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 ...

THE EIGHTH BOOK OF THE PRACTICE OF PHYSICK. Of the Diseases of the Heart. (Book 8)

The PREFACE.

THE Heart hath many Diseases, Similary, Organick, and Common: But be∣cause few will submit to the Physitian, in regard of the nobleness of the part, which will endure long pain, but a man is suddenly gone, and there is no time for Phy∣sick; we who intend to bring all our Labors into practice, will lay down only three Diseases of the Heart, which are usual, and require many Medicines; and we shall bring them into three Chapters. The first shall be of Swooning. The second of Palpitation of the Heart. And the third of Weakness.

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.

Chap. 2. Of the Palpitation, or Breathing of the Heart.

AS in a Synoope the motion of the Heart is diminished, so in this Disease it is depraved. It i•• wrongly stiled by some a trembling of the Heart, when trembling is a passion of the Animal and voluntary motion, and is not proper to any parts but such as have voluntary motion.

Galen in his Book of Trembling, Palpitation, and Convulsion, saith, That Palpitation comes on∣ly from the Disease that is from the Cause which lifteth up, and depresseth the part, without any help of the Faculty; but Trembling comes partly from the Faculty, partly from the Disease. Hence it is that many using the word Palpitation indifferently to any part, think it is in the Heart, as in the Skin and Muscles, in which it comes from wind driven violently thither: for if the Heart be moved as a Bladder by water or wind, they suppose that to be a Palpitation. But the reason is different; for the Skin and Muscles cannot naturally dilate and contract themselves, but by Diseases. But the Heart hath a Natural Faculty to contract and dilate it self, therefo••e a Palpitation cannot be without its motion. And they do in vain muster up Galens Reasons, so thought by them, to prove that the Palpitation of the Heart comes not by Nature, but by a Di••ease, or cause of a Disease. For Galen in all those places speaks of no other Palpitation than that which is in the Skin and other external parts, and not of the palpitation of the Heart, which is of another Nature; and Galen 2. de sympt. caus. cap. 2. saith that the Palpitation of the Heart and Arteries, is different from that of the other parts.

Therefore the Palpitation of the Heart is an immoderate and preternatural shaking of the part, with a great Diastole or Dilatation, and a vehement Systole or contraction which somtimes is so great that as Fernelius observes, it hath often broken the Ribs adjoyning, & somtimes displaced them which are over the Paps; and somtimes it hath so dilated an Artery forth into an Aneurism as big as ones fist, in which you might both see and feel the pulsation.

This immoderate shaking of the Heart comes from the Pulsative Faculty provoked.

But here may be objected, That in Feavers all these things are found, for this is an immoderat•• Systole and Diastole, by the provocation of the Faculty through some troublesom matter, or by en∣crease of heat in the Heart.

To this we answer, That the motion of the Heart in Feavers is distinguished from Palpitation, on∣ly by its degrees, and the depraved motion of the Heart when it is vehement, is called Palpitation; but if it be not vehement, it is called a quick, great, and swift Pulse, and is referred to the difference•• of Pulses.

Now the Efficient Causes of this Palpitation may be referred to Three Heads: Either it is som∣what which troubleth and pricketh; or necessity of Refrigeration; or defect of Spirits: which two latter may be referred to the encrease of Custom.

The Molesting Cause is most usual, so that many Authors knew no other, the other are rare, and that is either a vapor or wind which troubleth the Heart either in quantity or quality, or both. The quality is either manifest or occult▪

A vapor troublesom in a manifest quality, is either in the Heart and its parts adjoyning; or it is sent from other parts; and this suddenly getting to the inmost parts of the Heart, doth stir up the Expul••ive Faculty, which being Naturally very strong, ariseth powerfully with all its force to ex∣pel the enemy.

In the Heart, and thereabout, especially in the Pericardium, are gathered somtimes cold and thick Humors, which send up vapors to the Ventricles of the Heart, which cause Palpitation.

But from more remote parts, vapors and wind are sent to the Ventricles of the Heart; as from the Stomach, Spleen, Mother, and the other parts of the lower Belly.

Many times a Vapor that troubles the Heart by an occult quality, ariseth in malignant Feavers, Plague, and after Poyson, and somtimes from Worms putrified, and the terms stopped from corrupt feed, or other putrid matter which do much stir up the Expulsive Faculty thereof.

Divers Humors do molest the Heart, either with their quantity or quality; so too much Blood oppres••ing the Veins, Arteries, and Ventricles of the Heart, so that they cannot move freely, makes a Palpitation by hindering motion, which that the Faculty may oppose it moveth more violently. So Water in the Pericardium, being in great quantity, doth compre••s the substance of the Heart and its Ventricle, so that they cannot freely dilate themselves. The same do Humors flowing in abundance to the Heart, as it happens somtimes in Wounds, Fear, and Terror.

Humors offending in quality, hurt the Heart, if they be venemous, putrid, corrupt, sharp, or too hot, especially burnt Choller coming to the Heart, and provoking its Expulsion.

Also Tumors, though seldom, cause this Disease; as Inflamation of the Heart, Imposthumes, or Swelling in the Arteries of the Lungs neer the Heart; which Galen saith befel Antipater the Physi∣tian, 4. de▪ loc. aff. by which, after an unequal Pulse, he fell into a Palpitation and an Asthma, and so died: so Dodonaeus reports that he found a Callus in the great Artery next to the Heart, which cau∣sed a Palpitation for many yeers. Also Tumors in the Pericardium, whether they be without hu∣mors and scirrhus, or with humors in them, as the Hydatides or watery Pustles, and little stones, bones, and pieces of flesh are somtimes growing in the Heart, which cause Palpitation. So Platerus reports, that in one who had a long Palpitation, and died thereof, there was found a bone in his Heart. But Schenkius reports, that in a Priest who was from his youth to the age of forty two trou∣bled with a Palpitation, there was found in the bottom of his Heart an Excrescens of flesh which weighed eight drams, and resembled another Heart.

The Second Cause of Palpitation is necessity of refrigeration, which is, when there is a pret••••na∣tural heart in the Heart, by which the Spirits are inflamed within, and therefore the motion of the Heart and Arteries is encreased, that what is spent, may be restored, and the heat cooled; and this comes somtimes from an internal cause, which is rare, but oftener of an external, as anger, vehement exercise, and the like. As Platerus observed in a yong man, who being hot and angry at Tennis, fell into a Palpitation of the Heart, and so died.

The third Cause, is the defect of Spirits which comes by hunger, watching, anger, Joy, fear, shame, and great Di••eases, and other causes which do suddenly dissipate the Spirits, which defect the Heart laboring to repair, that it may beget more quick and plentiful▪ and send them into the whol Body sooner, it doth enlarge its motion, and make it quicker.

You must observe for conclusion that it is more ordinary to see a Palpitation which comes by con∣sent from other parts, than from the Heart it self: For it hath a consent with all parts by the Veins and Art••ries, by which, Vapors, Wind, and Humors are sent. Which all shall be shewed in the Diagnosis following:

The Diagnosis or knowledg of this Disease, is directed either to the Disease, or the Causes which produce it.

The Disease is subject to sence; it may be felt with the hands, somtimes seen and heard; for the Artery may be seen to leap especially in the Jugular. And Forestus saith it may be heard, by an Ex∣ample of a yong man, that they who passed by might hear it by laying their Ear to the Window.

Also the Causes are distinguished by their Signs: A hot distemper is known by the greatness of the Pulse and swiftness, by a Feaver and heat of the Breast, by great and often breathing, and desire of cold things.

If the Palpitation come of wind, it quickly comes and goes, and is presently raised by little moti∣on, and the Breath is difficult, with trembling somtimes at the knees, mists in the Eyes, noise in the Ears, and somtimes pain of some part, which quickly is gon••; but you must gather the Nature and quality of the Vapor by the signs of the Humor which aboundeth in any part, because vapors do alwaies arise from Humors.

If the Palpitation come from Humors in the Heart, the Disease doth not come so suddenly, and continueth longer, and you may know what kind of humor it is by the signs of the Humor which a∣bounds throughout the whol Body. And especially if it be from Blood, from which it most often proceedeth; and this is known by a divers and unequal Pulse, somtimes great, somtimes smal, slow, and swift, to which the Breathing answereth in proportion; the Patients heart seemeth to be bound and oppressed, as appears by the exceeding heat, distension of the Veins, redness of Face, the time being Spring, the Age, Region, and Diet causing Blood to abound▪

That which comes by consent from other parts, is known by the proper signs of the parts affected, so we know that it is from the stomach, when there is want of Appetite, loathing, vomiting of base Humors, and gnawing at the Stomach. A troublesom breathing about the Pancreas or Spleen, or a∣ny other disease of the Spleen, sheweth that the matter lurketh there, from whence the vapors fly to the Heart; so suppression of the Terms, and Hysterical fits, declare that it comes from the Womb.

The Water abounding in the Pericardium is harder to be known, but we may conjecture, if the Pulse be weak and faint, and the Patient bemoaneth himself, that his heart as it were is somtimes in Water, and is suffocated, and if it be constant, and he incline to an Atrophy or Hectick.

If malignant humors cause it, there will be great change in the Pulse, a loss of strength, somtimes fainting, and other signs of malignity.

If it come from a Tumor there is remarkable variety in the Pulse, and the motion of the Heart is different from the natural, very unequal and inordinate, and if the humor be hot, there will be great inflamation in the Body, great thirst, difficulty of breathing and fainting will follow with death: but if the Tumor be hard, and in the Pericardium, the disease is constant, and the Patient de∣cayes by degrees without any manifest cause: if flesh, or any more solid thing grow to the heart, there will be a continual Palpitation from the beginning of the Disease to the end of Life.

Lastly, You may know when it comes by want of Spirits, by the precedent causes, which destroy∣ed the Spirits, and by the quick and smal pulse, and when it comes from the least labor or motion. Somtimes the like befals them that are well from walking or other motion, with a change of Pulse, and a resembling Palpitation.

The Prognostick is to be taken thus: It is dangerous from the hinderance of the motion of the Heart, by which Life is preserved, and it brings Syncopes and death: For it is a true Observation of Galen, Com. Aph. 41. Sect. 2. and 5. de loc. aff. cap. 2. All that in youth, or in declining age are troubled with the Palpitation of the Heart very much, die before they are old; for the often Palpi∣tation is a sign that the Vital faculty was very weak.

A Palpitation by Propriety is worse than by consent, and somtimes deadly. And that which is of an internal, is worse than that which comes of an external Cause, unless it be from poyson, or some great wound.

If it come from a Tumor, or solution of Unity, it is incurable.

The Cure is various, according to the variety of the Causes: and first that which comes from a pe∣culiar distemper of the Heart and Pericardium, is incurable; therefore we must look only at the Cure of that which is by consent, which depends upon the divers diseases of the parts, whose Cure must be sought in their proper Chapters.

But besides those Remedies which take away the Cause, you must use those which asswage the Symptomes by refreshing the Heart, and strengthening it, and which discuss the vapors which arise from melancholly, or crude & waterish Humors; as Cordial Juleps, Opiates, Epithems, & Perfumes, which are prescribed in weakness, and these that follow.

Take of Conserve of Balm, Rosemary-flowers, Borrage-flowers, and Clove-gilly-flowers, of each one ounce: Confection of Acorns and old Treacle, of each one dram: the Pouder of Diam∣ber, and Diamoschi dulcis, of each one scruple: with the Syrup of Citron Barks make an Opiate, which let him take often.

Take of Bugloss, Rose, and Orenge-flower Water, of each two ounces: the syrup of Clove∣gilly-flowers, one ounce and an half: Cinnamon Water half an ounce: the spirit of Roses two drams: Confection of Acorns one dram: mix them and give two spoonfuls now and then.

This following Liquor which immitateth the Juyce of Hearts described in the following Chapter, is good.

Take of Hogs or Sheeps Hearts three: Cinnamon and Cloves of each one dram: Lettice and Sorrel seeds, of each one dram and an half: white Wine two ounces: Borrage, Scabious, and Rose Water, of each one ounce and an half: Confection of Alkermes, one dram: boyl them all between Two Dishes, and let him take two spoonfuls of the Liquor morning and evening.

Take of Red Roses and Rosemary-flowers of each two drams: Lavender flowers one dram: Angelica seeds, Citron peels, Cloves, Cinnamon, and Mace, of each half a dram: Saffron one scruple: Musk and Amber-greece of each six grains: Make a Bag with red Silk and sprinkle it with Rose water and white Wine, and apply it warm to the Heart.

Take of Oyntment of Roses half an ounce: Oyl of Cinnamon and Cloves of each six drops: Musk and Amber-greece of each four grains: Mix it for a Liniment for the heart.

Purging Clysters and Carminative to expel Wind are often to be given.

But in the Fit it is best to open a vein; And Galen witnesseth 5. de loc. aff. cap. 2. That he never did it without profit.

Some apply Cupping Glasses without Scarrification to the Breast, which they say are excellent to discuss Wind there contained. Others to the Hypochondria, when the matter of the Disease is there.

But Zacutus Lusitanus applied a Cupping Glass with Scarrification to the heart with wonderful success, as you may read in prax. admir. obs. 133. lib. 1.

Others commend true Rhapontick given to two scruples in Wine, or Wine wherein the same hath been steeped.

Chap. 3. Of WEAKNESSE.

ALthough Weakness of Strength doth generally comprehend the hinderance of al Actions, Ani∣mal, Vital, and Natural; yet more particularly it comprehends the Vital which are known by a Weak Pulse: yet this Weakness useth to be found in al great Diseases, in which Nature doth yeild or resist the Cause.

Therefore as in Palpitation the Action of the Heart that is Pulsation is depraved, so in Weakness it is diminished.

Which is the same with a Syncope, but it differs in this, In a Syncope it is so little that it is hardly perceived; but in Weakness the Pulse is manifest and not so little.

In this also the Animal Faculty is alwaies offended: Hence comes weak motion without hurt of the Brain, Nerves, or Muscles, but from the defect of Vital Spirits which are not so sufficiently sent to the Head that they may be made Animal.

The immediate Cause of Weakness is Defect of the natural heat and spirits from which the life and strength of the parts do depend.

And this Defect is in every part from the Defect of Vital Spirits, and heat flowing from the heart.

Now the Vital Spirits are Defective, either because they are not bred many; or because they are dissipated after they are Bred, or Corrupted, or Suffocated, as we said in a Syncope, where there is this difference, That in a Syncope the Causes of Defect of Spirits, do suddenly produce their effect; but in Weakness they operate by degrees. And therefore in Syncopes and Leipothymia al the Vital Spirits almost, do suddenly fail, but in this there are fewer then ought to be communicated to every part.

Moreover, When the Natural heat wants not only adventitious heat, but also radical moisture to feed upon: if this moisture be wanting and diminished, the natural heat must be less, and the strength abated.

Now the Causes which hinder the spirits from being Generated, or maketh them disperse themselves, or Corrupt, or Suffocate them, are propounded in the Treatise of a Syn∣cope.

The Diagnosis of this Disease needs no Explication because it is manifest, and the Patients do complain of their Weakness. But the signs of the Causes were Propounded in the Syncope.

The Prognostick depends upon the various disposition of Causes, for as they are greater or less, there is more or less danger.

The Cure of this Disease is to be directed to two things, To the taking away of the Cause, and the Restauration of the Heart and vital spirits.

The Causes are, almost al great Diseases, in which either Nature yeilds to, or resisteth with diffi∣culty, therefore the taking away of the Cause belongs to the Cure of almost al Diseases: which you must take from their proper Chapters.

But the strengthning of the Heart, and restoring of the vital spirits are to be here declared; som∣times to be preferred before the Cure of the Cause, when death seems to be at hand: but we must alwayes take heed least when we encrease the strength we encrease the Cause of the Disease: and therefore in a hot Disease you must use more temperate Cordials, but in a Cold Disease those that are more hot.

First then mix Cordials in his nourishment, as Confectio Alkermes, or Confectio de Hyacyntho in Broths, or with pleasant Wine or Cinnamon Water, if there be great weakness.

Boyl also between two Dishes a piece of a Leg of Mutton, after the skin and fat is taken off, and after that let the Patient drink the Broth, being strained, at one daught. Or,

Take the Flesh of a Capon after the skin and fat is taken away, cut it in pieces, and put it in a glassed Pot well Luted, and set it in Balneo Martae to boyl for five hours, then let the Patient take two or three spoonfuls of the Liquor in all his Broths.

Or you may make a distilled Water thus:

Take a Capon or an Hen, after the skin is taken off, and the fat, cut it in pieces; then powr upon it Water of Bugloss, Borrage, Sorrel, Roses, and Orange Flowers, of each half a pound: the Pouder of three Sanders, Aromaticum Rosatum, and Cinnamen, of each half an ounce: yellow Sanders one ounce: Lemmons sliced, three. Distill them according to art, which must be given every hour by the spoonful.

The Juyce of Legs of Mutton only is of much use.

Half roast a Leg of Mutton, and slash it upon the Spit; take the Juyce and boyl it a little in the dish, and give it either alone, or with Broth, or with Yolks of Eggs.

Valeriola doth much commend the Juyce taken out of Sheeps Hearts. And Zacutus Lucitanus confirms it by his Experience, saying, That he with this only Medicine a mouth continued, cured a rich man, who often swouned through weakness of the Vital Faculty, and resolution of the Blood and Spirits, when many other Medicines had been used in vain.

The Juyce is thus taken forth:

Slit the Heart of a Sheep or Goat in the middle, then wash it well, and last wash it with Rose Water; then cut it in slices and put it in a glassed Vassel with a few Cloves, and no other Liquor. And after the Pot is well luted, put it into the Oven after it is drawn, till the Juyce come forth. Give this to the Patient to drink.

The Italians use Caudles of Yolks of Eggs, Wine, Sugar, and Cinnamon, which is very resto∣rative.

Zacutus Lucitanus makes a fine dish of twenty Yolks of Eggs; as you may see in the 107. Ob∣servation, Lib. 2. of his Admirable Practice.

You may make Cordial Juleps thus:

Take of the Water of Bugloss, Roses, and Orange flowers, of each one ounce: Syrup of Apples and Lemmons, of each half an ounce: Confectio Alkermes one dram: Cinnamon Water two drams. Make a Julep.

Or make this following mixture:

Take of white Sugar two ounces: moisten it well with the best Cinnamon Water; then put to it as much Spirit of Vitriol as is sufficient to make it sharp; then ad of the Essence of Cinnamon four drops; the Essence of Mace, Nutmegs, and Annis seeds, of each three drops; the Essence of Cloves two drops. Mix them, and take it either by it self, or in Broth.

You may also make a restoring Opiate thus:

Take of Conserve of Roses, Bugloss, Borrage, and Clove gilli-flowers, of each one ounce: Ci∣tron Barks, and Nutmegs candied, of each three drams: one candied Myrobalan; Confectio Alkermes half an ounce: the Spirit of Roses, and Essence of Citrons, of each half a dram: the Essence of Cinnamon six drops: With the Syrup of Apples make an Opiate; take it often.

This Water following is excellent:

Take of the Jelly of Harts-horn drawn with white Wine, four pints: the Blood of a Lamb and a Calf clensed with the hands from all fibres, of each two pints: Muschadel, Canary, and Mala∣go Wine, of each three pints: of Calfs Hearts cut in pieces four: Crums of new white Bread dipped in Milk two pound and an half; the Juyce of Balm one pint and an half: Rose and Orange Flower Water, of each one pint: great Citrons sliced three: Cinnamon four ounces: Mace one ounce: Put them in a large glass Still, and still them in Balneo Mariae.

You may make a most excellent and precious Cordial Water after this manner:

Take of Amber-greese two drams: Musk two scruples: Lignum Aloes one dram and an half: the white part of Benjamin three drams: after they are bruised and mixed, put them into Spirit of Wine, and setting them upon a gentle fire draw out the Tincture fully; and then filter off the Li∣quor, and draw off half the spirit with an Alembick upon the ashes with a very gentle fire; keep the Liquor close stopped in a Glass, with a Cork waxed over, and a bladder; of which you may give two, three, or four drops in Broth, or in Juleps, or in this following Syrup.

Take of Cinnamon Water four ounces: the best Rose and Orange flower Water, of each six ounces: Mix them, and dissolve therein as much Sugar candy as you can, and make it into a Syrup without fire; with a spoonful whereof, mix four Drops of the aforesaid Cordial Liquor.

Of the Ingredients remaining from the former Liquor, with as much of Damask Roses, and four times as much Benjamin, you may make Cakes to perfume the Chamber.

Apply both Liquid and Solid Epithems to the Heart, and yong Pidgeons slit and sprinkled with Cordial Pouders.

Apply to the Stomach, bags of Spices dipped in Wine. Let the Stones and privy Members be fo∣mented with Confection of Alkermes dissolved in Wine.

Let the Arteries of the Temples, Hands and Feet be touched with Confectio Alkermes, adding a little Cinnamon Water.

Apply this following to the Nose:

Take of the Leaves of Balm, Bazil, and Marjoram, of each two drams: Citron peels, yel∣low Sanders, and Cloves, of each one dram: Saffron half a scruple: Amber-greese six grains: Musk four grains: tie them in a clout and dip them in Rose and Cinnamon Water, and smell thereto often.

Or make a Balsom to anoint the Nostrils with the Chymical Oyls aforesaid of Nutmeg, Cinnamon, and Cloves, with a little Wax.

The End of the Eighth Book.