A systeme of anatomy, treating of the body of man, beasts, birds, fish, insects, and plants illustrated with many schemes, consisting of variety of elegant figures, drawn from the life, and engraven in seventy four folio copper-plates. And after every part of man's body hath been anatomically described, its diseases, cases, and cures are concisely exhibited. The first volume containing the parts of the lowest apartiments of the body of man and other animals, etc. / by Samuel Collins ...

CHAP. XXVI. Of a Rheumatism.

THe Muscles are obnoxious to another vexatious Disease (that giveth a high discomposure to the Patient in violent Pains) a Rhematism, * 1.1 that hath for its remote subject, the Fleshy part of the Body, not much con∣cerned as composed of various Tubes of Arteries, Veins, and Lymphaeducts, but are framed of Nervous and Membranous Fibres, which are the parts chiefly affected in this Disease, as the great Ministers of Sensation.

The Muscular parts of the lower Limbs, * 1.2 are most oppressed with a Rheu∣matism, because the Blood enraged with Salt Particles, is propelled down∣ward by the Descendent Trunk of the Aorta, and Iliack Artery, into the Thighs, Legs, and Feet, as most distant from the Noble parts, which Na∣ture is ambitious to preserve.

This troublesome Disaffection, * 1.3 is not Afflictive perpetually after one man∣ner, by reason it doth not take one constant Course, but hath its Types and Periods, its Exacerbations and Remissions, more gentle, and more violent pains, and seldom hath in the beginning any eminent Swelling; which is more frequent about the state or declination of the Disease, and is caused by the sharp Particles of the Blood, transmitted into the empty Spaces of the Muscles; where they being lodged, give great Alleviation of pain to the discomposed Patient.

The subject of a Rheumatism, is not the same with that of a Joint Gout, The fine Coats encircling the body and heads of the Bones, constituting the Joints, but the various Membrane, the fine contextures of Nervous Fila∣ments, immuring the body of every Muscle, and many Nervous and Ten∣dinous Fibres, branched through the whole substance of the Muscles; so that these Membranous and Fibrous parts, as consisting of many Nervous Fila∣ments, are the parts affected in a Rheumatism, as instruments of acute Sense, whence they are rendred capable of pain, produced by the unnatural Fermen∣tative Elements of Vital and Nervous Liquor.

The main matter of Rheumatism is the Blood, * 1.4 which is impelled into various Muscular parts by several Arterial Branches, whence arise those wan∣dring pains, that torment now one, then another part, as afflicted with Fer∣mentative unkindly Blood, making several gesses through the Muscular parts relating to the whole Body: Whereupon the Blood consisting of Heteroge∣neous and unnatural Elements (doth give a disturbance to the Sensitive parts) which are not liable to Suppuration, because the Acid and Saline parts do preserve the Blood from Putrefaction; and an Inflammation happening in a Rheumatism is not the Disease, but a Symptome of it, flowing from a source of Blood settled in the empty Spaces of the Muscles; and the nature of this disaffection is founded in most irksome vellications of Nerves, tortured with Acid and Saline Particles.

It may be worth our enquiry, What parts of the Blood are most concern∣ed in a Rheumatism, whether the Chrystalline, or Red Crassaments are most active in the Production of it? To which I make bold to give this Reply: That the Serous Particles, and not the other, are a great Cause of

this Disease, * 1.5 as acted with sharp and Saline Atomes, which do highly dis∣quiet the Nervous Filaments; and as I apprehend, the Nervous Liquor doth claim a share in the production of this Distemper, as it is disaffected with Acid Atomes, which being in conjunction with the Serous parts of the Blood (as they both concur to Nutrition) do assault the tender frame of of Nervous Filaments, and vehemently prick them.

Whereupon, * 1.6 I humbly conceive, that pituitous Matter, or indige∣sted Chyme, is not the matter of a Rheumatism (but of an Oedematous Tu∣mour, as being of too soft an ingeny, to produce such a churlish and angry Disease, speaking so great a torment to the Nervous Filaments) no way agreeable to the more mild nature of the Chyle, holding great analogy with the temper of Milk, which sweetneth, and not enrageth; and being associ∣ated with the Mass of Blood, giveth rather an allay, then raiseth an unkind∣ly Fermentation, proceeding from Acid and Saline Atomes, chiefly resident in the serous parts of the Blood.

The best account (as I conceive) as most agreeable to Sense and Reason, is Mechanical, fetched from the principles of Nature (Chymically descri∣bed) constituting the Mass of Blood, which being unnaturally Heteroge∣neous in a Cachexy, do cause extraordinary Ebullitions, highly afflicting the parts of the Body through which it passeth; whereupon the main Ingredi∣ents of this Disease are Salts of different dispositions, * 1.7 residing in the Mass of Blood, and making great Effervescences, when they endeavour to enter into a mutual association, which is intended by Nature for each others In∣terest and Perfection; because the end of these sharp Encounters, is to refine each other, and by subduing their Dissimilar Natures, to become nearer akin to each other by a harmony of Temper, in which they being Assimilated, do leave their hostile disputes, and kindly entertain each other in an amica∣ble Converse.

And those different Saline Principles (which have so stubborn and un∣compliant disposition that are not capable to be reconciled, by being made Similar by natural Effervescences; * 1.8 Nature turneth out of Doors (as disser∣viceable to the Body) by several Excretory Vessels, terminating in the In∣testines, Bladder, or Ambient parts. These various Saline Elements are fixed, as Alkalies and Lixivial Salts, and being highly indisposed in diffe∣rent Tempers, and meeting with exalted Acids, do produce extravagant Fermentations; * 1.9 as Oil of Sulphur poured upon Oil of Tartar, or any other Acids mixed with Volatil or fixed Salts, do cause great Ebullitions.

And the Mass of Blood and Nervous Liquor, being made up of different Elements, of disaffected Acids and Alkalies of unkindly Volatil and fixed Salts, do hold a great Analogy with the Fermentations, flowing from the mixture of Spirit of Vitriol and Tartar, which entring into disputes with each other, do produce fierce Ebullitions; and they insinuate themselves in order to Nutrition, into the pores of Membranes and Nervous Filaments, which being of acute Sensation, are highly irritated and enraged by diffe∣rent Elements, fretting and gauling their most tender Compage, productive of tormenting Agonies, * 1.10 and most racking pains in a Rheumatism.

To render this Hypothesis more clear, I will speak somewhat of the man∣ner of Nutrition (as more conducive to the better understanding of it) which is accomplished by various Liquors; the one is the more mild part of the Blood, which much resembleth the Albuminous Juice of an Egg, and will Coagulate l••ke it, when held over the Fire in a Spoon: Another Li∣quor is that of the Brain, transmitted between the many Filaments of Nerves into all parts of the Body.

These two Liquors of several Families and Dispositions, associating in the habit of the Body (wherein they being severed from the Red Crassament) are transmitted into the Pores of numerous Vessels integrating the Muscular parts, and these Chrystalline and Nervous Liquors being of a clammy nature, do easily admit an accretion, and assimilate with the substance of the Mus∣cles, when conveyed into their innumerable Pores. * 1.11 Whereupon these vari∣ous Juices, consisting of Heterogeneous principles of Acids and Alkalies, of Volatil and fixed Salts (which being highly indisposed and embodied in ill habits of Body) do raise great Tumults and Ebullitions, in different Liquors, endued with disagreeing Tempers, which being compounded of fierce Salts and Acids highly disputing each other, and being Extravasated in the Interstices of the Vessels, into whose numerous Pores they are immit∣ted in order to Accretion and Assimilation, with the substance of the Fleshy parts.

So that the Nerves being Systems of many Filaments, are most highly aggrieved and tormented with Vellications in a Rheumatism, produced by enraged Fermentative Atomes of various furious Salts, and Acids, relating to the serous parts of the Blood, and Animal Liquor, endeavouring in the empty Spaces of the Vessels, to unite and incorporate with the substance of the most delicate parts of Body, the subject of Sensation.

Whence may easily be inferred, * 1.12 what are the antecedent and continent Causes of a Rheumatism; the one being In fieri, the other in factu esse. The antecedent relateth to the serous parts of the Blood, and Nervous Liquor (immitted into it by the Termination of the Nerves) discomposed by tumul∣tuary Alkalies and Acids, raising high Ebullitions in different Juices, while they are immured within the confines of the Vessels.

The continent cause of a Rheumatism, obtaineth the same Matter with the antecedent, and differeth in the parts affected, and both agree, as be∣ing derived from divers Salts, the one fixed, the other brought to a Fluor, and so turneth Acid; and they are Discriminated, by reason the Antecedent cause flowing from various fixed Saline, and Acid Elements embodied in the Mass of Blood, are contained and circulate in the Arteries and Veins; and the Continent cause proceedeth from the same principles, * 1.13 disaffecting the Serous parts of the Purple and Nervous Liquor confaederated, and then impelled out of the Arteries into the empty spaces of the Muscles, in order to be transmitted into the Veins, and in their passage some Particles are received in order to Nutrition, into the pores of the Vessels, to repair their lost Particles by Assimilation, whereupon the Preternatural Fermentative parts of different Liquors, making angry Effervescences in the substance of the Nervous Filaments, do produce vexatious pains; the immediate, or continent cause of a Rheumatism.

The Procatarctick cause may proceed from ill Diet, * 1.14 from too large an assumption of variety of gross Flesh, not well digested, by reason of Acid Ferments, transmitted out of the extreamities of the Arteries, or from De∣praved Liquor, distilling out of the Terminations of the Nerves, into the Cavity of the Stomach, perverting its laudable Concoction, or from eating of Meats highly salted or dried with Smoak, or from drinking of small Wines full of Tartar, which produce an Alimentary Liquor in the Sto∣mach (impraegnated with gross Saline Particles) which being carried through the Intestines, and Thoracic Ducts, into the Subclavian Vessels, doth em∣body with the Blood, vitiating its temper, and disposing it for the producti∣on of a Rheumatism.

The various Seasons of the Year do much disorder the Constitution of the Body, * 1.15 occasioned by different tempers of the Air, sometimes Hot, and pre∣sently after Cold (as in the Spring and Autumn) wherein Nature is sur∣prised, in a suddain different alteration of Air; and when the Pores have been enlarged by heat, they are immediately shut up by Cold, and the fiery and Saline Particles, and Acid steams of the Blood and Nervous Liquor are suppressed a prohibita Transpiratione; whereupon the various sharp Saline Recrements, endued with Fermentative Particles, do make great bussles in the Body, and vex the parts.

Violent Labours and Exercises, * 1.16 and extravagant Passion, and an immode∣rate indulgence of Venery, as also the suppression of the wonted evacuation of Blood by the Nostrils, Haemorrhoides, or Menstrua, do highly dis∣compose the Vital and Nervous Liquor in the Vessels, and enrage the Mor∣bifick Matter of a Rheumatism, by raising the Fermentation of various Juices, consisting of Acid, and Saline parts (the antecedent cause lodged in the Vessels) impelled into the habit of the Body (and so become the continent cause of the Disease) disquieting the Nervous parts, by giving them sharp pains.

Thus having given a brief Account of the Procatarctick Causes, I will now with Permission, attempt to shew the different Influences these various kind∣ly and unkindly primitive causes do produce, by making good or ill Dis∣position and Concoction in the Stomach, Blood, and Nervous Liquor, in the Vessels and habit of the Body, in reference to Nutrition; whence arise Na∣tural, or Preternatural Fermentations of several Liquors, composing, or di∣sturbing the quiet of the Nervous parts.

The Blood affected with a laudable Disposition, * 1.17 obtaineth a kind of Me∣diocrity of state (as Learned Dr. Willis hath well observed) as being nei∣ther too Fixed, nor too Volatil: And the parts of the Blood may be said to be too fixed, when the Elements of Sulphur, Salt, and Earth, are so firmly united in a close bond of mixtion, that they cannot easily be parted; as when Liquors are not well Concocted, by natural heat, and due Ferments, as out of Wine made of unripe Grapes, it is difficult to extract a Salt and Spirit in Distillation; but when the Saline associated with Spirituous Atomes are rendred Volatil, they are somewhat freed from the strict combination of Sulphur and Earth: As it is evident in the Distillation of Wine, after it is made fine by parting with its gross and earthy Lees, fallen to the bot∣tom of the Cask; whereupon out of Wine secerned from its Faeces, the Spi∣rituous and Volatil parts will easily ascend, and a Spirit of Wine may be readily extracted.

The Liquors (expatiating themselves in the body of Animals, * 1.18 and espe∣cially in a Humane Body) may have some analogy in their Fermentation with those of Vegetables; whereupon the Liquors of our Bodies, are endu∣ed with a moderate Fixation, when first the Chyle is duly elaborated in the Stomach, by the help of good Air, Meats of easie Concoction, and proper Ferments of Serous and Nervous Liquor, distilling out of the Arteries and Nerves (inserted into the inward Tunicle of the Stomach) into the Cavity of the Ventricle, whereby the well digested Chyle being secerned by a kind of Precipitation from the gross Saline, and Sulphureous, and earthy Faeces, is transmitted through the Intestines, wherein it is farther Concocted by the Pancreatick Juice, and Arterial and Nervous Liquor, by which the Chyle being rendred more attenuated, is carried through the Thorax by proper Lacteae into the Subclavian Veins, where it espousing the Blood in a

near union, receiveth a farther Exaltation, and is assimilated into Vital Liquor, whose more mild parts associated with Nervous Juice, * 1.19 become a good Suc∣cus Nutricius; which being conveyed by innumerable Pores into the solid parts, is made one uniform substance with them by Accretion.

But if upon the reception of highly salted Meat, dried in the Sun, or Smoak, and other Meat hard of Digestion (by reason the Succulent parts are dried up, by the Salt and Smoak) a crude Milky Humour is extracted; * 1.20 because the too solid Compage of the Aliment is not duly opened by a gross Air, a faint heat, and ill Ferments of the Stomach, whereby the Chyle is not well separated from the gross Saline, Sulphureous, and earthy Elements of the Meat and Drink; whereupon the Intestines, by reason of an impure Pancreatick Liquor, and other ill Ferments, do not attenuate the Chyle, which is imported through the Breast into the Vital Liquor, wherein it is not exalted by a dispirited Blood, affected with gross Sulphureous and fix∣ed Saline Atomes, which being transmitted into the Interstices of the Ves∣sels, do highly torture the Membranous and Nervous parts of the Muscles producing a Rheumatism.

This Disease doth not only proceed from the fixed Saline parts of the Blood, but from a depraved Nervous Liquor, * 1.21 which may be backed by pro∣bable Reason; because Persons liable to Rheumatisms, are often afflicted with Nervous disaffections, as gentle rigors (dispersed through the Membranous and Muscular parts of the Body) which are a kind of Convulsive Motions, seated in the Nervous and Tendinous Fibres, involuntarily contracted by some sharp Humours.

And again, the unnatural Contractions of Nerves, proceed from a disaffected Nervous Liquor, of which this Conjecture may be made, because these Convulsive Motions, were attended with the excretion of Urine, as salt as Vinegar, an Argument that part of the Acid Particles affecting the Nerves, were discharged by Urine, which were first secerned in the Glands, and afterward imparted by the Veins, or Lymphaeducts to the Mass of Blood, carried by the Descendent Trunk of the Aorta and Emulgent Artery, into the Glands of the Kidney, where it is severed from the Blood, and transmit∣ted by the Urinary Ducts and Papillary Caruncles, terminating into the Pel∣vis, the entrance into the Ureters, by which it is conveyed into the Bladder, and so out of the Body by the Urethra.

Furthermore it may be conjectured, * 1.22 That this Disease may partly borrow its production from vitiated Nervous Liquor, disaffecting the sensible parts: Because in the beginning of Rheumatisms, Patients are often troubled with Dulness, and pains of their Heads, attended with Sleepiness, which may come from a depraved Animal Liquor, disaffecting the Coats of the Brain; whence upon good grounds, we may be induced to believe, that a Rheu∣matism is not wholly derived from a disordered Mass of Blood, but also from a Nervous Juice impraegnated with Saline Particles, brought to a Fluor, thereby rendred Acid; whereupon the fixed saline parts of the Vital entring into a confaederacy with the Animal Liquor, do raise brisk Fermentations, exasperating the Membranes, Nervous and Tendinous Fibres of the Muscles, whence ensueth a high discomposure, and torture of the Sensible parts: So that the igredients of a Rheumatism, may be truly judged the Fermentative part of the Nervous and Vital Liquor.

As to the Prognosticks of this Disease, it is rarely attended with fatal Symptoms; and after the great storms of disquiet and pain are allayed, * 1.23 a Calm ensueth: and therefore a Rheumatism is not in it self liable to great

danger, but is a kind of Preservative, as by its mediation other Diseases are discharged, and the most discomposed Patient afterward is restored to Health; by reason the Matter of the Disease, the saline and acid Recrements, most offensive to the inward and noble parts, are discharged into the outward, and into the upper and lower Limbs, to secure the principles of Life, from the assaults of a troublesome and impetuous Enemy.

Sometimes in a Rheumatism, * 1.24 these fixed Saline in combination with earthy Particles, are concreted into a Chalky substance, accompanied with Extra∣vasated Blood (sometime tending to Suppuration) which being of a Cau∣stick nature, doth corrode the Fleshy parts and Skin, through which the Chalky Matter is discharged.

A Person of Honesty, keeping a Livery Stable in the Strand, was high∣ly afflicted with a Rheumatism, productive of divers Swellings in the Mus∣cular parts, accompanied with violent pains: These Tumours proceeded from Saline and Earthy parts Concreted, which did vent themselves very freely with Ulcerous Matter in divers parts of the Body; and upon Blood-letting, and Purging, and Diet Drinks, of Sarsaparilla and China, boiled in Water, and streined, and mixed with new Milk, the Pains were taken away, and the Ulcers Cured, by gentle detersive and drying Topicks, and the Patient perfectly recovered his Health, which he hath enjoyed for some Years.

Sometimes a Rhematism long afflicting a weak Chachectick Body, * 1.25 viti∣ateth the Ferments of the Stomach, producing an ill Chyle and Mass of Blood, causing an Atrophy of the whole Body.

A Knight, a Person of great Worth and Integrity, being of a weak Con∣stitution and ill habit of Body, frequently fell into a Rheumatism, accom∣panied with Vomitings, proceeding from Acid Particles, transmitted by the Capillary Arteries terminating into the Stomach, and from Bilious Humours transmitted from the Liver through the Hepatick Duct into the Duodenum, and from thence into the Ventricle; which took away his Appetite, and spoiled the Concoction of Aliment, making a crude Chyle, and an ill Mass of Blood (consisting of fixed Saline parts) and a depraved Succus Nutricius, infected with Acid Atomes, which raised the Ebullition of the Blood, im∣pelled into the empty spaces of the Vessels which gave him Pains, which were often alleviated by Blood-letting, gentle Purgatives, Diet Drinks, and distillations of Milk prepared with temperate Antiscorbuticks: But at last, this worthy Gentleman being impatient at his frequent returns of his Rheumatism he made use of Empyricks (great Promisers, and little Per∣formers) who contrary to Art, he being much weakned by an inveterate Disease, gave him churlish Purgatives, and ill prepared Minerals, which wholly took away his Strength, and motion of his Limbs; and at last his Mass of Blood, and Succus Nutricius being depraved, fell into an Emacia∣tion of his whole Body, which gave a period to his Life, to the great grief and trouble of all that were known to him; he having been a Person of high Honour and Generosity, Treating at his House Strangers as well as Friends, with a most obliging Civility and Kindness.

Doctor Glysson is of this Sentiment, * 1.26 That a Rheumatism taketh its birth not from Saline, but Sulphureous Vapours, associated with a Flatus; which, as I humbly conceive, being very fierce raiseth a great Ebullition of the Blood, and is very afflictive to the Nervous parts, in its passage through the substance of the Body.

Whereupon the Blood in violent Gouts, being affected with enraging Oily Particles, and accompanied with restless Wind, is impelled by the terminations of the Arteries, * 1.27 into the Interstices of the Membranes encir∣cling the Muscles; which being of a close and tender Compage, the tumultuary Purple Liquor is forced through it with great pain, proceeding from the great tension of many Minute well-struck Nervous Fibres.

And these Membranes immuring the Muscles, are not only afflicted with troublesome Tensions (caused by the Elastick Particles of Wind) but with sharp pricking pains, derived, as I conceive, * 1.28 from the impulse of the Blood (affected with hot Sulphureous parts) making its way through the Inter∣stices of the numerous Fibrils, endued with most accute sense.

The beating, pricking and tensive pains in a Rheumatism, * 1.29 are much aggra∣vated (as I conceive) by reason both the Interstices of the Filaments con∣stituting the Membranes, enclosing the Muscles, and the empty spaces of the Tendinous and Nervous Fibres integrating in a great degree the body of the Carnous parts, are often much obstructed, which rendreth the passage of the furious Blood (consisting of Sulphureous and Flatulent Vapours) very difficult and torminous.

A Rheumatism doth sometimes afflict the whole Body, * 1.30 which may be stiled a Universal Rheumatism, proceeding from an ill Mass of Blood, trans∣mitted into the proper Membranes, or into the Interstices of the Tendinous and Nervous Fibres, relating to all, or the greatest part of the Muscles of the Body, afflicted with universal pains, when the Patient looseth the use of his Limbs.

A Waterman of a hot plethorick and ill habit of Body, Rowing hard, put himself into a great Sweat, and a very free Transpiration, which was suddainly checked by a cold Air, shutting up the Pores of the Skin, where∣upon Nature was surprised, by hot Sulphureous Particles of an ill Mass of Blood (intercepted by a checked Transpiration) returning to the Heart by the Veins, and thrown out again from the Center to the Circumference by the Arteries, into the Interstices of the proper Membranes (encircling the Muscles) and into the empty spaces of the Nervous and Tendinous Fibres, chiefly framing the Carnous parts; whence do ensue raging pains, proceed∣ing from Oily flatulent Particles, torturing the tender Compage of Membra∣nous and Nervous Fibrils.

In order to a Cure, I advised repeated Blood-letting, * 1.31 contemperating Diet Drinks, Purging, Diuretick, and Sweating Medicines; whereupon the Pa∣tient was perfectly restored to his former Health.

Universal Rheumatisms are rare, wherein the Muscles of the greatest part of the Body are surprized with pain at one Instant, as in the former case; but most commonly some few Muscles are afflicted in one part of the Body, which proceedeth from some Particles only disaffected with hot Fermenta∣tive Atomes, conveyed into the empty spaces of the Membranous and Ner∣vous Fibres; and as more parts of the Blood are more infected with the Minera Morbi, they run into several Muscles, by the branches of Arteries in∣serted into the body of Muscles: This kind of Rheumatism admitteth a easie Cure, by reason some Muscles of the Body are only afflicted, and an great part of the Mass of Blood hath a good Constitution, as not acted with ill Ferments productive of this Disease.

The method of Curing a Rheumatism, is made up of three Indications: * 1.32 The first is Curative, which relateth to the Paroxisms, in speaking a quiet repose and ease to the Patient.

The second Indication is preservative in reference to the Intermission of the Fits of a Rheumatism, * 1.33 to take off, or at least to prevent the Violence of the Fits.

The third is Vital, * 1.34 which consists in the choice of proper Aliments, or in the Administration of Cordial, or Restorative Medicines, to comfort and give strength to the Patient, to render him able to encounter high afflictive pains very frequent in this Disease.

The first Indication relateth to the continent cause, to Cure the Dis∣ease, by wholly appeasing, or at least mitigating the pains (affecting the Membranous, Nervous, and Tendinous parts of the Muscles) proceed∣ing from the high Fermentations of the different, Vital and Nervous Liquor, enraged by fixed Salts and Acids, and sometimes with Sulphureous; which are all accompanied with Flatulent Matter, making great contests in the empty spaces of the Vessels; So that two Intentions do seem to offer them∣selves in this Indication. The first is to take off, or at least abate the high discomposure of the Nerves: The second is the manner of doing it, which is by taking away the matter of the Disease, and by giving an allay to great Effervescenses, caused by various Ferments of the Blood and Nervous Juice, which is to be effected by Phlebotomy, and by Purging, Alterative and Anodine Medicines.

Blood-letting is chiefly to be celebrated in the beginning of a Rheumatism, * 1.35 when the Patient hath strength, and before the Disease is too much Con∣firmed, when it is most beneficial in a hot Temper of Body, or in Youth and in Middle-Age, wherein Blood-letting may be most safely Administred, both to diminish the ill Mass of Blood, and to give controul to the Extrava∣gant disputes made between fierce Combatants of disagreeing Dispositions; the fixed Salts and Acids, and sometimes Sulphureous and Flatulent Parti∣cles associated with the Blood, and Nervous Liquor, inflicting great pains upon Nervous and Tendinous Fibres of the Muscles.

Purging Medicines are most safely advised after Blood-letting, * 1.36 and in the declination of a Rheumatism (when the Paronysmes do abate) lest in the beginning of the Disease the pains should be aggravated, especially in strong Purgings, which being of a churlish disposition, do raise the Fermentation of different Humours, and highten the Disease; whose offensive Matter is best discharged, * 1.37 when a Coction is made, and the Recrements of the Blood and Nervous Liquor, are severed from their more pure parts; whereupon the Matter of the Disease groweth more pliable after Coction, and is more easily transmitted by the Terminations of the upper and lower Miscenterick Arteries, inserted into the inward Coats of the Intestines.

The Purging Medicines serviceable in this Disease are numerous, * 1.38 as di∣vers sorts of Arthritick Powders, Medicines made of Hermodactiles, Me∣choacan, Diagridium, Syrupe of Buckthorn, given in Decoctions of Sarsa Parilla: Some Physicians advise Pilulas de Duobus, and other more strong Purgatives, which may prove less successful (except in Robust Constituti∣ons) by reason they weaken the Body, and enrage its unquiet Humours, which do imbitter the pains of this Disease: When the Patient is strong, some do deem Vomitories very proper in a foul Stomach, which have fre∣quent inclinations to Vomiting, caused by Bilious and Acid Ferments, thrown into the Cavity of the Stomach, out of which they are ejected by Emetick Tartar of Mynsicht, and by Sulphur and Flowers of Antimony, and most safely by Emetick Wine.

And not only Purgatives and Vomitories, but also Alteratives, * 1.39 consisting of Diet Drinks, made of Sarsaparilla, China, Lignum Sanctum (in cold and moist tempers of Body) Testaceous powders of Crabs Eyes, and Claws, Egg-shells, Pearl, and the like; and Chalybeats mixed with Anti∣scorbuticks, are very proper to sweeten the Blood, and alleviate pains, and to correct the ill habit of Body in Rheumatisms. And in order to repair the decaies of Nature in Emaciated Bodies, reduced to a kind of Hectick Scor∣butick Fevers in this Disease (when highly Chronic) Restorative and Cordial Medicines are to be advised; as distilled Milk, prepared with Antiscorbu∣ticks and Snails, mixed with new Milk, as also Asses Milk, and Decocti∣ons of China, Sarsaparilla, &c.

Whereupon in inveterate Rheumatisms, * 1.40 when Patients are reduced to great Weakness, and thereupon are not capable of Purging and Bleeding, the Vital Indication is to be highly considered, and nourishing Medicines are to be prescribed, which will support Nature in a languishing Condition, and will dulcifie and refine the Mass of Blood, by rendring the fixed Salts more Volatil, and by sweetning the Acids, and the depressed Fermentation may be raised by exalting the Depauperated particles of the Blood and Nutricious Juice by proper Diet Drinks, and Milk mixed with distilled Milk, and at last to observe a Milk Diet, which I know hath Cured inveterate Rheumatisms.

A French Merchant of London, a Person of great Civility and Virtue, of a hot and dry Constitution, and of an ill habit of Body, was severely treated many Years, with a Rheumatism, which brought him very low, as being oppressed with a Scorbutick Hectick Fever, proceeding from the Scur∣vy, and a tedious Rheumatism; whereupon I advised now and then gentle Lenitives, temperate Antiscorbuticks, * 1.41 and Alteratives contemporating the heat, attenuating the fixed Saline parts of the Blood, and sweetning the Acids of the Nutricious Liquor: And in fine, I advised a Milk Water, pre∣pared with temperate Antiscorbuticks and Restoratives, and ordered the distilled Milk to be drunk with new Milk; and at last, I prescribed as the Crown of all, that raised him to a great degree of Health (who was so weak, that he was confined to his House for many Years) and afterward, by the Grace of God, and help of proper Medicines, was able to walk Abroad with strength and vigor, leading his Life with great pleasure, to the joy of his Physician, and great comfort to his dear Friends and Relations.

When Purgatives, Blood-letting, and Alteratives have been advised, * 1.42 Topicks may be applied (to breath out the offensive Matter, to ease pain and to strengthen the Nervous and Tendinous parts) consisting of Anodine and Discutient, Emollient Medicines: And my humble Advice is, not to make use of Astringent, cooling Opiates, outward Applications, which hinder Sweats, * 1.43 and a free Transpiration, whereby the hot, Sulphureous, Saline and acid particles of the Blood and Nervous Liquor, are not emitted through the pores of the Skin, and the matter of the Disease being repelled, have a re∣course to the Noble parts, and produce sleepy Diseases, Inflammations of the Lungs and Pleura, Squincie in plethorick and ill habits of Body.

A Knight of Glocestershire, being of an ill Constitution of Body, did long la∣bour under a Rheumatism, accompanied with Swellings of the Muscular parts, which were abated by the Application of improper Topicks, which repelled the ill Humours from the Ambient parts, to the inward recesses of the Body, and at last were transmitted by the Extreamities of the Caeliac Arteries into the Stomach, causing frequent Hiccops and Vomitings; which were much appeased by drinking free draughts of generous Claret, and warm Cordial

Medicines, taking away the Hiccops and Vomitings, by remanding the peccant Matter to the confines of the Body, rendred painful and unquiet, which gave great ease and repose to the Praecordia, and inward parts; where∣upon he enjoyed his Health and Repose for many Years.

A Knight of the Bath (being a Gentleman of Honour and Fortune) of an ill plethorick habit of Body, was highly afflicted with a Rheumatism, productive of severe pains, immediately alleviated upon the Application of a Cataplasm, whereby the Humour settled in the outward, were repelled into the inward parts; whereupon the Patient was surprised with a conti∣nued Fever, associated with an Inflammation of the Lungs, in which he Cough∣ed up great quantities of Blood, and phlegmatick Matter: Whereupon I advised Blood-letting, Cordials, Pectoral and Diaphoretick Medicines, to lessen the offensive Matter by Bleeding, Coughing up of the gross phlegm, and by throwing off the Sulphureous, Saline, and Acid particles of the Vital and Nervous Liquor by Sweats, and insensible Transpiration, whereby the Patient perfectly recovered his Health.

As to an Arthritis, * 1.44 or Joint Gout, it doth not essentially differ from a Rheumatism, by reason it hath the same procatarctick, antecedent, and con∣tinent Causes, derived from gross Saline, Sulphureous, and Acid particles, mixed sometimes with Flatulent Vapours, seated in the Mass of Blood, and is for the most part Discriminated in the parts affected, as a Rheumatism hath for its subject (as I conceive) the Membranous, Nervous, and Tendinous parts of the Muscles: And a Joint Gout is seated principally in the thin Membranes, encompassing the body and heads of the Bones, and the tendi∣nous Extreamities of the Muscles, confining on the Bones, and in the Liga∣ments tying the Bones to their Sockets (as some will have it) which I con∣ceive have little or no sense, and therefore are not much concerned in this vexatious Disease.

The Blood is disaffected with divers kinds of Salts, as also Acids and Sul∣phureous Atomes, mixed with Flatulent Steams; which being so many He∣terogeneous Elements, do raise great Tumults, and unkindly Effervescenses enraging the Vital Liquor, carried into the Coats immuring the Bones, which being tender Contextures of small Nervous Fibrils, closely interwoven, are highly vexed by the important sollicitations of angry Fermentative particles of Blood, impelled by the Capillary Arteries, into the most narrow Inter∣stices of the Periostea, and Tendinous Extreamities of the Muscles, whence arise shooting, pricking, and tensive pains.

As to the Cure of an Artheritis, I refer the Courteous Reader to that of a Rheumatism, which hath the same Indications, with this of a Joint Gout.

Notes

• * 1.1

  Nervous and Membranous Fibres rela∣ting to the Muscles, are the subjects of a Rheuma∣tism.
• * 1.2

  The Muscles of the lower Limbs, are most liable to a Rheumatism.
• * 1.3

  Rheumatisms have Types and Periods.
• * 1.4

  The matter of a Rheumatism is Blood made up of Fermen∣tative Parti∣cles.
• * 1.5

  The serous parts of the Blood are most concern∣ed in a Rheu∣matism.
• * 1.6

  The pituitous Matter is not the cause of a Rheumatism.
• * 1.7

  Different kinds of Salts the causes of a Rheumatism.
• * 1.8

  Acids and Al∣kalies mak•• great Ebulli∣tions.
• * 1.9

  The Mass of Blood and Nervous Li∣quor, resem∣ble the diffe∣rent Elements of Vegeta∣bles.
• * 1.10

  Nutrition is performed by various Li∣quors.
• * 1.11

  Heterogene∣ous principles make great Fermentation in the Body.
• * 1.12

  The antece∣dent cause of a Rheumatism, proceedeth from Humours in the Vessels.
• * 1.13

  The continent cause of a Rheumatism, is derived from different ill Liquors sea∣ted in the In∣terstices of the Vessels.
• * 1.14

  Ill Diet is a Procatartick cause of a Rheumatism.
• * 1.15

  Heat and cold do alter the Constitution of the Body.
• * 1.16

  Violent La∣bours and too great indul∣gence of Ve∣nery, and the suppression of wonted Eva∣cuations are a Procatartick cause of a Rheumatism.
• * 1.17

  The Blood in a natural state is not too fixed nor too vola∣til.
• * 1.18

  The Liquors in the Bodies of Animals, hold some proportion with those of Vegetables.
• * 1.19

  Nutrition of the solid parts is made by Assimilation.
• * 1.20

  The crudity of Chyle is produced by the Compage of the Aliment not duly open∣ed.
• * 1.21

  A Rheuma∣tism proceed∣eth from ill Blood and Nervous Li∣quor.
• * 1.22

  An ill Nervous Liquor the cause of a Rheumatism.
• * 1.23

  A Rheuma∣tism is not dangerous.
• * 1.24

  A Rheuma∣tism flowing from saline and earthy parts concre∣ted into a Chalky sub∣stance.
• * 1.25

  A Rheuma∣tism associa∣ted with an Atrophy.
• * 1.26

  A Rheuma∣tism derived from Sulphu∣reous and fla∣tulent matter.
• * 1.27

  Pain proceed∣ing in a Rheu∣matism, from the tension of Nervous Fi∣brils.
• * 1.28

  Tension of the Nerves is caused by the Elastic parti∣cles of Wind.
• * 1.29

  Pain is hight∣ned by the in∣terstices of the Membra∣nous parts ob∣structed.
• * 1.30

  An universal Rheumatism is caused by the Muscles of the whole Bo∣dy disaffected
• * 1.31

  Bleeding, Pur∣ging, Diure∣tick, and swea∣ting Medicines are proper in a Rheumatism.
• * 1.32

  The Curative Indication.
• * 1.33

  The preserva∣tive Indicati∣on.
• * 1.34

  The Vital In∣dication.
• * 1.35

  Blood-letting is most benefi∣cial in the be∣ginning of a Rheumatism.
• * 1.36

  Purging Me∣dicines are most proper in the decli∣nation of a Rheumatism.
• * 1.37

  Purging is most profita∣ble, when the ill Humours receive a Co∣ction.
• * 1.38

  The several kinds of Pur∣ging Medi∣cines good in a Rheumatism.
• * 1.39

  Several sorts of Diet drinks and Powders, and Chaly∣beats, proper in a Rheuma∣tism.
• * 1.40

  Purging and Bleeding are improper in Hectic Bodies.
• * 1.41

  A Milk-water prepared with Antiscorbu∣ticks and Re∣storatives.
• * 1.42

  When Uni∣versals have been premi∣sed, Topicks may be appli∣ed.
• * 1.43

  Repelling Me∣dicines dange∣rous in a Rheumatism.
• * 1.44

  A Rheuma∣tism and a Joint Gout do not differ es∣sentially, but in the parts affected.