The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap. 1. Of Syncope, or Swooning.

Syncope is defined by Galen, 12. meth. c. 5. to be a sudden failing of all the Strength: For al∣though the Heart only suffer, and the Vital Spirits are only intercepted; yet when it fails, the rest must suffer, because they have a continual and necessary influence from it.

It is called a sudden failing of all the Strength, that it may be distinguished from other Diseases, in which the strength goes by degrees, till death come: nor is the Doctrine of Avicen against it, Fen. 1. Lib. 3. Tract. 2. Cap. 2. where he propounds the sign of a Syncope that comes by degrees; for although the Causes that dissolve the Spirits, do somtimes work by degrees, yet when they grow great they make a sudden Syncope: and therefore Avicen rather propoundeth the signs that go be∣fore a Syncope, than those that accompany it.

Moreover, This Definition may seem to agree with an Apoplexy, in which there is a sudden fai∣ling of all the strength; but in an Apoplexy there is strength in the Heart, and the Pulse is generally great and full. And also there is great hinderance of breath, with snorting; but in a Syncope the breath is no waies stopped.

The question is, Why? When the action of the heart ceaseth, doth the action of the Brain also cease, since the Animal Spirit is made of the Vital by way of Concoction, and must therefore stay some time in the Brain, although the Vital do not constantly come to it? We answer, That the Brain as all other parts, for the perfecting of its actions doth alwaies stand in need of adventitious heat, which is brought to it by the Vital Spirits, and therefore when the Vital Spirits come not, neither doth heat come for the Brain to perform its functions.

There are other Diseases very like to Syncope, differing only in degrees from it, namely, Eclusis, Leipothumia, and Asphuxia: Eclusis, is a light fainting: Leipothumia, or Leipopsuchia, or Apopsuchia, is a very strong and great fainting: Syncope is the greatest, which if it go so far that the pulse in the whol Body ceaseth to beat, it is called Asphyxia, which is next unto death.

The word Synchope, was not used by Hippocrates, and the Ancient Greeks; but they call'd this Disease Leipothymia, Lipopsychia, and Asphyxia. But it was invented a little before Galens time, and used for the greatest; so Galen, 1. ad. Glauc. cap. 14. saith, Leipothymia is an imperfect Syn∣cope, and goes before it.

By what hath been said, it appears, that the part affected is the Heart, where the Vital Spirits are all made; by whose influence the Natural heat and Spirits in every part are made to act: therefore when that ceaseth by stoppage of the Influx of the Vital Spirits, it is necessary that the strength of all parts should fail, and their actions cease.

The immediate Cause of this Disease, is the defect of the Vital Spirits, not wholly, for then sud∣den death would come; but so great, that Nature is constrained (lest the strength of the Heart should totally fail) to fetch the Spirits from the other parts to the Heart, by which means the parts lose their functions.

Now this defect of Spirits comes four waies: Either because they are Naturally few; or because they are dissipated, and spent; or because they are preternaturally altered and corrupted; or lastly, because they are suffocated and destroyed: They are few by fault of the faculty making, or matter from which they are made. The Faculty is hurt, either by a disease proper to the Heart, or by con∣sent from another part.

The proper Diseases of the Heart which are the chief, are great distempers, which overthrow the Natural temper, or destroy the substance of the parts, or of the Natural heat; as swooning Fea∣vers, sharp, and malignant, Syntacticae, or Colliquantes, or fainting, pestilential, hectical, or Ma∣rasmodes, which consume; to this come organical diseases, as too much constriction and dilatation, and constant solutions, which come to the Ventricles of the Heart.

The Faculty may be hurt by consent from other parts, which have great sympathy with the Heart, as the Brain and Liver, and somtimes from the mouth of the Stomach, by reason of its neerness and exquisite sence; from whence a Syncope is divided into a Heart and Stomach Syncope. The Car∣diaca or Heart Syncope, is when the Heart is principally affected; but the Stomachia, or Stomach Syncope, is that which comes by consent from the Stomach. Somtimes it comes from the Mother, by filthy vapors sent from thence to the Heart, from whence comes the Suffocation of the Matrix, Ap∣noea, or want of breath, and Hysterical Syncopes, as those vapors do assault the Lungs, Diaphragma, or the Heart.

The fault is in the Matter, when the Air or Blood is defective, or corrupted; from whence the Vi∣tal Spirits are generated. There is defect of Air when the Respiration and Transpiration is hindered; but the defect of Blood, is when Nutrition is hindered; there is a corruption of both, when their qua∣lities are changed: So when the Air is infected in time of Pestilence, it begets Leipothymia and Syncope, as also stinking vapors, and sweet also do the same with some Women; and the blood is corrupted from evil meats.

Too great Evacuations, whether sensible or insensible, do disperse the Spirits. The sensible are chiefly of Blood, from the Mouth, Nose, Womb, Belly, Hemorrhoids, Phlebotomy, and great Wounds▪ and next of other Humors, which though they are Excrementitious, yet because of their great Eva∣cuation the Spirits are much dispersed, and cause a Syncope. These Humors are discharged by Vo∣mit, Stool, Urine, Sweat, the opening of a great Imposthume, especially if it be inward, as an Empye∣ma; or outward, as in a Dropsie when the Navil is tapped.

The insensible Evacuations are by the Rarifaction of the Skin, and by the acrimony and thinness of the Humors, immoderate heat, hot Baths or Houses, great Labors. Also long watchings, and fa∣sting, Lechery, great anger, and joy, long and violent sickness do dissipate the Spirits; as also great pain of the Heart, Stomach, Guts, Reins, Ears, Teeth, and of all Nervous parts.

An evil disposition of the Bowels doth alter and corrupt the Spirits, and whatsoever doth procure a malignant quality which is adverse to the Heart, as Air, Stinks, venemous and pestilential, taken in by the Breath, or bred in the Body from putrifaction of Humors; as also poyson taken in, or ap∣plied outward, or sent to the Heart by biting of venemous Creatures.

Lastly, The vehement returning of blood and Spirits to the Heart, and an abundance of evil va∣pors

gathered about the Heart and the parts adjacent, and too much cold and thick blood gathered about the Heart and its Veins, Arteries, and parts adjacent, do suffocate and destroy the Spi∣rits.

We lately saw a Noble Lady, a Virgin, which from her Infancy was subject to this Disease, that with every light passion of the mind she was taken therwith, taken with a violent Syncope which ushered death in by a sudden return of blood and Spirits to her heart; for when she should have been married to a fine yong man which loved her deerly, and her Parents, Friends, and Kindred were so∣lemnly met about it, they gave her a Pen to write her hand to the Contract; but she having not ful∣ly written her name fel down dead upon the ground: Hence we easily conjecture, that there was a great and sudden retraction of the Blood and Spirits to the Heart by a vehement passion of the mind, which choaked the Natural heat, and the Spirits therein, of which she died suddenly.

Petrus Salius Diversus saw, as he reporteth, Lib. de aff part. cap. 4. a Girle of fourteen years old fal into a Syncope from abundance of cold and thick blood garhered about her heart and the great vessels: for having for a whol day a heaviness of head with giddiness and disturbance. she died the next day after suddenly: After being opened, the blood appeared so congealed in the great Artay and Vena Cava or hollow Vein, that taking it by the end you might draw it out like a Sword from a Scabbard.

Wherefore we judged, That the sudden death came from the interception and stopping of the Veins by congealed blood.

This happeneth seldom, for you shal seldom see blood in dead bodies so congealed: for the veins have such a property to retain blood, that even after death they keep it thin, though without them it growth alwayes thick.

But Salius gives the Reason of this Congealation by comparing it with blood without the Vessels, which as soon as it is cold, is congealed; and the sooner from the coldness, thickness and slyminess of the Melanchollick or Phlegmatick humor therein contained.

Somthing like to this may be-sal blood constrained in the veins which abounding with vicious juyce thick and cold, doth ••o sill the greater Veins, that it stops the spirits, and so extinguisheth them: and then the blood grows cold and thick, from those humors which otherwise would have been thin.

The Spagiricks refer this to a congealing Spirit, made of a peculiar and extraordinary mixture of Humors, which since it seldom happeneth, the Disease is very rare: And truly a simple Refrigera∣tion cannot cause that concretion, for then in dead bodies, especially in winter, the blood would al∣wayes be thick in the Veins, but we find it alwaies thin; but we may suppose that this Congealing Spirit is like that which causeth a Catalepsis, or Congealation which makes the parts inflexible.

The Chymists do acknowledge such kind of Congealing Spirits to be in many Creatures, Vege∣tables, and Minerals; such as are reported to be raised out of the Earth, in some Histories of Men and Beasts who have been Congealed by filthy vapors coming from Earth-quakes, or Dens; so, that their bodies became presently stiffe: And Cardanus saith, That such spirits are in Thunder-bolts, in his History of the Eight Mowers, who Supping under an Oak were struck stiffe, and remained as at first, the one seeming to Eat, the other to reach the Pot, and the other to Drink.

The Signs to this Disease by either are from the Subject which is more capable to receive it, or from the Fit either coming or present, or from the Causes that produce it.

The Subjects which are most fit to receive a Syncope are men who by some Natural Debility or Weakness from some Disease, become faint-hearted. Women rather than Men, especially in their Terms, or with Child: As also they who have fine Constitutions, subject to the Jaundice, Spleen, or Melancholly.

These things signifie that a Syncope is coming to them who are subject to it; Anxiety and sudden disturbance of mind, heaviness in the head, giddiness, an apprehension of divers colours, green, and yellow, a sudden and often change of the colour in the face, and of the beating of the Pulse.

When Leipothymy is present the same signs are, but greater; and there is often a cold sweat, as al∣so the sick complain of their faintness.

But these signs shew a Syncope, A sudden failing of al strength, a slow pulse, low and at length stopping, a pale and blewish face, coldness of al the body, especially externally; a cold sweat especially in the temples, neck, and breast, from whence the Disease is named.

The signs of the Causes are commonly manifest, for Feavers malignant, acute, syncopal or fain∣ting, cause a proper Syncope or Swoonding, are easily known: As also those external Causes which make a sudden Syncope, may be plainly seen, As Anger extraordinary and Joy, a sudden Fright, stinking smels, great bleeding, and other large evacuations, long watchings, and fasting, much leche∣ry, and grievous pain.

These things do signifie that the Humors and the Body are thin, a sharp nose, hollow eyes, tem∣ples fallen; and the gnawing of the mouth of the stomach, trouble of mind, pricking, heat and great pain, do shew abundance of Choller.

When there is abundance of crude Humors you may know by the enlarging of the body, swelling about the breast, a pale colour, black and blew, a smal, obscure, and unequal pulse.

A swoonding by way of Sympathy from other parts, is known by the sign of those parts affected; so that if it come from the stomach, that hath been distempered with loathing vomiting, gnawing, the mouth hath been bitter, and dry, and the like. The same Judgement is to be taken in other parts: but if you see no sign of any other part affected, you may conclude that it comes principally from the heart.

Moreover, A Syncope is distinguished from other Diseases by its proper signs. From an Epi∣lepsy, because that hath a Convulsion, but a Syncope not: From an Apoplexy, because in that the breath is stopt, and there is often snorting, and the pulse is not much abated, except when Death is at hand; but in a Syncope the Pulse is almost gone, and the breath is free. It is distinguished from the Mother, for in that the breathing parts are most affected, so that the Patient is almost strangled, but the Pulse is not much altered, nor the colour of the face, but keeps its natural complection, and som∣times is higher coloured; but in a Syncope the breath is not stopt, but the pulse is almost gone, and the face is pale: But somtimes a Syncope is joyned with the Suffocation of the Mother, and then the Pulse is not perceived.

The Prognostick of this Disease is first taken from Hippocrates, Aph. 41. Sect. 2. They who often and violently faint without a manifest Cause, do die suddenly. For as it is said, a great Syncope doth quite take away the strength from the heart.

A Syncope from which a man is not recovered by Rose Water thrown in his face, and Wine given to drink with sneezing-pouder put into the Nose is deadly.

When one is raised from a Syncope, health is not to be promised; for if his Pulse return not, but his colour be wan, and he still be cold, he wil quickly Relapse, in which is danger.

That Syncope which comes from immoderate Evacuations, fear, sorrow, or some evident Cause, is of less danger than that which comes from an internal Cause.

As for the Cure, because it comes from divers Causes, it must be various.

But of what Cause soever it come, in the time of the Fit these are good, Lying upon the back, throwing of cold Water in the face, provoking to neez, putting of strong Wine, Cinnamon, or im∣perial Water, Aqua vitae, Coelestis, and the like into the mouth, holding of hot bread to the Nose, loud calling and shaking, stopping of the Nostrils; wringing of the Fingers, pulling of the Hair, rubbing, binding, and cupping.

But in respect of the Causes which are divers, you must vary the Cure thus:

If it come from want of meat, he wil be Cured with strong Wine, and a Toast, or Sop: Also with nourishing broths, and Restoring distilled Waters among other things, a dish of Eggs with su∣gar, Wine and Cinnamon described in the following Chapter.

If it come from thinness of the Humors by which the spirits do easily flie away, give him sweet things and meats of good juyce, and thickning; let the pores of the skin be stopt with Oyl of Roses, and let the Patient stay in a cold place.

If it come from the Mother, you must give Medicines for that.

If it come from some evil quality, give Cordials and Antidotes, such as are prescribed in malignant Feavers.

If from poyson, give things to expel it: First a Vomit, and then Treacle; and then if he feel burning or gnawing in the Guts, let him take Milk of Butter, or fat Broth, or cooling Cordial Potions.

If it come of immoderate Evacuation, let the Patient be refreshed with Scents, Meat, Drink, sleep, and rest.

If from too great loss of Blood, lay him upon his bed, with his Head backwards, dash his face with cold Water, give him a little Wine with cold Water.

If it come of too much Purging, give him new Treacle, or old if you cannot get new, with two grains of Opium dissolved in Wine, or three grains of Laudanum which is better. And let the Belly be anointed all over with this following Oyl:

Take of Oyl of Myrtles, and Quinces, of each one ounce and an half: Oyl of Wormwood one ounce: With a little Rose Vinegar mix them and anoint often.

Give a Clyster of steeled Milk with three Yolks of Eggs, and two drams of Philonium Roma∣num.

Use Frictions of the Arms and upper parts, give him a Sop in Wine, or Wine alone.

And lastly, Every Evacuation whether it be of Blood from the Nose, or Womb, or other parts, or of Humors by Vomit, or Stool, must be stopped with their proper Medicines prescribed in their several Chapters.

That Syncope which comes from too much Sweat, is cured by Medicines that restrain Sweat; as with Cold, or Rose Water alone, or with a little Vinegar sprinkled upon the Face and Hands. Al∣so

let the Air be cooled with the same Water, and with Fanning. Apply cold Epithems to the Heart made of Rose, Sorrel, and Borrage Water, with Pouder of Diamargariton frigid, with a little Wine to make it pierce.

You must also give often cooling Juleps made of Syrup of Sorrel, Violets, and Apples, or Lem∣mons, with cooling Waters, and Lapis Prunellae. Let the Pores be closed with anointing the Skin with Oyl of Roses, Myrtles, and Mastich. Let him abstain from Wine. Let him not be rubbed, b••t let him move often gently, being lightly covered.

Let his bed be perfumed with this Pouder following:

Take of the flowers of Water-lillies, red Roses, of each three ounces: the best Labdanum half an ounce: Storax two drams: Myrtles, and grains of Sumach, of each two ounces. Make a Pouder.

If it come from suffocation of the Spirits, you must call them forth by Frictions▪ Ligatures, Cup∣ping-glasses, and the like. And if this Suffocation came of Repletion, you must bleed plentifully, but by degrees.

If it comes from terror and fear, you must also bleed, lest it cause an Obstruction or Inflama∣tion.