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. VII. Of the Cure of Cutaneous Diseases.

HAving Treated of the Pathology of the Skin, it may seem Methodi∣cal to say somewhat of the Cures, belonging to Cutaneous Diseases, among which the Measles and Small Pox lead the Van, which are different Disaffections, in reference to their several Aspects as various Tumours, and as proceeding from divers Causes; the one beginning in redness and driness, dis∣appearing in a Roughness, the other commencing in Red Pimples, grow after wards greater, and come by degrees to Maturation, appearing in numerous white Heads of small Tumours, which at last determine in dry Scabs.

These Diseases of Measles and Small Pox, though different upon many accounts, yet they are both attended with Cures, much alike in many cases, both in a slender and temper Diet, and the administration of gentle Cordi∣als: If Nature be slow in throwing out the matter of the Diseases from the Center to the Circumference, by Arterial Trunks, Branches, and Capilla∣ries, into the small Cutaneous Glands, and from thence by Excretory Ves∣sels, * 1.1 into the surface of the Body: And in both Diseases, a violent Loose∣ness and Bloody-Flux, gentle Cordials are to be advised to suppress these ir∣regular motions, which pervert the proper Course of Nature, in diverting the matter of the Diseases, from the surface of the Body to the inward Re∣cesses; wherefore upon this account, quiet Diaphoreticks are to be mixed with Astringents, at once to check the irregular, and promote the regular motion of the disaffected Humours, the Causes of these Diseases.

In the greatest Cases, that can happen in these Diseases, wherein they are accompanied with internal Inflammations, of the Lungs, (in a Perikneumo∣nia) of the Plura, in a Plurisie, of the Membranes of the Brain in a Phre∣nitis, of the Diaphragme, in a Paruphrenitis, or of the Muscles of the Larynx, in a Quinsie, or in any other internal Inflammation, a Vein is to

be opened, that the most urgent and eminent Disease may be first opposed, * 1.2 which will prove fatal without dispute, if the Patient be not speedily relieved by Blood letting, which will much advance the eruption of the Matter, of∣fending in the Measles and Small Pox; wherein the sick Person, being of a Plethorick Constitution, is oppressed with an exuberant Mass of Blood, highly obstructing the free motion of it, and the Succus Nutricius (in asso∣ciation with it) into the Cutaneous Glands, and surface of the Body; whereupon some part of the Blood being taken away, the remainder ob∣taineth the greater freedom of motion, and gaineth an easier recourse to the outward parts.

It is my humble Request to my worthy Brethren, the learned Professors of our Art, not to be over timerous in Bleeding, when the Measles and Small Pox, are associated with inward Inflammations, which may be Cured by bleeding, and without it will inevitably determine in a sad Catastro∣phe of Death: Wherefore I humbly conceive, it is better to consult Rea∣son and Conscience, then popular Air, and vain Applause, and not to let a Patient die for want of necessary Applications (though of ill Fame with the Vulgar and Unlearned to gain the repute of a safe Physitian) in great Inflammations, wherefore I am very solicitous to make good this Assertion of Bleeding, in the Measles and Small Pox, as a high preservative of Life, of which I can give many happy Instances in my own Practice.

A Sutlers relation, belonging to the Kings Guards, * 1.3 being of a very San∣guine Constitution, laboured some Years since under a high difficulty of Breathing, accompanied with a great Redness of her Cheeks, the Symp∣toms of an Inflammation, caused by Blood settling in the Lungs; where∣upon I ordered a Vein immediately to be opened in her Arm, and eight or ten Ounces of Blood to be taken away, upon which ensued an allevtaion in point of Breathing, and the next day the Small Pox appeared, and a day or two after, she was taken with a new access of ill Breathing; whereupon by reason of her suppressed Menstrua, I advised the Saphaena to be opened, and six or eight Ounces of Blood to flow, upon which she found great relief in a more free breathing, and the Offensive Matter, to be more largely trans∣mitted into the ambient parts of the Body, very conspicuous in her prodigi∣ously swelled Face, highly disguised in numerous Tumours, ending in Ulcers and Scabs.

And notwithstanding the free evacuation of Blood, by opening of divers Veins in the Arm, and Foot, and the course of her Terms (which was the consequent of her bleeding in the Foot) she was not wholly discharged of the depraved Humours, emitted out of the Capillary Vessels into the Exte∣rior parts, because in a short time, after she was recovered, by God's Mer∣cy, of the Small Pox, she broke out in a great many Boils, which having been Suppurated, ran very freely the space of a Month, and proceeded, as I conceive, from the reliques of the Matter, that was not sufficiently dis∣charged by the Small Pox; so that without Controversie, if a Vein had not been twice opened (which was attended with a free evacuation of her Menstrua) she had sunk under the Inflammation of her Lungs, of which she was perfectly Cured by the discharge of much Blood.

Another time a Butcher's Wife, being a gross and Corpulent Woman, * 1.4 of a Sanguine Constitution, was very much afflicted with a high Fever, and a great Colour of her Face; whereupon I ordered a Vein to be opened, and blood to be freely taken from her, upon which account she found great relief in reference to her Fever, and Inflammation of her Lungs, and the day after

she was bled, the Small Pox came out very well, and the violence of the Fever much abated, and she passed the several stages of her Disease very kindly, and was in a small time (with God's blessing) restored to her for∣mer Health.

And in great difficulty of Breathing, * 1.5 I have often advised Blood-letting in the Small Pox, with good success, and have relieved my Patients to my great Joy; whereupon the slow motion, or stagnancy of Blood being taken off, the Small Pox immediately discovered themselves, and in good time they kindly Suppurated, and afterward determined into Ulcers and Scabs, the happy close of the Small Pox.

Wherefore I most humbly beg, that this Opinion may be entertained with Candor, as coming from a love to Mankind, and not as if I were over-for∣ward to the great Scandal of Art, to advise Blood-letting upon every slight account, * 1.6 in the Measles and Small Pox; whereupon this is my most humble Request to my dear Friends, and my learned Brethren of Art, to prescribe Bleeding only in some great Cases, relating to the Measles, and Small Pox, as in a Phlogôsis of the Lungs, and great difficulty of Breathing, and all internal Inflammations, in high Plethorick bodies, in which great Diseases, (accompanied with the Measles and Small Pox) Blood-letting is necessary, as a most safe and generous Remedy, in order to sollicite the motion of gross and stagnating Blood, which is apt to obstruct the Capillary Arteries, near the surface of the Body.

But on the contrary, it is very rational and conscientious to forbear the opening of a Vein (as a descecrated, and unhallowed thing) in ordinary cases of the Measles and Small Pox, as fatal to the Patients, where bodies are not overcharged with an exuberant Mass of Blood (obstructing the small Vessels) and especially in a low proportion of Vital Liquor, not able to throw out the offensive Matter (unless assisted with mild Sudorificks) into the Cutaneous Glands, and by their Excretory Ducts, into the ambient parts of the Body.

Above all we are to forbear bleeding (as some great crime of Murder) that will render us obnoxious to a just Censure, * 1.7 as guilty of the death of our Patients, in Malignant Fevers (the frequent and sad concomitants of the Measles and Small Pox) whose nature doth not consist in overmuch blood, but a poisonous disposition of the blood, which must be corrected by Alexi∣pharmaca, * 1.8 supporting the Vital Liquor, to make a free Transpiration, by which the venenate steams of the blood, are transmitted through the Pores of the body: And if we lessen the Mass of blood in Malignant Fevers (which are the chief and essential Diseases, and the Measles and Small Pox, only Symptomes of the other) we render the Patient less able to encounter these great Diseases, and sometimes cut off the thread of Life.

A Gentleman of good Fashion, having complicated Diseases of a Fever and Small Pox, which did not cease, after good Applications having been made, the Small Pox appeared very fair, and distinct, and came to a lauda∣ble Suppuration, and Scabs scaling off: And it might have been thought with good probability, that the Patient had been upon Recovery; but alas, it proved otherwise: For though the Small Pox were Cured, yet the Fever continued higher, which shews it is to be essential, as remanent after the Small Pox were gone; upon which I passed a Prognostick, of great and eminent danger. That notwithstanding proper Medicines having been Administred, yet the Fever grew more violent, accompanied with ill Symptoms, of a quick tremulous Pulse, and a Delirium, so that the Patient plainly appeared

to be in a desperate Condition; whereupon the Friends of the Patient sent for Drop Doctor Goddard, who smiled (when I told him the great danger the Sick Person was in) assuring himself of a Cure by his Infallible Drops, as he thought them; whereupon I left my Patient, because his Friends ha∣ving a great opinion of the Drop Doctor, were desirous to commit him solely to his Care, which proved very unsuccessful, and gave me a high dis∣composure, because within two or three days, my former Patient was lost as well as my Friend, notwithstanding the Promise, the confident Doctor had made of his recovery, for which he had little Reason, and less Art.

In an orderly and kindly Small Pox, * 1.9 some few gentle Medicines may be gi∣ven for four or five days, to assist Nature to throw out the ill Matter by the Ca∣pillary Arteries, into the Cutaneous Glands; and when the Small Pox are well come out in distinct Conical Tumours, and beginning to fill, it is unne∣cessary to make any farther Medicinal Applications, and to advise only a thin temperate Diet, and that the Patient would repose himself in Bed, lest Transpiration being checked by the coldness of the Ambient Air, and the Cutaneous Pores be straightned, and the recourse of ill Matter be stopped into the confines of the Skin.

But in the Flux Pox, the care must be equal to the danger, which is very great, and needs the assistance of an Industrious and Skilful Physitian, who must make it his business to observe the motion of the Disease, which ap∣pears first in very small Pimples, and therefore it is called vulgarly the Pin Pox, which rise slowly; a great argument of Malignity in the Distemper, proceeding from a hot Serous Liquor, which being thin, is not apt to settle in the Ambient parts of the Body, but is speedily reconveyed by the Cuta∣neous Veins into the Mass of Blood, and in order to prevent the retrograde motion of the Matter, which being hot and thin, moderately cooling and thickning Medicines are to be prescribed; that when the Humours of the Small Pox arrive the surface of the inward Skin, they may be there deteined and fixed, to fill up the Skin, and render the Small Pox fairer.

If the Patient be restless in the Flux Pox, * 1.10 and by tossing and tumbling up and down the Bed, do disquiet himself, and raise the Fermentation of the Blood, by growing hot (procured by frequent and troublesome motions of the Body, made every minute from place to place) gentle Opiats are to be advised, as drops of Laudanum Liquidum, or Syrupe of Poppy in a proper Vehicle, to compose the Patient to rest, and to give an allay to the too much advanced Fermentation of the Blood: And that the Peccant Humours (the Materia substrata of the Small Pox) being rendred more sedate, in its mo∣tion may grow cool and thick, and apt to reside in the confines of the Body, and afterward the outward Skin will rise, as being big with gross Matter.

The Flux Pox, if not well mannaged by Art, * 1.11 is a most dangerous Dis∣ease, because the Blood is so much enraged in a troublesome Fermentation, that it is very difficult to govern it, and make it regular by most proper Medicines; and is very often attended, with a dangerous continued Fever (which is an associate of this ill kind of Small Pox) during all its several motions; of beginning, increase, state, and declination, signifying gentle Cordial Medicines, that do reduce the Effervescence of the tumultuary Blood into a moderate temper, wherein it being incrassated by proper Phar∣macy, doth stagnate in the outward confines of the inward Skin, breaking into numerous Pustles, which being indurated into Scabs, speak a happy pe∣riod to this nasty Disease.

And this may be prosperously accomplished by a most diligent inspection into the Nature and Motioos of this Disease, wherein I have often observed, that high Cordials, are unsuccessful, because they raise the Fermentation too high, and render the Distemper dangerous; whereupon I have fre∣quently advised with good success, cooling and incrassating Medicines, and a thin refreshing Diet of Small-beer boiled, and raw Beer made as warm as the Blood, and Posset Drink, made with Harts-horn shavings, without Marigold-flowers and Saffron (which are good in a kindly Small Pox, but too hot in these) and thin Water-grewel, Barley-grewel, thin Panada Bar∣ley-cream, made with Pearl Barley, pounded in a Morter, and boiled in a great quantity of Water, till half be consumed, which being streined; the Liquor is to be added to twelve Almonds blanched and pounded till their vertue is extracted, and then the streined Liquor is to be sweetned with Sugar, and drank as occasion serveth: Which is a fine cooling Aliment, easie of Digestion, and proper for this fiery Disease, which is often attend∣ed with large evacuations of Salival Liquor, resembling a Salivation raised by Art; and is to be promoted with Opening, Attenuating, and Clea sing Gargarisms, that the Parotides, Tonsils, and numerous Glands, besetting the Mouth and Palate, may be encouraged to spue out freely, the venome of the Disease, by their Excretory Vessels, into the cavities of the Mouth.

Therefore, * 1.12 I most humbly beg, that all Incrassating and Astringent Gar∣garisms, may be forborn, which do render the spittle more thick and clam∣my, and do shut up the Orifices of the Excretory Ducts (relating to the Oral Glands) and do intercept the currents of salival Liquor into the Mouth, and detein the matter of the Flux Pox in the Mass of Blood, rendring it more fierce, and the Disease more deplorable.

A Gentlewoman fell sick in the Strand in Westminster, and was afflicted with a high Fever, associated with a great pain of her Head and Back, for whom I advised gentle Cordials and an easie thin and cooling Diet, to charm the great Ebullition of Blood; and about the fifth day, the doleful symptoms of the Flux Pox appeared, discovering it self in most minute red Pimples, proceeding from a thin serous Liquor, which being thickned by pro∣per Medicines, was transmitted through the Cutaneous Glands, and their Excretories, into the outward surface of the inward skin; whereupon the Cuticula was more elevated into greater Swellings then at first, and her Face was denuded of all Features by this envious Disease, treating most severely the best Faces, and greatest Beauties; to teach us Humility and Self-deni∣al, to make us out of love with our selves, and Admire and Adore him, in kissing with reverence the gentle correcting Hand of our Great Maker and Redeemer, whose Dispensations, though they seem severe to the outward Man, yet they prove most advantagious to the inward, and work for the best to all that Love, Fear, and Obey him. Pray pardon the Digression, which I have added to divert the good Reader; and if any Person be so un∣kind to me and himself, to receive it (as impertinent) with scorn, I pity and pray for him.

But to return and visit our sick Patient, whose Body was preserved, though her Face ruined, which was chieflly accomplished by Nature her self, un∣der God, producing a great Ptyalisme; which I advanced by all means possible, in advising most powerful opening and cleansing Gargarisms, high∣ly assisting Nature in discharging the impurities of the Blood, by the Excre∣tory Glands belonging to the Mouth.

In the Flux Pox, complicated with a Spotted Fever, we ought always to consult the Honour of our Art, when we cannot be happy Ministers of a Cure, to fore-arm the Friends, and Relations of the Patient, * 1.13 with a Prog∣nostick of the eminent danger of the Disease (which in this Case is deplo∣rable) else we shall gain the repute of Unskilful Artists, though we satisfie the indications of the Disease with the most proper Remedies, and use our utmost Endeavours, and Art to recover the Patient, yet ill Success shall render us liable to the censure of the Vulgar, (who are governed more by Sense then Reason) unless we give account before-hand, what can be said in Humane Probability, relating to the event of the Disease, which in this case is very dangerous, if not fatal to the Patient; where the Person is not relieved in the Flux Pox, with the large Eruption, of the matter of the Disease, by the Cutaneous Glands, nor by free ejection of the faecu∣lent and serous parts of the Blood, and Succus Nutricius, by salival Liquor, spued out of the O••al Glands; and yet notwithstanding these hopeful Eva∣cuations the Disease prevaileth, and the blew spots appeared, the symptoms of a Pestilential Fever, the mournful Heralds, proclaiming the approaches of Death.

Person of great Honour and Virtue, being of a timorous disposition, was frequently daunted at the apprehension of the Small Pox, denying her self the ease and happiness of her Life, as being always in pain with the phancy of a Disease, which at last surprised her, though she often quitted beloved London (the Dalilah of Women) to preserve her self from this noisome and afflictive Distemper; which seised her by the imprudence of her Landlady, who lodged her in a bed, infected with a Body lately dead of the Sall Pox, complicated with a Spotted Fever, which made the same impres∣sions in her, as receiving the pestilential Steams into her Body, as reposed in the infected Bed; in which, when she found her self discomposed, she took free draughts of Strong Waters, thinking thereby to calm her Distem∣per, which in truth had a contrary effect, and raised the Storm much high∣er, by producing a much greater ••bullition of Blood, which taking its pro∣gress from the inward to the Ambient parts, in which the serous parts of the Vital Liquor, and Succus Nutricius, discover themselves in most minute Swellings, and pustles; and Nature in this person of Honour, did not make a discharge only of the offenssive matter by the Skin, but also by streams of Salival Liquor, flowing out of the Excretory Channels (relating to the nu∣merous Oral Glands) which I promoted by proper Gargarisms.

In reference to her Pestilential Fever, which highly afflicted her, * 1.14 I order∣ed pearl Cordials, and many kinds of moderately cooling Julaps, and tem∣perate Diaphoreticks, consisting of mild testaceous Powders, which brought out the Small Pox very fair, and to a laudable Suppuration, appearing in the white heads of fruitful Tumours, big with a well digested purulent Mat∣ter, which at last began to dry into Scabs, interspersed with large blew spots, the sad Emblems of Death (which happened in the seventeenth day of her Sickness) which highly discomposed me to part with a Friend, as well as a Patient, a person of so great Honour, Kindness, and good Humour, whose Memory I shall account sacred, and for ever revere; being now ready upon this sad History (which happened many Years since) to dapple my Paper with Tears, as a due resentment of my great trouble and loss.

A Salemans Wife fell sick of a dangerous Small Pox (as cofaederated with a Spotted Fever) which had so unkindly an Eruption, that the Livid Spots far exceeded the Pimples in number, but upon due applications of gentle Dia∣phoreticks,

and Cordial Julaps, the Fermentation of the Blood was reduced to a good allay, as being not too much exalted, nor depressed; so that the offensive Matter, was brought out and thickned, whereupon the Fever dis∣appeared, and the Small Pox growing first plump, and then the Ulcerous Matter was dried into Scabs, whereby the Patient being recovered, liveth a Momument of Gods wonderful Mercy.

I humbly beg the favour of all, * 1.15 that shall so far Honour me, as to read this rude Treatise, as they have a value for their own Health, rather then my Interest, not to trust themselves in the hands of Quacks and Empericks, in any Distemper, and especially in this dangerous Disease, in which out of Arrogance, to speak themselves an attribute, they contradict the safe and wholesome advice of Physitians, and contrary to all Reason, Art, and Experi∣ence, they confound the Aeconomy of Nature, and destroy their Patients with strong Vomits, and Purges, and hot Faetide Drops and Spirits (as knowing no better) which too much raise the Fermentation of the Blood, and wea∣ken the course of Nature, and divert its regular Current of offensive Hu∣mours in the Measles and Small Pox, from the outward confines of the Body, to the inward and tender Recesses of the Bowels, where their violent Medi∣cines produce Loosnesses, Bloody Fluxes, Lypothymies, Syncopies, and Death, speaking a sad Catastrophe of all Worldly Joy and Happiness, ha∣stned by impudent new Experiments, which they make upon their overcre∣dulous Patients.

Notes

• * 1.1

  Dyarrhaeas and Disenteries, are to be sup∣pressed in the Measles and Small Pox, and by gentle A∣stringent Cor∣dial Medicines, throwing out the Matter from the in∣ward to the outward parts.
• * 1.2

  A Vein is to be opened in the Measles and Small Pox, when they are accompanied with dange∣rous Inflam∣mations of the inward and noble parts.
• * 1.3

  An Instance of a Person, Cured by bleeding in the Small Pox, attended with an In∣flammation of the Lungs.
• * 1.4

  Another Per∣son Cured by Bleeding in the Small Pox.
• * 1.5

  Bleeding very safe in the Small Pox, when the Pa∣tient being of a Plethorick Body, is af∣flicted with difficulty of Breathing.
• * 1.6

  Fleeding is not to be ad∣vised, except in internal In∣flammations, and great cases of the Small Pox.
• * 1.7

  Bleeding is not to be ce∣lebrated in Measles and Small Pox, ac∣companied with a Malig∣nant Fever.
• * 1.8

  The Small Pox is to be cured by Alex∣ipharmaca, and gentle Sudo∣rificks, in a Malignant Fe∣ver.
• * 1.9

  Few Medi∣cines are suffi∣cient in a kindly Small Pox, wherein a thin Diet is to be prescri∣bed, and the great part of the Cure is to be recommen∣ded to Nature and careful attendants.
• * 1.10

  Opiates and thickning Me∣dicines are to be given to Patients wan∣ting rest, whose Blood is over acted with too high an Ebullition.
• * 1.11

  The Flux Pox is very dange∣rous, and to be managed by a skilful Hand, giving gentle Sudori∣ficks at first mixed with cooling and incrassating Medicines.
• * 1.12

  Thickning and astringent Gargarisms are ill in the Flux Pox, which hinder the evacuation of salival Li∣quor by the Oral Glands.
• * 1.13

  Pronosticks give an Ho∣nor to Art where Disea∣ses are dange∣rous, or de∣plorable.
• * 1.14

  Medicines ap∣pliable to the Small Pox, in case of Malig∣nant Fevers.
• * 1.15

  Mens Lives are not to be trusted in the hands of Em∣pericks, which are very un∣safe and de∣structive in reference to the Cure of the Small Pox, and all other Diseases.