy mass is corrupted, neither can it be circulated in the Vessels, nor rightly inkindled in the heart.

If it be yet demanded, what mutations, the Bloud infected with Poyson, undergoes, either in its substance, or consistency, that, for that reason it is rendred unfit for the sustaining of Life? I answer after this manner; Some Poysons fuse the Bloud, and too much precipitate its serosity, such are Medicines, which by a strong killing Purging, or by a Profluvium of Urin, or a discoloration, or swelling up of the whole Body, or with an eruption of Pustules, cause a very great secretion of the serous Latex; in the mean time a great ebullition of the mass of Bloud is induced, whereby the Vital Spirits are greatly destroyed, the Particles of Salt and Sulphur too much exalted, by the con∣coction, and are often so roasted, that a Yellow or Black Jaundice is caused.

There are Poysons of another kind, far more dangerous, which congeal the Bloud, and by destroying its mixture, corrupt it, viz. the first induce a congelation to the bloudy mass, and then a Putrefaction: for when the Spirits of the Bloud, being overthrown, by the conta∣gion of the Poyson, are dissipated, the equal mixture of the Liquor is loosned; wherefore the more thick Particles mutually infold one another, and (like Milk, when Rennet is put to it, or growing sowr of it self) are coagulated apart: hence the Bloud curdles in the Vessels, that it is

less readily circulated in them: coagulated portions of this, being inwardly diluted, into the bosom of the heart, are apt to stagnate there, and so to bring forth frequent syncopes and swoun∣ings: being carried outwardly, and in the circulating, fixed in the skin, sometimes being more plentifully heaped together, they induce a suffusion of blackness through the whole, sometimes being more sparingly dispersed, they cause only spots, or Purple marks, like black and blue stroaks, and other appearances of malignity. But the coagulation of the Bloud, quickly disposes it to putre∣faction or corruption; as is seen in extravasated Bloud, which is wont to grow soon black and putrid. For the Spirit being exhaled, the Particles of Sulphur and Salt remaining in the Bloud, begin to go apart one from another, and to break the bond of the mixture, from whence follows Putrefaction.

These things being thus premised of Poyson in general, the reason of the method requires that we enter upon the handling of Feavers, which draw their Original, altogether from a malignant, and invenomed infection: and as under this title, the Pest or Plague easily obtains the chief place, I will begin with its consideration, and afterwards, I will speak of Malig∣nant Feavers, Small Pox, and Measles, in order. But yet, before I shall propose its defini∣tion, I will briefly inquire, of the pestiferous Poyson, what its Disposition and Nature may be; also, from whence it may be born; and lastly, by what means it is propagated into others, by con∣tagion.

For the expressing the Nature of the Plague, Authors are wont to chuse some invenomed Bodies, and from their Names, to frame an Elogy of this most wicked Disease; wherefore in the definition of the Pest, are commonly recounted the Nepelline, Aconital, and Arsenical Poyson: the Lethiferous force of which however, as it consists in a very thick matter, and does not exert or put forth it self but by a Corporal contact, doth not truly imitate the essence of the Pestilential Disease: for this is founded in a Spiritual and Vaporous Infection, by which its Effluvia being every way diffused, so potently unfold themselves, that out of the best se∣minary or seed-plot, they quickly propagate a fruitful Crop of Death and Destruction. By reason of its notable activity, this Infection may deserve to be called, as it were a certain quin∣tessence of Poyson; the very agil and subtil Particles of this, do penetrate all Bodies, and in∣spire them with its ferment: for either being dispersed through the Air, or hid in a certain ten∣der or cherishing nest, tho' they strike against the humane Body but lightly, and as it were through a Casement, they easily subdue it; for both the Animal Spirits, and those of the Bloud, they quickly infect, and by that means, shortly pour forth the venomous taint, into all the mem∣bers.

When a Pestilential Breath or Vapour, hath invaded any one, and that Poyson hath first laid hold on the Animal Spirits, or those of the Bloud, or both of them at once, (as hath been already said of Poysons) the taint is quickly derived from the subtil and more thin substance of these, into a more thick matter: because it quickly ferments the whole Mass of Bloud, or of the Nervous Juice, and the Excrementitious Humors, every where abounding, and from thence is deduced into the solid parts, and fixes the evil in them. If this Disease, first possesses the Ani∣mal Spirits, presently the hurt is communicated to the Brain, and the Nervous stock, and espe∣cially to the Ventricle, forthwith it impoysons the humour growing in these; loosens its mix∣ture, perverts the regular motion, and renders it wholly incongruous and infestous to the more tender substance of the containing parts: by and by from thence, Cramps and Convulsive Mo∣tions, cruel Vomitings, pains of the Heart, also Phrensies, Deliriums, or pertinacious Watch∣ings, are stirred up, about the first assault of the Disease: when in the mean time, the infection not being yet dispersed through the Bloud, the sick are not Feaverish, nor are troubled with in∣ordinate Pulse, or Syncope, or appearances of marks; which symptoms however arise after∣wars, as soon as the Bloud is infected. If when the Spirits of the Bloud are first possessed, with the impoysoned infection, either drawn in with the Air, or attracted through the Pores, its ferment is presently dissipated through the whole Mass of the Bloud, the infested portions im∣mediately begin to be loosned from their equal mixture, to go into parts, and to be coagulated, and the same, being delated, into the bosom of the Heart, are wont there to stagnate, and so to induce a Syncope, Swoonings, and often sudden Death; also being carried outwardly, fixed about the skin, to cause Buboes, inflamed risings, and other marks of Poyson; in the mean time, the sick appear well in mind, nor are they troubled with Delirium nor Convulsive Motions. If that from a more strong cause, the hurt is inflicted to both parts at once, the course of the Disease is performed with a more horrid provision of symptoms, and especially with a Syncope, and Phren∣fie at once infesting.

As to what appertains to its rise; when the Plague first arises in any Region or Country, there is attributed a two-fold cause of it, viz. Primary or Metaphysical, also Secondary or Na∣tural, subordinate to that: The very Heathens did acknowledge this Disease, wherever it raged, sent first of all from God, for the castigation of the wickednesses of men, and therefore for its extirpation, they equally made use of Prayers and Sacrifices as of Medicines. As to what belongs to the Natural cause, there are divers opinions. Some will, that the Pestilence newly arisen, be

derived from the Heavens, and influences of the Stars only: on the contrary, others have af∣firmed it only to arise from the internal putrefaction of the humors of our Body: but these en∣deavour to deduce the cause of this sickness too far off, and these more near than it ought. We will walk in the middle way, and what reason persuades, and what very many Authors assert, we will place the chief and first seminary or seed plot of this Poyson, in the Air; because; it seems consonant to Reason, that from the same Fountain, from which the common food of life is had, the beginnings of death, no less diffusive, are to be sought. There is the same necessity for our breathing in the Air, as of Fishes living in the Water; wherefore, as to Waters infected by Poyson, the Murrain of Fishes dying in heaps is ascribed; so Men dying of an Epidemical slaughter, without any manifest cause, nothing could kill, besides the Infection of the commonly inspired Air.

For the Air, which we necessarily draw in for the continuance of Life, consists of an heap of Vapors and Fumes, which are perpetually breathed forth from the Earth; in which the exha∣lations of Salt and Sulphur, being mingled with the atomical vaporous little Bodies, constitute here as it were a thick cloud: the motions of these are swift and unquiet, they are of a mani∣fold figure, and very much diverse, wherefore some continually meet against others, and ac∣cording to their various Configurations, they cohere with these, and are mutually combined one with another, and from those they are driven, and fly away: from hence the reasons of the Sympathy and Antipathy of every thing, depend. From the diverse Agitations of these kind of Atoms, near the Superficies of the Earth, this or that Tract of the Air, enters into diverse alterations, by which, Bodies, chiefly the living, are variously affected: because the intestine motion, of the Particles of every Animal, depends very much upon the motion and temper of the Particles of the Air: forasmuch as these perpetually exagitate those, raise up those lying asleep, repair the loss of those flying away, shake the vital flame with their Nitro∣sity, and supply it with a Nitrous-Sulphureous Food, eventilate its being inkindled by conti∣nual turns of access and recess, and carry away the Soot and Fumes. So long as an apt con∣temperation happens in either, for motion and configuration, living Creatures injoy perfect health and life; but if the little Bodies swimming in the Air, be of that sort of figure and power, that are plainly adverse to the Spirits implanted in living Creatures, they loose the mixtures of these, from the rest, from whose Elements they are collected, and pervert their motions; hence the dispositions of things are destroyed, life profligated, and, the same being scarce extinct, the Bodies undergo putrefaction; hence the tops of Trees, or of Corn, being struck with a blast, suddenly grow dry or wither; hence, among Cattel, the Murrain often rages, which kills at once whole Flocks; by reason of this kind of cause, the Seeds of the Pestilence first put themselves forth, and attempt the slaughter of humane kind: for as inve∣nomed Bodies in the bowels of the Earth or concreted on its superficies, produce the Arsenical or Aconital mixtures, so these being even resolved into vapour, and heaped together in the Air, create most pernitious Airs, from which Malignant and Pestilential Diseases arise; the infection, which after this manner Contaminates the Air, the most ingenious Diemerbrochius, a searcher of this Disease, contends, that is only sent (as the wrath of angry Apollo) imme∣diately from the angry right hand of God: but this were to multiply without any pretext of necessity (I will not say beings but) Miracles, and in every Plague to assert a Creation of new substance; when in the mean time, the virulent product of Minerals and Vegetables, which daily appear, and of as quite adverse Nature to us, as the Plague, clearly testifie, that there lives hid in the Bowels of the Earth, plenty of invenomed matter, sufficiently fitted for this business. For the little Bodies, which being rouled about with earthy matter, do constitute the Poysonous mixtures in the bosom of the Earth, the same being resolved into vapours, will be no less hurtful afterwards, and impress a pestiferous blast to the Air, which they wander through: wherefore, by the leave of so Learned a Man, I should say, that it seems not impro∣bable, that the things which first of all affix the seed plot of the Pestilence, to any tract of Air, be the Poysonous Effluvia of fierce Salts and Sulphurs, and (by the Divine Will instigating) breath∣ing forth from the bowels of the Earth; which sometimes, being a long time before shut up, are leisurely exhaled out of Dens and Caverns; sometimes by reason of the motion of the Earth, or Earthquake, or a gaping of the Earth, they break forth in heaps; also, of the same kind, are those which ordinarily are breathed forth from the filth of Souldiers in their nasty Camps; or from unburied Carcases; or from places, beset with standing and stinking Mud: but the little Bodies after this manner exhaled, obtain their wonderful height, properties, and abilities, by a long putrefaction, that therefore they are incongruous, and heterogeneous to all others whatso∣ever, and so being received into the Air, ferment it (as it were a mass of Liquor) and pervert it from a wholsom and benign, into a most pernicious and wicked Nature.

Some Bodies more easily, others not so readily receive the malignant tincture of the Pestilent Air. Those who by reason of ill feeding are full of evil humors, and who by reason of ful∣ness, have their Bloud stuffed with firable Sulphur, receive the Pestilential Poyson, by the least blast of the invenomed Air, especially if fear or sadness happen, which convey inwardly,

and lead to the Heart, as it were by a certain attraction, the most light darts of the Contagi∣on. On the contrary, those who have their Viscera clean, and the Mass of Blood well tempered, and are endued with a strong and fearless mind, do not so easily receive this infection, and sometimes exterminate itsoon, being received.

Thus much for the beginning and divulgation of the Pestilence, according to its first Fo•…•…n∣tains, and from thence the stream of the infected Air being deduced; it remains for us to speak concerning its propagation by contagion, forasmuch a•…•… it is derived, as it were extraduced from some, and so to others.

We understand by Contagion, that force or action, by which any Distemper residing in one Body, excites its like in another. But as this may happen, either immediately by contact, as when any one lying in the same Bed with another, taken with the Plague; or mediately, and at a distance, as when it happens that the infection is is trans-ferred from one house to others re∣mote, or also if the Plague come upon any one, after many days or months, perhaps years, handling a Garment, or Houshold-stuff, brought from an infected House; therefore that the Nature of the Contagion, and its diverse modes may be plainly made known, we will first weigh what that is, which streams from an infected Body. Secondly, How it bears it self through the Medium of its passage. Thirdly, by what means it begets a Distemper like it self, in another Body.

1. That from every Body, although of a more fixt Nature, Effluvia of Atoms constantly fly away, and run forth, which round about constitute as it were a Cloud or Halos, and as it were cloath it, like the down of a Peach, is so much received among the more sound Philosophers, that nothing can be more. But by how much the more any thing consists of active Particles, by so much the more it sends from it self little Bodies of more remarkable virtue and Energy. Hence the Effluvia which fall from Ambers, are able to move other Bodies from their place: Emanati∣ons proceed from Sulphureous things, which fill the whole Neighbourhood with Odors. And so when the Pestilential Venom, as hath been already said, is from hence any where fixed, and though in the smallest Bulk, is of great efficacy and operation, there is a necessity that some ema∣nations proceed from the Body imbued with it, which refer the Nature or disposition of the same Poyson and Malignity, and diffuse them on every side according to its sphear of activity. But when these little Bodies, which retain the contagion of the Pestilence, as they stream from one Body, are not presently received by another, we shall enquire how they carry themselves, in respect of their passage through the Medium.

Where we shall presently meet with a difference in those, from many others, for that the Ef∣fl•…•…via, which ordinarily evaporate, do not long retain the Nature or Disposition of the Body, from which they flow, but either vanish into Air, or being impacted to other Bodies, are assimi∣lated to them; but those Particles, which fall from a Pestilential Infection, are not easily sup∣ped up by the Air, or any other Body, so as they may be wholly destroyed; but among the va∣rious confusions of Atoms, and the dashings of other Bodies, they keep themselves untouched. For this untamed Poyson remains still the same almost, and not to be overcome by others, and though it consists of never so little heap of Atoms, will not presently vanish; but with its Fer∣ment, imbues the next little Bodies, and so acquires new forces, and gains strength by going; from whence it lurks a long while in some Nest, and after a long time, when it assaults a conve∣nient Subject, puts forth it self, and imparting the taint of its Poyson to another, raises up again the Disease of the Pestilence anew, which seemed before to be exploded, and though from the smallest Seminary, sprinkles far and near its deadly poyson.

For the Pest brings forth such most sure signs of its Contagion, that some Authors contend, that for this reason it only continues among Mortals, and doth never spring up anew, but is only conserved from its Nest, and carried from thence, from one Region to another. Histories relate, that the Seeds of this have lain asleep for several years, in some Garment or Bed-cloaths, and that afterwards, they being stirred, it hath appeared, and hath stirred up anew the Disease of the Pestilence, increasing with a mighty slaughter of men. When by rea∣son of the Tinder, or cherishing Nest, the Plague is propagated after this manner, at a distance, the invenomed little Bodies, which remain in the infection, being moved, presently leap out, and unfold its Poyson every way, as it were by a certain irradiation: if that they strike against any human body, presently they lay hold on the Spirits, and are by their Vehicle conveyed in∣wardly, and then by an easie labour, they infect the Blood and Humors, wheresoever flowing in the Vessels, with their Ferment, and quickly bring to them coagulations and putrefaction. And after this manner, through the most subtil Effluvia, is made as it were a certain transmigra∣tion of the pestilential Disease, even as when a shoot being cut off from some Tree, and laid up for a time, and afterwards ingrafted to another Trunk, though from the smallest Bud, it is able to produce a Tree of the same kind and nature.

CHAP. XIII. Of the Plague.

THus far we have discoursed of Poyson in general, also of the Pestilence, its beginning and propagation by Contagion: it now remains, that we explicate the Description of the Plague, its Nature, according to its Accidents and Symptoms, most worthy os note; then some things shall be added which belong to its Cure.

The Plague may be described after this manner; That it is an Epidemical Disease, contagious, highly infestous to human kind; taking its beginning from an envenomed infection, received first by the Air, and then propagated by Contagion; which having hiddenly and largely set upon men, causes extinctions of the Spirits, coagulations of the Blood, Blastings, Mortifications or Deadnesses of the solid parts, and with the appearances of Whelks, Buboes, or Carbuncles, as also with the horrid Provision of other Symptoms, brings the Sick in danger of Life.

Although the Plague be one kind of Disease, and its specifical differences, or essential are not found, yet by reason of the divers kinds of Accidents, which come upon it, some diversities and irregularities of it are observed, which something vary the type of the Disease, though they change not the species. For first this Distemper sometimes is more universal, that it rages every where through many Villages and Cities at once; but sometimes it is circumscribed in narrower bounds, and only threatens one Region or Tract of Land, Secondly, Sometimes the Plague comes simple, and unmixt with other Diseases, wherefore privily, and as it were by surprize, almost without a Feaver, or vehemency of Symptoms, brings a secret killing of the Sick. Some∣times it is complicated, with a number of other Diseases, that the business is carried with tu∣mult and frequent skirmishing between Nature and Death. Thirdly, the degree of Malignity constitutes a great difference; for the Plague in some places and times is much more mild, that many of the Sick escape; sometimes it is highly mortal, that most taken are killed, and that scarce one of a hundred recovers.

But because this Disease hides its weapons, and coming on men unawares, kills them suddenly, therefore it shall be our work, that by some signs, as it were Watchmen planted, we may know the clandestine coming of this Enemy, although we are not able to foresee it from afar. Very many signs happen, which foretel shortly a Plague about to come; to wit, if the Year keeps not its Temper, but has immoderate, and very unseasonable excesses, either of Heat or Cold, or Driness or Wet; if the Small Pox or Measles do every where rage; if Boils or Buboes ac∣company reigning Feavers. Besides, Astrologers are wont, from the Aspects of the Stars, or Appearances of Comets, to predict the approaching Plague, but this ought rather to be called a vain Conjecture, than a certain foreknowledge. From a preceding Famine, a most certai•…•… presage may be taken, of a Plague to follow, as in the Adage, 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉; the Plague comes with the Famine. For the like Constitution of the Year, which for the most part, by rea∣son of the Corn being blasted, brings scarcity, is apt also to produce the Plague; also, an evil way of feeding which people in Dearths use, eating all unwholsom things, without choice, dis∣poses their bodies to the more easie receiving the Infection. Yea, also Earthquakes, fresh open∣ings of Caverns and secret Vaults, by the gaping of the Ground, by reason of the Eruptions of malignant and empoysoned Airs, often give beginning to the Pestilence. For indeed, as there is need of great diligence to foresee, as it were from a Watch-Tower, the approaching Plague, so there is no less need of care and diligence, to consider, or take notice of the same, being fresh risen, and the shooting of its first darts; for oftentimes, being too solicitous, we dread vulgar Feavers, if perchance they end in Death, for this Disease; and sometimes being too secure, contemning the Pestilence, by reason of its Symptoms, like to a common Feaver, we apprehend not our danger, till too late; wherefore, for the more full knowledge of this Disease, we will subjoyn its Signs and Symptoms both Common and Pathognomic, or peculiar, and briefly de∣scribe their Causes, Means and manner of being done.

Besides the Signs already delivered, which by a certain demonstration a priori, or before∣hand, bring a suspition of the Plague about to come, there are others, the concourse of which, plainly •…•…hew its presence in the sick Body; of these, some are common to the Plague, with a Putrid F•…•…aver, some are more proper to this Distemper. For the impression of the Pestilence most often stirs up an effervescency of the Blood, and so has frequently a Feaver joyned with it, that among some, in the definition of the Plague, it hath the place of a kind of Feaver; wherefore, by re•…•…∣son of the ebullition of the Blood, and the hurt brought to the Viscera, presently there follows, a growing hot, a spontaneous weariness, thirst, a burning of the Praecordia, often great vomit∣ings,

pains of the Heart, Torments of the Intestines, a Scurfiness of the Tongue, or a Black∣ness, a pain of the Head, Watchings, Phrensie, Palpitation of the Heart, Swooning, and sud∣den loss of Strength; though Feavers are most often beset with these kind of Symptoms, yet if at the same time the Plague hath spred in the Neighbourhood, and a fear of it hath possessed the minds of men, hence a greater suspition of this Evil is caused, especially, because, whilst the Pestilence reigns, other Diseases in any one, leave their proper Nature, and change into it: wherefore, if there happens to the Distempers but now recited, a Communication of the same Sickness to many, and a frequency of Burials, that it becomes every where very deadly, and spreads largely even by contagion: and if besides, Buboes, Carbuncles, Spots, or other marks of the Pestiferous Infection appear, the business is put without doubt, and we may with no less faith denounce it the Pestilence, than when we see an House flaming, with fire breaking through the Rafters, we cry out Fire. But because here is mention made of Buboes, Carbuncles and of other Symptoms (of which we have already spoken, where we treated of Putrid Feavers) it remains that we briefly touch the Causes of them, and the manner of their being made: They are these; A Carbuncle, a Bubo, Whelks, Inflammations, and malignant Pustles.

Concerning these in common, we say, that they are all produced of the Blood and Nervous Juice, touched with the pestiferous Poyson, and coagulated in parts, in their Circuit, and di∣stempered variously with Putrefaction; forasmuch as the Spirits residing in either Liquor, espe∣cially in the Blood, are no sooner profligated, by the blast of this malignant Disease, but a coa∣gulation is induced to the remaining Liquor, even as Milk growing sowr, or when some acid Juice is powred to it, wherefore, portions of it being more grievously touched with the Poy∣son, they soon curdle or grow into gobbets, and suffer corruption with blackness, like Blood out of the Vessels; from whence, presently they hinder the motion of the rest of the Blood in the Vessels, and in the Heart, and by means of its Ferment, more coagulate it; but whatso∣ever by congelation grows into curdled gobbets, unless it be presently cast out of doors, causes Death quickly, by restraining the Circulation of the Blood; and being thrust forth outwardly, towards the superficies of the Body, it is stopped in its motion, between the narrow Windings of the Vessels; and being wholly destitute either of Spirit, or being struck by a blasting, pro∣duces its Deadness, black and blew Spots, and black or purple Marks; or by reason of the Salt and Sulphur being exalted by the Pestilential Ferment, and affecting new things, grow together into tumors of a various kind.

A Carbuncle, or fiery Inflammation, is a fiery Tumor, with most sharp and burning Pustules round about it, and infesting the sick with an acute pain; which arising in various places seve∣rally, will not be ripened, but creeping more abroad on the superficies, burns the skin, and at length shakes off the Lobes or Gobbets of its Corruption, and leaves an hollow Ulcer, as if burnt by an Escharotick or burning Plaister.

The Generation of Plague-Sores, seem to be made after this manner, when poysonons Infe∣ctions do strike into the Blood, in its own nature torrid, portions of it congealed, are fixed in the superficies of the Body; and in that place, because the motion of the Blood is a little hin∣dred, a Tumor at first small, is induced; which afterwards, by a malignant Ferment, unfold∣ing it self more largely, being leisurely increased, creeps into the neighbouring part: A Sup∣puration follows not, because the matter being extravasated, and stagnating, is not concocted and digested by a gentle heat, but by reason of the Particles of the outragious Sulphur, toge∣ther with the carried forth Salt, being heaped up in these Tumors, and because of the stagna∣tion, they being presently loosened from the mixture, a burning is excited, as if a Cautery were affixed to the part: pieces and lobes of skins, eaten as it were from a covered Eschar, fall off, because the corrosive Venom, impacted in the Muscles, gnaws not only to the superficies, but those that lie transverse through the whole substance; wherefore, before all the flesh is consu∣med with the Membranes, in which the eaten Pieces were invalved, some piece, as it were cut off from the rest, falls away. A Carbuncle, oftentimes but one, oftentimes more arise: some∣times they are alone, sometimes they are accompanied with a Bubo.

A pestilent Bubo springs forth only in glandulous places, into whose substance goes, not only the Blood congealed by the Poyson, and carried through the Arteries, but the nervous Juice heaped up there, and carried back into the Veins. Because this Tumor happens from less torrid Juices, and in part more frigid, therefore it partakes of suppuration: for the matter being lei∣surely heaped together, when (by reason of the stagnation) the vital Spirit being departed) it had lost the form of Blood, it was by a long concoction converted into matter, from the particles of Salt and Sulphur exalted, and restrained in the Tumor. But that these Tumors only happen in the Glandula's, the reason is, not that by the destination of Nature, the Nest or Tinder of the Disease is carried to these parts, but as the particles of the virulent infection, abound every where in the Blood, and nervous Juice, they are more readily gathered together, as in a common Family, and where the Blood being dilated to the extream parts of the Arteries, and is so not rea∣dily received, and carried back by the Veins, and also the alible Juice to be carried back from the Nerves, into the Veins, is deposed; either of these, as it appears clearly, by late observations of

Anatomists, and by experience, are made or done about the Glandula's; wherefore, when in these parts, either humors, being stuffed with the pestilent seeds of the Contagion, come toge∣ther at once, as it were the Nest of the malignity, because of the virulency here deposed from either, is blown up.

Whelks, fiery Inflammations, and purple Spots, in respect of the Venom, are of the same fluff as the Tumors but now described: but in these, the product of the virulency consists in a lesser substance, yet with greater danger, by reason of the seeds of the Poyson being more dis∣persed; more small portions of the coagulated Blood being fixed in the skin, constitute these lesser appearances, wherefore, out of these, some being increased, are ripened into little itching blisters; others, by reason of a certain blasting, or deadness of the corrupted Blood, grow in∣to black and blew, and purple spots.

Although the Plague, by reason of its sudden, secret, and very swift assault upon sick peo∣ple, hardly gives time or place for a Prognostick, and when this Disease, by reason of the oc∣cult manner of hurting, contains in it self nothing that is not suspected, yet there are some signs that appear in its course, by which we are wont to foretel either Life or Death. The bu∣siness is then desperate, if the Disease pass presently into an Epidemical Distemper, and makes violent Assaults; if that bleeding, or only a small Sweat follows in the beginning of the Disease, if the Urine be thick and troubled, the Pulse unequal and weak; if a Convulsion, or a Phrensie presently follow: if the Vomits or Stools are blewish, black, or highly stinking; if the Whelks at first contract a redness, afterwards a blewness; if the Carbuncles are many; if the Buboes at first swelling up, disappear; if strength be suddenly lost, the Face horrid, or grows black and blew; if with a shivering of the outward parts, there be a heat of the Bowels; especially if these, or many of them happen in a Body full of ill humors, or in an unwholsom season. On the contrary, the sick may be bid to be of good chear, if the condition of the Pestilence be lighter, and less deadly; if the the Disease happens in a robust and healthful body, with a strong mind; if Remedies may be timely had, before the Disease hath possessed the whole mass of Blood. Also, if with a continuance of strength, high and equal Pulse, a suppuration of the Buboes, and a large profusion of Matter, with the absence of more horrid Symptoms, the course of the Disease is performed: In the mean time, although here we may hope all good, yet we are not to be secure, because, sometimes the snares of life are laid privily, with the lau∣dable appearance of signs, and we suffer most grievously as from a reconciled Enemy, whose fierce threatnings we seemed to have shunned.

Concerning the curing of very many sicknesses, the business is chiefly committed to Nature, to whose necessity, Physick is the Midwife; and the Office and Science of a Physician chiefly is bu∣sied in these, that occasions of giving convenient Aids to this labouring be attended; but the Plague hath this peculiar, that its Cure is not at all to be left to Nature, but that it is to be endeavoured any way, by Remedies gathered from Art. Nor are we to be solicitous of a more opportune, or as it were a gentler time, but Medecines are most quickly to be prepared, and we must not stay for them some hours, no nor minutes: But because, whilst the Pestilence reigns, there is no less need of care, that the Contagion may be driven far away, than that the Disease being impressed, may be cured; therefore a double task is incumbent on the Physician, to wit, that he looks to the prevention of this malignant Disease, as well as to the Cure. To prescribe a method for both these, had been a work of too much tediousness, and to have given you a Dish a thousand times dressed by Authors; wherefore, we will only touch lightly here some chief Indications, and haste to other things.

Preventive Cautions either respect the Republick, and belong•…•… to the Magistrate, or private persons, to whom it should be taught, what is to be done by all men, when the Plague is feared.

The publick Care in the time of the Plague, consists chiefly in these, That Divine Worship be truly observed, that all Nests of Putrefaction be cut off, that Filths, Dunghils, and all stink∣ing things may be removed out of the Streets, and all occasion of the Contagion diligently avoided, and that an wholsom means of Living be constantly observed by the Citizens: For which end, the use of Fruits, and of other unwholsom things should be interdicted; that poor people, who have not plenty or choice of food, should be provided for at the publick Charge: If still the Pestilence begins to spread, the empoysoned force of the Air should be corrected as much as may be, which may be best done, by the frequent burning of Sulphureous things; the the infected should be separated from the sound, and the dead Carcases and Houshold-stuff should be avoided; and lastly, that able and fit Physitians, and Ministers be provided for the use of the sound, and necessities of the sick.

The preventive means of a private person, is wont to be concluded in these three things; viz. Diet, Physick, and Chirurgery. Diet respects the six non-natural things, among which, of the greatest moment are, the Air, and Passions of the mind; as to the rest, Hippocrates his Precept may suffice, viz. Labour, Meat, Drink, Sleep, Venus should be taken moderately. The Pestilent Air should be avoided, by going into some other place;, or corrected by the well burn∣ing

of Sulphureous things, or whilst we breath it should be cured by fumigations and sweet smells' often carried near the nostrils. As to the passions of the mind, fear and sadness, whilst the Pe∣stilence rageth, are as it were another Plague; for in these, the seeds of the envenomed Conta∣gion, which are placed in the superficies of the Body, as it were on the edge of a Whirlpool, are snatched inwardly, by a certain force, and carried to the Heart; wherefore 'tis a most ex∣cellent Antidote, to be of a chearful and confident Mind. I have known many, who (as Hel∣mont was wont to say) by fortifying the Archeus, with Wine and Confidence, never used any other Poison-resisting Medecines, and remained without any hurt os the Contagion among the infected; and on the contrary, some struck with fear, when they have dwelt far from all Conta∣gion, have drank in the seeds of the Pestilence, as if they were derived from the Stars.

Among the Chirurgical things to be administred for preservation sake, are wont to be com∣mended, the opening of a Vein, Cauteries and Amulets. Where there is a fulness with a great swelling up of the Blood; or in those who constantly, by long custom are wont to be let Blood, it is convenient to open a Vein; for the less the Blood grows hot, and is circulated without tumult in the Vessels, it will be so much the longer ere it be contaminated by the pestiferous Disease. Issues made by Cauteries, are so much used, almost by the suffrage of all, for preser∣vation sake against the Plague, that it is become the most common Receipt; for these by a com∣mon transmission poure forth the assiduous coming of the superfluous and excrementitious mat∣ter; and if that the infections of the Pestilence be admitted inwardly, they are cast forth of doors at these open ports.

Amulets hung about the Neck, or born on the Wrists, are believed to have a wonderful force against the Pestilence; of these, among some of the greatest esteem, are such as are made out of Arsnick, Quicksilver, the Powder of Toads, and other Poysons. That the same in this case may be profitable, besides the Observations of Physicians, this reason may seem to persuade something. The Effluvia, or Atomical little Bodies, emerging now from these Bodies, now residing upon these, are before affirmed to fly about through the whole Region of the Air; these, as they are diversly figured, some of them easily cohere with others, but if they strike against some of another form, they oppose and overturn them: hence the particles of the pe∣stilent infection, which are adverse to our spirits, excellently agree with those little Bodies of Poyson, placed near, and are readily fixed to them; wherefore the Amulets made of Poyson, do this, viz. They receive the seeds of the Pestilence meeting us, into themselves, by reason of the likeness of parts; also, by alluring the same from our bodies, into their embraces, they in some measure, free the infected from the infection.

The Medicinal prevention hath a twofold scope: First, That the assiduous coming of the excrementitious matter or humors be taken away by a gentle purging as often as there is need: Secondly, That by the daily taking the Poyson-resisting Medecines, our Spirits and Body may be fortified against the Assault of the poyson; By the former, the Food and Cherishers, of which encrease putrefaction brought in by the poyson are drawn away; by the latter, the first enkindling of the pestiferous infection, as it were, a deadly fire is inhibited. Alexiphar∣mies or Medicines contrary to poysons, seem to be helpful against the contagion of the Plague, for this twofold Reason; both because the Mass of Blood and Viscera being filled with the par∣ticles of these, and also the Spirits before possessed with the same, they do not easily admit of the company of the impoysoned infection; also, because the Blood being incited by the gentle fury of these, is kept from coagulation.

Thus much for preservation, it follows now, that we speak of the Cure of the Plague. The Doctrine of which, is either general, and comprehends Remedies, which for this end, are ta∣ken from Diet, Chirurgery, and Medecine; or special, which delivers the use and Cautions to be exhibited about those Remedies; and by what means we are to oppose the Symptoms vari∣ously arising.

Diet comprehends the use of the six Non-naturals, but the chief care, and medical Cautions, are to be given about Eating; the primary Indications of this, consist not at one and the same time together, but ought to be supplied by turns, according to the nature of the thing, and the exigency of Nature. In respect of the malignity, and of the loss of strength, Aliments are to be desired, which greatly cherish the Spirits, and bring a more plentiful Nourishment: in respect of the Feaverish Distemper, a more slender refrigerating Diet, and temperating the Blood, seems to be required: the Physician must regard either, but he may rather intend his Remedies against the Malignity, than the Feaver.

The Helps that belong to Chirurgery, are the opening a Vein, which seldom and very cauti∣ously ought to be used in this Disease, because the Blood being too much exhausted, and the Ves∣sels falling down, Sweat is not so easily procured; instead of this, it is better to use Cupping, with Scarification; for this and Blistring are rightly applied for the drawing forth of the Ve∣nom; moreover, against Buboes, Inslammations, or malignant Ulcers produced by them, Ca∣taplasms, Fomentations, Plaisters, Oyntments, and many other things, to be outwardly ap∣plied, are to be sought for from Chirurgery, in which some Poysons, as the Electric of Poyson,

are prescribed by some to be admixed; wherefore, Preparations of Arsnick, to wit, the Oyl and Balsom of it, are commended by many, in this case too of most excellent Use and Efficacy.

Medecines for the Cure of the Plague, are either Evacuators, or Poyson-resisters: The in∣tention of the former is, that the serous Latex in the Blood, and the excrementitious Humors, which abound in the Viscera, be thrust forth of doors; and together with them, very many Particles of the envenomed Infection, every where dispersed in the Body: But these are both Vomitories and Purgers, the use of which is more rare, and only in the beginning of the Disease, also Diaphoreticks or sweating Medecines, which at sometimes may be suffered according as there is strength, are to be prescribed in the Plague; for these more fully, and from the whole Body at once evacuate, yea, and by agitating the Blood, defend it from Congelation, and as they move from the Center, still to the Circumference, they drive the empoysoned Ferment, also the Corruptions of the Blood and Humors, far from the Heart, and so chase the Enemy without the Camp. But Vomits and Purges evacuate less universally, and by concentrating the malignant matter, oftentimes carry it inwardly, and fix it to the Bowels. But these Mede∣cines, whether they operate by purging, or sweating, ought to be of that kind, which have particles, rather agreeable to the empoysoned infection, than to our Blood or Spirits; for such a Medicine will pass through the various windings of our body, with its whole forces and un∣mixt, and by reason of the similitude of either, more certainly takes hold of the virulent Mat∣ter of the Disease, and carries it forth of doors with it self, by the mutual adhesion of the parts, which way provoked Nature leads. Wherefore, Medecines, whether Catharticks, or Sudorificks, are commended before others, which are prepared out of Mercury, Antimony, Gold, Sulphur, Vitriol, Arsenick, and the like; which, when they cannot be subjugated by our heat, or mastered, become the best Remedies against the poyson of a Pestilent Disease; for these do not only potently evacuate superfluous things, but whenas they put forth very strong and untameable particles, and explicate them every where in the Body, dissipate the Ferments of the Poyson growing here and there, and hinder them from maturation; and as these Reme∣dies, being of themselves not to be overcome by Nature, are necessitated to be carried out∣wardly through through the open passages of the Body, they carry forth of doors with them, whatsoever extraneous or hostile thing is met with.

As to Poyson-resisting Medecines, or Alexiterians, which are said to resist the Poyson of this Disease, without any sensible evacuation, they are (for the most part) such whose particles are not very much of kin to Nature, so as to go into Aliment; nor so diverse, as to provoke to an excretion. The same being inwardly taken, and broken into the smallest pieces, inspire the Blood, and Juices flowing together in the Vessels, and Viscera, with their little Bodies, as with a new Ferment, and by moving the same gently, and by keeping them in an equal mixture, defend them from Coagulation and Putrefaction; dissipate the particles begun to be heaped up, one from another, by the same gentle agitation, and hinder them from maturity; and lastly, by prepossessing the Blood and Spirits, defend them from the impressions of the pestilent Mark. Among these, some more simple Remedies are commended, as Rue, Scordium, &c. But most of all by far are esteemed, those that are compounded; wherefore, Treacle, Mithri∣date, and Diascordium, some of which are composed of no less than fifty simples; that it is esteemed a Crime in Medecines so compleat in all numbers, to omit one Plant, or one Dram of them in their Compositions; the reason perchance is, because very many things being put to∣gether, may make a Mass, whose diverse kinds of particles being exalted, by long digestion, may stir up the greater Fermentation in our Blood and Humors.

Having after this manner ranked the Remedies, in which we ought to be instructed, for the curing of the Plague; now next we should speak of the Method of Cure, viz. What first, and then what next should be done in order: but that Disease hath so precipitous a course that there is neither place for deliberation, nor is there frequently any Physician to be gotten, for fear of the Contagion; wherefore, there is no need here of many prescripts, or a long series of Indications; this business is to be quickly performed, and may be comprehended in a few things. Therefore, when the Pestilence reigning, any one is distempered with the Contagion of this Disease, the help of the Omnipotent God being requested by Prayers, presently Re∣medies are to be flown to. If the Plague happens in a Body not throughly purged, and prone to Vomiting, presently let a Vomit be taken, whose operation being finished, immediately let a Sweat be provoked, by taking Diaphoreticks, and the same continued as strength can bear it, and afterwards be often repeated. Besides, let Alexipharmicks or Poyson-resisters be used almost every moment, until by the eruption of Whelks, Inflammations, or Buboes, all the Venom be wholly driven forth of doors; but in the mean time, proper and respective Remedies are to be opposed to the most urging Symptoms; but especially fit helps are to be sought from Chi∣rurgery, for the Cure of the Buboes, and Plague-Sores: the whole weight of this business leans on these two Intentions, that the pestiferous Poyson may be every way expelled from within, and then, that the Recourse of what is driven forth, be with equal diligence prevented.

Concerning the Plague, we cannot so readily write Examples, and Histories of sick persons, with exact Diaries of the Symptoms; because these kind of Sicknesses came not every year, nei∣ther when they spread, is it lawful for every Physician that takes care of his own health, fre∣quently to visit the sick, or to stay long with them, whereby he may denote all Accidents, and diligently consider the reasons of them; which Task however, the renowned Diemerbrochius did so firmly persist in, that after him, others may lawfully be superseded from this Work: when some times past, in this City, viz. 1645. the Plague (though not great) had spred, Dr. Henry Sayer, a very Learned Physician, and happy in his Practice, many others refusing this Province, boldly visited all the sick, poor, as well as rich, daily administred to them Phy∣sick, and handled with his own hands, their Buboes, and virulent Ulcers, and so cured very many sick, by his sedulous, though dangerous Labour. That he might fortifie himself against the Contagion, before he went into the infected Houses, he was wont only to drink a large draught of Sack, and then his perambulation about the Borders of Death, and the very Jaws of the Grave b•…•…ing finished, to repeat the same Antidote: After he had in this City, as if invio∣lable as to the Plague, a long while taken care of the Affairs of the Sick without any hurt, he was sent for to Wallingford-Castle, where this Disease cruelly raged, as another Aescupulapius, by the Governour of the Place: But there being so bold, as to lie in the same Bed, with a certain Captain (his intimate Companion) who was taken with the Plague, he quickly received the Contagion of the same Disease; nor were the Arts then profitable to the Master, which had been helpful to so many others, but there with great sorrow of the Inhabitants, nor without great loss to the Medical Science, he died of that Disease. As to others, distempered by the Pestilence, he was wont to order this kind of method of healing, if he was sent for before the Buboes or Whelks appeared outwardly, for the most part he gave a Vomit, the prescriptions of which were the Infusion of Crocus Metallorum, sometimes with white, and sometimes with Roman Vitriol: The Vomiting being ended, he commanded them presently to be put into a Sweat by the taking of Diaphoreticks; and thence, some intervals being granted, for the re∣covery of strength, the sweating to be continued to the declination of the Disease: but if he were sent for to the sick, after the appearances of the Marks, the Vomiting being let alone, he insisted only upon Sudorificks.

CHAP. XIV. Of Pestilential and Malignant Feavers in Specie, and of others Epidemical.

AFter having having unfolded the Nature of the Plague, by the order of our Tract, we ought to proceed to the Diseases which seem to be nearest like its Nature; which chiefly are Feavers, called Pestilent and Malignant; for it is commonly noted, that Feavers sometimes reign popularly, which for the vehemency of Symptoms, the great slaugh∣ter of the Sick, and the great force of Contagion, scarce give place to the Pestilence; which however, because they imitate the Type of putrid Feavers, and do not so certainly kill the sick, as the Plague, or so certainly infect others, they deserve the name not of the Plague, but by a more minute appellation of a Peslilential Feaver: Besides these, there are Feavers of another kind, the perniciousness and contagion of which appear more remiss, yet because they are in∣festous, beyond the force of putrid Feavers, and seem to contain in themselves in a manner, the 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 or Hand of God of Hippocrates, are yet by a more soft Appellation, called Ma∣lignant Feavers.

Those Feavers differ both from the Pest, and from one another according to the degree, and vehemency of Contagion and deadliness; as the Plague is a Disease highly contagious, and deadly to humane kind; 'tis the Pestilent Feaver, which commonly spreads with a lesser diffu∣sion of its infection, and frequency of Burials. When the infection is only suspected, and the Crisis happens beyond the Event of vulgar Feavers, only not to be trusted, or less safe, it is esteemed for a Malignant Feaver, They are yet more fully described thus;

When the Feaver commonly spreads abroad, which for the variety of Symptoms, puts on the likeness of the putrid Feaver so called, to wit, when there are present, Thirst, Burning, Weariness, Anxiety, roughness of the Tongue, Watchings, Phrensie, Vomiting, want of Ap∣petite, Syncopy, Swooning, Heart-pains, and a concourse of other most terrible Accidents; if there happen besides, Spots either like to the little Flea-bites, or broad ones, like black and blew strokes, and livid, we esteem this Disease of an evil Nature. If besides these, it is not cured

after the wonted manner of Feav ers, but that the strength of the Sick is cast down, without any manifest cause, and that Death comes often unlooked for, and unsuspected, against the Progno∣stick of the Physician, there is yet a greater cause of suspition of malignity: But if it kills very ma∣ny of the sick, and that those who converse with the sick, contract the evil of the same Disease, that the same Disease spreads through all the Villages or Cities, it may be said to be more than malignant, a pestilential Feaver; which is yet fully proved, if it rages in very many ordina∣rily with a certain common symptom, as when a Squinancy, Dysentery or deadly Sweat, such as in times past spred in England, accompany these sort of Feavers.

If that a Feaver arises, which distempers many living in the same Region together, almost after the same manner, which notwithstanding observes the Laws of a common putrid Feaver in its course, and is cured almost after the same manner, this is not said to be Pestilent, but only a Malignant Feaver; unless that in some labouring with a remarkable Cacochimy, or fulness of ill humors, the appearances of Buboes, or of spots, sometimes with a deadly Crisis, and a Con∣tagion creeping upon others, betray some signs of Malignity.

If it be demanded, to which Class of the aforesaid Feavers these sort of Pestilential and Malignant Feavers ought to be placed, we ascribe them only to the rank of continual Feavers; we dischage or acquit intermitting Feavers, because by intervals they grant such firm Truces to Nature, and then they regularly and exactly observe their periods, which does not consist with an envenomed disposition. Also we except Hectick Feavers from malignity, beause otherwise their mortality would not be so long delayed, but that partaking of poyson, they would kill sooner: among continual Feavers, although we affirm, that the simple synochal Feavers are not free, yet they are rarely touched with this evil; but most of all, the Feaver which shews the notes of Pestility or Malignity, is of that sort, which resembles the figure of the putrid Feaver so called: for when in these Feavers, besides the appearances of virulency, we perceive a continual grow∣ing hot of the Blood, which passes through the courses or stadia of beginning, increase, stand∣ing and declination, as in putrid Feavers, we deservedly affirm here, the sulphureous part of the Blood to be heated and enkindled, and by its burning to have brought in the Feaver; where∣fore in these kind of Feavers two things are especially to be noted, the growing hot of the Blood, and the malignity joyned with it, of which now this, now that is the greater: also, in both there is a great latitude, and very many degrees of its intension or heat, according to which the Feaver becomes more or less acute or malignant.

The growing hot of the Blood is performed after the same manner, as is already said con∣cerning Putrid Feavers, to wit, the sulphureous part of the Blood growing hot above mea∣sure, as it were takes fire by its fervor; in the time of its burning, it accumulates a great quan∣tity of adust matter, upon whose subaction and seclusion, depend the State and Crisis after the wonted manner of Feavers; but besides these, the Blood being infected with a certain venomous taint, in the burning it begins by reason of the malignant ferment, to be coagulated into parts, and to putrifie: wherefore besides the usual Symptoms of the common Feaver, by reason of some congealed portions of the Blood, follow either deadly Distempers, Swooning, a Dejection of the Spirits, also appearances of Spots and Marks; besides venomous Effluvia, which depart from the sick, that are able to raise up the like Distemper in others, by the force of their Con∣tagion; wherefore by reason of its perniciousness and contagion, and their various degrees, it is called either a Pestilent or Malignant Feaver.

Also whilst the Blood growing hot, is infected with a venomous and malignant ferment, not only proper coagulations of its mass, with a disposition to putrefaction, are induced; but also the Nervous Liquor, easily contracts the taint of this, from whence it being made impropor∣tionate to the Brain and Regiment of the Animal Spirits, stirs up great irregularities in them: wherefore upon these sort of Feavers, come not only spots and whelks, but most often a Deli∣rium, Phrensie, Sleepiness, Tremblings of the Limbs, Cramps, and Convulsive Motions; I have often observed, that in some certain years, Malignant Feavers have increased, which have shewn their virulency, without the appearances of Marks, chiefly about the Nervous stock; be∣cause in some, presently after the beginning, has followed a sleepiness, with a mighty heavi∣ness of the Head, in others, strong Watchings, a perturbation of Mind, with Trembling and Convulsive Motions, but in most, either none, or only an uncertain Crisis, and instead of it, a translation of the Feaverish Matter to the Brain; besides it is observed, that these Feavers creep upon others Contagion, and that very many are killed by them, that therefore they do d•…•…serve to be called Malignant.

But these kind of Feavers are sometimes first begun from a venomous infection, and the Blood being touched with the Particles of the Venom, conceives of it self an Effervescency, and is en∣kindled; as when from a Contagion or Malignant Air being inspired, any one hath fallen into a Malignant Feaver, without any evident cause or predisposition: But sometimes the Feaverish Distemper is induced from a proper Cause, and then the Seeds of the Malignity, either lying hid within the Body, exert themselves in the effervent Blood, or they come from another place by the contaminated Air, as it were the Food of the Flame before enkindled; for it appears by

frequent observation in the time in which an Epidemical Feaver spreads, that others being any way arisen, turn into it.

Malignant Feavers, as also Pestilential, for the most part are popular, and invade many at once; but sometimes they are private, and not ordinary, so that perhaps only one or two are taken in the whole Region; in such a case it is to be suspected that they come not from a malig∣nant Air, or Epidemical cause, but from a morbous provision of the Body; for I have often ob∣served that when in the Spring or Autumn, a Feaver sufficiently common, hath spred in some City or Town, of which very many have died, perhaps some one on whom an evil predisposi∣tion and a more strong evident cause, hath brought the Feaver, hath lain by it, with more hor∣rid Symptoms, and great notes of malignity: in which case that malignity is not to be called common to the Feaver, but not ordinary and accidental only.

Although the greatest reason of the difference, by which these kind of Feavers are distin∣guished from one another, and from other Feavers, consists in their deadliness and contagion; yet sometimes they are noted with a certain peculiar Symptom, from which they take for that time, both the note of malignity, and the appellation of the name: hence in some years an Epidemical Feaver reigns, which induces to most of the Sick a Squinancy, another time an In∣flammation of the Lungs, a Pleurisie, Dysentery, or some other Distemper, and that often∣times most dangerous, and contagious; so the seeds of Diseases, not only derived from the Parents by traduction, excite their fruits as it were by a certain designation, in the same part or member; but also those received from an infection commonly spreading, produce in all, a distem∣per of the same mode and figure; which yet I think to happen, not because the seeds of the ve∣nomous Infection, respect either this or that Region of the Body, with a certain peculiar Vir∣tue; but these so affect the Mass of Blood, by a like manner in all, that there is a necessity, for the sake of washing away this stain, that a Crisis be attempted after the same manner in all. For when, without malignity, the Bloud, by coagulation, or perhaps other Causes, is apt to be extravasa∣ted, the usual places, in which portions of the same being extravasated, are wont to be fixed, are the Throat, Pleura, Lungs, and Intestines; wherefore, 'tis no wonder, when from a ma∣lignant cause, the congelation of the Bloud, and for that reason an extravasation is induced, if the Disease is nested in the accustomed cherishing place of Nature.

Concerning the Causes of these kind of Feavers, there is not much business; they are for the most part deduced, in respect of the malignity, from the vicious constitution of the Air; in respect of the Feaverish heat, from the morbous provision of the Body; either of these are easily made clear, by what hath been already said concerning a putrid Feaver, and the Causes of the Pestilence: If the malignity be stronger than the Feaver, and hath induced it, the impression of it is to be imputed to the inspired Air, or to a contagion received from others, if the Feaver be first, its inkindling is ascribed to transpiration being hindred, to a Surfeit, or to some other of the evident Causes above enumerated.

As to the Signs, besides Contagion and Destruction, these shew the malignity of the Feaver, a sudden loss of strength, a weak and unequal Pulse, and evil affection of the Brain and Nervous parts, being suddenly induced, cruel Vomitings, Blackness of the Tongue, a suffusion of Dark∣ness through the whole Body, but chiefly the appearance of Spots, Buboes, and of other Marks.

For the Cure of Feavers, both Pestilential and Malignant, there is greater need of Judgment and Circumspection, than in any others whatsoever: For when there are two primary Indicati∣ons, to wit, the Malignity, and the Feaverish Intemperance, and when one can scarcely provide for the one, without detriment to the other, it is not easily to be discerned, which should first be helped, or soonest regarded. In respect of the Feaver, Purging, opening a Vein, and cool∣ing things do chiefly help; but whilst these are performed, the Malignity, for the most part is increased, and being neglected, spreads abroad more largely its Poison; against the Malignity, Poyson-resisting Cordials, and Diaphoreticks are required, but these extreamly heighten the Feaver, they more shake the Bloud and Spirits before inkindled, as it were with the blast of Bellows, and force all as it were into a Flame; wherefore, here is great need of Skill, that these things be rightly ordered in themselves, and where there is most of danger appearing, thence the curative intentions are to be more immediately designed; but so, as whilst one is consulted about, the other be not neglected. But in these Cases, besides the private Judg∣ment of every Physitian, experience may supply the chief means of healing; for whenas these Feavers first spread, every one almost tries several Remedies, and by the success of them collated together, it may be easily reckoned, what kind of Method is to be relied on, till at last, by a frequent trial, or the footsteps of those passing before, there is made as it were a high and broad Road, for the curing of these sorts of Distempers, bounded both with various observations and warnings.

Besides these sort of Feavers, which spread on many at once, and by reason of the Conta∣gion, Deadliness, and conspicuous Notes of Virulency, deserve to be called Pestilent or Malig∣nant; there are some others, Epidemical or Popular, which almost every Year, either in the Spring or Autumn rage in some Countries; of which the Inhabitants for the most part of them are wont to be sick, and not few, especially of the Elder, to die: In which notwithstanding, no signs of Pestilence or Malignity appear, neither does the Disease seem to spread, from one and so to another, so much by contagion, as to lay hold on many, by reason of a predisposition, impressed almost on all. But these kind of Distempers depend chiefly upon the foregoing consti∣tution of the Year: for if the season going before was very intemperate, by reason of excess of cold or heat, of driness or humidity, and so had continued for a long time, it changes our Blood very much from its due temperature, whereby it is apt afterwards to conceive Feaverish Effervescencies; and from hence a Feaver, now of this Type or Figure, now of that is produ∣ced; which presently becomes Epidemical, because it draws its beginning from a common cause, wherewith the bodies of all are in a manner affected: But such Feavers, forasmuch as they de∣pend upon the Blood having gotten a disposition, now sharp, now austere, or of some other kind, by reason of the temper of the Year, for the most part are of the rank of intermitting Feavers; yet by a proper provision of Symptoms, they are wont to be noted according to the pecu∣liar constitution of every Year. These are not able to be comprehended under a certain common Rule, or formal Reason, which may quadrat to the Nature of each of these; because they vary every year according to their several Accidents. However, we will give you the descriptions of these kind of Feavers, spreading of late years in this Region, had at that time, for some specimen of the rest, and add it for a conclusion at the end of this Tract.

There yet remains to be ascribed to the rank of Malignant Feavers, some other private Fea∣vers, and participating of no contagion; of which sort chiefly are those which are wont to happen to Child-bearing Women, by reason of difficult and hard Labour, or by reason of the stoppage of their Courses. Indeed it sufficiently appears by common observation, that these are very dangerous, and often mortal: for if by the parts of the Womb being hurt, or by Cold being admitted, or perhaps by any other cause, the Courses are stopped, and the Humor which ought to be thrust forth, shall be confused with the Mass of Blood, it most wickedly in∣fects it, as it were with a certain venomous mixture; that by that means, presently a Feaver is excited, which with an evil provision of Symptoms, is very much beset, viz. with heat and cruel Thirst, Vomiting, pain of the Heart, and Watchings, and for the most part obtains, either no Crisis, or a very difficult one; because, unless the wonted way of the flux of the Courses, may be at length restored, it is wont, after the heat of the Blood hath been conti∣nued for some days, to communicate the evil to the Brain and Nervous Stock; from whence, by and by, a Delirium, Phrensie, Convulsions, and other most wicked Distempers, are most of∣ten induced, which do not seldom end in Death: but these sort of Feavers deserve a peculiar consideration, which we have more fully determined to shew hereafter in a particular Discourse concerning this business; in the mean time, we will undertake to propose some Instances or Ex∣amples of the Feavers, but now delivered, viz. of the Pestilent, and Malignant.

The Pestilent Feaver, of late years, hath more rarely spred in these Regions, than the Plague it self: of the only one of this kind, which fell under our observation, I will give you a brief Description. In the Year 1643. when in the coming on of the Spring, the Earl of Essex besieged Reading, being held for the King, in both Armies there began a Disease to arise very Epidemical; however, they persisting in that work, till the besieged were forced to surren∣der, this Disease grew so grievous; that in a short time after, either side left off, and from that time, for many Months, fought not with the Enemy, but with the Disease; as if there had not been leisure to turn aside to another kind of Death, this deadly Disease increasing, they being already overthrown by Fate, and as it were falling down before this one Death. Essex's Camp moving to the Thames, pitched in the places adjacent, where he shortly lost a great part of his men; but the King returned to Oxford, where at first, the Souldiers being disposed in the open Fields, then afterwards among the Towns and Villages, suffered not much less; For his Foot (which it chiefly invaded) being pack'd together in close Houses, when they had filled all things with filthiness, and unwholsom nastiness, and stinking Odors (that the very Air seemed to be infected) they fell sick by Troops, and as it were by Squadrons. At length the Feaver, now more than a Camp Feaver, invaded the unarmed and peaceable Troops, to wit, the Entertain∣ers of the Souldiers, and generally all others, yet at first (the Disease being yet but lightly in∣fllcted) though beset with an heavy and long languishment, however many escaped. About the Summer Solstice, this Feaver began also to increase with worse provision of Symptoms, and to lay hold on the Husbandmen, and others inhabiting the Country. Then afterwards spred through our City, and all the Country round, for at least ten Miles about. In the mean time, they who dwelt far from us, in other Counties, remained free from hurt, being as it were without the sphere of the Contagion. But here this Disease became so Epidemical, that a great part of the people was killed by it; and assoon as it had entred an house, it run through the same,

that there was scarce one left well to administer to the Sick; Strangers, or such as were sent for to help the sick, were presently taken with the Disease: that at length, for fear of the Contagion, those who were sick of this Feaver, were avoided by those who were well, almost as much, as if they had been sick of the Plague.

Nor indeed, did there a less Mortality, or slaughter of men accompany this Disease; be∣cause Cachectick and Phthisical old men, or otherwise unhealthful, were killed by it; also not few of Children, young men, and those of a more mature and robust age. I remember in soma Villages, that almost all the old men died this year, that there were any left who were able to defend the Manners and Priviledges of the Parish, by the more anciently received Tradie∣tions.

When this Feaver first began, it was something like the Figure of a putrid Synochus; but it was harder to be cured: and when it seemed to be helped by a Sweat or Loosness, presently it was wont to be renewed again; but for the most part, after the deflagration of the Blood, continued for six or seven days, this remitting, and instead of a Crisis, the adust matter being translated to the Brain, the Sick for a long time keeping their Beds with raging sometimes, but more often with a stupefaction, with great Weakness, and sometimes with Convulsive Motions, scarcely escaped at last. About the middle of the Summer, besides the Contagion and frequent Burials, this Disease betrayed its Malignity, and Pestilential force in open Signs, viz, by the eruption of Whelks and Spots; because about this time in many there appeared without any great burning of the Feaver, an unequal, weak, and very much disordered Pulse; also without a manifest expence of Spirits, their strength presently became languishing, and very much de∣jected: In others, Sick after the same manner, appeared little Blisters or Measles, now small and red, now broad and livid: in many, Buboes (as in the Plague) about the Glandula's: of these some died silently and unforeseen, without any great strugling of the Spirits, or Feaverish Burn∣ing excited in the Blood: in the mean time others, by and by becoming furibundous, whilst they lived, suffered most horrid Distractions of the Animal Spirits. Those about to escape from this Disease, without any laudable Crisis (unless they were the sooner freed by a Sweat provoked by Art) the Brain, and nervous stock becoming distempered, at length, with a be∣nummedness of the Senses, Tremblings, Vertigo, Debility of Members, and Convulsive Moti∣ons, did not grow well but of a long time after. During the Dog-days, this Disease being still infestous, began to be handled not as a Feaver, but as a lesser Plague, and to be overcome only by Poyson-resisting Remedies; letting of Blood, was believed to be fatal to this: Vo∣mits and Purges, sometimes though not often, were made use of, but the chiefest means of Cure, were accounted to be procured by Alexiteriums, and timely Sweat. For this end, besides the Prescripts of Physicians, to be had at the Apothecaries, some Empirical Remedies deserved no small praise; then first of all, the Pouder of the Countess of Kent, began to be of great esteem in this Country; also of no less note was another Pouder, of the colour of Ashes, which a cer∣tain Courtier staying by chance in this City, gave to many with good success; and to others approving of the use of it, he sold it at a great price; the sick were wont having taken half a dram of this, in any Liquor, to fall into a most plentiful Sweat, and so to be freed from the vi∣rulency of the Disease; That Diaphoretick (whose Preparation I afterwards learnt from the Cozen German of the Author) was only the Pouder of Toads, purged throughly with Salt, and then washed in the best Wine, and lightly Calcined in an earthen Pot. The Autumn com∣ing on, this Disease by degrees remitted its wonted sierceness, that fewer grew sick of it, and of them many grew well; till the approach of the Winter, when this Feaver almost wholly vanished, and Health was rendred to this City, and the Country round about fully and wholly.

Thus you have seen the Beginning, Progress, and End of this Feaver, at first only a Camp-Feaver, but at length became Pestilential and Epidemical. That at first the Disease began in the Souldiers Camp, may seem to be imputed not only to their Nastiness and stinking Smells, but in some sort to a common Vice of the Air, for as these Feavers come not every year, their Original may be ascribed, partly to the peculiar Constitution of the Year; because by that means a more light intemperance of the Air being contracted, though it did not affect the more healthful Inhabitants; yet in the Army, where evident Causes, viz. Errors in the six non-naturals, very much happen to the general procatartick Cause, there is a necessity for these kind of Sick∣nesses easily to be excited. For the constitution of this year, was in the Spring very moist, and slabbery, almost with continual shours, to which a more hot Summer succeeding, and the infecti∣on of the Feaverish Contagion here first increasing, still grew worse, and disposed all Bodies the more for the receiving it; wherefore, that this Disease was almost proper to this Region, and at this time Epidemical, the seed of it ought to be ascribed to its first rising from the Army, being quar∣tered round about. But forasmuch as it afterwards being made Pestilential, and very Epidemi∣cal, it infected most of the People living here, and killed not a few, the reason was, the evil affection of the Air; which because of the intemperance of the year, being unwholsom, besides by the continual breathing forth of stinking Vapors from the Souldiers Camp, and the quarters of the Sick, it became at last so vicious, that the infection of the Feaver, being dispersed in it,

was greatly exalted, and arose almost to the virulency of the Plague▪ Diemerbrochius relates from the like Camp-Feaver, arising in the Summer at Spires, afterwards another Malignant and Pestilential, and then the Plague it self to have accrued. Also, it was a sign that this Feaver of ours, became at last equal to the Plague it self, besides the great force of the Contagion, and the frequency of Burials, most wicked Distempers of the Blood, and nervous Liquor, being brought presently upon all, by it: because, strength being suddenly overthrown, the weak intermitting Pulse, the creeping forth of Measly Blisters, the eruption of Buboes, argued the Coagulation, and corruptive disposition of the Blood: besides, the Delirium, Madness, Phrensie, Stupefaction, Sleepiness, Vertigo, Tremblings, Convulsive Motions, and divers other Distempers of the Head, shewed the great hurt of the Brain, and nervous Stock.

That the Figure or Idea of this malignant Feaver, may be painted to the Life, very many Observations or Histories of sick people are easily to be had; of the many Examples of this Dis∣ease, I shall only mention a few, which hapned some years since in the House of a venerable man, and as with a mournful slaughter, so not without some admiration.

About the Winter Solstice, in the Year 1653. a Youth of about seven years old, without any manifest cause, found himself ill, being troubled with a pain in his Head, Sleepiness, and mighty Stupefaction; with it he had a Feaver, though not strong, with an ordinary burning, which grew more grievous, only by wandring fits, sometimes once, sometimes twice in twenty four hours space: presently from the beginning, he slept almost continually; also he was wont in his sleep to cry out, to talk idly, to leap often out of his Bed; being awakened, and sometimes of his own accord awaking, he presently came to himself, and constantly called for drink; his U∣rine was red, and full of Contents, his Pulse equal, and strong enough; in his Wrists appear∣ed light contractures of the Tendons, and in his Neck, and other parts of his Body, some red Spots like Flea-bites. At the first, was ordered a light Purgation, and a frequent taking down os the Belly, by the use of Clysters; he daily took Cordial Juleps, with Poyson-resisters; Ve∣sicatories or blistering Plaisters were applied to his Neck, and other Plaisters to the Soles of his feet: on the sixth day, a little Blood streamed from his Nostrils; on the seventh, without any manifest through Crisis, the Feaver very much abated, the heat so gentle as to be perceived only by the Touch; also the Urine pale, thin, and without any sediment, yet he was much more grievously troubled with sleepiness, and a stupefaction of the Head, so that his Urine, and the Excrements of his Belly came away involuntarily; however, being called upon, he knew the standers by, and answered to their Questions: These Distempers, notwithstanding the Remedies, every day grew worse: About the fourteenth day, the sick Youth became so stupid, as neitherto be able to understand, nor to speak, yet he swallowed still what was put into his Mouth, though unknowingly, and his Pulse was laudable enough: About this time, he fell into a Flux, excited of it self by Nature for four days, which at last ceasing, a whitish Crust or Scurf, and as it were Chalky, began to spread over the whole Cavity of his Mouth and Throat, which being often in a day wiped away, new presently broke forth: when he had thus for four days more been sick, he became better in his Intellect and Sense, so that he was able to know his Parents and Friends, to take notice of their words, and to do something as he was bid; but as his sensitive Faculty began to be restored, so he began to grow worse as to his Speech and the Organs of swallowing; without doubt the matter being fallen from the Brain, into the beginnings of the Nerves, a Palsie in the Tongue and Throat had succeeded to the heaviness and stupefaction: which Distem∣per in a short time so increased, that afterwards the sick person could not swallow at all, but that what he took in at the Mouth, presently flowed back again, neither could any thing go down into the Stomach; when besides the cruelty of the Disease, there was danger lest he should be killed by Famine, an Instrument was prepared of a Pin of Chalk, put into a little pliant Wand, and on the top of it a little tuft of Silk made fit; and this being thrust down his Throat, opened the closing for a time, whereby the Food taken in, was suffered to pass; after the use of this for a day or two, he was able to swallow again, and afterwards to take his Food well enough; and within a few days, he began to speak, to discern any thing, and becoming won∣derful hungry, to ask for, all day long, all sorts of Food, and greedily to devour whatever was brought to him. In the mean time, by reason of his long Sickness, and the nervous parts being grievously hurt, he was grown so lean, that the Bones scarce sticking to the Skin, he re∣presented exactly a living Skeleton. But afterwards, by the sedulous, indefatigable, and pru∣dent Care of the Mother about his Diet, he recovered perfect Health, and is yet living, and well.

When this Child had hardly arrived to the height of his Sickness, his Brother, elder about two years, on the Ides of January, was taken almost after the same manner: At first he was troubled with a Torpor and heaviness of the Head, then growing Feaverish, with a sleepiness and stupidity; he began to talk idly in his Sleep, then being awake hardly to come to himself: after four or five days, these Symptoms grew more grievous; he was able to understand little, nor scarce to speak articulately, and not without stammering. His Urine was thick, cloudy, without Hypostasis, or setling of the Contents: There appeared, as in his Brother, red spots,

small, like Flea-Bites: his Excrements both of his Belly and Bladder, came away involuntari∣ly: but his Pulse was yet strong and equal; his Hypochondria were stretched out, and inflated with a tumor of the Abdomen; about the eighth day, he had a small stream of Blood: on the eleventh day of his Sickness, he fell into a Diarrhaea, by which, in the space of five hours, he cast forth seven times, bilous, thin, and highly stinking stuff, from whence there was some hope of his amendment; but the next day after, the flux of his Belly ceasing, pains and torments cru∣elly infested his Belly, that crying out and moaning night and day, he sent forth most heavy complaints; his Hypochondria and Abdomen were tumid like a Tympany, and mightily distented; when he could not receive any thing of ease, from no Remedies, the most exquisite Skill of many Physicians being tried, on the fourteenth day he died Convulsive, in these Tor∣ments.

A little after his Death, viz. on the thirteenth of February, his Brother, elder than him, about eleven years old, a Youth of great hopes, began to be Feaverish; and as the others, with a torpor and heaviness of his Head, though less strongly affected; but the heat in the Blood was greater, which was of a more hot temperament, and greater perturbation appeared, that for the first six days, besides heat and thirst, he was troubled with a continual endeavour of ex∣cretion, now by Sweat, now by Stool. His Urine was red and troubled; some red Spots, as in the rest broke forth; on the seventh day he had a bleeding about five Ounces, which ceasing, a great benummedness succeeded, that for all that day and the night following, he could scarce lift up his Eyes: On the eighth day, a most plentiful bleeding followed again at the Nose, that there was danger, lest he should have lost his Life, together with his Blood; the Blood sprang so copiously from his left Nostril, that being received in a Bason, it made little Bladders or Bubbles by its fall: when he had lost above two pound of Blood, and being taken with a cold Sweat, began to lose his strength, Remedies were at length administred, and the Flux was yet hardly stopped. The Haemorrhage being stayed, the Youth slept soundly, and all that day became sleepy; yet often awaking, he remained well in his Senses, and was quick in sense, and understanding; and being asked of his health, he said he was pretty well; his Urine, which which was before red and troubled, then appeared pale, thin, and with a laudable Hypostasis, that the Sick seemed (especially because he wanted thirst, or immoderate heat) to be perfectly cured and freed from the Feaver: on the following Morning, being the ninth day of the Fea∣ver, he remained yet torpid, but being raised up, he living chearfully and intemperance, seemed to be in a condition of growing well, but that he began a little to faulter in his Speech: in the Evening, when it was least suspected, the Feaver being again enkindled, on a sudden he fell into a Lethargy, that he was scarce able to be awakened from sleep, and being pulled, scarce to know any body, or to speak plainly; although so great a loss of Blood had gone before, the Pulse was yet quick, high, and vehement; also the Urine red; after deriving and withdraw∣ing Remedies had been used all that night, this Youth seemed to be in a little better condition, so that in the morning, he continued a long time from Sleep, but began to rowl about his Eyes hither and thither, and to set himself up a little; yet without speaking, or knowledge of those that were about him: before noon, his Eyes being shut again, he wholly lost the use of every Ani∣mal Faculty: he lay for three days as it it were Apoplectick, with an high and vehement Pulse, with a palpitation of the Heart, and a difficult and painful breathing; his Pulse at length grow∣ing lesser by degrees, he died the thirteenth day of the Feaver.

On the fifteenth of F•…•…bruary, his Sister somewhat lesser than he was, began to complain of a pain and torment in her Belly, a trembling in her hands, and a painful tension or stretching out of the Muscles of her Neck, with a feaverish intemperance and thirst: on the last day of Fe∣bruary, she growing plainly into a Feaver, could not keep out of her Bed: moreover, she was troubled with a wandring heat, now in her Face, now about her lower parts; also she became heavy and somnolent, and awaking from sleep, could not presently come to her self. On the first of March she was lightly Purged and with ease, with an expression of Rhubarb: her Urine was thick and red; also petechial red spots (as in the rest) were conspicuous: we gave her after that, for four days, at several times, to wit, after the interval of every six hours space, ten drops of the Spirit of Harts-Horn, in a spoonful of Cordial Julep; the aforesaid Symptoms afterwards leisurely remitted, and this sick Child, though slowly, recovered health without any manifest through Crisis.

About the same time her little Brother, younger than any of these, fell sick almost after the like manner; who, yet, a Loosness arising naturally of it self, for many days, voyding Chole∣rick and greenish stuff, was easily cured. Also in the same Family, many other Domesticks, and some Strangers coming to help them, the evil being propagated by Contagion, fell sick of the same Disease: who notwithstanding, at length became well, though with difficulty, and slowly, without any regular Crisis being made.

That this Feaver was malignant, plainly appears by the Contagion, Mortality, and Appear∣ances of Spots, and many other signs; though that infecting Contagion, whereby it spred from one to another, shewed it self slow, and of lesser efficacy; because, between the Sicknesses of

each of them, many days, and oftentimes weeks hapned to be, that the Infection of this though acute Disease, and the dissemination on others, was scarcely finished in four months space, in the same House. The Feaver about the first beginning seemed gentle and mild, not very ter∣rible as to burning; but the matter being heaped together, from the deflagration of the Blood, became presently untameable, hard to be exterminated, also enemical to the Brain and Nervous Stock; wherefore in each of them, the beginning of the Disease was to be known ra∣ther by the torpor and somnolency, than the fervor and heat; also the Crisis, though by several ways attempted, viz. by Sweat, Flux, Bleeding, did not happily succeed, but for most part, the Blood growing turgid with the Critical Motion, endeavoured to transfer the Feaverish matter, upon the dwellings of the Animal Spirits; yet it self notwithstanding, became not pu∣trefied by this means, but that about the standing of the Disease, both humors (to wit, the Blood, and Nervous Juice) being vitiated, by an impure mixture together, and grievously touch∣ed, caused the event of the Disea•…•…e, to be either deadly, or extream dangerous.

CHAP. XV. Of the Measles and Small Pox.

IN the next place, we refer the Small Pox and Measles to the Rank of Pestilential and Malignant Feavers, which indeed are mixt Distempers, consisting at once according, and contrary to our Nature. As to their Original, they have their Seminary born with us: but as to the effect, they produce preternatural Symptoms, and (as the Plague it self) poyso∣nous; so that they constitute as it were a certain peculiar kind of Feavers, proper indeed to men, but after another manner, than Porphyrius has assigned; for it happens for every man only, and once to be distempered with the Small Pox or Measles: if perchance any one lives free their whole life, or another more often fall into these Distempers, they are rare and unusual events of Nature, which lessen not common observation; yea 'tis fully confirmed, to wit, that all, and only men are obnoxious to the Small Pox and Measles, and are wont to be rid of them at one Sickness. Concerning the Small Pox, we will treat of them apart from the Measles, what the Cause of them is, then what Signs and Symptoms they have, and lastly, what things belong to the Crisis and Cure.

Concerning the Causes, we ought to consider in the first place, what is the secret leading Cause, to wit, which renders only and all Mankind, and that once, obnoxious to this Disease. Secondly, We will enquire concerning the evident Causes, viz. by what and how many ways, this latent and occult disposition is wont to be, now sooner now later, deduced into Act. Thirdly, It shall be declared, what is the conjunct Cause, to wit, by what motion and alteration of the Blood, the figure of this Disease is produced.

1. As to the first, This disposition or natural predisposition, which inclines humane kind to this Disease, seems to be a certain evil or impurity of the Blood, conceived in the Womb, among the first Rudiments of Generation; almost all Authors would have this ascribed to the Menstruous Blood; which Opinion seems not altogether improbable; because in a Womans Womb (otherwise than in most other living Creatures) there is generated a certain Ferment, which being communicated to the Mass of Blood, affords to it Vigor and Spirit, and then at set periods, procures a swelling up, and an excretion of the superfluous Blood; but at the time of Conception, when the Menstrua wholly cease, very much of this Ferment is bestowed on the Foetus or Child; and its Particles being heterogeneous to all the rest, as a certain extraneous thing, are confused with the mass of Blood and Humors; with which being involved, and se∣parated one from another, lurk or lie hid a long while; yet afterwards at some time, being moved or stirred up, by some evident cause, they ferment with the Blood, and induce to it an Ebullition, and then a Coagulation, from whence very many Symptoms of this Disease arise.

These Fermentative Seeds sometimes are few and gentle, and so involved with other little Bodies, as they do not easily appear, and are brought into act; sometimes they are more and stronger; so that on the least occasion they are ripened into this Disease; hence indeed some are taken sooner, with the Small Pox in their tender years; others more slowly, and not till full or more ripe Age; also some easily receive the Contagion, but others converse often with the sick without danger. The sooner that any one hath this Disease, the more secure they are; wherefore Children most often escape; old men, or such as are of years, are more in danger, viz. in Children or young people, Transpiration is more easie, also the habit of the Body

more firm and healthful. But altho the venomous seeds of this Disease, for the most part are wont to be dispersed or blown away at once, and with one sickness; yet it sometimes happens, that a part of the infection being still left, the sick have fallen into this Disease twice or thrice.

2. The evident cause which stirs up these fermentative seeds, and most often brings them into act, may be said to be threefold, viz. The contagion received from some place: the disposition of the Air, and the immoderate perturbation of the Blood and Humors. It is most manifest by daily experience, that this Disease doth come upon others, and spread abroad by contagion; viz. from the infected Body, continually flow Effluvia, which being received by other Bodies, pre∣sently like poyson, they ferment with the Blood, and suscitate or awaken the lurking or sleeping Seeds of the same Disease, homogeneous with themselves, and dispose them into the Figure or Idea of this Disease: neither is the Infection only communicated by contact, but at a distance. They who live within the same House, or neighbouring to the Sick, easily receive the Infection; also it is cherished in Cloaths, and dissipated afar off, and transferred to more remote places. They who are of kin one to another, soonest infect each other; also they who are fearful, and extreamly dread this Disease, more readily fall into it: For by Fear, the Particles of the Infection are conveyed inwardly from the superficies of the Body. At what time the Contagion spreads, and that the Small Pox are Epidemical, all other Diseases almost degenerate into this. Secondly, a certain peculiar disposition of the Air, notably induces the Small Pox; hence most often it be∣comes popular, and rages ordinarily through whole Regions, Cities and Villages; hence also it more often exists in the Spring and Autumn: because at that time especially divers manners of little Bodies, and by that means tumultuating flow about in the Air, which we draw in with the Air, and so various effervescencies of the Blood and Humors, and Idea's of Diseases are raised up. Neither doth this Disease become only more frequent and Epidemical for these Causes, but also it gots a manifold Nature, that sometimes the Small Pox are deadly, and as it were pestife∣rous, and sometimes they are more mild and benign; to wit, as they have contracted more or less of Malignity from the Air; hence also sometimes black and livid Whelks or Pustles appear, and have much of the Nature of the Plague. Thirdly, Sometimes, though the Tinder of contagion be absent, and that no malignant Constitution of the Air had gone before, yet by reason of the Blood and Humors being immoderately disturbed, theSmall Pox do arise: so I have known some to have fallen into this Disease, from a Surfeit, or immoderate exercise, when none besides in the whole Country about, hath been sick of it, to wit, the Seeds of this evil, lying hid, with∣out any previous infection, being stirred up by a too great fervor of the Blood, and being as∣sociated, gathering together, easily defile, and infect the whole Mass of the Blood, with their Ferment,

3. So much for the secret leading, and evident Causes, but as to the conjunct Cause, viz. which is the formal reason of this Disease, or the manner of its being made, the business seems a little more intricate. It is commonly wont to be compared to Must growing hot, or Beer when it purges in the Vat: for if you put to these Liquors any thing of Ferment: as their Particles are heterogeneous, and of wonderful activity, presently they diffuse themselves through the whole substance of the Liquor, they exagitate the more thick and impure Bodies, against which they are dashed, beat them asunder, and roul about them, until a flowring being made, they drive the same from the intimate embrace or company of the Liquor, to the outmost Superficies. After the like manner the heterogeneous Seeds of this Disease, are thought to ferment the Blood, and then by a certain eruption of Whelks or Pustles, like the flowring, purifies it. But indeed, if we should more strictly consider the Business, there will appear here a great difference; because the infection of the Small Pox, is as it were a Ferment, or corruptive, and compels the Blood to grow hot, not towards perfection, but depravation; for when the Particles of this veno∣mous infection strike against the receiving Subject, they presently raise up little Bodies like to themselves, and born with us, with which being associated, they pass through the whole Mass of the Blood, and make it to grow highly turgid, and to boil up, and after some time growing fervent, to go into parts, and to be coagulated, viz. the dispersed Seeds of the Poyson, dissolve the mixture of the Blood, presently profligate the more pure Spirits, then they joyn its more thick Particles to themselves, and by their adhesion, render them as it were congealed: The portions being so coagulated, together with the infolded Seeds of the Poyson, being left by the rest of the Blood, in its circuit, between the extremities of the Vessels, are affixed to the skin: by which means, if Nature being strong enough, doth cast forth the whole poyson, with the congealed Blood, the remaining Mass of the Blood, although made poorer, remains however in a condition to continue Life and Health; but if the Blood, being too excessively congealed, cannot be purified after this manner; or if portions of the Blood growing together with the Poyson, do not fully break forth, or at last do stagnate within, they wholly corrupt the Liquor of the Blood, or else being affixed to the Viscera, and especially to the Heart, they de∣stroy their constitution and strength.

Portions of the congealed Blood, with the Poyson, begin to break forth about the fourth day (now sooner, now later) because Coagulation is not presently induced, but after some time,

in which the Venom unfolds it self, and ferments the Blood with its Effervency: First, •…•…light portions of the infected Bloud, and those but few in number, like to Flea-bites, are fixed in the Skin; quickly after more appear, and those first broke forth, by the accession of new Matter, and by the continual appulsion of the congealed Blood, increase, and are elevated into a tumor; then these Whelks at first red, being by degres increased, at length grow white, viz. the Bloud being thrust forth of the Vessels with the Poyson, by reason of the heat and stagnation, is chan∣ged into Matter: about the seventh day after the eruption, the white tumors grow crusty, into a dry Scab; for the more thin part of the matter being evaporated, the rest grows hard, which then having eaten, and broke off the Cuticula, or outward thin Skin; falls away from the flesh or next Skin.

When the infection of the Small Pox is at once impressed on the Blood and Spirits, it very rarely can be blotted out, or dissipated by Medecines, or Bloud-letting; but that its hidden disposition, will break forth into act; wherefore at first it diffuses it self by little and little, and inspires the mass of Bloud, as it were with a Ferment, hence an ebullition and growing hot are produced in the whole Body, the Vessels are distended, the Viscera provoked, the Mem∣branes pulled, until the Seeds of the Contagion, by fusing and coagulating the Blood, being at length involved with its congealed portions, are thrust forth of doors. The Essence of this Disease will be better laid open, if that I shall recount the Signs and Symptoms, which are to be observed in its whole course, and shall add in order the Reasons and Causes of them, on which they depend; but they are those which either indicate the Disease being present, or that fore∣tel its state and event.

As to the Diagnosis of this Disease, by which it may be known, whether any one at first fal∣ling sick, will have the Small Pox or not; at that time are to be considered, the force of the Contagion, and the concourse of the Symptoms first appearing; for if by reason of the evil constitution of the Air, this Disease doth spread abroad every where, none then is taken with a Feaver, without the suspition of the Small Pox, especially if they never had them before in their lives; but if this Disease be more rare, and without fear of Contagion, yet its unlooked for Assault quickly betrays it self, by these sort of Signs and Symptoms.

1. There is a wandring and uncertain Feaver, sometimes strong, sometimes more remiss, ob∣serving no reason of increase, or growing continually hot, so that the Sick are now highly hot, by and by without any evident cause, they are without a Feaver; the cause of which is, for that the fer mentative Seeds are not agitated by an equal motion, but like fire half choaked, now in∣creases more, and now are almost quelled, and ready to expire; until the burning spreading more largely, the flame every where breaks forth.

2. A pain in the Head and Loins, is so peculiar a Sign in this Disease, that it almost alone, in a continual Feaver, signifies the approach of the Small Pox; the reason of which is commonly imputed to the greater Vessels being very much distended by the effervency of the Bloud; but indeed it appears not, wherefore the same trouble is not caused equally in other parts, by reason of the like distention of the Vessels, and wherefore in the Small Pox, more than in a burning Feaver, or in other Feavers, where the Bloud grows more hot, these kind of pains should in∣crease; yea, it may be observed, that great pains, now in the Head, now in the Loins, do urge, when the Blood but little swelling up, the Vessels are not amplified, viz. in the beginning of the Disease, when the Feaverish distemper is not yet conspicuous, while the sick as yet go a∣broad, and are well in their Stomach, upon the first coming on of the Small-Pox, they betray themselves by these kind of Pains. Wherefore, the cause of these kind of dolorifick pains, seems rather to subsist in the nervous stock, viz. in the Brain, and spinal marrow, and that by reason of the membranes, and nervous parts being pulled or hauled by the particles of the poy∣son, these pains do arise. For it is most likely, that the innate seeds of the Small Pox are chief∣ly hidden in the Spermatick parts, and that first of all, the Contagion lays hold on, for the most part, the Animal Spirits; hence, the first effervescency is stirred up in the Juice, wherewith the Brain and nervous parts, but especially the Spinal marrow are watered, and from thence the evil is communicated to the mass of Bloud; wherefore, this Disease beginning, the Head and Loins are tormented with cruel pain; afterwards, the venom being translated into the Blood the Feaverish effervesency is stirred up in the whole.

3. Greatanxiety, and unquietness, and somtimes a swooning, infest the sick, viz. by reason of the perturbed motion of the Blood, as also its equal mixture, beginning to be solved, by the Poysonous ferment, the Blood from thence being apt to stagnate in the Heart, and to be hindred in its Circuit, causes the•…•…e affections to be thus excited.

4. Cruel Vomiting, also when the Ventricle is free from an impure ballast of Humors, very often accompanies this Disease.; the reason of which is, because the fermentative seeds, being stirred up into motion, by the little Arteries gaping into the coats of the Ventricle, are depo∣sed by every appulse of the Blood, and raise up Vomiting, as if the particles of Stibium had been swallowed; but afterwards, assoon as sweating being procured, the Poyson is driven forth outwardly, this Symptom ceases, and the Sick are well in their Stomach, without any purging forth of the noxious matter.

5. With these may be ranked, the Symptoms which shew themselves, according to the va∣rious habitudes of the Body, after a diverse manner, as heavy sleepiness, terrors in sleep, de∣liriums, tremblings, and convulsions, sneezing, heat, redness, a sense of pricking over the whole Body, involuntary tears, a sparkling, and itching of the eyes, a tumor or swelling up of the Face, a vehemency of Symptoms from the beginning, that the Disease seems presently to have attained his strength: the reason of all which may easily be elucidated, if what hath been already said concerning the Symptoms of Feavers be observed; with respect to the diverse tempers of the Sick, their habit, and age, as also the condition of the year.

2. As to the Prognosis of this Disease, by the Symptomatic Signs, it is indicated to be ei∣ther salutary, or mortal, or of a doubtful Event.

1. The business promises well, when this Disease has benign circumstances; to wit, when it happens in a good constitution of the Air and Year, and at what the Small Pox are less ma∣lignant and pestilential; as in the year 1654. at Oxford, about Autumn, the Small Pox spred abundantly, yet very many escaped with them: but before, in the year 1649. this Disease was more rare, yet most died of it. Also, there is less danger, if it should happen in the age of Childhood or Infancy, or in a sanguine temper, and good habit of Body, or in a Fa∣mily to whose Ancestors the Small Pox have not proved mortal: Resides, if in the whole course of the Disease, the Symptoms prove laudable, if in the first Assault, there be a gentle Feaver, without cruel Vomiting, Swooning, Delirium, or other horrid Distempers; if the Feaver about the fourth day be allayed, with the Symptoms chiefly urging, and then some little red spots begin to appear; if on the second day of the coming forth of those little red spots, they become more conspicuous, which afterwards grow together by degrees into little Pimples, and are ripened into Matter; if about the tenth day, or thereabouts, after the Erup∣tion, the white tumors begin to scab, and by little and little from thence to fall off; if after their first coming forth, the Small Pox are soft, distinct, few, round, sharp-pointed, lying only towards the skin, and not in the inward Parts, you may be confident the Sick will do very well, and is in a good condition.

2. The appearances, which in the Small Pox, signifie the business to be suspected, and full of danger, are of this sort; if there be a malignant constitution of the Air, that this Dis∣ease becomes Pestilential, and many die of it; if men of more ripe years, or middle Age, be taken with it; if it happens in a cold and melancholick temper, or in an impure or evil hu∣mor'd Body, where the Bloud is not rightly circulated, nor transpiration truly performed, or if the Hypochondria or Praecordia are obstructed, some of the Viscera infirm, or troubled with an Ulcer, or if the habit of the Body be too fat, the Small Pox happen not without great danger of Life; nor is it less to be feared, when presently after the beginning, a great Feaver, cruel Vomiting, Swooning, a dejection of strength, Phrensie or Delirium come up∣on them, and that these desist not, upon the full coming forth of the Small Pox, for these sig∣nifie a too great perturbation in the Bloud and Humors; also, a confusion and contumacy of the morbifick matter, which can neither be subdued, nor easily separated from the mass of Bloud, or equally extruded from it: if there be an anxiety, and great unquietness, with an inordinate boiling up, and growing hot of the Bloud; also a great thirst, a difficulty of breathing, also a flux of the Belly, or Dysentery, they shew that sweating is hindred, and that the malignant humors restagnate towards the inward parts: The small Pox breaking forth slowly, argue the crudity and untameableness of the matter, and the impotency of Na∣ture, and 'tis much more a sign, if they come forth double, and continued, in too excessive a quantity and confusion, and also if there be a disordered expulsion, and irregular, of that matter, when not in certain issues, but every where undistinguishable. The Pox being hard, signifie the incoction of the same matter, being depressed, a weak expulsion; and they are the worse, if in the midst of them appear black spots; or if purple spots familiar to the Fea∣ver, or the Plague, are sprinkled among the Pox, they indicate a great malignity and putre∣faction of the Bloud, such as is wont to be found in the Pestilence. Lastly, the Pox being black, livid or green, are of an evil omen, because, besides the coagulations of the Bloud, they argue its deadlinesses and corruptions, as in a Gangreen or Pestilent-Plague-Sore; if when the small Pox being come forth, they presently grow dry, and the swelling of the parts remit, it shews a going back of the malignant matter, or of the congealed Bloud, with the Poyson, and a restagnation of it to the inward parts; from whence, unless a more free Dia∣phoresis or sweating be excited, that it may be thrust forth of doors again, Death for the most part quickly follows: For from hence the Bloud being more coagulated, enters into putrefaction, also it is apt to be hindred in its motion, and to stagnate in the Heart and Ves∣sels. If after the coming forth of the small Pox, a flux of the Belly, or a bleeding at Nose, comes upon them, it is an evil sign, because, by this means the Venom driven outwardly, is again called back inwardly; but sometimes I have observed these Symptoms to have hapned, with great ease to the sick, viz. Nature being before oppressed and burthened; after this

manner, part of the burthen being as it were detracted, she was eased; wherefore, she buck∣led her self to the work of sweating, and more readily expedited the expulsion of the noxi∣ous matter.

As to the Curative part, since the stadium or course of this Disease, hath three Seasons, as it were so many measures, distinct one from another, the Curative intentions ought to be accommodated to each of these; wherefore the Curative Method concerning the Small Pox, teacheth first, what is to be done so long as the Bloud boyls up, and grows hot inwardly, with the motion of the fermentative matter, and before the small Pox appear, which period for the most part is finished in four or five days.

Secondly, what means or manner of Diet and Physick is to be instituted, after the coming forth of the small Pox, until the state or standing of the Disease, viz. whilst the Whelks or Pox come to the height, and being fully suppurated or ripened, begin to dry.

Thirdly and lastly, what we must observe in the declining of the Disease, even whilst the small Pox growing dry, fall off.

1. As to the first, let the Intention be, that we may carry away every impediment of Na∣ture, whereby the Bloud being infected by the Ferment of the small Pox, and apt to be coa∣gulated, may yet retain an equal motion in the Heart, and without stagnation in the Vessels, and growing hot, may expel forth of doors the congealed portions with the Poyson; in the mean time, there must be a caution, lest the work of fermentation or growing hot be any ways hindred, or too much provoked; for by this the Mass of the Bloud is agitated into con∣gealed portions, more than it ought to be; by that other it is restrained too much in its mo∣tion, nor are the invenomed Particles sent forth of doors with the congealed Bloud; Na∣ture in the work of secretion and expulsion, is wont to be hindred by too great an heap of excrements in the Viscera, or by the abundance of Bloud in the Vessels; wherefore upon the first assault of the Disease, care must be taken, that if need be, an evacuation by Vomit or Stool, be timely procured; but only more mild Purges, and gentle are to be used, which do not too much provoke, or disturb the Humors: wherefore, at this time, Purges, Emeticks, or Clysters, now these, now those, take place; also the letting of Bloud, if there be a ful∣ness, is performed with good success.

During this growing hot of the Bloud, Diet ought to be instituted slender and moderate∣ly cooling, viz. Barly-Broth, or Grewel of Oatmeal, Posset Drink, Small Beer, or the like: Flesh, and Flesh-Broths are to be avoided, whereby the Bloud, by reason of the too great plenty of sulphureous Food, may be enkindled more than it ought; also all cold, and sharp or acid things are hurtful; for these congeal the Bloud more, and contract the little mouths of the Vessels by their astriction or binding nature, that the small Pox come forth less freely; also hot things, and Cordials are cautiously to be administred; for by these the Bloud and Humors are too much agitated, and driven into confusion.

2. When the Small Pox begin to appear, there are three things, which by a constant Rule we prescribe to be performed to every sick person, to wit, that a soft and gentle Sweat be still continued in the Bloud; also, that the Throat and Eyes may be preserved from a too great eruption of the Small Pox. That the Bloud lightly growing hot may emit the Small Pox, Decoctions of Figs, Marigold flowers, and shavings of Harts-horn in Posset-drink, are commonly prescribed, and the use of them is general for a long time, almost with all peo∣ple; for the same intention, we are wont sometimes in a day to give them moderate Cordials; but the more hot and strong are carefully to be shunned: Purging and Bloud-letting here are most wickedly enterpriz'd, and these, though Necessity compelled, Physicians dare not meddle with for fear of blame: For to defend the Throat and Guttural parts, we put on the outer Skin a defence of Saffron dipped in Breast-Milk, and sewed in a Rag; for these, by opening the pores, draw away the venom outwardly, from the most inward part or the Throat; also for this end, we administer Gargarisms, and things to wash the Mouth, which by their restriction, restrain the coming forth of the Small Pox within: we defend the Eyes with pe∣culiar Medecines, of Rose-water, and Breast-Milk, with Saffron, and such like, frequently iterated, from the incursion of the Small Pox: Besides these, sometimes certain most horrid symptoms do trouble, which must be timely helped with convenient Remedies; sometimes there are present, Watchings, Phrensie, Bleeding at Nose, Vomiting, Loosness, and a fal∣ling back of the Small Pox: for these and divers others, as occasion arises, a prudent Physi∣cian knows how to provide; in which however there is need of great caution, lest whilst we take care of the smaller matters, the great work of Nature should be disturbed by a too great molestation of Medecines. For in all this time there is one and a continued Crisis: wherefore nothing is to be medled with rashly. There is required the most care and circumspection of the Physician and Nurses, or those that administer to the Sick, when this Disease is at its height or standing, viz. lest that when the Small Pox be fully come forth, and brought to their greatest height, transpiration should be hinder'd; for then the sick are in danger of renewing the Feaver,

and of the restagnation of the Malignant matter within, whilst we study to prevent the one, we for the most part bring on the other.

3. When the Disease shall be in its declination, and the Small Pox begin to wither and scab, the business for the most part is out of danger, nor is there much need of a Physician; let the sick, though he grow very hungry, content himself still with a slender Diet, and without Flesh: if the Scabs fall off slowly, we are wont to ripen them with Liniments, and peculiar Medecines, to make them fall, and care should be taken that they leave not behind them too great Pits: after the Sick having the Scabs every where fallen off, and are able to rise and walk about the Chamber, the filthy Excrementitious Matter in the Bowels, is to be carried away, by two or three times Purging, and then they may be permitted to use a more plenti∣ful and stronger Diet.

The Measles are so much akin to the Small-Pox, that with most Authors they have not de∣served to be handled apart from them, but that either Distemper have been treated of toge∣ther, after the like manner and method. The Essence and Cure differ at least accidentally, or as they are greater or lesser; because in the Measles the Whealks rise not up to so great a Bulk, neither are they suppurated; wherefore the Sickness is sooner ended, and with less danger. this Distemper is wont mostly to spread upon Children, more rarely amongst those of years, or old men; also those who first have had the Small-Pox, are not afterwards so obnoxious to the Measles, but in most things, either Distemper are of kin, viz. the Evil being contracted in the Womb, disposes men only, and all men once to the Measles; the malignant constitution of the Air, and sometimes a Surfeit, and most often the Contagion, are wont to bring the hidden disposition into act; there are present marks of malignity, and the Sickness often∣times becomes Epidemical, and with Mortality and Contagion.

That I may briefly contract the Sum of the Matter, it seems that the Measles are a certain lighter flowring, of an extraneous ferment, contracted from the womb; by which, some Particles being stirred up into motion, make the Blood lightly to grow hot, and to be a little coagulated; wherefore the Marks from thence spread abroad, are dissipated without any breaking of the Cuticula, or outward Skin, by evaporation only; but the Small Pox are a more full and strong agitation, according to all the Particles of the same Ferment, which caus∣ing a great ebullition and coagulation of the Blood, produces far more full whelks, and great∣er in bulk, and not to be dissolved, but by suppuration, or growing into matter: when the Small Pox precede, they are not only exempt from the same Disease any more, but also from the Measles, because they consume only some of the Particles of the Ferment, leave still a dis∣position to the Small Pox; wherefore old men, or those of years, are not so readily infected with the Measles, because they are either freed from the contagion, by having before had the Small Pox, or else the Infection of this more light Disease, is easily resisted by their more strong Spirits.

It were easie to illustrate the afore-cited Doctrine concerning the Small Pox, with Histo∣ries and Observations of the Si•…•…k, because there is no Disease besides can supply with a grea∣ter plenty of Examples, or variety of Accidents; but of the great number of this kind, I shall only propose in this place a few Cases, and those remarkable for some irregularities.

It is a usual thing to handle all that are sick of the Small Pox, with a like, or wholly the same method of Curing, and manner of Diet; wherefore, a Physician is rarely sent for to the common sort, but the business is wholly committed to some Women, professing them∣selves skilful in this Disease; and these are wont to boil in their Broths, and all the Suppings of the sick, Marigold-flowers, shaving of Harts-horn, and sometimes Fig•…•…; also every night to administer a Bolus of Diascordium; and they who grow not well by this kind of Govern∣ment, though not neglected, yet are affirmed to be incurable, by reason of the cruelty of the Disease. But truly this kind of Practice is not convenient for all alike, nor to be admi∣nistred to every one indifferently; as these two following Histories will make mani∣fest.

A young Man, about 20 years of Age, of a slender Body, and more hot temperature, be∣gan to be Feaverish in the beginning of the Spring, at first cruel Vomitings, an oppression of the Heart, and frequent changes of heat and shivering, a pain in his Loyns, a disturbance of his Fancy, and Wakings infested him; on the third day, the Small Pox appearing, those Symptoms remitted, but still the Feaver, with heat and thirst continued. Not only the ac∣customed Decoctions in this Disease, but also a most elegant Julep, of a most grateful taste, were so nauseous and troublesome to him, that he would not so much as taste the same, but with a great deal of trouble; as often as he took going to sleep, Diascordium, or any other more temperate Cordial, for the continuing his Sweat, though in a very little quantity, the night following he was without sleep, and in great disquiet; and then in the beginning of the morning a Bleeding followed, by which means indeed, the Small Pox being full come forth, the Life of the sick was in great danger, by reason of this occasion hapning once or twice; where∣fore,

when I had found by observation, his Blood apt to grow immoderately hot, by so light a provocation, I instituted this method as occasion served. All Medecines being let alone, he to ok for the quenching his Thirst, small Beer, and simple Almond-Drink, at his pleasure: for his Food, because he vomited back all Oatmeal Grewel, or Barly-Broth, he eat only Ap∣ples roasted tender, and drest with Sugar and Rose-water, often in a day. Nature being con∣tented with this slender ordering, and being seen to be disturbed with any other thing per∣formed happily its work, that the sick person grew well, without any grievous Symp∣tom afterwards, the Small Pox from thence ripening, and then of their own accord fal∣ling off.

In the middle of Autumn of the former Year, a Gentile Young Man, being endued with a sharp Blood, and obnoxious to a frequent bleeding at Nose, fell sick of the Small Pox; his Blood of its own accord grew immoderately hot, that the Whelks very quickly broke forth over all his Body: Posset-Drink, with Marigold-Flowers, and other usual things boiled in it, also Juleps, or any Cordials, though temperate, and gently provoking Sweat, most certain∣ly stirred up a Flux of Blood in this Person; wherefore I ordered the like manner of Diet, as in the sick person before cited, by which he found himself better; however, in the very state or standing of the Disease (when the Small Pox being fully come forth, by reason of a more difficult transpiration, the Feaver is wont to be somewhat renewed in all) this sick man fell into a most plentiful Bleeding; that after a large profusion of Blood, the Small Pox be∣gan to flagg or fall: After that Remedies, very many, were tried in vain, for the staying of the Blood, at length a little Bag being hung about his Neck (in which was a Toad dried in the Sun, and bruised) he first, and immediately perceived ease; though the bleeding was by this means stayed, and not any more returning (whilst he constantly wore this peculiar Mede∣cine in his Bosom) our sick Man still using a most thin and cooling Diet, grew quite well; that indeed from hence it may appear, that although the Blood in this Distemper, is apt to be greatly coagulated, yet so long as the vital Spirits, being strong and robust, are able suf∣ficiently to execute their government, they endeavouring by their proper strength or forces, do best of all separate and thrust forth the congealed portions of the Blood, as it were by a certain skilful separation; and this work is most of all hindred, when the same Spirits are too much irritated by Cordials, or more hot Food, and agitated into confusion: But in the Plague it happens otherwise, because in this, if any delay be granted, the Spirits themselves are presently profligated by the Venom; wherefore, here they must fight close and quick, when in the Small Pox, the Physician does his business better by delay.

Concerning letting of Blood, at the instant breaking out of the Small Pox, it is very dubi∣ous; formerly, among our Countreymen, this was esteemed a wicked business, neither were they wont to admit of Phlebotomy under any pretext of necessity: but of late, experience having taught us, in some cases, it is found, that to let Blood, hath been wholly profitable and necessary; which evacuation however, if it should be administred indifferently in every con∣stitution, or when this need should be, it should be performed in too large a quantity, by that means oftentimes very great dammage arises.

Some years before, I visited a young Gentlewoman, of a florid countenance, and more hot temperature, growing into a Feaver, after the fourth month of her being with Child; she was troubled with a cruel Vomiting, a most cruel pain of the Loins, besides with most strong heat and thirst; her Pulse was swift, with a strong and vehement vibration or beating; altho the Small Pox had never been in that Place, yet these Symptoms gave no light suspition of this Disease; however, its great effervescency indicated that Blood should be taken away; wherefore I took away about six ounces presently, upon which the heat remitted somewhat, yet the Vomiting, with a cruel pain in the Loins remained still: At the hour of sleep, I gave her a Cordial Bolus, with half a grain of our Laudanum, by which means quiet sleep followed, with a pleasant sweat, and an allaying of all the Symptoms: the next morning the Small Pox came forth, with which, although the sick Gentlewoman was greatly distempered, yet she grew well without any dangerous Sickness, or fear of miscarrying, and went out her full time.

The last Autumn, a strong Man, of an active and robust constitution of Body, yet of a pale Countenance, and more cold Temper, fell into a Feaver; on the second day he was torment∣ed with heat and thirst, and a most cruel pain in his Loins: when I had prescribed Blood to be taken in a small quantity, the unskilful Chirurgeon, who was sent for, took from him al∣most half a pound; a little after, the sick man began to be all over in a cold sweat, on a sud∣den to lose all strength, to be troubled with a shivering, a weak Pulse, and unequal, and fre∣quent swooning. At this time being sent for, I gave him a temperate Cordial, to be taken frequently. His Spirits and Pulse being thereby restored, the Feaver was renewed, which afterwards, for some days, yea, weeks, exercised the sick man after a very irregular manner; for he was wont for three or four days to grow very hot, also to be infested with thirst, watch∣ings, Head-Ach, and other Symptoms, then to be troubled all over with a copious and criti∣cal

sweat, by which indeed for half a days space he found himself better; but from thence, the Feaver still growing worse, heaped together again new matter, till it was dispersed by another Crisis, and then another. After that he had been thus feaverish for at least twenty days irregularly, at length the Small Pox began to come forth in several parts of his Body, here and there, and then the Feaver wholly remitted; yet within few days, by reason of some Errors committed in his Diet, very many of the Whelks began to fall down again, few of them only being brought to maturity: However, instead of the subsiding small Pox, a mighty Bubo grew up behind his right Ear; from which, being soon ripened, and broke, a great plenty of Matter flowed forth for many days, and so at length the Corruptions of the Blood, unable otherwise to be dissipated, were carried forth by degrees, and the sick Person recovered perfect Health.

CHAP. XVI. Of Feavers of Child-bearing Women.

VUlgar Experience abundantly testifies, that the Feavers of Women lying in are very dangerous, beyond the disposition of other common Feavers: also that the same differ very much, as to their Essence, from both a simple and putrid Synochus, plainly appear from their signs and symptoms rightly weigh'd: wherefore, I believe it not to be from the matter, to handle after Malignant Feavers, the acute Diseases of Women lying in, being exceeding near of kin to those, for their mortality or perniciousness. Yet, before I shall enter upon the unfolding these Diseases, it behoves us to consider their Subjects, viz. the Bodies of Women in Child-bed, after what manner they are predisposed, and by what provision they are made obnoxious to these kind of Sicknesses.

Concerning this, the first thing that offers it self, is, that the Flux of the menstruous Blood is wholly convenient to be suffered by human kind, and at this time for Women, concerning whose Nature and Original we shall not enquire in this place; but it shall suffice to note, that in them, the particles of the Blood to be periodically thrust forth, are very Fermentative; which, if retained in the Body, beyond the wonted manner of Nature, are very often the cause of many Diseases; unless only when a Woman conceives with Child. For all the time of her being big-bellied, the monthly Flowers are stopped without any incommodiousness; and in the mean time, Milk, or the alible Juice, is disposed in great plenty, about the parts of the Womb, for the nourishment of the Child; but after the Birth, this daily suppression of the Monthly Flowers is recompensed by a copious flowing forth of the Lochia, or what comes a∣way after the Birth; and the Milk within three days having wholly left the Womb, springs forth plentifully into the Breasts: at which time, Women lying in, are wont to be troubled with a small Feaver. If that the Milk be driven away from the Breasts, it restagnates again towards the Womb, and is thrust forth, together with the Lochia, under the form of a whi∣tish humor. In the mean time, the Womb, after the Birth, becomes subject to various Di∣stempers; for oftentimes its tone is hurt, the unity is dissolved, and many other Accidents are induced, which render Women lying in, subject to danger: wherefore, that their acute Diseases may be rightly unfolded, it is convenient to consider chiefly these three things, viz. First, The Nourishment of the Child, or the Generation of Milk, both in the Womb, and in the Dugs, and the Metastasis or translation of it from one to another. Secondly, The pur∣ging of the Mothers Blood, or the Profluvium of the Lochia, after a long suppression of the Menstrua. Thirdly, The condition of the Womb after the Birth, and its influence on other parts of the Body. And these being premised, we will speak of the Feavers of Wo∣men lying in, viz. both the Milky and the Putrid, called, and that deservedly, malignant, by reason of its deadliness.

First, the Milk and nourishing humour, being heaped up in the parts of the Womb, for the nourishment of the Child, are of a like Nature, though somewhat different in consistency. Milk is indeed more thick, because it ought to be received in at the mouth, and to be kept in the Ventricle, and afterwards its more thin portion to be conveyed to the mass of Blood. The o∣ther alible Juice is more thin, and like the Water of distilled Milk, because it is immediately poured into the Blood of the Embryo, through the umbilick Vessels, without any previous dige∣stion. Either Juice is supposed to come from the Chyle fresh made in the mothers stomach; what is reposed or laid up in the Breast, is more thick and white, by reason of the more thin or open

strainer, and coction in the greater Glandula's; on the contrary, it happens in the Womb otherwise, where the Glandula's are smaller, and the straining more close. But there is a great disagreement among Authors, concerning the passages, by which this Humour is carried, both in the Breasts, and into the Cake of the womb. Some contend, that Milk only is begotten of the blood, more plentifuly cocted in the glandula's, which yet, by reason of the immense dispense of Milk, which consists not with the Blood, this seems not probable. Others affirm, that the Chyle, or Milky humor, is immediatly convey'd from the Viscera of concoction, through occult passages, without any alteration, into either receptacles: But in the mean time, while these passages lie o∣pen, it seems indeed to me more likely, that from the meat taken into the Mothers Stomach, a portion of the Chyle thence made, is presently supped up into the Veins, which having ob∣tained the Vehicle of the Blood, before it be assimilated by it, is laid up in the Glandula's, de∣stinated here and there for the receiving of it, being carried by the Arteries, and lastly sepa∣rated from the Mass of Blood; for as it appears, that Drink being plentifully taken, pre∣sently passes through the whole Mass of Blood, and is rendred by Urine like Water; and as old Ulcers, by means of the Blood coming between, prey upon the nutritious Humor, from the whole Body, and powr it forth under the shape of a putrified Matter, why may not the alible Juice in like manner, being strained by the Collander of the Glandula's, before it has indued the colour of Blood, go into a Milky Humour? This indeed seems more probable, because, whilst the Milk is carried from the Womb into the Breasts, and on the contrary, passing through the Mass of Blood, it is wont to stir up a perturbation through the whole, with a Feaverish Intemperance; besides, in the first days, after the Birth, when the Glandu∣la's do less rightly perform the Office of Secretion; Beasts, who have not the Lochia, give abloody Milk, which is drawn forth of their Udders, that is, mixt with Blood, by reason of the plenty of it flowing forth together.

Secondly, As to what belongs to the Menstrua being suppressed, in the time of being with Child, and the Lochia plentifully coming away, after being Delivered, we say, that after the Conception of the Child, the Menstrua ought to be suppressed by Divine Designation, for that the flowing of them often causes Abortion; then, because the Vessels are filled by a continual stilling forth of the alible Juice into the parts of the Womb, the Mass of Blood doth not arise into swellings up, to be allayed by the Menstruous Flux. For the same reason, Women for the most part, have not their Courses so long as they give suck. Perhaps in some, indued with a more hot Blood, the monthly Courses flow, both whilst they are big-bellied, and in the time of their giving Suck, but that more rarely, and is wont not to happen with∣out trouble; yet in the mean time, the Menstrua being suppressed, during the time of being with Child, because much less of the nutritions Humor is expended at that time for Milk, they much more deprave the Blood, than the same being restrained at the time of suckling the Child, are wont to do: yea, from them being long suppressed, in the former condition, an, as it were, envenomed taint is impressed on the Mass of Blood, which, unless it be pur∣ged forth by the daily Flux of the Lochia, presently after being brought to Bed, produces grievous, and almost malignant Distempers. Wherefore, that I may give my Opinion of the flowing of the Lochia, I say, that this Bleeding proceeds immediately from the Vessels being broken, by which the After-Birth did stick to the Womb, and that by this way, the excre∣mentitious Blood and Humors being partly heaped up about the Womb during the time of being with Child, and partly flowing from the whole mass of the Blood, are evacuated, viz. whilst the Womb at first intumefied in its bulk, falls down presently after the Birth, and is contracted into a lesser space, the Blood is plentifully pressed forth from the Vessels opening into it. But besides, forasmuch as during the suppression of the Courses, the bloody mass is imbued with very fermentative Particles, assoon as after the Birth, the mouths of the Vessels are opened, forthwith, as it were at the instant of a more large Flux of Monthly Courses, the whole Blood grows hot (even as Must or new Wine upon the opening the Bottle) and endea∣vours to purge forth the highly fermentative particles out of its bosom, by the going away of the Lochia, as it were the flowring: And therefore, besides the Blood, which in the first days oftentimes flows pure, by reason of the fresh opening of the Vessels, afterwards is sifted forth matter very much discoloured, viz. livid and green, and this very stinking. This kind of Flux is wont to continue at least for fourteen days, yea, in some for a month; and if that by reason of any error, it be stopped before the mass of Blood be throughly purified by such flowring, presently a Feaver, very dangerous, with horrid provisions of Symptoms, is wont to be induced: of which we shall speak anon in its proper place.

The third Consideration, previous to the Doctrine of Feavers, belonging to Women in Child-bed, is chiefly about the Womb it self; to wit, how it is affected after Child-bearing, and what influence it has on other parts of the Body. As to the first, there are chiefly two Ac∣cidents, upon which the acute Diseases of Women in Child-bed very much depend, viz. First, The falling down of the Womb, or the reduction of it, from the bulk of ingravidation, to its

natural Site and Magnitude: Secondly, the solution of the unity, within its cavity, by rea∣son of the breaking of the connexion, or tying to the Cake of it, or After-Birth. When the Child, with what wraps it about, is put forth, presently the sides of the Womb it self, be∣fore very much amplified or enlarged, do mutually close, and by the help of the Fibres, lei∣surely contract themselves into a narrower space; by reason of this kind of contraction, the Blood and Corruptions, or Matter are plentifully pressed forth from the Vessels and Pores of the Womb, and are thrust forth with the Lochia. But sometimes it happens, by reason of some preternatural thing contained in the Womb, as part of the Secondine, or After-Birth, a Mole or piece of Flesh, Clodders of Blood, &c. also, if there happen after a painful Birth, a Contusion or great Dilaceration, that the Womb cannot rightly draw it selftogether, but by an inverse motion of the Fibres, ascends upwards, and is lifted up into a bulk; also the membranes being affected with a Convulsion, it self is still tormented with Torments, as if it were yet in travel; which kind of Distempers, if they long continue, by reason of the Orifice of the Womb being tied together, with the Convulsive motion, the Lochia are often∣times stopped also: from hence grievous Symptoms follow, and very often the Feaver is ei∣ther first e•…•…cited, or it happens, being for some other cause induced, to be rendred far more dangerous. Secondly, as to the solution of the unity, from the Cake of the Womb being broken, it comes to pass, that the Birth, either at its just time, or precipitous, being too much hastened; then the Secundine is cast forth, either whole, or being torn, or puil'd a∣way, part of it being left behind, it is cut off as it were in half. If the Child be born at its just time, and the Birth, with what enwraps it, comes away from the cavity of the womb, as ripe fruit from a Tree, whole, and without violence, the mouths of the Vessels are some∣what unlocked, and the Lochia moderately flow; but from hence no grievous Symptoms is to be feared: but if the Child, not being yet ripe for the Birth, is pulled away, or breaks forth as it were by force, although the Cake, with the membrane is pulled away whole, yet the Vessels being torn, a greater hemorrhage or bleeding, and at length an ulcerous disposi∣tion follows, the little mouths of the Vessels spewing forth a stinking matter. If that part, or the whole Secundine sticks to the sides of the Womb,, after the Birth, it there putrifies, and sends forth very stinking matter or corruption, and stirs up wicked Distempers: often∣times the Orifice of the Womb is shut up, and retains within gobbets of clodder'd Blood, little pieces of Membranes, or Flesh, which putrifying, by reason of the heat, impoyson the Blood and Humors, flowing together to that place, by Circulation, from the whole Bo∣dy; also, by a troublesom itching or provocation, they stir up the parts of the womb, being so very sensible, into Convulsions.

When therefore hurt is brought to the Womb from Child-bearing, after the aforesaid ways, the same is quickly communicated to other parts, not without trouble to the whole Body; which thing indeed is wont to be done by a double means. For first, this happens, because the Lochia being hindred from being thrust forth, presently restagnate or flow back upon the mass of Blood, and infect it as it were with a virulent taint: moreover, from the contents putifying in the Womb, either the substance it self of the Matter, or the Particles coming away from the cadaverous substance, are mingled with the Blood, and nervous Juice, passing through that place, and quickly infect their whole Liquors. Secondly, Hysterical Distempers are more largely extended, by reason of the notable consent, which happens be∣tween the Womb and the Brain, with the Fibres and Membranes of the whole Body, by the means of the nervous passage; for when the extremities of the Nerves, planted about the parts of the Womb, are driven into Cramps and Convulsive motions, by reason of the pre∣sence of some hurtful humour, the Convulsions there received, presently creep more largely upwards, by the endeavours and circumduction of the Nerves towards the Brain; and so it happens to the Viscera to be successively inflated, and cruelly haled together, and the Brain it self at length to be pierced, and its functions to be as it were overwhelmed; hence from the convulsive motions, arising about the Womb, an inflation of the Belly and Hy∣pochondria, a rumbling, vomiting, sobbing, and streightness of the Praecordia, difficult breathing, a sense of choaking, and oftentimes a stupor, and want of Speech, or at least some of these are excited: nor does the Tragedy so easily leave, but that also the Brain be∣ing hurt, by the continuance of the Distemper, by that means, the evil is retorted upon other parts, that oftentimes the whole nervous stock is compelled into irregularities of motions; for what commonly is said to be done by vapors, and the Distemper, called the ascent of va∣pors, creeping from the nether parts, to the upper, is nothing else than the parts of the Membranes and nervous passages, being successively driven into Convulsions. Further, in these sort of Distempers, the hurt action doth not always begin, or is at first perceived in that Region or Place where the hurt is inflicted, neither do the passions which are called hy∣sterical, proceed only from the Womb; for sometimes the trouble is immediately brought from the Brain, or the convulsions and contractions begin in the extream parts, and sometimes the

extremities of the Nerves, somewhere in the Viscera, as the S tomach, Spleen, Reins, •…•…no less than the Womb are haled; in which, irregularities being arisen, they are continued into the neighbouring part, and from thence to the Brain; from whence again the Convulsions are reflected to other parts, and not seldom through the whole Body. Just so the business in Child-bearing Women, and with others in Feavers, as I have often observed; to wit, some by reason of their Womb being evilly affected, but others by reason of a Feaverish matter fixed in the Brain, by a critical metastasis or translation, fall into Passions like to the hysteri∣cal. And these things being rightly praepensed, concerning the praevious provision, in the Feavers of Women in Child-bed, there is not any thing that we should stick at in the en∣trance more, so that we take notice that the bodies of Women lying in (especially those who are feeble, and of a more tender constitution) are debilitated, chiefly after a difficult and hard Labour; so that, by reason of this occasion only, they easily conceive feaverish intem∣peratures, and being brought in by this or any other means, they are hardly able to bear them. We will next speak of the Feavers themselves, with which Women lying in, are wont to be sick, of which Distempers there are commonly recounted as it were three kinds, viz. the Milky Feaver, the Putrid, the Symptomatic, or of that manner by a certain borrowed symptom, but is chiefly marked with the Pleurisie, Squinancy, or the Small Pox: of which we will discourse in order.

The Milky Feaver.

WE have already said, that as yet it was uncertain of what matter Milk was immedi∣ately made, and by what passages it is carried into the Breasts, moreover when this part appears not at all to anatomical inspection, I am of the opinion, that the Milky Chyme, being made out of Aliments in the Bowels, and from thence confused to the Bloud for nou∣rishing Juice, is presently again, for the most part of it, separated from its mass by the help of the Glandula's in the Womb, or in the Breasts, that it might supply the Child with nu∣triment, either in the Mothers Belly, or in her bosom by the Breasts. In the time of going with Child, although the greatest part of this is derived to the Womb, yet in the last months, a little quantity of it is laid up in the Breasts; but about the third or fourth day, after being brought to Bed, the Milk is more plentifully carried into the Breasts, and as it were with a certain force, that it quickly fills them to a stretching them forth, and begins to be troublesom. At this time, Women lying in (though not all, yet most) are wont to be troubled with a feaverish intemperature, with thirst, heat, and an inquietude of the whole Body, they complain of a pain very troublesom in the Back and Shoulders, of a fulness and burning of the Breasts: and unless the Milk be diligently drawn forth, it being too much con∣gested or heaped up, oftentimes brings forth an Inflammation, with an Imposthume follow∣ing of it in the Breasts. This Feaver, whilst the Lochia are in good order, hardly lasts three days, but that about that space it is wont to be allayed, a plentiful sweating arising of its own accord; yet this intemperature being excited by the coming of the Milk, is somewhat increa∣sed and continued longer, if that the Milk entring the Breasts in abundance, be not milked forth, but is again repelled from thence; for by its departure, as well as by its coming, a perturbation is wont to happen in the whole Body, with thirst and heat, which also more certainly comes to pass if it happens to be driven away violently, by repelling Topicks. But being driven by their help from the Breasts, or departing of its own accord, it is thrust forth, with the Lochia, in the form of a whitish humor, and a sweat, or more plentiful transpiration, exterminates the Reliques of the Disease. If that with this kind of intempe∣rance, brought in by reason of the commotion of the Milk, the Lochia be stopped, or errors in eating and drinking be committed, or any other evident cause should happen, that may in∣crease the fervor of the Blood, very often the Milky Feaver, presently acquiring worse Symptoms, changes into a Putrid or rather malignant Feaver.

The Cause, or formal Reason of the aforesaid Feaver (whilst the way of the Milk lies hid) may be only propos'd, from an Hypothesis, and as it were a certain Augury; for being sup∣posed, that this milky humor is carried to the Breasts immediately, by a peculiar passage, from the Viscera of concoction, without any commerce with the Blood, this feaverish Distemper arises, for that the Breasts being filled with Milk, and greatly distended, the sanguineous Vessels are so compressed, that they do not easily transmit the Blood flowing thither; from whence, the Blood being hindred in its circuit, begins to tumultuate through its whole mass, and the Spirits being inordinately moved, and wholly confused, it conceives a fervor, such as being induced by a Stopping, Surfeit, Inflammation, or Wound, constitutes ordinarily the simple Synochus; but if the matter of the Milk (as it is not improbable) passes through the Blood, this Feaver of Women in Child-bed, seems to spring from hence,

that when this Latex is transferred to the Breasts, having left the Womb, a great portion of it subsists in the mass of Blood, which indeed, for that it exceeds the provision of the nourishing juice, and so cannot be wholly assimilated, and besides abounds in heterogeneous parts, and as it were something extraneous, and not mingleable with the Blood, creates a trouble, therefore for the carrying it forth of doors, and putting it forth, this three days feaverish Distemper is employed; For when the milky Chile, being used to be separated a∣bout the Womb, by and by, after being Delivered of a Child, that wax of excretion is hindred, restagnating into the mass of Blood, it is there first of all heaped up more plentifully, than that the whole may go into nourishment, or be received into the Breasts: wherefore, the Milk, not only in its passage to the Breasts, but also in its return towards the Womb, brings forth the Feaver, to wit, by reason of either passage thorow the Blood.

But however the cause of this Disease is ordained, it matters little or nothing towards the Cure; for this is wholly committed to nature, and so long as the Lochia are in good order, it proceeds for the most part happily, without any Physical help, because af∣ter the growing hot of the Blood, for three or four days, either a plentiful sweat, or a more free transpiration, cures this Distemper, to wit, either the Particles of the Milky humor, degenerate in the assimulating, or the adust recrements, remaining after the deflagra∣tion of the Blood, or both of them at once supplying the food or tinder of the Feaver, are by little and little subdued, and evaporated out of doors, which being excluded, the Blood becoming free from the extraneous mixture, quickly recovers its pristine condition; yet in the mean time, certain vulgar Rules are wont to be observed, about the admission of the Milk into, or the driving away of the same, out of the Breasts. If the Milk too plentifully springs into the Breasts, that their inflammation, as also the immoderate growing hot of the Blood, may be prevented, at that time, a more thin and sparing dyet, to wit, no flesh broths, and also in a less quantity, is to be ordered: also the Breasts are to be frequently drawn. If it be not commodious for the Mother to suckle her Child, it is usual after the first or third day of her being Delivered to cover all the Breasts over with Sear-Cloaths moderately binding (as the Plaister of Red-lead, &c.) for so the spongious substance of the Glandula's, is somewhat constrained, or closed together, whereby they less readily receive the milky humor flowing thither, yet this kind of Remedy ought to be cautiously administred, lest if the Milk be wholly excluded, or driven out of the Breast too abruptly, restagnating suddenly in the Blood, it induces its disorder, the prodromus or forerunner of the Putrid or Malignant Feaver: of which it remains that we speak next.

The Putrid Feaver of Women in Child-bed.

WOmen Lying in, from the fault of an evil affected Body, as by the Contagion of a received Pestilential Air, are found to bee too obnoxious to the Putrid, or rather Malignant Feaver; but all do not alike receive the Infection of this sort of Disease; for poor people, Labouring Women, Country Women, and others accustomed to hard Labour, as also Viragoes, and Whores, which are brought to Bed clandestinely, bring forth without any great difficulty, and then, after a little time, leaving their Beds, return to their wonted Labours. But more rich Women, tender and fair, and most living a sedentary life, as if participating after a more grievous manner of the Divine Malediction, bring forth in pain, and then presently after the Birth they are subject to difficult and dangerous chances; the reason of which seems to lie in this, that those who are used to much exercise, continually agi∣tate and eventilate the Blood, and therefore fewer infectious taints from the monthly Flowers being suppressed, do gather together for the matter of a Disease; moreover, laborious and nimble Women, as they have their nervous parts more firm, therefore they are less subjected to convulsive motion, and to the passions commonly called hysterical; on the contrary, in delicate, and idle Women, the mass of Blood, in the time of their going with Child, becomes very impure and fermentisible; besides, because they have the system of the Nerves, and the Brain soft and weak, upon every light occasion, they suffer distractions of the animal Spirits, and inordinate motions of the nervous parts And here, by the way, it is to be noted, that Women more than men, and that some of the same Sex before others, are sensible of the af∣fections called hysterical, not so much by the default of their Womb, as for that they are of more weak constitution of Brain, and nervous stock; for in those so affected, the passions of anger, sadness, fear, as also all troublesome and more strong objects, easily pervert the dispositions and functions of those parts, which when they are once hurt, for the most part afterwards, are accustomed to those irregularities. But we will return from whence we have digressed. The Feaver but now proposed, is wont to infest Women Lying in, indeed

at various times, and by reason of diverse occasions, now presently after the Birth, especially if it be difficult and laborious, now it arises in the first, now the second, third, or fourth week; yet the sooner it begins, the more safely it is wont to be cured. The Type or Figure of this Disease, is performed almost after this manner. After a previous indisposition, an open feaverishness, for the most part with a shivering, or horror, constitutes the first assault, which is followed with heat, and afterwards succeeds a sweat: perhaps, for a day or two, they have various reciprocal fits of heat and cold; then the Blood being wholly inkindled, the Lochia, if not before suppressed, either flow smally, or are wholly stopt: If the Disease be acute, and of a swift motion, it comes to its height on the third or fourth day, then an intense heat, with a very troublesome thirst, a vehement pulse, and quick pertinacious wakings, a great in∣quietude of the whole Body, that they are continually tossing themselves in their Beds hither and thither, a thick Urine, and high coloured, and other most grievous symptoms, are wont to trouble them: whilst the Feaver is after this manner at its height, no Crisis is to be expected; for I never saw this Disease cured by a critical sweat, but that the busin•…•…ss was still very preci∣pitously acted, as after the Blood was grown hot for a little time, presently the adust matter being translated to the Brain, most dangerous and heavy inordinations of it, and the whole nervous stock forthwith come upon them; for most often are stirred up, convulsive moti∣ons of the Tendons, wonderful distentions, and inflamations about the Viscera, like to the hysterical passions; then sometimes, also follow a phrensie, or delirium, not seldom a slupe∣faction, and speechlesness; the strength is suddenly cast down almost in all, without any mani∣fest cause, the Pulse becomes weak, and unequal; and the sick are suddenly precipitated to death; If that any perhaps escape, either by the returne of the Flux of the Lochia, or a Lask, coming upon it, they hardly recover but of a long time: I have known in so•…•…e, purple spots to have appeared, and certainly in many, symptoms that respect either the Blood or nervous juice, which argue no light Malignity.

We will distinguish the causes of this Feaver, after the ordinary manner, into Procatartic, Evident and Conjunct. Those of the first sort, upon which the malignity, and the greatest perniciousness of the Disease depend, are two, viz. first, a depraved disposition of the Blood, from the long suppression of the monthly Flux. Secondly, after the Birth, the evil affections of the Womb, from the dangerous Labours of Women, (who undergo the Divine Maledicti∣on appointed them) from the Menstrua being long suppressed, the Blood not only swells up, and its Sulphureous parts being too much carried forth, are rendered more apt for burning, but besides, the mass of the Blood is imbued with very fermentative Particles, so that (as hath been already hinted) as if it were touched with a venomous infection, presently growing fervent, it is disposed towards putrefaction, and corruptive disorders; and besides, forthwith impoy∣sons the nervous Liquor, and renders it infestuous to the Brain and the whole nervous stock. These kind of evils, being impressed on the Blood, ought to be purged forth, by the Flux of the Lochia; but if after the Birth, the Womb be out of order, the Lochia are not only stopped, and so a purifying of all the Blood is hindred, but besides, stinking corruptions or defilements, are thence bestowed on the Blood, and grievously infect it: Also, by reason of convulsive motions, begun about the Womb, and from thence continued to other parts, in∣ordinations are stirred up in the Blood and juices, which oftentimes conspire, either the pro∣duction, or the acerbation or growing worse, of the Feaver.

The evident causes, which induce an actual effervescency, either to the Blood, having gotten an ill disposition, or invert the vices of the whole Body to the Womb, are after a diverse sort. A painful Labour, a solution of the unity about the Womb, a bruise, a re∣tention of preternatural things, an ulcerous disposition, and very many other accidents, which are induced by a certain necessity, may do this. But the occasions, that are at the dispose of the Patients, and easily to be avoided, which are wont to excite this kind of Feaver, are chiefly two, viz. an ill manner of Dyet, and the taking of cold. It is an usual thing, to give to weak Women, after being Delivered, on the first or second day, the flesh of living Creatures, or Broths made of flesh meats, and other foods, very improportionate to their dispositions, from whence presently arise an indi∣gestion, and great trouble in the Bowels, and a feaverish distemper in the Blood by reason of a more rich nutritious juice than ought to be. Besides, the errors in Dyet, of∣tentimes hurt is caused, for that their Bodies, being so very tender, also by reason of the labours of the Birth, and bringing forth the Child, the passages are on every side opened, they are exposed too heedlessly to the cold: for most of them, being impatient of their Bed, within a day or two, or sooner than they should do, rise out of it, and put on their Cloaths, from whence, presently the Pores of the skin being suddenly contracted, and the Air being admitted into the parts of the Womb, transpiration is hindred, and often the Lochia, on the sudden are stopped, either of which suffices to excite the feaverish distemper.

The conjunct cause, or formal reason of this kind of sickness, chiefly comprehends these three things, to wit, there are present, first, a very notable discrasie of the Blood, that grow∣ing hot, from the Feaver being occasionally induced, it doth not equally burn forth, nor leisurely overcome the adust recrements, and afterwards critically thrust them forth; but the Blood growing hot, is presently loosned in its mixture, and its frame being unlocked, turns and declines towards corruption; hence, when it grows but a little cool, the spirits being shaken out of thier dominion, are moved into confusion. In the mean time, the Sulphureous Particles become untamed, and fierce, wherefore, the strength falls down without any manifest cause, the Pulse is made weak and disordered; after the deflagration of the Blood, altho the adust recrements are very much heaped up, yet nothing is rightly concocted or separated, but the sick being greatly oppressed in Nature, tho they continually sweat, receive nevertheless oftentimes no ease from thence; but the feaverish matter, which ought to be thrust forth, be∣ing transmitted into the head, and nervous stock, induces there most grievous perturbations of the animal regiment. Secondly, the Tragedy of this Disease owes no small part of it, to the nervous juice being presently made sharp, and so improportionate to the Brain, and its Appendix; for this being infected, from the taint contracted from the Blood, doth not gently water, or pleasantly blow up its subjects, but notably hale or pull those tender parts, (as when an infusiōn of vitriol is poured upon a Worm) and irritates or provokes them into convulsions, and into motions, as if of daucing or suddenly leaping forth, and sometimes wholly overturns their functions; hence comes contractures, grievous convulsions, delirium, wakings, and some∣times stupification, and the sleepy Disease, upon Women Lying in. Thirdly, whilst these things are done, oftentimes a third band of symptoms infest the sick, to wit, for that the Womb, being hurt by some evil, moves it self disorderly, and is struck with a Convulsion, according to these or those parts, from thence by and by, convulsive motions invade, by the membranes, and nervous passages, the whole Region of the Abdomen; wherefore, the Viscera and Hypocondria are blown up, belchings, and grievous vomitings are stirred up, then the Distemper creeping upwards, and possessing the nervous parts of the Thorax, a difficult breath∣ing, and unequal, a palpitation of the heart, a sense of choaking in the throat, by reason of the Muscles being there drawn backward, and other symptoms, through the whole Body are excited, the same evil being at last carried to the Brain.

The Feavers of Women in Child-bed almost never want danger; but sometimes it happens, about the beginning, that they are cured by a slender Dyet, and by the Flux of the Lochia being restored; but if the feaverish distemper does root it self more deeply, that the whole Blood is inkindled, and immoderately grows hot, the Prognostick ought not to be esteemed of a light Omen; and there will be a greater reason of danger, if besides the heat being suffused all over▪ the sick are troubled with a frequent shivering, if they are affected or molested with a great disquietness, and wakings, with sudden concussions of the Body, or a contracture of the Tendons: or if, Thirdly, they complain on the fourth days of a tingling of their ears, with a great repletion or fulness of the head, you may from thence collect the evil to grow worse, viz. a translation of the feaverish and hurtful matter to the Brain; nor is it less to be feared, if they have on them an op∣pression, and weight of the Praecordia, that the sick cannot breath freely, nor draw their breath deep, and from the bottom of their breast, but only from the top, and that fre∣quently, and sighingly, and that they move themselves restlesly hither and thither: For this argues the Blood to stagnate in its circulation, about the Heart and Lungs, and also to be apt to grow into clodders, and to be coagulated, that if yet worse distempers of the Brain and nervous stock follow, and the Pulse •…•…hould become weak and unequal, you may pronounce the business almost deplorable; but if (as sometimes tho it more rarely happens) after the Feaver being inkindled, and grievously threatning, either the Flux of the Lochia returns, or a Diarrhea with ease succeeds, some hope of health may be admitted, tho the same be at the last cast.

Concerning the Cure of these kind of Feavers, there lies a very great task upon the Physiti∣an, because any Physick is esteemed with the vulgar not only unprofitable, but also hurtful for Women in Child-bed; wherefore, Physicians are rarely sent for, unless when there is no place left for remedies, and the opportunity of all profitable means be wholly past: If that perchance they should be present, about the beginning of the Disease, it will not be easie to procure health to the sick by vulgar Remedies, but whatever they should attempt, unless it should bring help, it would be said by the Women, and others about the person, to be dead∣ly and the only cause of her death; that in truth there is wont to happen to us, less of profit, or more of ignominy, about the Cure of no other Disease, as in this.

But the method of curing (even as in Contagious Diseases) ought to be instituted twofold; to wit, Prophylactic or Preventive, and Therapeutic or Curative: The former of

these, delivers Precepts and Cautions, whereby Women lying, may be preserved from the assault of Feavers: the other suggests curative intentions, whereby the sick (if it may be done) may at length recover health.

1. Although this Feaver be somewhat Malignant, it is not caught by Contagion, and there is no fear of the sicks receiving outwardly any invenomed taint; notwithstanding, all Women in Child-bed have an innate mine of virulency, and from the evil of this, as it were the tin∣der of most high Malignity, they ought to beware; wherefore, they need an exact ordering, to wit, whereby after the Birth, the impurities of the Blood and Humors may be rightly purged forth, without danger of a Feaver; also, that the evil affections of the Womb may be healed, and that the strength being broken and debilitated by the Labour, may be resto∣red after its due manner. For these ends, these three things are chiefly to be inculcated, for prescripts by Physicians.

First, I judge it necessary, that a most exact manner of Diet be commanded to Women in Child-bed; to wit, that they be wholly fed with Oatmeal-Cawdle, made sometimes of Beer, and sometimes of Water and White-Wine mixt together, also with Panada, and other light Nourishers, for a week at least; because they are much emptied, therefore it may be lawful for them to sup often, but nothing of solid or more strong food is to be given. For I have diligently observed that these Feavers have been oftenest induced by the eating too soon Flesh, or strong Broths, or Food. Forasmuch as Women lying in, ought to be handled, not only as those that are grievously wounded, but as those that have got a Feaverish indisposition, from a disturbed disposition and temper of the Blood: For with them, the Blood being al∣ready too much carried forth, and as it were touched with an impure infection, most quick∣ly catches Flame, by the access or means of any Sulphureous thing.

Secondly, After Diet, the care will be, lest the Pores be shut up, by the incautiously taking cold from without, or that the Lochia be stopped: for upon the least occasion, the manner of transpiration being changed, the Blood first growing hot, conceives disorders; also the Womb being touched by the blast of Air, contracts it self, and shuts up the mouths of the Vessels, whereby the Lochia flow forth less: wherefore, for five days at least, after being de∣livered, I would have Women wholly to keep their Beds. I know that it is a common custom to raise them from Bed on the third day, but by that means I have known many that have fal∣len into Feavers; and in truth, if we desire to keep Women in Child-bed from all danger, the safest means will be, that they may be kept long in their Beds.

Thirdly, Concerning Preservation, the intent remains, that by causing a gentle provoca∣tion of the Blood in Women Lying in, the Flux of the Lochia may be continued; for this end, Midwives are wont (if after a difficult Labour they fear that Evil) to give them Sperma Ceti, or Powder of Irish Slate, or Saffron steep'd in White-Wine; moreover, to make them Oatmeal-Cawdle, that may more fuse the Blood, of Water, and White or Rhenish Wine mixed together, in which they boil, or in Posset-drink also, Marigold-flowers, Leaves of Penyroyal, or Mugwort; there are many other kinds of Administrations extant, about the ordering of Women in Child-bed, which being commonly known, I willingly pass over here.

The Cure of the subsequent Feaver of Women in Child-bed, is far from the usual method in Putrid Feavers: for in this, it is not to be expected, that the Blood being touched with a Feaverish burning, should by degrees burn forth, and the same should be separated by a Cri∣sis, but rather (as it is done in a Malignant Feaver) assoon as the Blood grows immoderate∣ly hot, it is convenient for it to be moved by gentle Diaphoretick Remedies, and its hetero∣geneous and impure mixtures to be carried forth of doors; wherefore, among the common people it is a custom (and that not bad) to give to Feaverish Women Lying in, Sudorificks presently; by this means, the Blood being eventilated, its effervency is allayed; also, by rea∣son of its agitation, the Lochia apt to be restrained, are provoked into a Flux. There is great difference among Authors, from whence the beginnings of these kind of Feavers ought to be computed, viz. whether from the Birth it self, or from the first sense of growing Fea∣verish? However it matters little whether it be after this or that manner: For since this Fea∣ver runs not the usual stadia or courses of the Putrid, neither hath a Crisis, nor wholly ad∣mits the use of Cathartic or purging Remedies, we need not be solicitous so much for the days, concerning its period and mensuration. But yet, as to the Curative Indications, it will be of use only to distinguish what is to be done in the beginning, increase, and end of this Disease: also, what we ought to endeavour whilst there is some strength remaining, as also what, when 'tis oppressed, and very much dejected.

When therefore any Woman in Child-bed is first taken with this Feaver, (whose assault is known from the Milky Feaver, because for the most part it begins with a shivering) you must presently let it be your work, that the more plentiful sustenance may be drawn away from the burning Blood, and as I have already admonished, that the flesh of living Creatures, and

Broths made of them, be utterly forbidden; yet in the mean time, all cold things, and that are indued with a stiptic or binding virtue, are equally to be avoided; for these fix the Blood, and bind it too much, and hinder its very requisite Purgation, bot•…•… by the Lochia, and by transpiration through the skin. But rather, though the Feaver be urgent, give them Decoc∣tions, Powders, and Confections of things moderately hot, of which sort are (as is al∣ready said) Decoctions, or distilled Waters of the Flowers of Marigolds, the Leaves of Penyroyal, Mugwort, the Roots of Scorzonera, also Bezoartic Powders, Spirits of Harts-horn, fixed Salts of Herbs, &c. If the Lochia should be stopt, that their Flux may be again provoked, must be endeavoured every way: To the moving of this, conduce Frictions and Ligatures about the Thighs and Legs, sometimes Cupping-Glasses, or Blisters about the Thighs or Hips, also in the Soles of the Feet; also, sometimes the opening of a Vein in the Ankle, is convenient; in the mean time, a Fomentation of the Hysterical Decoction, is to be applied about the Pubis, or the Caul of a Weather or Sheep taken out warm, may be laid to the bottom of the Belly; and experience manifests, that sometimes Injections into the Womb are profitable: If the Belly yields not, it may be gently brought down, with a Violet Suppository, so called, or an emollient Clyster; of more strong provocations you must take heed, because in Women Lying in, even as in a malignant Feaver, from a copious dejection, with loss of Spirits, Life is quickly lost. If withthe suppression of the Lochia, there be a notable perturbation of the Blood, with Vomiting, thirst, and wakings, I have often known Lau∣danum mixt with Saffron, given with happy success. Instead of a cooling Julep, this kind of mixture is convenient, viz. Take of Water of Penyroyal and Balm, each three ounces, of Hysterical Water two ounces, of the Syrup of Mugwort three ounces and an half, of the tincture of Saffron two drams, of Castor ty'd in a Rag, and hung in the Glass, one scruple, mingle these, and let them drink of this three or four Spoonfuls oftentimes in a day.

2. If notwithstanding the use of these Remedies the Feaver grows worse and worse, and by degrees is increased with worser Symptoms, that besides the disorders of the Blood, the Brain and nervous parts begin to be touched, Medecines, though many of every kind may be tried, do little; yea, in this case the indications are almost the same with those made use of in the Plague it self: forasmuch as the Lochia being for a good while suppressed, they can∣not easily be reduc'd, or scarcely at all, in the great confusion of the Blood and Humors, therefore it is convenient quickly to move a Sweating, to wit, that the corruptions impres∣sed on the Blood and nervous Juice, and restagnating from the Womb, may be carried forth some how, by sweat and insensible transpiration. Therefore here, Powders, and Confecti∣ons of Bezoar, Spirit of Harts-horn, or of Soot, Tinctures of Corals or Pearls help. I have sometimes seen, by the help of these kind of Medecines, in a desperate case, when the Pulse, and other symptoms have appeared a little better, some small hopes to shew themselves; yet Cure rarely to follow: but when the use of these Cor•…•…ials were left off, the sick with a weak pulse, and a Loosness presently arising, have been precipitated to Death.

3. When yet the business of the sick proves still worse, when the Feaver being increased, the pulse is weak and unequal, and frequent horrors, and convulsive motions in the whole bo∣dy, with a delirium and stupefaction infest them, then the Physician having first made a prog∣nostication of Death, may insist upon a few Remedies, and those only Cordials, and must wholly abstain from Blood-letting, Scarification, Blistering, or the use of Cupping-glasses; for such administrations beget only an odium or blame, that by so doing, we are esteemed by some Women, as wicked and cruel.

The Symptomatic Feavers of women in Child-bed.

THE Acute Diseases of Women in Child-bed, shew themselves not only according to the Figure of the aforesaid Feaver, but sometimes they are beset with some signal sym∣ptoms, to wit, the Squinancy, Plurisie, Inflammation of the Lungs, Dysentery, Small Pox, or of some other kind; and at that time, they get the appellations of those Distempers. It will not be here seasonable to repeat at large what belongs to the Essences and Natures of each; but I shall briefly shew what these sicknesses, being complicated with the Distempers of Wo∣men lying in, contain peculiarly, as to the Causes or Cures.

All these Symptoms, we suppose to proceed from a certain coagulation of the Blood, and from thence its extravasation; But whilst the Blood is extravasated, or put forth of the Ves∣sels in one part, its efflux, however natural and critical, is hindred in another: wherefore it is dangerous, lest whilst the Bloo•…•… begins to be coagulated, either in a particular or accustomed nest of Coagulation, or universally in its whole mass, the flowing of the Lochia be stopped,

which in truth for the most part happens, and therefore these Distempers, for the most part, are deadly to Women in Child-bed; yet the Cause of their Death, for the most part, hap∣pens with some difference, viz. in the Small-pox, the flowing of the Lochia draws inwardly the malignity, begun to be carried forth outwardly, and forthwith compells the mass of Blood, and the Heart it self to be empoysoned with its evil; and therefore in the Small-pox, these purgings of the womb are convenient to be stopped; but in the •…•…leurisie, Squinancy, and the rest, when the provocative of the Disease being fixed here or there, in a particular place, draws to it self the impurities of the Blood, which ought to be separated or sifted forth by the Lochia, and derives it streight from the Womb, for that reason it increases the impurity of the Blood. The Lochia being stopped in the Small pox, by the more universal manner or way of excretion, may be shut forth of doors, with the venomous particles of the Disease, which thing indeed does not succeed in the rest, by reason of the minute, and more sparing manner of excretion.

Of these, the Squinancy, Pleurisie, and Inflammation of the Lungs, by reason, both of the great similitude of the Cause, and analogy of the Cure, may be considered together; when any Woman lying in is distempered with any of these, it is to be supposed, that be∣sides the infection gathered together in the time of being Big-bellied, there happens a certain sowrish disposition of the Blood, by the means of which, whilst that it self grows feaverish∣ly hot, certain Particles of it, being fused with the Sowrness, enter into congelation, in this or that part, like Milk growing sowr, and then to be coagulated: The Blood being there frozen or congealed, and hindred in its circuit, stops the passage of the rest; but the Blood being obstructed in its motion, buts against the impediment, and so being heaped up about it, and driven forth of the Vessels, grows into a tumor: from thence presently, what∣soever is contained in its mass, that is heterogeneous, and to be sifted forth, is laid aside into the distempered part, as it were a sink: wherefore, the corruptions of the Blood, that ought to be purged forth by the Womb, are derived from thence towards the nest of this Disease, which, when they cannot be sufficiently purged forth by this way, both more remarkably corrupt the Liquor of the Blood, and render the particular distemper, viz. the Squinancy, Pleurisie, or any other more hard to be cured.

For the Cure of these kind of complicated Distempers, presently from the very beginning, it should be endeavoured, that the Blood being fixed somewhere, and begun to be extravasa∣ted, may be restored to Circulation, that it may not impostumate; because, very rarely, Women lying in, are cured of these Symptomatic Feavers, by an Imposthume, or spitting forth of the corrupt Matter: wherefore, internal Remedies, which fuse the Blood, and free it from coagulation, are to be made use of; of which sort are chiefly Diaphoretics full of vo∣latile Salt, as Spirit of Hart-horn, Soot, Urine, also the Salts themselves; in like manner, Shelly and Bezoartic Powders, Lapis Prunellae, Decoctions and Juleps of Vegetables provoking Urine, or the terms, with all which ought to be mixed, what by experience are found proper for the distempers of the Womb: Besides, discussing Remedies, which may drive away the im∣pacted matter, and disperse it (of which sort are Liniments, Fomentations, and Cataplasms) are diligently to be applied. In the mean time, the more impetuous motion, and immode∣rate effervency of the Blood, are to be removed, and its purgings, by all the wayes possible transferred to the inferior parts. For this end Frictions, Ligatures, Epispastics, and (if need be) Scarifying about the Feet and Legs, are to be administred; if the distemper very much growing worse, a taking away of Blood be indicated, unless there be a great fulness in the whole Body, and a very acute inflammation in the distempered part; it will be best to open a Vein in the Foot, or to take away Blood from the hemorrhoid Veins by Leeches: But if necessity urges, it may be done in the Arm it self, if after that Letting Blood (if another be admitted) let it be done in the Leg; but you are to be warned, that in these cases, the opening a Vein is to be ordered very cautiously, for unless it brings present help, (which I have rarely known it to do) immediately the Pulse being made more weak, the business of the sick becomes much worse.

The Dysentery takes its rise almost for the like cause, with the aforesaid distempers; but in this, because the extravasated Blood is presently poured forth, nor being retained in the Body becomes there troublesome, or is any more corrupted, and as this Flux makes an excreti∣on near the Womb, and does not afterwards drive it to any other place, there is less of danger to be feared, from this Disease, than from those aforesaid: yet oftentimes this Disease, is satal to Women in Child-bed, for that indeed, the rather, because things attempering of the Blood, and moderately binding, are ordered for the Dysentery: for these are found too apt to inhibit the Flux of the Lochia; wherefore in this case, until the Women Lying in are sufficiently purged by a long Flux, the Cure of the other Disease is to be omitted, and the fierceness of the symptoms is to be allayed, only with gentle asswaging things.

The indications of the Small Pox, do not only differ from those above described, but indeed

they are beset with contraries to themselves; for they require (as hath been said) that the Flux of the Lochia should be moderately staid: yet in the mean time, that the flowring forth of the Blood, and a gentle sweat ought to be continued; for when in this Disease, the in∣venomed ferment is twofold, and the corrupt Particles of the Blood, are carried outwardly in a twofold way, you must beware, lest that the lesser, and straiter part, should draw to its door, the whole matter, or more than it were able to send forth: therefore, lest the Lochia flowing more plentifully, should recall inwardly the venom, apt to flower outwardly, the manner or way of Dyet is somewhat to be changed, and especially those things which have a poyson resisting force, and are also astringent (as the roots of T•…•…rmentil and Bistort) are to be boyl•…•…d in the Broths of the sick; also Powders, Juleps, and Opiats, indued with such like virtue, are convenient to be administred at due intervals, yea, in this case, by no means, Women should be indulged, that they might eat flesh, or Broth made of it, or to rise out of their Bed: but the quiet, both of mind and Body, is to be procured, as much as may be, and a Dyet to be ordered of those things, that move not the Blood, and the business almost wholly to be committed to God and Nature.

What hath already been said, concerning the acute Diseases of Women in Child-bed, may easily be illustrated with Histories and Observations: But examples which may be brought in this thing, for the greatest part, are mournful and of an ill chance: because those Feavers for the most part end in Death. But to describe these kind of sicknesses, does neither con∣firm the work of the Physitian, nor render approved the method of Medicine, altogether taken in them; however, because the knowledg of these may make for the better discovery of this Disease, I shall here propose some singular cases of Women Lying in, and variety of symptoms; in which, altho the forms and means of Cure more sparingly occur, yet we may have some rules of precaution, of no contemplable use.

A Gentlewoman in her six and twentieth year of her Age, brought forth her sixth Child, with very difficult Labour, and not without danger of her Life; yet presently after, she be∣gan to be better; on the second day she eat a whole Chicken, on the third rose out of her Bed, and sate in a Chair for four hours; the night following she sound her self ill, at which time her Milk came into her Breast; which, by the application of Diaculum Plaisters, soon vanish∣ed; the next morning she complained of a weariness and as it were an ulcerous pain of her whole Body, also of a vomiting, nauseousness, and fulness about the Ventricle, and Hypo∣condria: the following night was full of trouble; on the fifth day she was plainly in a Feaver, she felt now a shivering, now a heat, every where increasing, she nauseated every thing, and was troubled at her Stomach; moreover being unquiet, and without sleep, the Lochia flowed little, but a whitish humor (commonly called the Flux of the Milk) came away: In the even∣ing she had a weight, and as it were a sleepiness about her forehead and temples, and began to sleep a little; but awaking in half an hour, being disturbed with Phantasms, she com∣plained of her head, as if increased in bulk, also of her jaws being set, that she could not open her teeth, and her fists being strongly clutched, she seemed as if she felt a pricking and stupor, or numness in her whole Body; her Ventricle and Hypochondria stood still inflated, and stretch∣ed forth; they administred to her Frictions, Ligatures, Cupping-glasses, and other Remedies, both inward and outward, that might recall the Lochia, and drive the recrements of the Blood from the head: Her Pulse being weak, and disordered, would not admit of Letting Blood; Powders, and Juleps, which might gently move sweating, and fuse the Blood and nervous juice, and hinder them from restagnating, were diligently given her; yea, fomentations, now of Woollen Cloaths dipped in emollient Decoctions, and now of warm inwards of living Creatures, were applied to her Belly; in the mean time, stinking things (such as they use to the Mother Fits) were put to her nose, which might drive away the impetuousness of the Spi∣rits and Blood, carried into the head, but these, and other things, being for several hours carefully performed, she seem'd to feel some ease; but still she feared to shut her eyes, or to settle her self to sleep, for her eye lids being closed, a thousand Phantasms ran in her mind, with noise and tingling in her whole head: she continued that night almost without sleep; as∣soon as she had begun to sleep, presently being affrighted, and feeling a weight in her Precor∣dia, she was awaked: on the sixth day about noon, she was troubled with a great shivering, or rather a horror, with a strong concussion of the whole Body; to which, as in the fit of an Ague, by and by heat, and then sweat copiously followed: but from thence, nothing of ease accrued to the sick, for presently after the sweat, the feaverish heat was renewed, and con∣vulsive distempers infested her more: the night following, with the rest of the symptoms growing worse, first a Palsie was excited in her tongue, and by and by in her throat, that she could not speak, and fearce swallow at all: on the seventh day, about the same hour, a shive∣ring invaded her again, with heat and sweat; then her Pulse being much weaker, and un∣equal; also a difficult breathing, and fetching the breath short and quick, with her Breast lift∣ed up, she knew not them about her: on the eighth day she died.

There was a manifold occasion of the death of this Gentlewoman, predisposed to a Feaver, by reason of her Big-belly, and which had increased the malignity of the Disease over and a∣bove; for the hurt received by her hard Labour, the sudden exclusion of the Milk from her Breasts, the eating of flesh, and the rising too soon out of her bed, hapning together made, as it were a conspiration for the greater evil: The Blood being touched with a feaverish burn∣ing, presently conceived inordinations, and snatched into it self the Lochia, and perhaps o∣ther defilements of the Womb, and so by that means acquired a greater infection, and plainly venomous disposition; the membranes of the Viscera, being imbrued with the degenerate nervous juice, were struck either with Convulsive motions, or with Convulsions continued to them from the Womb; for these kind of inflations, about the Abdomen, and those distentions are the effects of Convulsions: For altho the direct Fibres drawing the member, do oftentimes press it, yet since the Fibres are direct and transverse, and others placed in a various site, the membranes are pulled together into an hollowness, by their coming together, the part swells up like a blown bladder, into whose vacuity the Air being rarefied secondarily carries it selfforward: But it is not the Air (as is commonly said) or a blast there at first heaped up, that is the cause of the distention. The Blood growing hot in our sick person, and being quickly filled with an a∣dust and malignant matter, did endeavour to subdue it, and being unable to put it forth by sweat, forthwith fixed it in the Brain; the first suffusion of the same matter into the head, by reason of the animal Spirits being half overthrown, brought in that sense of her head being much increased in bulk; which thing happened by the like means as when the foot being taken with a sleepiness, seems as if it felt much bigger then it is: But that after some ease, the dis∣temper grew worse, by sleep and closing of her eyes, the reason is, because waking, and the exercise of the senses, shake off and remove from them, somewhat, the matter besieging the Brain and Nerves; which notwithstanding being neer and in its precincts, sleep creeeping on, is as it were supped up by them, and enters their Bodies more deeply with the alible juice. But the Blood, altho it had plentifully poured forth its recrements in the Brain, yet did not it self become free; but being still full, with an impure ballast, it conceived as it were a criti∣cal flowring, and attempted to shake off its burthen once or twice (as it is wont in a great ex∣cretion) with a shivering and with heat and sweat following it, by which endeavour however nothing was further effected, than that the matter sticking to the Brain, pierced more deeply into it, and becoming fixed in some little shoots of the Nerves, took away her speech and swallowing, and afterwards her senses; and the mass of Blood, being by degrees more and more depraved, at length became unable to sustain Life.

A NobleGentlewoman, being married a little before she was twenty years of Age, and being with Child, used, during the time, an ill dyet, and little or no exercise; yet falling into Labour, and fuffering the torments with intermission, and frequent ease for twelve hours, at length was brought to Bed of a Son: The Child, with the after∣birth came away, and all things were right about the Womb: the first and the second day she found her self indifferently well, but on the third, after a light shivering, she began to complain of thirst and heat; to which a loosness followed, that she had that day four stools: the following night she was almost without sleep, the feaverish distemper remained, after that in the same manner for two days; daily she purged three or four times; the Lochia as yet flowed moderately: when on the sixth day, by the per∣suasion of the Women, she had took some astringent thing, to moderate the Flux of her Belly, the purgings of the Womb were almost wholly stayed: at which time the Feaver became more strong, and symptoms as it were hysterical, appeared; for in her Precordia, she had great and frequent oppressions, and was troubled with a sense of choaking in her throat; on the seventh day, the heat was yet stronger, and her breath∣ing difficult and laborious; but then, by the prescription of a Physician, at that time first sent for, Blood was taken from her foot to three ounces, by which she was better for four hours; for a quiet sleep, with a plentiful sweat followed upon it, and the Lochia appeared again th•…•… in small quantity: In the Evening again, all things grew worse, her strength being very much lost, her Pulse weaker and unequal; she complained also of a noise and tingling of her ears, with a fulness of her head, moreover a leaping up of the tendons in her wrists; also she had sudden concussions of her whole Body, yet still her loosness held; to her were administred, by the prescripts of several Physicians, Cordials, and other Remedies, and kinds of Administrations carefully, but nothing profited, her Pulse being more weak, and her strength leisurely wasting, she died on the ninth day, after she was delivered.

This Feaver very much depended upon the vitious provision of the Body, as the pocatartic cause; for I have often observed, that it fares ill with Women Lying in, who when Big∣bellied devoured fruit, and any unwholsome trash, and living without motion or exercise, indulged themselves with ease and rest: the Blood, by reason of the previous Cachexie, conceived a burning without any evident cause, as it were of its own accord: But growing hot lay∣ing

inwardly still its recrements, and impurities, caused the Diarrhea: neither yet was its mass made more pure, by its almost continual excretion, yea rather being still more depraved in its mixtion or crasis, the blood at length wholly departed from its proper disposition, and became unable to be fermented in the heart, whereby heat and breath might be every where dispersed: The loosness, excited by the motion of Nature, was untowardly stopped, especi∣ally by the use of astringent things; for this I have often observed, never to be done with∣out paying for it; because the Flux of the Belly has cured some that have been ill, but in this Lady, and in many others (as has abundantly appeared to our Experience) altho it did not take away the Feaver, yet it freed her from the more grievous Distempers of the Brain and nervous stock: from whence this sick person was wholly free from a Delirium, nor was struck with Convulsive motions, till reduced almost to extremity.

The Mother of a Family, and a Gentlewoman about 36 years of Age or upwards, being with Child of her seventeenth Child, was troubled, and very anxious, lest she should die of that Child-bearing: But (God favouring) she was delivered well enough of a Son, and for three days after she was very cheerful: on the fourth day, when she had eaten more than she should do of a Chickeu, a little before night she fell into a feaverish Distemper, with vo∣miting and a stopping of the Lochia: all night she lay restless and without sleep, the next mor∣ning she had four stools, and seemed somewhat eased: about Noon (about which time I came to her) she complained again of heat and thirst, as also a palpitation of the Heart, and of the ascent of some substance in her throat; her Pulse was quick and small, her Urine red, the Lochia scarce appeared: I ordered her Juleps, Cordials, and things to purge the Womb, besides a fomentation for the bottom of her Belly, also her Legs and Feet to be rubbed of∣ten, with warm woollen Cloaths; at going to sleep I gave her of Landanum one grain, with Saffron Powder half a scruple, in a spoonful of Tr•…•…acle-Water: She slept well, and the Lochia came down plentifully, and by that means, with a slender Diet, and continuing to provoke moderately the Flux of the Womb for a few days, she became very well.

The immoderate eating of Flesh, as an evident and almost only sufficient cause, with∣out any great provision, or vicious predisposition, induced the Feaver. The Lochia restag∣nating into the Blood, increased its intemperance, and presently brought troubles upon the nervous kind; but in the mean time, the Blood altho growing hot, did not undergo any great corruption, but when the Recrements, heaped up by the Surfeit, were sent forth by the Loosness, and the Blood, the Lochia being restored, began to be purged forth again af∣ter its wonted manner, this Feaver wanting a further malignant Ferment, quickly vanished.

A Noble Lady, young and fair, was brought to Bed of a second Child, and for six days, as to the Lochia and other Accidents, she was well, and wholly free from the suspition of any intempe∣rature, she ate flesh daily, and rising from her Bed, was brisk and chearful in her Chamber: on the seventh day, without any manifest cause, a shivering came upon her, with a Feaver, and a lessening of the Lochia, but not suppressed: to the tenth day after her Delivery, she was only moderately feaverish; whilst the purgings of the Womb yet flowed, she remained free from any grievous Symptom: but then, although she was greatly feaverish, she was more chearful than ordinary, and ieemed more confident of her health: At Night she slept little or nothing; the Morning following (at which time I first visited her) she clearly raved, the Lochia were stopped, also her whole Body was shaken with horror, the tendons of her Wrists were pul∣led together, so that I could hardly distinguish her Pulse, which in the mean time was weak, unequal, and very quick. I said she would die quickly, unless God should miraculously re∣store her by his Divine Power; however, six grains of Oriental Bezoar being given her in a spoonful of Cordial Julep, brought upon her a plentiful Sweat, with a better Pulse; then other Cordials being given, with due intervals, gave some little hopes, tho I doubted they would not continue: after four hours from the time that I came, the sick Lady had of her own accord a great Stool, and presently her strength wholly failed her, and within half an hour she died.

When there happened nothing of ill to this Lady, as to her Delivery, or Womb, so per∣nicious a Feaver, and so suddenly mortal, could not happen without a great and malignant procatarsis of the Blood and Humors; whether a more full Diet, or taking Cold, or any other evident cause, gave a beginning to this, is uncertain; because, the Women and Nurses help∣ing her, knew of no manifest occasion of her Sickness: The Feaver being inkindled, the infection of the Blood could not be wholly carried away, by the purging of the Womb, tho long continued; tho for that reason, the more cruel Symptoms ca•…•…e not presently upon her, yet the Evil still lurked within, and the Disease being very acute, shewing it self with a swift motion on the fourth day, when Nature should have endeavoured a Crisis, the matter of the Feaver being moved, but not overcome, as it were in a moment overturned at once, the Brain and nervous parts, whence Death was to be expected, and suddenly followed.

A Woman well known, who had scarce passed the twentieth Year of her Age, es a florid Countenance, and slender Body, after her being brought to Bed, when the Lochia flowed im∣moderately,

made use of some astringent Remedies, by the counsel of those about her, by which means they were wholly stopped; but a Flux of her Belly succeeded, which when it had increased for three days, the Women gave her other things for the stopping her Loosness: nor were they frustrated in the success; in the mean time, in the place of the former evil, they had brought a most dangerous Feaver, and distempers as it were hysterical; for the unhappy Gentle∣woman Lying in, was troubled with thirst, heat, wakings, and at several turns, with swoon∣ings, and cold sweats; at this time being sent for, I prescribed her Cardaic Remedies, and such as moved the purgings of the Womb, and also a Clyster to be given her: at length, the Flux of her Belly being provoked, the Lochia also came down, and the sick Woman being freed from the aforesaid symptoms, and the more grievous Disease, to wit, the Remedies of the Nurses, quickly grew well of her Feaver.

The more plentiful Flux of the Womb, hapning to this Woman, removed the Procatartic cause of a more grievous Disease: wherefore, when they had committed so many errors about the ordering her, (viz. first in stopping the Lochia, then what might compensate their defect, in hindring the Flux of her Belly) yet the Feaver was only light, and without any venomous taint impressed on the Blood; the like to this I have known to happen frequently, to wit, when at first the purgings of the Womb have flown very plentifully, afterwards when they have flown very sparingly, and sometimes stopped, the Women in Child-bed have escaped. And by the way, it is here to be noted, that it is wholly dangerous, to inhibit, or at least divert, and cross any motion of Nature, incited, tho' irregular.

A Noble Gentlewoman, about Twenty Years of Age, indued with a smooth and full habit of Body, miscarried twice in the space of a Year; when she had again Conceived, by the pre∣scription of her Physician, she provoked a Vomit once a Month, by drinking plentifully Posset-Drink, by which she was wont to cast forth much thick tough Phlegm; also in the time of her being with Child, he let her Blood five times; the time of her going being over, she was brought to bed of a Son, with very hard Labour; the Secundine came whole away, and she purged notably: on the second day, whilst she was lifted upon her feet in Bed, that the Sheets and the Blankets might be laid in better order, she took cold, and by that means the bloody Lochia wholly stopped, and only a little serous Water came away: on the third day she began to complain of an acute pain in her right side, to which the Women laid Bags of Camomil made hot with Bricks, but the distemper grew worse with a bloody spittle; on the fourth day of her being brought to Bed, a most sharp pain, with a difficult breathing, and very laborious, invaded her: by the prescription of her Physician, then coming to her from the neighbourhood, six ounces of Blood was taken away, out of the Basilic Vein, and she felt sudden ease; for ten hours she was better, in the middle of the night the pricking pain returned with its wonted fierceness: at length, other Physicians being called toCounsel, they agreed that it was necessary to open a Vein again, in the Arm of the distempered side: four ounces of Blood being taken away, the pain remitted, and the sick breathed better; then by Diasphoretic Remedies, she fell into a great sweat, with a quiet sleep: But the Pulse was made quicker and weaker, also contractures of the Tendons in her wrists appeared: presently afterwards she talked idly, and within twenty four hours, after she was last let Blood, she departed.

That this Lady fell into a Pleurisie, with a Feaver, upon the Lochia being suppressed, the cause in some measure seemed to be, the letting of Blood so often in the time of her being with Child: for by this means, the Blood being accustomed to be eventilated at the Arm, afterwards growing hot, leaving the Womb, was carried violently towards the place of its letting forth, where, when it found not a passage, it fixed in the neighbouring side, as the next nest to the place of extravasation; yea, besides the usual manner of a Pleurisie, there was no small malig∣nity hapned to this Disease; for the Blood being hindred from being let forth of the Vessels, began presently to be corrupted in its disposition, and in the third day of the Feaver, was so much depraved, that it could not be any longer fermented in the heart so as to prorogue life.

It was not so with the Wife of a certain Smith, who was brought to Bed, at what time her Children had the Small Pox in the same House, and she her self, as it seemed, had taken the Con∣tagion of the same Disease, for on the second day after her Delivery, they began to break forth with a feaverish heat, and pain in her Loyns, which indeed for three days, whilst the Lochia moderately flowed, arose rightly into little swellings; altho' the purging of the Womb was very copious at that time, she had the Small Pox very thick all over her Body, not only in the superficies of her skin, but also they filled the cavity of her mouth and throat, so that she could scarce speak or swallow: The sixth day of her Lying in, the Lochia flowed immode∣rately, from whence presently fell upon the sick, a frequent swooning, with a flagging of the Small Pox, Convulsions, and other symptoms of an ill nature, which threatned Death soon; being sent for, I prescribed half a dram of this Powder, to be taken con∣stantly every three hours, in a spoonful of the following Julep, viz. Take of the Roots of Tormentil in Powder, drams two, of the best Bole Armonie, dram one, of the species of Hya∣cinth half a dram, make a Powder. Take of the Compound Water of Scordium, of Dragons, of Mea∣dow-sweet,

each three ounces, of Therecal Vinegar one ounce, of the Syrup of Corals two ounces, of Harts-horn b•…•…rnt half a dram; make a Julep. Besides, I ordered to be boiled in her Broths, and in every thing she drank, the Roots of Tormentil; by these Remedies, the purging of her Womb was soon wholly stopp'd, and the Small Pox by degrees being ripe∣ned, came off without any grievous symptom.

Indeed this case was difficult, and was cured with great danger, viz. for either the Lochia, or the Small Pox to have been restrained inwardly, was very dangerous, and yet the more full eruption of the one, hindred the motion of the other; so long as either moderately proceed∣ed, things being permitted to the conduct of Nature, was moderately well; but when one of them became ill, the work of Art was required, and it was requisite to bridle the Lochia, but to provoke the Small Pox.

CHAP. XVII. Of Epidemical Feavers.

HAving meditated rather a Commentary, than an entire Tract, I had thought here to have concluded our Discourse of Feavers: But forasmuch as certain Epidemical Feavers do often spread, which observe no Laws, nor can be brought to no cer∣tain Rule of Doctrine, but being irregular, vary every year, and for that reason, as often as any of them increase or spread abroad, presently it is call'd the New Disease; therefore I thought it worth our while, because general Precepts concerning these Feavers, are not to be delivered, to subjoyn some particular Histories, of some of this kind; for out of the vari∣ous provision of Symptoms, whereby they are wont to be noted, the nature and the whole formal reason of these kind of Distempers, may somewhat appear. Since theresore of late years, within a short Tract of time, three popular Diseases have spred in these Countries, I will add, as a Crown to this Work, the several Descriptions of them, made at those times, when these Feavers raged.

A Description of an Epidemical Feaver, spreading about Autumn, in the Year 1657. taken in the middle of September.

WHilst we meditate the Description of a Feaver, at this time cruelly raging, it is fit, that following the example of Hippocrates, we first consider the foregoing constitu∣tion of the Year, its intemperance and excess of qualities. For Epidemical Diseases, and commonly excited among the people, are from a common Cause; such as the habit of the Year, and by that means contracted, a disposition of the Blood, by which many are alike af∣fected. But that we may draw the Matter from the beginning, the last Spring, and the time succeeding it, even to the end of the Summer, was all that half years space extreamly dry and hot, but especially after the Summer Solstice, the heats were so intense for many weeks together, that day and night there was none that did not complain of the heat of the Air, and were almost in a continual sweat, and were not able to breath freely: About the Calends of July, this Feaver, at first sporadical or particular, began to break forth in some places, that perhaps one or two were taken in the same City or Village: In many it imitated the likeness of an intermitting tertian Feaver, viz. the Fits returned every other day; which yet infested the sick with a most intense heat, without any cold or shivering going before; Vomiting and Cho∣leric Stools plentifully hapned to most, sweat succeeding, but difficultly, and often interrupt∣ed, whereby the feaverish fit rarely ended in a remission, but that all the time between, the sick continued languishing and weak, with thirst and restlessness; in some, when the business be∣gan to grow better, after three or four fits, cold and shivering began the fits, and the Feaver became an exact intermitting Tertian; but in most, the Feaver still grew worse, and present∣ly became of an evil nature, and difficult cure, with a depraved provision of symptoms; for when the sick were highly heated in their fits, and hardly sweated, they were wont to commit errors, which daily increased the strength of the Disease, because by reason of the impatience of the sick, and the unskilfulness of Servants, the sweat being interrupted, which should have ended the fit of the Feaver, after one fit was scarce finished, another presently succeeded, and so the Disease was wont to have wandring and uncertain periods, without any intermission be∣tween, and afterwards to pass into a kind of continual Feaver. The condition of which, some∣times

being very dangerous, with an evil affection of the Brain and nervous stock, so that oftentimes a Lethargy, or Dilirium, or not seldom cramps and Convulsive motions, were excited: About the month August, this Feaver began to spread far and near, among the people, that in every Region and Village many were sick of it; but it was much more fre∣quent in the Country, and smaller Villages, than in Cities or Towns. It was still like an intermitting Feaver, unless that it seemed more infestous than that is wont, and with more cruel fits, and shorter intermissions, and therefore was called the new Disease: besides, it under∣went the note of a certain malignity, and gave knowledg of its Contagion and Deadliness; insomuch, that it crept from house to house, infected with the same evil, most of the same Family, and especially those familiarily conversing with the sick; yea, old Men, and Men of ripe Age, it ordinarily took away.

If you respect the nature and essence of the Disease, this Feaver properly should be referred to the rank of intermitting Feavers, for the Fits returned at set times, also for the most part they began with cold and shivering, and oftenest with vomiting, and by and by a most in∣tense heat proceeding they were finished, at last with a sweat. The Urine in most appeared of a flame colour, thin in the fits, with some hypostasis, without it more thick, and with a redish sediment; altho with a most copious sweat, and often iterated, the Disease was not cured, which might then be expected in a coutinual Feaver; yea, the distemper continued exceeding long, for many days, sometimes months, tho much evacuation almost daily hap∣ned by vomit and sweat; which we observe frequently in an intermitting Feaver, rarely to happen in a continual: out of the fit, at any time of the Disease a purge was profitably in∣stituted, which in a Synochus before the sign of concoction, were a wicked thing to attempt; besides that this Feaver was of the intermitting kind, it seems to appear from hence, because that very many recovered of, that scarce one of a thousand died, which I scarce ever knew in an Epidemical Synochus. About the first bginnings of this Disease, it appeared very like to an intermitting Tertian, altho afterwards in some, by reason of the vitious provision of their body, and errors committed in Dyet, and sweating it seemed to change into a continual; for in whom the fits were not rightly concluded nor ended in a remission, by reason of the mor∣bific matter not being throughly dispersed, their Blood was continually hot, from whence in came to pass, that the fits sooner returned, and continued longer; till at length, by reason of the plen∣ty of matter and the languishment of Nature, the Blood being made weaker endeavoured no lon∣ger to swell up and to seperate the feaverish matter, at set hours, but to subdue it by little and little, with a cantinual effervency.

We are to inquire concerning the causes of this Disease, what may be the leading, evident and conjunct cause, by the means of which is spread so generally, and became Epidemical through all England; by what means, and for what occasion, it was wont to be excited in all men: and lastly; what kind of alteration of the Blood and humors, being induced brought forth this kind of Feaver, with such a provision of symptoms, and conserved it in the Act.

I know it is easie to place wholly the cause of this so popular Disease in the malignant con∣stitution of the Air, to wit, that the particles of the Aire which we breath, were infected by a certain extraneous •…•…fection and not agreeable to our Nature, the little bodies of which Infections being admitted within, did ferment with the Blood and humors, and so in most, brought in this Feaver, almost with the same appearance of symptoms. For who dares de∣duce the Original of a Disease so generally raging from a less publick fountain? Or refer to any other place, the received causes of Diseases, than to that nest of Vital Air, on which every one feeds? But whilst I more attentively consider the thing, it seems to me, that its stem, and as it were its first beginnings, are to be sought a little deeper. To wit, that this Feaver is born not from the Contagion communicated by the Air, and immediately fixing its evil on men, but rather from a certain feaverish predisposition or nature, impressedsomewhile be∣fore on our Bodies, because of the intemperance of the Year, which at length having gotten maturity, on the least occasion is brought into Act, and so breaks not forth into this Feaver, so much as it sifts it forth.

For when upon the Calends of July, the Air was immoderately hot, with a most intense heat for many days, it easily altered our Blood towards an hot and bilous intemperance, by which (as in wine growing more hot than it should do) the sweet part and the spirituous was much consumed, in the mean time, the Saline and the Sulphureous was too much carried forth, that by that means, the liquor easily contracted a rancor or sourness: We have in another place shewn, that this kind of disposition of the Blood, whereby indeed it turns from a sweet and spirituous temper, into a boylous or choleric, is most apt for an intermit∣ting Feavers: Hence the alible juice, which is continually carried into the mass of Blood, is not rightly concocted, nor assimilated into Blood, but perverted as it were into extraneous and fermentative matter; which arising to a fulness in the bosom of the Blood it self, and growing turgid according to its increase at set periods, as we have already shewn, induces

the fits of the intermitting Feaver: when therefore, from the great burning heat of this Sum∣mer, the Blood almost of all men, becoming more hot than usual, was very much scorched, it is no wonder, if from thence it should contract a great aptitude for intermitting Fea∣vers. But why not whilest the fervor of the Heaven was yet urgent, but a little after, this Disease spread it self, the reason is, because this indisposition is not impressed on our Blood at once or at one time, but by little and little, and not but of along time; and therefore Diseases like Fruits, are chiefly ripened in Autumn, after the foregoing heat of the Sum∣mer.

This aptitude or feaverish disposition, all do not contract alike; those whose Blood is of a more hot Nature, and abounds more in Sulphur, and for that cause is sooner scorched, also such who labour, or stay long in the heat of the Sun, and open Air, by reason of their Blood being more remarkably torrified, more easily fell into this Disease; wherefore, at first, it chiefly raged among Husbandmen in the Country: of these, who had required an aptitude to this Feaver, from the Blood being before scorched, some perhaps fell into this of their own accord, the feaverish disposition being leisurely carried forth to a maturity; others by reason of a light occasion or evident cause, which was wont otherways to stir up the feave∣rish burning, as from taking Cold, Surfeit, drinking of Wine, and the like; and others fell sick from the Contagion received of others, for as the effluvia constantly came away from the sick, when they peirced Bodies predisposed to the like distemper they easily excited the hid powers into Act.

As to the third Proposition, to wit, that the conjunct cause of this Disease, and its formal Reason, may be known, we must put you in mind of those things, which we have elsewhere delivered concerning the nature of intermitting Feavers, for we suppose the torrid and bi∣lous constitution of the Blood, as the basis of this Disease, by reason of which the alible juice being supplied daily, as it were in a certain measure, is not rightly concocted, but by the a•…•…ation or scorching, becomes or goes into a fermentative matter, not miscible with the Blood. When the Blood is filled to a fulness with this matter (which happens at set intervals of times, because the alible juice is supplied as it were by a set measure) it of its own accord conceives a swelling up, and the growing hot or esferve•…•…cency being excited, for the car∣rying away of this matter, causes the feaverish fit: which so long indures till this feave∣rish matter being inkindled, and as it were burnt in the heart, is wholly dissipated with sweat.

From these things premised, it is made plain, that in this distemper, we now discourse of, there are some things happen by a peculiar way, from the common kind of intermitting Feavers, and therefore it was noted, that not undiservedly, with the appellation of a new Feaver; which are, First, that about the beginning of the Disease, fits did a long while afflict the sick, without cold or shaking, but with a most intense heat, thirst, and cruel vo∣miting; by which, the sweat hardly, and for the most part partial, and often interrupted, succeeded, whereby the fit was not finished but of a long time. The reason of which, may be only laid upon the very choleric disposition of the Blood, and being above measure scorched: For this proceeding from the domineering Sulphur, wholly inhibits the wonted sourness of the Blood, which follows its turgency or swelling up, and is wont to stir up the cold or shivering; and by reason of this kind of temper of Blood, too much roasting and as it were burning the alible juice, the Blood growing turgid, together with that juice, and being stirred up into motion, is inkindled more then it was wont in the heart, and by its deflagration, induces a most intense and troublsom heat, with thirst, to the sick. Choleric vomitings, happen not only at the beginning but in the middle of the fit, by reason of the abundance of choler, with which, the Choleduct Vessels being too much filled infuse the intestines; which then a Con∣vulsion being stirred up, is easily emptied into the Ventricle: Sweat hardly succeeds, be∣cause the bile abounds more than the serum, wherefore the Feavourish matter being burnt, it is not easily sisted forth by sweat, but being either mingled with the Blood, causes the long ef∣fervency, or being carried towards the intestines, produces vomiting or a Flux. Secondly, This Feavour differs from the vulgar intermiting Feavour, because after the fit was ended, there was no full intermission, even to a remission, but the sick still remained languishing and thirsty; and as to appetite, sleep, and other accidents, very ill: which indeed happened, be∣cause, by the intense heat of the fit, more of the Blood and feaverish matter is inkindled, than that its recrements remaining after its deflagration, are able presently to be dissipated, espe∣cially, because the sweat, by reason of the dryness of the matter, very hardly succeeds, nor is the Feaverish matter enough diluted with the serous Latex, to be sifted forth; wherefore, the Blood by its Contagion in the time of the fit, not being perfectly freed, grows hot still, nei∣ther the fit being ended, doth it get any full truce from the disease: In the mean time, whilst the Blood is urged after this manner, with almost a continual effervency, it differs from a Synochus; because in this, the Sulphureous part of the blood, being too much carried forth, and as it were inflamed, causes the Feaver by its deflagration; but the continual ebullition,

which after this manner comes upon this intermitting Feaver, wholly depends upon the confu∣sion of the not miscible matter, and its hard secretion from the Blood. The Synochus hap∣pens like Wine growing hot of its own accord, by reason of its richness, the other conceives its fury, like the same Wine, by reason of some heterogeneous thing powred to it: wherefore weremark, that whilst our Feaver is seen still to be continual, it is not cured by Sweat or the Flux of the Belly, altho they frequently and copiously happen; because it depending upon the Blood being depauperated, rather than being inflamed, it continues long, and disposes the sick towards a Cachexie.

3. There is a third reason of difference, by which this Feaver may be distinguished from the common rank of intermitting Feavers, and it is this, that it is easily propagated to others by contagion; the reason of which is, because here very many Bodies are predisposed after the same manner, towards the same Distemper, which happens not at another time; wherefore, the meer Effluvia's from a diseased Body, are able to excite the like effect, in a very fit subject; even as some beams of Flame enkindle Flame, in a very combustible matter: In the mean time all do not alike contract the Infection of this Feaver, but that some being less prepared or fit∣ted for it, converse with the sick without harm.

4. There is another Symptom occurs, not constant to this Feaver, but only hapning in some places, that discriminates it not only from the common, but varies its own proper type; to wit, sometimes it happens, this Disease to be accompanied with a Dysenterick Distemper; in some Cholerick Vomits, and Bilous Stools very much infest; and in others Bloody Stools follow, with cruel pains and torments of the Belly. The former I often observed in our Neigh∣bourhood, and the reason of it may be deduced from the highest bilous temper of the Blood: For by reason of this, the adust matter, not to be dissipated by Sweat, is copiously sifted into the Liver; then by reason of the Choler-carrying Vessels, being filled to a flowing over, it is sent away to the Ventricle and Intestines. The other Dysenterical Distemper was found only in some places, and there peculiar rather than common, it laid hold only of some sick. The Ori∣gine of it may be referred to the peculiar dispositions of some Bodies, or vicious provision, also to the site of the place, or condition of the Air; then the Disease is to be suspected, to be then•…•…e translated to others, not without the communication of a certain infection.

There is to be had a double Prognostication concerning this Disease: First, of the Feaver in General, what end it shall have, when, what it may threaten to the Land: whether it precede not (which is commonly feared) the Plague, or Pestilential Sicknesses. Secondly, The signs ought to be laid down, whereby we are wont to presage health, or danger, in the various cases of the sick.

As to the first, Because we have shown that the Origine of this distemper is not to be fetch∣ed from the Contagion of the Air, or its being infected with any venomous Infection, nor from •…•…ny malignant seeds of Vapours diffused through the Air, but only from the signal bilous temper or diposition of our Bodies, with the Blood being made adust and roasted extreamly, by reason of the Summer heats, I think there is no reason of fear, that this Feaver should be carri∣ed forth into any thing worse by the vice of the Air, or might at length grow to be Malignant or Pestilential. But rather (that the season of the Year being changed, and the alteration of our Blood assuredly to be expected) we might fear lest this Feaver, which now imitates the way of an intermitting Feaver, should afterwards pass into a Quartan, the Blood growing into a melancholy temper. Which thing indeed I observed to happen to some already, and I believe, that before the Autumn be fully passed over, will happen to many more.

As to the particular Prognostication, the chiefly notable signs, which occur in the course of this Feaver, and in a manner foretel its condition and event, are of this sort; if the Disease happens in a firm Body, well tempered, and easily perspirable; if vomiting with ease suc∣ceeds, and that the Belly be loose: if the fit begins with a light shivering, and afterwards a moderate heat, with sweat concludes it, and that the intermission be with some tolerable re∣mission; if the Pulse be strong, the Urine of a flame colour, clear, and with a laudable hypo∣stasis, we may Predict that the Disease will quickly end without any danger. But if this Fea∣ver be excited in a fat Body, and of a vicious habit, if with troublesome vomiting, an intole∣rable thirst, and fierce heat, long exercise the sick; if to the heat a difficult sweat, and partial, and often interrupted, and between frequent vomitings succeed, and that it ends not in a re∣mission, we may declare, that this Disease may belong, and of a dangerous issue. But if the sick remain in strength, and the Urine shew signs of concoction, we need not dispair of health; especially, if after four or five periods, the Disease, as it is wont to do, remits of its wonted fierceness. Thirdly we observe, if this Disease is excited in an old Body, or others broken with sicknesses, or debilitated; if besides horrid vomitings, there happen swoonings, faintings, Deliriums or Lethargic distempers; if after many fits, the sick having lost their strength, the Disease remits nothing, but exerciseth the Blood, with a continual effervency, and that the Vital Spirits are much destroyed; if the appetite be lost, wakings pertinacious, and that they

have Convulsive motions, with a weak Pulse, and Urine troubled, or thick, we judge the matter to be full of danger: yet is not the sick to be left as desperate, because the Disease is not hasty, and kills not suddenly, and out of hand; but is drawn out at length, and grants time and occasions to nature, of recollecting her self, and to the Physician, of giving Reme∣dies.

The Therapeutic Indications, which have place in the Cure of this Feaver, are chiefly four. First, That the Blood being now scorched, and made too cholerick, may be reduced to its due temper. Secondly, That the depravation of the nourishable juice, and its alteration into a fermentative matter, may be inhibited, or at least lessened. Thirdly, That about the declining of the Disease, the Blood depauperated by a frequent deflagration, and made more impure by the fusion or pouring into it the morbific or adust matter, may be restored, and rendred as it should be volatile. Fourthly, That the symptoms, which chiefly infest in the course of the Disease, may be timely helped by fit Remedies; that these intentions may be satisfied, I counsel that this following method be used.

About the beginning of the Disease, if the bilous or choleric humor, flowing forth of the choler-bearing Vessels, and being suffused into the Ventricle, cause the sick to be prone to vo∣miting, let a more plentiful evacuation be procured, by a gentle Emetic in the time of the fit: The opening of a Vein, and Purging, ought not to be administred, unless between the fits: for whilst the Blood grows mainly hot, or is resolved into sweat, Nature ought not to be called back from the Work begun, nor her endeavours to be disturbed, by the prescriptions of Phy∣sicians; wherefore, after the fit being past, and the sweat throughly finished, a Purging may be instituted, by a gentle Cathartic, and the same afterwards sometimes repeated, on the like occasion: for by this method, not only the provision of the excrementitious matter, is brought away, from the first passages, but chiefly the choler-bearing Vessels being emptied, the choler is copiously drawn forth from the mass of Blood, and by that means the Blood is restored to its natural Crasis or disposition. The letting of Blood, if it be indicated, should be performed presently after the beginning; for so its Liquor being too turgent or swelling up, is eventilated, whereby both the nutritious juice is less perverted, and the fit urging, it burns forth with a less heat, together with the morbifick matter: but otherwise, if a Vein be opened after a long sickness, when the Blood being made poorer, and more watry, more of the morbifick matter is heaped together, and does not rightly concoct, and sift it forth, it detracts much from the strength of Nitre, and nothing from the power of the Disease. In the interval of the fits, when there is no place for opening a Vein, nor Purging, let the Belly be kept loose, by the constant use of Clysters; also digestive Remedies, of acetous or saline Liquors and Powders, are to be exhibited; of which sort are Cream of Tartar, fixed Salts of Herbs, Tartar Vitriolate, Harts-horn burnt, Spirit of Vitriol, and Salt, &c. for these restore the lost or sleepy ferments of the Viscera, purifie the Blood by fusing it, also separate the morbifick matter, and as it were precipitate it: also, at this time between, if pertinacious waking infest the sick, and overthrow their strength, it may be lawful to admi∣nister anodyne, and gentle narcotic Remedies; but never in the fit: for then they greatly hinder the subduing, and sifting forth of the feaverish matter, and draw out in length the fit that would end sooner.

These things are to be done about the interstitia, or intervals of the fits; but whilst the fit is urgent, altho' the sick then chiefly send for, and call upon Physicians, yet at this time their Prescripts are limited to a narrower space: If Vomiting (notwithstanding an Emetic being given) still infest, it may be more freely provoked, either by simple Posset Drink, or with bitter Herbs boiled in it: But let the chiefest means of help be, in temperating the heat and thirst, which most grievously torments the sick in this Feaver: For whilst the Blood growing hot, with the morbifick matter, and being inkindled in the Heart, leaps forth into the Lungs, stirs up there a cruel Inflammation, which requires a profusion of a cold humor, as it were for the extinguishing the Flame; wherefore they greedily desire without any measure drink, for want of which the sick are almost killed with too great heat, and their Blood being almost wholly rarified into flame and fume, the thrid of Circulation is hardly continued; wherefore, drink ought to be wholly granted, to those in Feavers: which however, if it be taken in too large a quantity, it at first more disturbs the estuating Blood, and at length brings confusion to the feaverish matter, begun to be separated; that from thence, the Work of subaction and secretion is longer protracted, and the fit is made longer: also, besides, large drinking causes troubles in the Ventricle, and by disturbing it, and often provoking Vomiting, hinders the breathing forth, and calls inward the sweat breaking forth, or perhaps already broke forth: wherefore, at first, the heat of the Feaver being inkindled, altho' the sick be very thirsty, let them only sip a little, and abstain from drink as much as they can; afterwards, when the matter being burnt, and subdued, begins to be dissipated by sweat, they may be more freely indulged as to this, for so the sweating is greatly helped, and the fit is sooner finished: as to the nature of the Drink, let them take sometimes Posset Drink, sometimes Small

Beer, or Barly-Water, and sometimes simple Water, or sharpned with the Juice of Limons: In this case, the use of Sal prunellae is deservedly praised, to be given in every Liquor; for this, with its nitrosity, wonderfully allays the raging Blood, and potently moves Sweats: I have often observed, in the midst of a Fit, the sick wont to fall into a Swoon, or Syncopy, to whom presently they give Cordials or hot Waters, that much increase the violence of the Feaver, and bring forth more troubles than usual, that the Fit is more difficultly finished; but these faintings, for the most part, happen, either from a bilous humor suffused in the Ventricle, or by reason of the sweat suddenly breaking forth; and against these, I always found the most pre∣sent Remedy, that either a feather being put down the throat, Vomiting may be provok'd, or that Liquor being plentifully drunk, a sweat may be again raised up; also in the whole course of this Feaver, 〈◊〉〈◊〉 am wont never to give any Cordials, or Alexiteriums.

The Diet in this Feaver ought to be only slender, and not nourishing, all sorts of Flesh, or any prepared of them, are wholly to be avoided; for as these abound with Sulphur, they give a more plentiful food (as Oyl poured on Flame) to the hot or enkindled Blo•…•…d: Besides, no∣thing spirituous, as strong Waters, strong Beer, or Wine, is to be yielded to; but Decocti∣ons, or Broths of Oatmeal, or Barly, altered with cooling Herbs, are chiefly to be used; also Posset-Drink, and Small Beer, or Whey, is to be given them at their pleasure: for by this means, when a very slender and watry nourishing Juice is conveyed to the mass of Blood, the soluted Particles of Sulphur, burn forth sooner, and with the less tumult; also the Recre∣ments of the adust matter are more easily carried from the bosom of the Blood; but if on the contrary, a more rich or plentiful Nourishment be administred, the effervescency of the Blood is thereby very much augmented, and the Blood is more infected, by the confusion or pouring in of the adust matter.

After that the Blood being much burnt forth by frequent fits, and the Feaver being in its de∣clination, remits of its fervor and fierceness, you must take heed, lest the sick at length grow∣ing well, fall not into a Cachexy, or Scorbutic Distemper; for the disposition of the Viscera being hurt, and the Blood being much depauperated, the alible Juice, though not scorched so as at first, is not however rightly concocted, and ripened into perfect Blood; but by reason of the want of Transpiration, the serous Excrements being imbued with a fixed Salt, are greatly heaped together, and now fixed in the Bowels, now in the extreme Parts, bring forth various Distempers. Wherefore in a long languishing of the sick, or otherwise for the sake of being sooner well, Remedies should be given them, which volatilize the Blood, or hinder the stuffings of the Viscera, or if stufsed, may open them, and their ferments as if extinct, restore: for this use, those Remedies and Preparations chiefly help, which are com∣monly called Digestives and Antiscorbuticks; with which, being timely administred, I have known very many weak, pale, and as it were without Blood, suddenly to recover a Liveliness and Vigor.

The Description of a Catarrhal Feaver Epid•…•…mical in the middle of the Spring, in the Tear 1658. taken the fourth of June.

AN equally intense Frost followed the next Winter, the immoderate heat of the forego∣ing Summer, so that no one living could remember such a Year, for either excess both of heat and cold. From the Ides of December, almost to the Vernal Equinox, the Earth was covered with Snow, and the North-Wind constantly blowing, all things without doors were frozen: Also, afterwards, from the beginning of the Spring, almost to the beginning of June, the same Wind still blowing, the Season was more like Winter than Spring, unless now and then a hot day came between. During the Winter (unless that a Quartan Feaver contracted in Autumn, infested some) among our Countrimen, there was a moderate state of Health, and freedom from all popular Diseases. The Spring coming on, an intermitting Tertian (as used to do every year before) fell upon some. About the end of April, suddenly a Di∣stemper arose, as if sent by some Blast of the Stars, which laid hold on very many together; that in some Towns, in the space of a Week, above a thousand People fell sick together. The particular symptom of this Disease, and which first invaded the sick, was a trouble∣•…•…om Cough, with great spitting, also a Catarrh falling down on the Palat, Throat and No∣strils; also it was accompanied with a feaverish Distemper, joyned with heat and thirst, want of appetite, a spontaneous weariness, and a grievous pain in the Back and Limbs; which Feaver however was more remiss in some, that they could go abroad, and follow their Af∣fairs in the time of their sickness, but complainining in the mean time, of want of strength, and of languishing, a loathing of Food, a Cough, and a Catarrh: But in some a very hot Distemper plainly appeared, that being thrown into Bed, they were troubled with burning, thirst, waking, hoarseness, and coughing, almost continual; sometimes there came upon this a Bleeding at Nose, and in some a bloody Spittle, and frequently a bloody Flux; such as

were indued with an infirm Body, or men of a more declining Age, that were taken with this Disease, not a few died of it; but the more strong, and almost all of an healthful constitu∣tion recovered; those who falling sick of this Disease, and died, for the most part died by reason of the strength being leisurely wasted, and a serous heap more and more gathered to∣gether in the Breast, with the Feaver being increased, and a difficulty of Breath, like those sick of an Hectic Feaver. Concerning this Disease, we are to enquire, what procatartic cause it had, that it should arise in the middle of the Spring suddenly, and that the third part of Mankind almost should be distempered with the same in the space of a Month; then the signs and symptoms being carefully collated, the formal reason of this Disease, also its Crisis and Way of Cure ought to be assigned.

That the Northern Wind is most apt to produce Catarrhs, besides the Testimony of Hip∣pocrates, common Experience doth make known: But why Catarrhs did not spread, at least in some peculiar places, all the Winter and Spring, but only in one Months space, and then joyned with a Feaver, this Distemper should become Epidemical, doth not so plainly appear. I know many deduce the Cause from the unequal Temper of the Air at that time; which al∣though for the most part very cold, yet the North-Wind sometimes lessening, there would be a day or two very hot between: wherefore from this occasion, as from cold taken after the heat, men should commonly fall sick: But indeed, for the exciting the Distemper, so suddenly rising, and commonly spreading, there is required, besides such an occasion, a great foregoing Cause or Predisposition, though the other might suffice perhaps, for an evident cause, for to distemper them with this Sickness; for we ought to suppose, that almost all men were prone to the receiving this Disease, otherwise no evident cause could have exercised its power so potently on so many; wherefore, it seems very likely, that this Disease had its Ori∣gine from the intemperance and great inordination of the Year: and as the Autumnal inter∣mitting Feaver before described, was the product of the preceding immoderate heat, so this Catarrhal Feaver depended altogether upon the following part of the Year, being so ex∣treamly cold; for the Blood being now throughly roasted, by the very hot Summer, and prone to the Feaver before described, then being made more sowrish by the Autumn urging it, and apt for a Quartan Feaver, afterwards being a little eventilated by reason of the strong Cold of the Winter, and hindred from its due perspiration, retained yet its Dyscrasie, or evil Dis∣position, and readily broke forth on the first occasion given: wherefore, when the Blood, in the middle of the Spring (as the Juice of Vegetables) being made more lively, and also begun to flower, and grow rank, by reason of the stoppage being still continued, was strait∣ned in its Circulation, and easily made prone to a feaverish effervescency: and as the serous Water redounding in the Blood, could not evaporate outwardly, because of the Pores being still straitned by the cold, restagnating within, and chiefly falling upon the Lungs (where it might be moved about, instead of an outward breathing forth) excited the so frequent and troublesome Cough.

The Original therefore, and formal Reason of this Disease, are founded chiefly on two things, to wit, that there together hapned a greater effervescency of the Blood than usual, from the coming on of the Spring-Season, and also a Stoppage, or great constriction of the Pores, excited by the too great Cold of the foregoing Season; that therefore there was not a free space granted to the Blood, flowring or luxuriating in the Vessels: the business being after the same manner, as if Wine begun to grow hot, should be put up into close shut Vessels; for by this means, either th•…•… Vessels, or the Liquor were in danger to be lost.

Wherefore, that we may contract the thing in short, the cause that this Disease begun in the middle of the Spring, having presently spred largely, seized very many, was not the blast of a malignant Air, whereby the sick were distempered, as if struck with a blasting, but that at this time, the Blood being inspired by the constitution of the Spring, and so luxu∣riating, and apt to grow hot, was contracted or straitned in its motion, and the effluvia's being constrained inwardly, could not be sufficiently eventilated or cooled. In every year, tho temperate, it is usual in the Spring and Autumn for some Epidemical Diseases to reign, because at this time, the Blood being as it were restored, flowers anew; and therefore, in∣termitting Feavers, and sometimes the Small Pox ordinarily spread in this Season; wherefore, 'tis no wonder, after a great unequal constitution of the Year, and not natural, when in this Spring, the Blood boyling up more lively within the Vessels, by reason of transpiration being hindred, could not be freely circulated, and sufficiently eventilated, if for that cause, great disorders follow, and from this most common cause, a Distemper greatly Epidemical should be excited.

As to the Symptoms joyned with this Disease, a feaverish intemperature, and whatsoever belongs to this, the heat of the Praecordia, thirst, a spontaneous weariness, pain in the Head, Loyns, and Limbs, were induced from the Blood growing hot, and not sufficiently eventila∣ted; hence in many, a part of the thinner Blood being heated, and the rest of the Liquor being only driven into consusion, a simple Synochus, or of more days was induced, and this

for the most part ceased within a few days: But in some endued with a vicious disposition of Blood, or evil habit of Body, this kind of Feaver arising by reason of the same cause, quick∣ly passed into a very dangerous Putrid Feaver, and often Mortal.

The Cough accompanying this feaver with a Catarrh, draws its Origine from a serous hu∣mour heaped up together in the Blood, by reason of transpiration being hindred for a long time, and then an effervescency being risen, dropping forth more from the little Arteries, ga∣ping within; for when the Pores are constrained, the superfluous serosities in the Blood, being wont to evaporate outwardly, are poured forth on the Lungs, by a proper castration or cleans∣ing of the blood, wherefore, by taking cold (as they commonly term it) that is, from tran∣spiration outwardly being hindred, the Cough for the most part is stirred up: And for a fore∣going cause to this Distemper, the flowing forth of the serum into the Mass of Blood, hath for the most part the chief place; for, from the long cold hindring the scorching of the blood, or the provision of the Bile, and prohibiting the breathing forth of the watry humor, there was a ne∣cessity, that very much of the serous Humor should be heaped up in the Blood: wherefore, when the Blood flowring in the Spring, conceived a heat, the flowing forth of the Serum, and a powr∣ing of it on the interior parts, was wont to cause first the Cough, as the proper symptom of this Disease; and those, whose Blood was more diluted by the mixtion of the Serum, and who were greatly obnoxious to the Cough, and a Rheumatic Distemper, were cured with less trou∣ble of the feaverish Distemper. The Prognostick of this Disease, concerning private persons, is for the most part easie, that one may deliver the event, from the first assault; for if this sickness be excited in a strong body, and healthful before, and that the feaverish Distemper be moderate, and without any grievous and horrid symptom, the business is free from danger, and the Distemper is to be accounted but of light moment, as that commonly is of catching Cold, neither needs a Physician be consulted, nor Remedies, unless trivial and ordinary, be administred: But if this Distemper happens in a weak and sickly Body, with an evil provision, or that the Feaver being carried into putrid Feaver, or the Cough growing grievous, induces difficult breathing, and as it were a tabid or consumptive disposition, the event of the Disease is much to be suspected, and often terminates in Death. The common Prognostic that was taken from hence, concerning the future state of the Year, contains nothing to be feared, or ominates any great ill; by reason of the unequal intemperance of the Year, the great heats, and then excessive cold, we might fear Diseases to arise from the Dyscrasie of the Blood, yet from the present condition, we need neither suspect any noted depravation of the Air, or Infection with poysonous breaths; that from thence may be had any Judgment of the Plague, or Malignant Disease to be at hand.

As to what belongs to the Cure, when this Disease is more lightly inflicted, its Cure for the most part is left to Nature; for this Feaver, when it is only a simple Synochus, is wont to be cured within a few days by sweat: wherefore, by a copious sweating, for the most part about the third or fourth day, the heat and thirst, the weariness, and heavy pains are allay'd; then the Cough being somewhat longer protracted, by little and little afterwards remits, and at length the sick leisurely grow well; if this Disease hath rooted it self more deeply, there is need of fit Remedies, and an exact method of curing; the Feaver growing worse is to be heal∣ed, according to the Rules to be observed in a Putrid Feaver; but nevertheless with this dif∣ference, that, because transpiration being hindered, and the suffusion of the serous humour on the Lungs, are chiefly in fault, therefore Diaphretic Remedies, and those called Pectoral, are of more frequent use; for these restrain the flowing forth of the Serum from the Vessels within, or by opening the Pores, convey it forth of doors; or precipitating it from the bo∣som of the Blood, send it forth by the Urinary Passages; therefore the Method of Medecine for this Disease, being brought into the worser state, respects both the feaverish intempe∣rance, for the sake of curing which, you are to be directed, according to the intentions shewn in the Putrid Feaver, and also the Rheumatic Distemper, which however let it be se∣condary, and not every expectorating Remedy, or those used against a Cough, are to be admitted, but of that kind only which do not increase the Feaver: the forms of these, and the means of curing, are to be sought from the Precepts delivered generally for the Cure of the Putrid Feaver, and of the Cough; the Helps, which now by frequent experience, are com∣monly said to bring Cure chiefly in this Disease, are sweating, or the provoking of Sweat, and letting of Blood; for the Vessels being emptied by this or that means, both the immo∣derate heat of the Blood, and the abundance of the Serum are restrained.

A Description of an Epidemical Feaver arising about the beginning of Autumn, 1658. taken the 13th. of September.

THE Vernal Feaver but now described, did not last longer than six weeks, that it plainly was seen, that it was only a more light flowring of the Blood, which swelling up in the Spring, and at the same time streightned in space, for want of ventilation, most impetuously

boyled up, like new Wine close shut up in bottles, and then ceased of it self. Yet from thence, as neither the year, so neither our blood did recover its due temperature, and so another Tinder or Nest for a new Feaver, was quickly gathered together: because after the Summer Solstice, the North wind still blowing, a cold season remained for a long while; so that the Fruit and Corn this year, was feared by the Husbandmen, would scarce be throughly ripened; but after this, a little before the beginning of July, a most fierce heat followed, for several days; and when the Dog days were begun, the Air grew most cruelly hot, that one could scarce endure the open Air. By reason of this Heat and Cold in excess, the temperature of this Year was very unequal: wherefore, there was a necessity for our Blood to be now fixed, and as it were congealed, now too much roasted, and so perverted from its natural disposi∣tion, to a scorched and Melancholy Temper; also it came to pass that the Pores of the skin were much altered from their right constitution, that by that means, an insensible transpi∣ration could not be performed after the wonted manner.

From the time that the former Feaver ceased, almost to the end of the Dog-days, there was a state of Health, and free from all Popular Diseases; but then a few here and there among the Villages, and in lesser places, first fell sick; but afterwards, about the end of Au∣gust, a new Feaver suddenly arising, began to spread through whole Regions, every where round about us; also this, as the other which spread the last Autumn, raged chiefly in Country Houses and Villages; but in the mean time, few of the Inhabitants of the greater Towns and Ci∣ties fell sick. At the same time, in other Regions, situate at a distance from us, almost throughout England, the EpidemicalFeaver was said to rage; and in some other places, to be far more deadly than it was about our Country. Perhaps the Idea of this Feaver now reigning had not the provision of its Symptoms alike in all places, or was noted wholly with the same Appearances and Accidents: yet whatever it shewed in our parts, as to its Nature, I shall briefly and succinctly add, from our own proper observation, or what I had learnt, being communicated from others.

About the beginning of this Disease, its figure was wandring, and very uncertain; because in some there was a continual fervor, in others it was intermitting, being renewed by set fits; but at this time it happened to very many, as a pathognomic Symptom, that they were ill in their Brain and Nervous Stock, that presently from the very beginning of this Feaver, almost all complain•…•…d of their Head being grievously distempered; For a cruel Head-ach in∣fested some, and hardness of hearing, with a noise in the Ears troubled others, but to most was wont to happen, either a stupidness, and heavy sleepiness, with a vertiginous Distemper, or pertinacious wakings, with a Delirium, and distractions of the Animal Spirits. I have observed in some, that on the first or second day of their Sickness, that little broad and red spots, like to the Measles, have leisurely broke forth in the whole Body, which being shortly vanished, the Feaver presently became stronger, and especially the Distempers of the Head, far more grievous. From thence a benummedness of the Senses, and a Sleepiness fell upon some for many days, that they lay a long while as if dying, without speaking, or know∣ledge of their Friends. I knew others to have fallen from hence into a Lethargy, and others cast into an Apoplexy, and some into a Phrensie and Delirium. Of these the younger and strong men (yet not without a long languishment, and doubtful recovery) most of them escaped; in the mean time, old men, or other ways weak and sickly, generally died. Those who fell sick with the Feaver, as it were continual, with those notes of malignity, were more rare, and the distempered were only sporadically, in some Houses only, But the Sickness which most commonly spred about us, fell upon most, and tho it cruelly raged, it seemed to imitate an intermitting Feaver, to wit either a Tertian, or a Quotidian; for that the sick had fits, either every day, or (which I more often observed) every other day, which infest∣ed them grievously, and a long while, with Cold, Heat and Sweat, succeeding in order: but these kind of fits, as also the course of the whole Disease, were wont to be noted with di∣versity, according to the Age and Temper of the Sick, and with various concourse of Symp∣toms and Accidents. Yet this was common to most of (I had like to have said all) the sick, that together with the Feaver, they were troubled with Cephalic Distempers.

When therefore any one was troubled with this Disease (whether the Sickness was excited from an evident Cause or Contagion, or without any manifest occasion) its coming betrayed it self by a Pain in the Head, and often in the Loyns, with Thirst, Want of Appetite, spontaneous Weariness, and Heat tho not strong: If it hapned in a young Body of a florid Blood, and more hot temper, the Fits wanted the Cold and Shivering, about its beginning, but they were very troublesome and sharp, with long heat: The sick were often troubled with Vomiting, and their Head aked cruelly for the most part, Sweat difficultly succeeded, which being often partial and quickly broke off, rarely cured the Fit, but when the Sweat failed, they grew hot again, that scarce in eighteen or twenty four hours the Fit was finished in some. In the mean time, from the Blood being very fervent, the Phantasie was disturbed, that oftentimes a Delirium, absurd or idle Talking, Wakings, and high Inquietudes were stirred up during the Fit;

but the same being finished, in the time between, still a troublesom Thirst, a slow Heat, Languor of Spirits, and great Debility of strength, with an Head-Ach, and a vertiginous Distemper, for the most part molested them. It was rarely found, for any to find them∣selves indifferently well, as in a common Tertian, between the Fits. About the beginning of the Disease, the feaverish Fiercenesses were somewhat more mild, which afterwards at every turn, leisurely grew worse, and then began with Cold and Shaking; to which nevertheless, after a long and very troublesome heat, Sweat very hardly succeeded in most, so that the Fit rarely ended in its due temper. Within six or seven Periods, the strength of the Sick was much cast down, that being made languid and weak, they had an hard task to struggle with the Disease; because unless Nature were succoured by Art, the Feaver still prevailed, and rarely or never in a short time, was it cured by a Crisis, or leisurely remitted; but it brought the sick into great streights, by its long siege, and still persisting, till the Blood being by its frequent deflagration made very liveless and watery, was unable to grow too hot in the Vessels of its own accord, or to be enkindled more plentifully in the Heart, and then often∣times became so dead, and wanting of Spirits, that being insufficient for the continuing the Vital Lamp, it brought in Death. But sometimes the Mass of Blood being depraved, and made poor by this Disease, was able (tho hardly) to continue the half extinct Vital Fire, and to renew it by little and little, with Spirit and Vigor, in a long time; yet in the mean time, after the height of this Disease, when the blood being made more weak and im∣pure, could not expel forth of doors this feaverish Matter, or adust recrements, by a critical motion, it often transferred it to the Brain; and therefore about the height of this Feaver, a torpor, and stupidity of Spirits, Sleepiness, Vertigo, Tingling of the Ears, Tremblings, and convulsive motions, with a great oppression of the whole Animal Faculty, were most often induced.

Men of a cold temperament, or in years, who were taken with this Disease, altho they were but little feaverish, were wont however to be in greater danger of Life; because, in these, besides the disposition of the blood, not easily reducible, also what was gathered to∣gether in the fits, that was extraneous and not to be mixed, was hardly subdued, and diffi∣cultly sifted forth of the Mass of blood; wherefore, both the blood was still more notably depraved in its Crasis, and in every Fit more infected by the impure mixture: Moreover, the nervous Liquor was greatly perverted from its due temper, and defiled most badly, by the adust recrements continually poured on the Brain. Therefore, when old men, melancholic, or otherwise sickly persons, fell into this Feaver, they became, presently after its first Assault, stupified, and for the most part vertiginous: Tho in the Fits, the heat was not very sharp and piercing, they were however very unquiet, and still tossing about, oftentimes they talked idly and at random; after a long burning, either no Sweat, or only partial, and often broke off, followed; whereby the Fit was not fully helped, but that in the whole intervals, the sick were thirsty, and remained very ill, with a driness of the Mouth, a scurfiness of the Tongue, and a suffusion of a viscous Filth. After some Fits, their strength being exceedingly cast down, they were wholly fixt to their Beds, or rise only for a little while, could scarce stand or set a foot before another, to move from place to place, or able to walk: in the mean time, they laboured with a languishment, a difficult breathing, a nummedness of senses, and a great debility of the whole nervous stock: The Urine in most was highly red, of a more deep co∣lour, and of a thicker consistency, than in a common Tertian: The Pulse, whilst the strength was not wholly cast down, for the most part was strong and equal; afterwards. when the sick became very languishing, it was weak and unequal, and oftentimes intermitting; to which also, constructures of the Tendons, and convulsive Motions in the Wrists, being joyned, were for the most part Prognosticks of Death. Those who leisurely being debilitated, decli∣ned towards Death, some little time before they died, lay for the most part without speak∣ing, or knowing those about them, as it were stupid; and it rarely hapned in this Feaver, that any one about to die, was so perfect in their Memory and Intellect, as to dispose of their Family-Affairs, or to take leave of their Friends. But it hapned to those that escaped, from a deep languishment and almost desperate condition, not quickly or suddenly to recover, from their manifest evil disposition, but lying a long while wavering, stupified, and without strength, that Nature at length, not but after a doubtful and difficult strife, got indeed scarce∣ly the better of the Disease, and then recovered strength by degrees, and health lingringly and slowly.

If the Nature, and formal Reason of this Epidemical Feaver but now described, be demand∣ed, we say, that this (as that of the former year) properly is an intermitting Feaver: for what commonly spread bore that figure; altho some here and there, more rarely, had it con∣tinual, which we shall by the way mention by and by. The Seed-plot or Seminary of this, need not be derived from the Air, being infected with any Infection, but rather its leading Cause is to be sought, from the undue constitution of the Year, and from thence an indisposi∣tion of our Blood being acquired. Because, in the Spring and Autumn, intermitting Feavers

have yearly sprung up and increased; to wit, for that our Blood, like to the Juice of Vegeta∣bles, is wont to be more lively moved than usual, and to flower at those times. Wherefore if the mass of Blood, by reason of the foregoing season, of the Summer or Winter, should be altered from its due temperature, and should contract either a sharp or atrabilous disposition, or of any other kind, its evil dispositions begun before, are chiefly ripened about the Equi∣noxes; to wit, when the Blood more freely fermenting (if that it hath departed from its na∣tural disposition) doth not so eafily sanguifie, but that it will be apt to pervert the alible juice, poured to it, into an extraneous and feaverish matter. When therefore this year had not very much declined from a right Constitution (as not only the Dog-days going before, but) that the two Solstices, and the Equinoxes, were wholly intemperate, it was no wonder if intermitting Feavers, more frequent than usual, and those noted with some unusual Symp∣toms, did encrease about the Autumn. That therefore an intermitting Epidemical Feaver ra∣ged at this time, I judge it not to be attributed to the fault of the present Air, but to the Irregularites of the foregoing season: yet from what Causes and Occasions, some Symptoms proper to this Feaver, and distinct from the common Rule of intermitting Feavers, did arise, will be worth our Enquiry. I have already said, that the provision, that made this Feaver so deadly, consisted in two things chiefly, viz. the temper of the Year, now extreamly cold, then upon it very hot, then that it had variously perverted the disposition of our Blood, and had distempered the Pores of the Skin, with an undue Constitution. According to the Reasons taken from either, I shall endeavour to explicate the Accidents of this Disease, and to assign the Causes of its Appearnce.

1. First, We shall observe, that the Type of this Feaver was various, to wit, in some with a continual heat, in others with an eruption of Spots, but in most intermitting, and like a Tertian, and sometimes (tho rarely) a Quotidian, repeating the Fits every day, or every other day: the Cause of this diversity, we impute to the more strong and potent morbi∣fic procatarxy of this Year, which produced in the Autumn, a more common intermitting Feaver than it was wont; wherefore, in some (perhaps indued with a more praved habit of Body) it stirred up Feavers something malignant; and in whom it caused intermitting Fea∣vers, according to the wonted manner of the Season, it made them to be noted with a pe∣culiar appearance of Symptoms.

2. Those taken at this time with the Epidemical Feaver (whether it was Continual or in∣termitting) suffered presently evil Distempers of the Head, viz. now they were wont to be infested with cruel Head-Ach, now with a Stupor, or too great Distraction of the Animal Spirits. The reason of this is, that the nervous Juice, as well as the Blood, by reason of the intemperance of the Year, was much altered from its due Crasis or Disposition, viz. by nature sweet and spirituous, and was become now heavy, and almost lifeless, now sharp, and too much pungitive. Besides, also, the Mass it self of the Blood very much contributed to this Evil; for whilst it grew hot, the vaporous Effluvia▪ which ought to have been dispersed outwardly, by reason of the Pores being shut up, were poured upon the Brain, and Mem∣branes of the Head; and by reasoe of this kind of stopping, impressed almost upon all, sweat hardly, and not but partial, and often interrupted, succeded in the fits; hence also in the height of the Disease, a perfect Crisis, or spontaneous, rarely or never happened to cure it; but instead of this, if the business was committed to Nature, the adust Matter, or Recrements gathered together in the Blood, were transferred to the Head, and there raised up now the sleepy Evil, now Phrensies, and those long and stubborn.

3, That the Fits sometimes begun without cold or shivering, but with a troublesome heat, and were prolonged with a difficult Sweat, partial, and often interrupted; then forasmuch as the same being finished, the sick began again to wax hot, that the Fits were not finished without a long evaporation of a dry breath; the cause was, the too sharp and bilous disposi∣tion of the Blood, whereby when it grew turgid, it was stuffed rather with adust Salt and Sul∣phur, than a serous Juice, and presently conceived an enkindling, without any previous Flux of nitrous Matter; and therefore for want of Serum, and by reason of the Pores being shut up, its deflagration was continued for a long time, almost only with a dry Exhalation, and scarce at last ended in a remission. And therefore the interstitia of the Fits were most trou∣blesome with Heat and Thirst, Head-Ach, Vertigo, and other Distempers; because the fea∣verish Matter, being heaped up in the Blood, was not all dispersed by the several Fits, but part of it being left after the Fit, as it were extraneous and not miscible, induced almost a continual burning.

4. It was observed, that those distempered with this Feaver, presently lost their strength and flesh, that after a fit or two, they panted for breath, and being very weak, were not able to stand or go, without being led; when it is an usual thing in an intermitting Feaver that is common, for the Patient to be very lively and chearful between the Fits: the reason of the Difference is, because in this Feaver, the Mass of Blood is both

more depraved by the impure mixture of the degenerate Juice, and especially, that the same is more perverted from its natural disposition, and therefore, when it boils up less out of the fits, it yet ferments not rightly and equally in the bosom of the Heart: where∣fore, when by any more quick motion, or agitation of the Body, the Blood is carried more impetuously into the bosom of the Heart, because it is not there presently enkindled, it both leaps forth of doors, and by its stagnation, causes the oppression of the Heart, and great weakning of the Vital Spirits. By reason of this kind of dyscrasie of the Blood, to wit, whereby it is made more unfit for due Fermentation and enkindling in the Heart, also some Beasts,, and especially Horses, in the Spring-time, are made hard-breath'd, and very unapt to any rapid motion.

5. Lastly, We are to enquire, concerning this Feaver, wherefore it spread chiefly in Vil∣lages, in lesser Towns, and the Countrey, when Cities and greater Towns were less trou∣bled with it. It might seem that this Distemper should be excited from Marshy Fogs, and other hurtful Vapors, plentifully heaped together in this or that Tract of the Air: but there is a better reason, for that the Inhabitants of these kind of places, being more exposed to the Spring-cold, and then to the Summer-heats, might have contracted a greater Dyscrasie of the Blood, and so a more apt disposition to this Feaver. For in truth, the Inhabitants of the Country could scarce go out of their houses, but they were exposed to the Sun's beams, or the fervor of the heated Air. Besides, Countrymen, Husbandmen, and such as were accustomed to Labors (among whom this Feaver chiefly raged) from their immoderate toil in the Sun or open Air, also using a bad and sharp Diet, sooner acquired an adust and tor∣rid disposition of the blood, and so more apt for this Disease than Citizens and Townsmen, who lived an idle Life, and enjoyed wholesom food, and mostly continued within doors, and in refrigerating Shades. We may believe this Assertion, for that not only the Epidemical Feaver now raging, but also another of the Autumn before, excited by reason of the evil disposition of the blood increased chiefly among the Countrymen, and Inhabitants of the Countrey: but the popular Feaver, which arose in the middle of the Spring, depending chiefly upon transpiration being hindred, mostly infested Citizens and the Inhabitants of Towns; whilst Rustical men, that were wont, by Labour and Exercise, to procure a more free breathing forth, remained free.

The general Prognostication of this Disease seems only to ominate or foretel the like evil almost to follow this, as followed the Epidemical Feaver of the former Autumn, to wit, the Augury being taken rather from the intemperance of our Blood, than from the evil of the Air) not the Pest, but a Quartan Feaver might be feared to come upon it. As to the particular Indication, as Signs that promise Health or Death, I shall briefly mention them; and they chiefly respect the temper and government, either of the Blood, with the Vital Spirit, or else of the nervous Juice, with the Animal Spirit. If it be plainly indicated from the Pulse, Urine, from Actions less hurt, and the appearance of other Symptoms, that the Blood, as to its feaverish disposition, is not very much perverted from its natural temper; that in the fits it moderately burns forth; and in every Combat easily subdues the load of the feaverish matter, and wholly shakes it off from its company; that after some fits, the mass of Blood is somewhat restored towards its due Temper; that it perverts little the alible Juice, and sifts forth, with a more gentle rising up, what is extraneous and not mingleable, and that if in the mean time, the other spirituous Liquor, rightly inspires and waters the Brain and Nervous Bodies, that Sleep, Waking, Sensation and Motion are performed well, or at least indisferently, all good is to be hoped concerning the sick. But if it appears from the same Fountains of Indications, that the Blood hath acquired in this Feaver, a disposition far removed from the natural, if it perverts much of the alible Juice, and then from its ex∣traneous and incongruous mixture, the Liquor of the Blood is greatly disturbed, and the Spirits driven into confusion; if in the fits, the Blood too strongly, and in a long time burns forth, yet doth not truly subdue the feaverish matter, or exclude the whole, but that by its impure mixture, it is still more and (in every feaverish fit) more infected, and the Spirits being continually consumed, it becomes poorer, we may pronounce the Life of the Patient to be in much danger. Besides these, if the Vices of the Nervous Juice happen, that being altered from its due temper, or being too dull, and as it were lifeless, little actuates the Brain and nervous Stock; or being above measure sharp, continually provokes the same into Convulsions and Distractions; and if besides the vaporous Esfluvia's continually falling away from the Blood, or the adust recrements being wont to be sifted forth by a critical Sweat, should be transferred into the Head, and there induce Lethargic or Phrensical Di∣stempers, the hopes of Health will be little, and we may fear a very deadly event.

Concerning the Cure of this Disease, the Intentions will come under three Considera∣tions chiefly. First, a quick reduction (as much as may be) of the Blood and nervous Liquor, to their natural tempers, or at least a prevention of their too great depravation. Secondly, Concerning the right handling the fits of the sick, it ought to be procured, First, that less of

the degenerate Juice may be gathered together for matter of the fit: 2ly, that what is gathered together, may be wholly dispersed by every fit, that thereby the sick may be better in the in∣tervals: Thirdly, that the body being altered for the better, the fits may be inhibited by Anti-feaverish Remedies. The third intention respects the Symptoms chiefly urging, which should be timely opposed, whereby Nature, being not hindred, may reduce whatsoever in∣temperanc•…•… may be contained in the Viscera or Vessels, may subdue and sift forth the extra∣neous Matter, and at length may recover a lively force, and pristine vigor.

First, therefore, for the reduction and emendation of the Blood and nervous Juice, di∣verse manners of Evacuations are wont to be exhibited in this Disease, about the begin∣ning of the Sickness, with good success. It appears plainly from modern Practice, that Vomitories are of more noted Use in this Distemper, than in a common Tertian: where∣fore in a robust body, and prone to vomit, about the beginning of the second or third fit, it is convenient to give an Emetic Medecine. The operation of this seems to be very help∣ful in this Feaver, forasmuch as it more plentifully evacuates the filth from the Ventricle, and the yellow Bile from the Choler-bearing Vessels; and because it copiously presses forth the serous Juice from the Emunctories of the Nervous Stock, planted about the Pancreas and Intestines, and by provoking them, draws it out. Wherefore we observe, that from a Vomit being taken, the sick do find themselves better about the Distempers of the Head. A Purge (to whom a Vomit is not convenient) may be ordered instead of it; the day following the fit, also tho an Emetick have been taken, it may be well permitted after a fit or two: But yet only with gentle and benign Physic, let it be performed, which will not disturb or too much move the Blood. We were wont in these Feavers, letting alone Diagridium or any Aloetic Medecine, onIy to give an Infusion or Powder of Senna, Rha∣barb, and yellow Saunders, with Tartar and Salt of Wormwood, and to celebrate this kind of Purgation not very long after the beginning of the Disease, but at other times to keep the Belly soluble with the frequent Use of Clysters. Frequent Experience hath suffici∣ently taught, that Letting of Blood is highly profitable in this Disease; for when by rea∣son of the Pores in every one, being more strictly closed than usual, the Blood growing hot, by the Feaver, wanted Ventilation, the Letting of Blood supplies the place of a more free breathing forth, and prevents the restrained Esfluvia from so readily suffusing them∣selves on the Brain and nervous stock. But this Remedy is chiefly indicated from the very fervent Blood, and more hot temperament, nor ought to be indifferently used to old men, Phlegmatic, and other very weak Persons, unless perhaps in a small quantity, that the mass of Blood may be somewhat eventilated, and that the removal of the feaverish Matter into the Brain, may be hindred. If it be convenient to open a Vein, Iet it be done about the beginning of the Feaver, or at least before the fourth or fifth fit, viz. before the Blood is made very lifeless by the frequent deflagration, and rendred too impure by the confusion of the adust matter; because, if Phlebotomy be made use of,, whilst the Blood is highly cor∣rupted, the Vital Spirits, and by that means the strength of the sick are more debilitated, nor yet is there any thing taken away from the power of the Disease, or from its Cause. There remains another famous way of evacuation, in this Feav•…•…r, to wit, Vesicatory Plaisters applied to various parts of the Body; these are commonly observed to be so helpful, that those that abhor and dislike very much such a Remedy, by the example of others being the better for them, have admitted them. By what means they separate the Cuticula from the Skin, and lift it up like a Bladder filled with Water, or whether they press forth this watery and limpid humor, out of the Arteries, or out of the Nerves, is not in this place to be en∣quired into; yet that they are profitably administred in this Disease, besides Experience, Reason seems something to perswade, because it in some manner compensates the want of Transpiration, by the large profusion of this kind of serous Latex: Moreover, this kind of Remedy, as it were, opens the ways and doors, by which both the Blood, and nervous Juice, may forthwith send forth by a proper purging, the extraneous matter, confused with them; wherefore, in the Plague and Malignant Distempers, Vesicatories are esteemed very pro∣fitable. Also it appears by common observation, that in this and other Feavers, frequent at the same time, they did prevent the more grievous Distempers of the Head, and were wont to help them, if they were brought in before: wherefore, Epispatic Plaisters may be applied about the beginning of the Disease, for preservation sake, to Phlegmatic Persons, Elderly People, and men of a more cold Temper; and they are wont profita∣bly to be administred to several others, labouring with a Vertigo, Stupefaction, or cruel Head-ach, for the Cure of the same Distempers. But in Constitutions very hot, where with the defect of the Serum, the Blood is too much burnt, and if those sick of the Feaver are ob∣noxious to Wakings, or a Phrenzy, with intolerable heat, Blisters seem then to be of little use.

For the mending of the temper of the Blood, and also the tenor of the Viscera, at vacant times, when there is leisure from purging, attemperating Remedies have place, and Dige∣stives, which fuse the Liquor of the Blood, and separate its faeculencies, and as it were by

precipitating them, thrust them towards the Emunctuaries: For these sort of intentions, are wont to be given Juleps, and refrigerating Decoctions, sharpned with Spirit of Vitriol, of Salt, Tamarinds, or with the Juice of Oranges or Limons; forms of which choice enough are commonly to be had. Also for this end, acetous, saline, and shelly Powders are used, to wit, prepared out of Tartar, Salnitre, the fixed Salt of Herbs, of burnt Harts-horn, also the Claws and Eyes of Crabs. As for example, Take of Cream of Tartar drams three, of Salt of Wormwood dram one and a half; the Dose half a dram, in an opening Decoction, twice in a day out of the fit. Or take of Cream of Tartar dram one, of the Powder of Crabs Eyes dram one, of purified Nitre half a dram, mingle them; let them be taken after the same manner. Or take of Harts-horn burnt drams two, of the Spirit of Vitriol, what the Powder will drink up, the Dose is one scruple, it is of excellent use when those in Feavers are infested with Worms. These kind of Remedies promote the secretion of the feaverish matter, and also restore the almost destroyed ferments of the Blood and Viscera.

The second intention, viz. concerning the right handling the fits, comprehends more. First, There ought to be instituted a right order of Diet, whereby the more full heaping up of the degenerate Juice, for the matter of the fit, may be inhibited; wherefore, they are only to be fed with thin Aliments, and they must wholly abstain from Flesh (or Broth made of it) Eggs, strong Drink, and all rich Meats and Food whatsoever, and be contented only with Bar∣ly Broth, or Grewel, Panada, Whey, and small Beer; for that a more plentiful Aliment is not digested, or assimilated, but loads the Ventricle, and being powred into the Blood, di∣sturbs its Liquor, and compels it to grow impetuously hot. In the beginning of the Fit, and the time of its duration, no food should be taken, unless for the allaying of thirst; But for the tempering of heat and thirst, Juleps, and cooling Decoctions, and especially small Beer: and Posset-drink should be granted. Secondly, a little before the coming of the fit is expected, a gentle Medecine may be administred, which may drive away the fit by preventing it, or make it more easie by procuring a Sweat: for this use the Febrifuge Potion of the most Learn∣ed Riverius serves well, of the Water of Carduus, with Oyl of Sulphur, and Salt of Worm∣wood: Or take of Cream of Tartar, of Salt of Wormwood, and the seeds of Nettles, each one scruple, let it be given in the Decoction of the Roots of Sorrel; when the Feaver begins to decline, and that the fits are a little more remiss, proper Febrifuges, applied outwardly, often inhibit the comings of the fits. Yet in the mean time, so long as the fits of the Feaver return, the sick are to be handled so, that in every fit, the feaverish matter heaped in the Blood, may be throughly dispersed; wherefore, when Sw•…•…at hardly succeeds, it should be a little excited by temperate Medecines: Also the sick should be kept in bed, with a gentle breathing many hours, nor quickly permitted to rise; for I have o•…•…ten observed, that sick persons have been still worse, because impatient of their Bed, they have put on their cloaths before the vaporous Effluvia were sufficiently exhaled.

Thirdly, As to the Symptoms and particular accidents, wherewith the sick are wont to be infested in this Feaver, it is sufficiently provided for most of them, with Remedies, in the method of Cure hitherto described; again, thirst, the heat of the mouth, the scurfiness of the tongue, vomiting, the loosness, fainting, swooning, may be referred hither, very well the prescriptions commonly used in other Feavers: But what may seem to require in this Disease a peculiar Method of healing, are chiefly the Distempers of the Head and Brain, with the nervous Stock, which not being timely helped, may soon put the sick into great danger of Life: As to the Indications of these kind of evils of the Head, they are of a twofold kind; if it appears from a Stupefaction or Torpor, a Sleepiness, Vertigo, or Head-Ach, that the nervous Juice is become too dull, and as it were vapid or lifeless, and therefore doth not sufficiently actuate the Brain and nervous Bodies; besides the Remedies already delivered, and especially Vesicatories, Medecines full of a volatile Salt do chiefly help: wherefore Spirits of Harts-horn, and of Blood, also the Salts of them, are of excellent use; but if the nervous Liquor be too sharp, or the effluvia suffused from the aestuating Blood, drive the Animal Spirits into confusions or distracti∣ons, Remedies of the same sort of volatile Salt are administred with success in a little s•…•…aller quantity. Besides, a frequent letting of Blood, and asswaging Medecines against its Fervor, help much; as Emulsions, Whey, and simple Water, plentifully drunk; Opiats are cautiously to be given in this Feaver, for the Phrensie being often allayed by them, is changed into a Le∣thargy, or a deep Stupefaction.

FINIS.