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 ...

SECT. II. Of Putrid Feavers.

The PREFACE.

PƲtrid Feavers are divided, into Continual, or intermitting. The continual Putrid Fea∣vers are generated when a putrid Vapor, or a preternatural Heat, which ariseth from pu∣trefied Humors, doth perpetually afflict the Heart, and stirs up therein a continual Heat; from whence likewise is perpetually diffused a Feaverish Heat into the whol body. But the intermitting Feavers are caused, when the said Vapors are carried unto the Heart, only at certain distances of time. Continual Feavers are again divided into Essential, and Primary, or Symp∣tomatical. Those are called Essential and Primary, which spring from a putrefaction inflamed in the common Veins, and not in any particular part of the Body. Those are Symptomatical that arise from the putrefaction or suppuration of som particular part inflamed; out of which part by commu∣nion of the Vessels, a putrid vapor may continually be carried unto the Heart: Such feavers are seen in the Pleurisie, Inflamation of the Lungs, Inflamation of the Liver, and in the Inflamation of other Internal Parts. Again, the Primary continual Feavers are two-fold; for some are without a∣ny Exacerbation or Fits, and remission, but continue alike from the beginning to the end, and are called Sunochi, or Continentes. But others have manifest Exacerbations or fits, and remissions, and are called Sunecheis, or Continuae, by the name of the kind. And these again from the difference of their Exacerbations or fits, and remissions, are divided into three sorts. For some are called continual Tertians, which have their Exacerbations or fits every third day; others continual Quo∣tidians that are exasperated every day; others continual Quartans, that are exasperated every fourth day. The intermitting Feavers or Agues, are likewise divided into Tertians, Quotidians, and Quartans, according as their Fits are wont to return every third, every fourth, or every day. There are other Differences of Feavers likewise, which are either Accidental, or arise from the Composition of those aforesaid; all which we shall Particularly and briefly Explain.

Chap. 1. Of Continual Putrid Feavers.

ALthough there are divers sorts of a continual putrid Feaver, yet have I determined to describe the Cure of them all together, because in a manner the same Remedies are suitable to all, of which some differ only in more or less, and are accordingly to be varied; which depends more upon the Judgment of a Physitian, and his Dexterity attained by Practice, than upon particular Pre∣cepts, Yet shall I as neer as I can, observe what is peculiar to every sort of Feaver, in its peculiar place.

Feavers Putrid, Continual, and Primary, or Essential, are wont to be bred of the putrefaction of Humors, which are contained in the Veins and greater Arteries: And according to the various Na∣ture of putrefying Humors, several Species do arise.

Synochus Putrida is distinguished with no fits or exacerbations, but its whol time is taken up as it were with one fit, which reaches from the beginning to the end of the Disease and of this as of a simple Feaver there are made three differences. The first whereof is, that which continues all alike during from the beginning to the end. The second is that which encreases by degrees. The third is that which decreases by little and li••tle. The first is named Acmastica or Homotonos, and it happens when the whol course of the Disease the manner of putrefaction is one and the same. The second is called Epacmastica, when more putrefies than is dissipated. The third is called Paracmastica when less putrefies than is dissipated. Yet allthough these kind of Feavers do perpetually increase or decrease, or keep the same Tenor: yet doth not this hinder but that they have four times, if they terminate in health; but some have them longer, others shorter, if they be considered according to the vehemency of the Symptomes. So that which is called Homotonos, hath a very breif beginning and Augmenta∣tion, but a long state. The Epacmastick hath a long augment: the paracmastick a long declination, but the other times do quickly pass away. Yet we must know, that the times of Putrid Feavers are two waies considered; either with respect to the Symptomes, or with respect of coction and crudity; which two in other Feavers do commonly comcide or happen at one and the same time: But in these continent Feavers called Sunochoi it is not so. For their times ought not so much to be defined by the increase and decrease of the Symptomes, as by the signs of Concoction or non Concoctions, which appear cheifly in the Urines.

Now Galen propounds two sorts of this continent Feaver called Synochus: one springing from Blood putrefying, of which he treates in the second of this Method Chap. 7. and 9. as also in the 9. of his Method Chap. 3. and 5. another arising of choller putrefying in the greater vessells, of the kind of burning Feavers, which he explaines in his second of the Differences of Feavers and the se∣cond of Crises Chap. 6. The first is called Synochus Sanguinea; and the other Synochus Biliosa. For allthough the whol Ma••s of Humors conteined in the Veins do go under the name of Blood, yet do we acknowledg four Parts thereof, of which the more temperate is specialy called Blood; the hotter Part Choller; the rawer and colder, flegm; and the thicker and more dreggy Melancholy. So then; if that more temperate Part, which is more especially called Blood, do surmount the rest in quantity, and the whol Mass putrefy, that Feaver is caused which we term Synochus Sanguinea. But if the thinner and hotter Part of the Blood, which is of th•• nature of Yellow Choller, do exceed the rest, and putrefy, that Feaver is caused, which we term Synochus Biliosa.

Synochus Putrida is ingendred by the same causes which are wont to produce the simple Synochus, And so not only the shutting the pores of the Skin, but the obstruction of the vessells also, by reason of much Blood and thick and cla••my Humors, is wont to cause this Feaver. For seeing by such like obstructions the Transpiration of Fuliginous Vapours is hindered, putrefaction is bred in the ••lood redounding within the Veins.

A continual tertian, which every third day doth more afflict the Patient than ordinary, takes its Rise from bad and Chollerick Blood putrefying in the Vena Cava. And the Causes thereof are all such things as multiply this Humor in the Body, as an hot and dry distemper of the Liver, Meats hot and dry, Youthfull Age; fasting or very spare Diet; vehement and frequent exercise; hot and dry constitution of the Air; over great watchings and such like.

A continual Quotidian (which the Barbarous writers term Latica or lurking, because it hath a certain, hidden and concealed heat) is produced by flegmatick Blood putrefying within the Veins; & therefore it hath its exacerbations or fits every day. It is wont to assail flegmatick bodies, as of Infants and Children and old men, as also of such as are of a fat and corpulent constitution given to idleness and cramming of bellvchear, and inhabiting moist places. This kind of Feaver happens but seldom because flegm is hardly putrefied.

A continual Quartan, is that which is exasperated every fourth day, being Caused of Melancholly Blood putrefying in the branches of Vena Cava. And all things may Cause this Feaver, which are apt to breed Melancholly Blood and to Cause the same to putrefy. Howbeit this kind of Feaver is most rarely observed.

The accidental differences of Feavers are taken from their evil Symptomes, which are wont to be complicated with the Essentiall, and from them they are named. Among these are wont to be reckoned Febris Ardens that is the Burning Feaver, Colliquans the ••elter or dissolving Feaver; the shivering Feaver Horrisica, Assodes the tumbling, tossing and vomiting Feaver; ••lodes the sweating Feaver; Syncopalis the swouning Feaver Epiala the Feaver which makes the Patient hot and cold at one and the same time.

Causus or Febris Ardens the burning Feaver, is properly that, which is perpetually accompa∣nied with these two symptomes viz. an ardent burning heat, and an unquenchable thirst though the Patient drink never so much. Galen. 3. Epidem. Com. 3. text 34. It is divided by the same Galen in Com. 4. de Vict: Rat: in acutis text. 13. into a Ligitimate or bastard burning Feaver. The Legitimate or exquisite burning Feaver is that, which hath the two symptomes a∣foresaid,

allwaies, and evidently conjoyned therewith. The bastard, in which those symptomes are less vehement, the thirst less Urgent, and the body not so burning. The Lightimate is Caused by a Chollerick Humor putrefying within the large Vessels near the heart; the bastard is caused by Choller mingled with Flegm or Salt Flegm putrefying in the Vessels aforesaid. Whence it ap∣peares that a Ligitimate burning Feaver is no other, but a continual Tertian Feaver, whose Matter is more sharp and plentiful than ordinary and conteined in the larger Vessels which are neer the Heart; whereas the Matter causing a simple continual Tertian is in Vessels Remoter from the Heart. Again there are two sorts of an exquisite burning Feaver the one from the beginning to the end hath one only accession or fit, which we before named Synochus Biliosa, and it is likewise called Synochus Ardens; which is caused when the Humor putrefying doth occupy al the Vessels which are most neert the Heart: the other is named Ardens Periodica and conteines in it self divers fits or accessions; it is caused by the same Choller conteined in the Vessels neer the Heart, but not in al or not so neer as in Synochus Ardens. So that a Continual Tertian, Synochus Ardens, and Ardens Periodica, do differ one from another, only as the Choller causing them is more or less sharp, plentiful, and neer the Heart.

Febris Colliquans, the Melting Feaver is of the kind of burning Feavers, which in regard of the exceeding heat, do••h suddainly melt the Fat, Flesh, and substance of the solid Parts, and somtimes the Blood conteined in the Veins, and dissolve the same, by insensible Transpiration, Sweats, Urines or Stools. It is wont to be caused by a thin, sharp and Chollerick Matter, which is vehemently in∣flamed, and Galen teaches that often times there is adjoyned thereunto a malignant and pestilential Quality. Comment in 3. Epid. Sect. 3. Sent. 57.

Horrifica Febris, in Greek Phricodes, is that Feaver in which the Patient doth often undergo shaking fits, it is caused by a mingled Matter, viz. Partly Chollerick and Partly Flegmatick o•• wheyish, which being unequally moved is wont to excite those Horrors or Shakings; either because the thin sharp and wheyish Matter, doth twitch and nip as it were the sensible and menbranous Parts; or the inflamed Choller doth putrefy and put in motion the crude Humors; or because Nature doth in Vain seek to shake of the crude undigested Humor whereupon the Heat being driven Back to the Centre the Extream Parts of the Body are cold; and afterwards, when the same blazes out again, they grow hot.

Assades Febris, the Feaver so called, is a kind of burning Feaver, in which the sick do tumble and toss and are exceeding unquiet, much oppressed with the disease, being for the most Part subject to stomach sickness and vomiting. Because it is wont to arise from the vexation of the Stomach by sharp and Chollerick Humors, biting the orifice or Coats thereof.

The Feaver Elodes, is that in which the Patient prepetually Sweats: and it is caused by a mighty Putrefaction or Maliginty of Humors, dissolving the Substance of the Body.

The Feaver Syncopalis, is that in which the Patient often Swoones and Faints away. Avicenna makes two sorts hereof, one of thin sharp and Venemous Choller: another of much Flegm, or abundance of crude Humors. The former is called Syncopalis Minuta, because it arises from a little Quantity of Humor, but thin and malignant. The latter Avicenna doth call Syncopalis Humo∣rosa vel Repletionalis, because of a great Quantity of crude and Flegmatick Humors abounding therein and there is also Joyned a weakness of the mouth of the stomach, by which means e••pecially the sick persons come to Swoon so often.

That Feaver is by Galen termed Epiala 2. de diff. Feb. cap. 2. & Lib. de inaequali intemperie cap. 8. in which at the same time, through the whol Body in the smallest particles thereof there is felt both cold and heat. For, albeit one and the same Part cannot be the subject of contrary qua∣lities: yet is that which hath been said of this Feaver to be understood of the smallest particles in respect of sense, but not indeed and in truth. Galen shewes that this Feaver is caused two waies; the one is by means or Glassy Flegm mingled with bitter Choller and ••o diffused into the whol body. For Choller causes a sence of heat and the Flegm a sence of cold. The other is by means of Glassy Flegm alone, but partly putrefied and partly void of putrefaction. For, inasmuch as Glassy Flegm is extream cold and clammy, it doth not readily putrefy, nor al at once, but only by peecemeal; so that one portion thereof being putrefied the other remains unputrefied. That Part of the said flegm therefore, which is not putrefied being shed among the sensitive Parts, causes a sence of cold, by reason of the extream coldness thereof; and that which is putrefied causes a sence of heat. And so the whol body at one and the same time feels both cold and heat. Platerus also hath invented a way how this Feaver may be bred, viz. when intermitting Feavers, or Agues, do one fal upon the Neck of another the same day in the same Patient, so that the cold fit of the latter Ague begins, ere the hot sit of the former be ended; or else when intermitting Feavers co••cide with those which are con∣tinual, so that the heat of the continual Feaver and the cold of the Intermitting, happen at one and the same time.

There are likewise other accidental differences of continual Feavers, which because they are wont

to be reckoned among the Symptomatick Feavers, they shal be discussed forthwith in the Description of the said Symptomatick Feavers.

Now although the Cure of Symptomatick Feavers depend upon the Cure of those Diseases in particular, from whence they arise, yet must we declare their Nature, least they come to be con∣founded with Essential or Primary Feavers.

Those therefore are called Symptomatical Feavers, which arise from the Inflamation and putre∣faction of Humors conteined in some of the Bowels. Of which kind are those Feavers which accom∣pany the Pleurisy, Inflamation of the Lungs, Frenzy, Squinzy, Inflamation of the Liver, and other Inflamations, Ulcers or Impostumes of the internal Parts.

And it is diligently to be observed, as a thing of great moment in Practice and by few taken notice of, that al Feavers perpetually which are Joyned with Inflamations of the Parts of the Body, are not Symptomatical; But that some of them are essential & the foresaid Inflamations, do follow upon them. For it often falles out that Blood corrupted or filled with evil Humors, after it hath raised a Feaver, comes to be agitated by Nature and her as hurtful to her expelled to the weaker Parts, or to such as are most convenient to receive them: whereupon an Inflamation is caused in those Parts, which doth not cause the Feaver, but is rather a Consequent thereof. So we may often see in the Course of our Practice, the Patients sick of a continual Feaver, for a day or two before Pain in the side and other Signes of a Pleurisy appears So many on the third or fourth day fal into a Phrensy; so, al Gouty persons in a manner, before they are troubled with Pain, swelling and Inflamation of their Joynts, are wont to have a continual Feaver for a day or two. So they which have the Rose or Saint Anthonies Fire, have a Feaver somtime, before the swelling break forth. The same thing appears by the Urine, which in such Inflamations as these, do shew manifest signs of putrefaction in the Veins. For in the beginning they appear crude and undigested, and in the progress, they shew tokens of concoction dayly encreasing. Also Blood is often taken away very corrupt. Which things would not happen if such Feavers were only Symptomatical, simply depending upon those Inflamations.

And these Feavers whether they be Symptomatical or primary and attended by Inflamations of the Parts, have their accidental differences. For if the Inflamation be of Blood, the Feaver is called Phlegmonodes: if it be of Choller, Typhodes. And peculiarly an Erysipelas or Chollerick Inflama∣tion of the stomach and Guts brings the Feavers called Zipyria, in which the outward Parts are very cold and the inward Parts burn. For the inward burning doth draw the Blood and spirits co the Part inflamed; whereby the heat is so encreased, that the inward Parts seem to be burned with unquenchable thirst, but the outward are cold, being destitute of heat and spirit.

Lenta Febris, the flow or Lingring Feavers, is wont also to be reckoned amongst Symptomatical Feavers, which arises from some hidden obstruction and putrefaction, sticking so close to some Bowel and so impacted, that the substance of the Bowel is for the most Part Vitiated. And when a portion of the putrid Humor is shed into the Veins and mixed with the Blood, it stirrs up a slow Feaver, and so mild, that it troubles the Patient with no greivous symptom, yea and the Patient is scarse sensible of any Feaver. Yet some notes of putrefaction appear in the Pulse and Urin. And somtimes this Febris Lenta is bred of the putrefaction and corruption of some of the bowells; be∣cause by the Veins inserted into that Bowel, putrid and hot Vapors do breath unto the Heart. Such a kind of Feaver is often bred in the Consumption of the Lungs, which degenerates into an Hectick. It is also somtimes caused when the substance of the Liver or spleen corrupts: or when putrefaction settles upon the Mesentery, the Caul or the Pancrea, or other Parts; or also somtimes when the Child or After-birth are corrupted in the Womb. And hence not only slow Feavers, but somtimes also acute ones do arise, according to the different Nature of the putrefactions. And finally, to this kind of slow Feavers, those are to be referred, which are found in Cachectical persons, and in Maids which have the Green-Sickness; which Fernelius conceives do arise from a light putrefaction of wheyish flegm shed abroad in the Body.

Besides these forenamed differences of continual Feavers, which are most frequent, and are com∣monly set down by Authors; there are also some other, arising from peculiar and extraordinary Causes, which somtimes we meet with in our Practice. The Case of a certain Infant may serve for example, propounded by Zechius in his 46. Counsel. The Infant was scarce two yeares old, and had a continual Feaver, with most greivous Symptomes viz. Unquietness, convulsions, and con∣tinual stomach Sickness enclining to Vomit; and it was conjectured that there was some Malignity adjoyned, because such greivous symptomes did not answer to that Feaver. For al the external Parts were cold, though the inner Parts were burned with heat, as appeared by the heat about the brest and under the short Ribs, and also from the dryness and blackness of the Tongue. The Cause of which was blood putrifying conteined in the stomach. For this Infant being tongue-tied, was lately cut by a Chirurgion, in which work some Veins or other was opened which shed some blood into the stomach, which putrefying there, by sending forth hot, putrid, and as it were poi∣sonous Vapors into the heart and Brain, was the Cause of al the symptomes aforesaid. But how

this cause was found out and removed, it is worth the while here to recite, out of the Story of Zechius. So often (quoth he) as I diligently consider with my self, how hard a thing it is to understand in∣ternal Diseases, and thier causes, I come easily to be of the mind that Hippocrates in his second Book of vulgar Diseases, Sect. 4. did not without greatest premeditation leave in writing; then in the Curing of all hidden Diseases, the Physitian must diligently enquire the first assault of the Dis∣ease, that is to say, the first occasion of the Patients illness. For of that for the most part depends the knowledg both of the Cause and Cure. See an Example hereof: This Disease of the Gentle∣mans Child was very acute, and the Cause very hard to find, had not I diligently asked of the Pa∣rents touching the conditions of the Child and the Nurse; who told me that two daies before its be∣ing first ill, a certain Chyrurgeon had cut the Membrane, whereby the Tongue of it was fastened to the parts beneath it. And when I again asked them, if presently after this was done, they had cau∣sed the Child to be held forward, or if any blood had come out of its mouth; they said no, it was neither so held, neither came any blood from the mouth of it. Whereupon I presently conjectured, that blood was fallen from the place cut into the Stomach, and there putresied, and was the cause of the Disease, and symptomes aforesaid. Neither did my Opinion deceive me; for having given it Oyl of sweet Almonds to make it vomit, it uttered a considerable quantity of clotted blood, and mat∣terish. Also it voided with a Clyster many clodders of blood. And presently, by the blessing of God Almighty, the Feaver was abated, and all Symptomes began to cease. Whereupon it fell gree∣dily and lustily on sucking its Nurse, and all the following night it slept quietly, and was afterward perfectly well.

The Diagnostick Signs of putrid continual Feavers, do some of them shew the continu'ty, others the putrefaction, and the rest the peculiar differences of them.

The continuity is easily known, in that the Feavers is continual, and hath no intermision.

The putrefaction is signified by a sharper heat than ordinary, and more biting, and by a sharp and biting Sooty vapor, produced by the exhalation of putrid Humors. The pulse is not only great and frequent, and oftentimes unequal; but it hath this peculiar property, That the Systole is quicker than the Diastole; because the Expulsion of Sooty Excrements is more necessary than refrigeration. The Urins are in the beginning crude, or very little digested The Exacerbations or fits keep their cer∣tain times, which yet is not to be understood of the Feaver Synochus. A cold shaking fit at the begin∣ning of the Disease. Hereunto are added various Symptomes, commonly accompanying putrid Feavers, as Ilness of stomach, vomiting, heaviness of the body, pain of the head, raving, giddiness of the head, hiccoughs, anxiety, heart-burning, thirst, roughness and blackness of the tongue, stretching of the parts under the short ribs, and the rest. Before which preceded, weariness without labor, pur∣siness, troubled sleeps, watchings, tension of the parts under the short ribs, difficult breathing, pain and pulsation of the head, stomach-sickness, want of Appetite, plenty of stinking Excrements, fre∣quent yawnings and reachings, or some of these.

But the peculiar Differences of continual putrid Feavers, may be discerned by these Signs fol∣lowing:

A continual putrid Feaver, called Synochus putrida, hath the same signs which were propounded in Synocha simplici, but more vehement; for the heat is more sharp, the watchings, head-ach, thirst, disquiet, and other Symptomes are more vehement; also the pulse is unequal, so that the Systole ap∣pears greater than the Diastole, the Urines are crude, red, and thick.

The Signs of a Feaver from Choller, are burning pain, a pulse mighty frequent and swift, a sharp Urine, fiery, in the beginning alwaies crude, without Sediment; Stomach-sickness, Chollerick vo∣mitings and Stools Chollerick, much anxiety, mighty thirst, bitterness of the mouth, driness and blackness of the tongue, watchings, raving, and an ulcerous kind of weariness, soregoing, paleness of Face, or a citrine Color, youthful Age, temperature hot and dry, Summer season, hot and dry Diet, Chollerick Evacuations suppressed. And a continual Tertian is distinguished from a Synochus bilio∣sa, or continent Feaver springing of Choller, because it hath Exacerbations or fits every third day, but the Synochus biliosa, keeps stil one and the same tenor.

The Signs of a continual Quotidian are, Heat at first rather vaporous than biting, afterwards somwhat sharp, but unequal, because of the thickness of the Humor which is difficultly dissolved; the Urines are at first white, watry, troubled; afterward somwhat red and thick; the Pulse is seldomer, slower, and less than in the rest of these Feavers; thirst little or none; seldom sweat, unless there be salt flegm; the Face of the Patient is somwhat bloat or blown up, lax, flaggy, and as it were Lead colored; Drowziness, want of Appetite, flegmatick Excretions, a cold and moist Temperament, old Age, Winter Season, Cold and Moist Diet, Evacuations suppressed, and a dayly Excretion of the Disease.

A continual Quartan is known by these Signs. The Heat is less sharp than in Feavers of Choller, yet sharper than in Feavers of Flegm; likewise Thirst greater than in a Quotidian, and lesser than in a Tertian; a Pulse in the beginning slow, rare, languishing; afterward stronger, frequenter, and

very unequal. The Urine in the beginning thin, afterwards various; the body dry and lean, of a tawny or swarthy color; Temperament cold and dry; Age inclining; Autumn of the Yeer, or very changable weather; a life intangled with many Cares and Studies; suppression of the Hemorrholds, Swelling of the Spleen, and Exacerbation or vehemency more than ordinary of the Feaver every fourth day.

The Signs of a Causus or burning proper to that Disease, were propounded before, viz. a burning heat of the Body, and an unquenchable Thirst. Yet it is to be marked, if any Cough a∣rise, that the Patients Thirst is thereby diminished, viz. by such moisture as is drawn by the Cough out of adjacent parts; howbeit, the Cough is never wholly taken away while the Feaver lasts. The other Signs are all such as we have before shewed, do signifie a Feaver from Choller. Yet the signs which signifie a bastard burning Feaver, are much more remiss than the foresaid.

A melting Feaver is known by a sudden Consumption of the Body, and growing lean; the Eyes are hollow, the Temples fallen, Nose sharp, Stools red, fat, stinking, clammy, corpulent, sincere, chollerick, and frothy; the Urines, fat and Oyly.

The Shivering Feaver, and the tumbling and tossing Feavers are to be known, by what is said of them in their Descriptions.

In the Feaver called Elodes, the Skin is ever moist with a clammy moisture, and the heat to feel to, is not very sharp. Malignity is distinguished from the largeness of putrefaction; because in Case of malignity, the Urines are in a manner Natural, or appear not much different from the Natural; or somwhat swins in the Urines like a Spiders Web, when the Fat melts; or if with the Urine there comes away somwhat like Vetches or Barley, which signifie a melting of the flesh; or finally, abun∣dance of Urine coming divers daies together, when the blood and humors are melted. Add hereunto an extream decay of strength; a smal contracted Pulse, not very frequent. In great putrefaction the Urines are thick and troubled, the Pulse great, soft, and frequent.

Syncopalis Febris, viz. the Swooning Feaver, is known by fainting sits, and swoonings frequent∣ly befalling the sick. And that sort called Minuta, is distinguished from that Humorosa, because in the former are seen the signs of a Chollerick, in the latter of a Flegmatick Feaver, as they were lately set down.

The Feaver Epiala is known only hereby, That at the same time, heat and cold is felt in the whol Body.

Finally, Symptomatick Feavers, and such as are called Comitatae, are known by what hath been said of them in their Histories, or Descriptions.

Now in every of these sorts of continual putrid Feavers, the Prognostick Signs are to be described, by which their events may be presaged.

And first for Synochus Putrida, seeing it is of the kind of acute Feavers, it is not without dan∣ger. Yet if signs-of Concoction do evidently appear upon the fourth day, and no error be commit∣ted, it will terminate towards health the seventh day. But if the Signs of Concoction appear later, it may reach unto the eleventh or fourteenth day. But if no signs of Concoction appear, and the sick have a round swollen Face like a Globe, it signifies the Disease will be long. By how much the U∣rine is redder at the beginning, other signs corresponding, by so much safer it is, and signifies the Dis∣ease wil soon come to an end, if there appear therein signs of Concoction; but with signs of Crudity it threatens death, especially if the party be weak. White Urine is the worst of all, and commonly portends death. Among the Differences of Synochus, Paracmastica is more secure, Acmastica more dangerous, Epacinastica most dangerous of all. Furthermore, an exquisite Synochus, and benign rightly Cured, is safe; a bastard one that hath malignity in it, with cruel Symptomes, and strength decayed, is dangerous.

Chollerick Feavers inasmuch as they are acute, are also dangerous; and that more or less, accor∣ding to the more or less distemper, vehemence of the Symptomes, and validity of the Patients strength. The distemper is measured not only absolutely by the degree of Heat it self; but also comparatively, with reference to the Natural Constitution of the sick party; so that look how much the heat is encreased above the Natural temper of the Patient, so much the greater is the danger. So a burning Feaver in an old Man, or in Winter, is for the most part deadly. The vehemence of Symp∣tomes, is considered in actions Animal, Vital, and Natural; in Excrements, qualities changed, and proper adjuncts; whose enumeration requires a work by it self, according as we have expounded them, in the third Section of our Semiotica, or Doctrine of Signs, out of Hippocrates his Aphorisms, Prognosticks, Predictions, and his Coic Praenotions, which may easily be transferred to this place. And finally, the strength of the Patient must be compared with the vehemence of the Symptomes; For if the strength be lusty, and likely to hold out against the Cruelty of the Adversaries, there is good hope; if not, we may justly fear the Patients death.

A continual Quotidian, is wont to be long by reason of the thickness and contumacy of the Humor: but if divers Evacuations happen in its course, it is wont to be the shorter. We must measure the

danger thereof, by comparing the vehemence of the Symptomes, with the Patients strength. And the cheife care ought to be least it degenerate into a Cachexy or dropsy, by reason of the obstructi∣ons of the Liver and spleen, which happen in these long Feavers.

A Primary continual Quartan is most rare, yet somtimes an intermittent Feaver or Ague degene∣rates thereinto, and then for the most Part deadly.

The melting, shaking, Tumbling, Sweating and Swouning Feavers, seeing they borrow their Names from such bad symptomes as they are attended with; they are in regard of such symptomes extream dangerous, and for the most Part is deadly.

Finally, the Prognostick of Symptomatick Feavers, is to be gathered from the Excellency of the Parts affected, vehemence of the Symptomes and Validity of the Patients strength.

Now in the Cure of al putrid Feavers, we must take our Hints or Indications from the Feaver, from its Cause and from the Patients strength. The two former indicate their own ablation or removal; the third, its own Preservation. Which must be done by assistance of those ordinary Medicinal Utensils viz. Diet, Manual Operation, and Medicaments.

The Diet in all Chollerick Feavers ought to be cooling and Moistening, in flegmatick and Me∣lancholick more warming and attenuating. Let therefore the Air be cold and moist, which being drawn in by the Lungs unto the heart, doth exceedingly temper the burning heat thereof. Yet must not the Patient be laid bare to the cold Air, because transpiration, which is exceeding needful, would by that means be hindered; and the sooty Vapours and sweats would be driven back again into the Body. Howbeit the sick must be covered only with light and soft Coverings, and not loaded with over many blankers or Rugs. also the Feather-bed must be taken away and a flock-bed put in place, upon which also in the extremity of Summer a covering of Leather wil conveniently be laid on. Let the bed be wide, that the sick may change place therein. Let the Patients Linnen Shifts be often changed contrary to the vulgar opinion; provided they be not newly washed, nor smel of Soap, and that the Time of the Crisis be not at hand, in which nothing is to be stirred, least the motion of Nature be hindred and disturbed. The Sun-beams are to be kept out of the Patients Chamber, and store of Company is to be avoided. Water is often to be powred out of one Vessel into another, in the sick Persons chamber. The Pavement of the Chamber is to be sprinkled with Water, Vinegar and Rose-Water mingled; or with cooling Herbs and flowers; as Vine Leaves, Willow Leaves, Leaves of Water Lillies, Flags; Roses, and flowers of Violets and of Water Lilly; which must be kept at hand in good Quantities in a cool place, and be often fresh sprinkled and strowed about the Patients Chamber; for when these Herbs and flowers are dried, they heat the Chamber. If the Chamber be cold, as in winter, it must be a little tempered with a fire avoiding Smoak. Howbeit in flegmatick Feavers the Air must be Moderately hot and dry.

As for Point of Nourishment, the Diet ought to be thin and spare in acute Feavers. And therein the Antients were so severely diligent, as to place the greatest Part of the Cure in ordering the Diet, enjoyning such as were sick of a most acute Feaver, to keep a most thin and slender Diet; and giving them nothing but a ptisan drink of Barley Water, as most convenient for persons in a Feaver; see∣ing it cooles, and Moistens; withal extenuating and opening and hindering no Evacuation. And they had two kinds of Ptisans. One simply so called, or whol Ptisan not strained; the other was strained, which we cal Barley Cream. Barley clensed of the Husks boyled in sair Water, to a Consistency or Pottage, is the whol Ptisan; this being strained with pressing, is called Cream or Juyce of Barley.

But in our Times, at least in our Country, by the refractoryness of Women [who fear nothing but that the sick person shal be starved, as al their care in a manner is to cram their Children with meat like Pudding Bags, how empty their Brains be of wit, or their Hearts of Grace and wisdome, matters not] and the Indulgence of Physitians [who the best of them smel too strong of the Mounte∣bank] it is grown into a fashion in al Feavers, yea the most acute and violent, to allow the sick at al times broaths of the flesh and Hens Chicken, Capons mutton; and that for the most Part they give every third or at most every fourth hour. And in the Summer the flesh of a pullet, kid or Lamb is added to the former Diet. And somtimes again broaths are made of nothing but a chick with cooling Herbs, as Lettice, Endive, Sorrel and Purslan. Or to ordinary broaths is added Juyce of Oranges, Lemmons, or Pome-Granats, when the heat of the Feaver is very great, or the putrefaction very intense.

Moreover in Feavers not so very acute Panadaes are given twice or thrice in a day made of washed bread and broath. Also Barley broaths are somtimes used of the Ptisan of the Antients being strained, with the broath of the flesh aforesaid, and Sugar; or without broath, adding sweet Almonds. But these for the most Part do oppress the stomach, and therefore the use of simple broaths and Pana∣daes seems more convenient. Howbeit very profitable it it to boyl a little Barley with flesh and thereof to make broaths.

In long Feavers, a fuller Diet is fitting, of the flesh of Chickens, Veal Hens and Pullets, Capons, Partridges, Mutton, or of the Juyce pressed out of them, Gellies made with them, and such like.

Concerning the time of giving the Patients meat, this is principally to be observed, that they never eat in the time of the Exacerbation or fit but in the time of the Feaver. But if the Exacerbation be very long, let the Patient eat in the declination thereof.

For drink, the Ptisan of the later Physitians, made of the Decoction of Barley with Liquoris, is usually given in all Feavers. To which if the Feavers be very burning may be added a little Lettice, Sorrel, Tamarinds. But more ordinarily are added the Roots of Grass or Sorrel which makes the Water look of an Elegant Colour like Wine. But in long Feavers may be added sweet fennel Roots, Parsley Roots, Annis Seed, Coriander Seed, or Cinnamon, as oft as the stomach through weakness is offended with drinking.

Take of the ordinary Ptisan-drink of Barley and Liquoris two pints: spirit of sulphur as much as shall suffice for to make it pleasantly tart. Harts-Horn burnt till it be white one ounce: Let the Patient use it for ordinary drink, shaking the Vessel before it be powred forth.

Also Water that hath had a peice of bread boyled in it either by it self or sweetned with Sugar is good; or mingled with a little Vinegar; or Water alone, boyled to take away the Cruditie; wherewith somtimes a little Suger is mixed, and somtimes a little of the Juyce of Lemmons, Pom∣granats, Barberries, Cherries, or of their Syrups; or as much spirit of sulphur or Vitriol as may serve for a great full Acidity; or a little Sal Prunellae, if need be of potent refrigeration.

Water is commended wherein are steeped Tamarinds, Berberies, or Prunes.

A Decoction of french Prunes is very pleasing to the tast.

Or Barley is boyled with Tamarinds, and towards the End, the broath is Aromatized with yellow Sanders and Cinnamon. Which drink doth not only Quench thirst, but loosens the belly, and cools and strengthens the Liver.

Take Sugar eight ounces: Sal Prunellae one ounce: Make it into a Pouder, to be taken with the Patients ordinary drink. Whereunto if thirst be extream, the spirit of vitriol may be added.

Touching spirit of Vitroil and of Sulphur, this is diligently to be observed, that in putrid Feavers the use thereof is great, because they have a mighty cooling, opening, and putrefaction quelling faculty; prohibit the Inflamation of the Humors, and quench thirst. Howbeit in the Pleurisy, Inflamation of the Lungs, Spitting of blood, Consumption of the Lungs and other Diseases thereof (unles they spring from thick flegm stopping the Vessels thereof) Inflamation of the stomach, Dysentery or bloody flux, Pissing of blood, Ulcers of the Kidneys and Bladder, they do very much hurt and therefore we must abstain form them.

In Feavers arising from very thin and hot Choller, or Joyned with a sharp thin distillation, sharp things are not convenient; but rather such as gently thicken, as Syrup of Violets, of dried red Roses, with Barly Water, or Bread boyld-Water, or simple Water boyled, or smal beer, mixed therewith.

Where thick and clammy humors abound, the Syrup of Vineger will be very profitable. in stead of those last named.

Also somtimes Conserve of Roses, Violets, or Borrage is wont to be mingled with cleer Water boyled, with Barley Water, and to be strained through an Hippocras bag for ordinary drink, unto which some drops of spirit of Vitriol may profitably be added. Or a Tincture of Roses is made after this manner, most delightful in colour and in tast.

Take Red Roses one ounce: Bloodwarm Water three pints: spirit of sulphur or Vitriol one dram and an half: Let them stand infusing cold for three or four hours. To the strainings add, white Sugar, four ounces: Rose-Water half a pint: Make thereof a clear Julep for ordinary drink.

Also Julepus Alexandrinus, is very good, and extream pleasant. It is thus made.

Take Fountain Water one pint: Rosewater, Juyce of Lemmons, and white Sugar, of each four ounces: Boyl them over a light fire till you have taken away the Scum.

As for other things pertaining to Diet, Sleep is extream good and watchings bad. Yet over much Sleep doth overwhelm the natural heat and hinder the Evacuation of excrements. Rest is necessary in acute Feavers; but in long Feavers, light and gentle exercise is good. Also we must endeavor, that nothing be retained which ought naturally to be expelled; howbeit al immoderate Evacuations, which exhaust the strength, are to be stopped; and al vehement Perturbations of mind, must be turned out of Doors.

Among manual Operations, Blood-letting holds the cheifest place. for it doth not only diminish plenitude, whether it be a simple fulness so as to stretch the Vessels, or only a fulness with reference to the strength of the Patient; whether it be in the whol body or in some Part; but also revels the influx of Humors Causing obstructions; cools the whol body and makes it perspicable; keeps back putrefaction, and furthers the concoction of putrefying Humors. Presently therefore, and at the

beginning of the Disease, blood must be drawn (unless weakness hinder, as in the Swooning Feaver, and other like Cases) and that after the Belly hath been loosened with a Clyster, or a Suppository. How much blood should be taken, it gathered from the Patients strength, from the greatness of the Ple••hora, Custom of the Patient to bleed or not to bleed, and other circumstances. The Antients in the Synochus Putrida, and the burning Feaver, did let blood til the Patient fainted away. But it is much more safe (as we have said in the Cure of a simple Synochus) to take away at several times so much as shall be sufficient; then suddenly to put the Patient in danger of death. Avicen∣na in a burning Feaver, and in a continual Tertian, doth forbid letting blood, unless the Urine be thick and red. For he fears lest Choller should be the more inflamed, which he saith is bridled by Blood. But the wiser Physitians do explode this Opinion of his, seeing these kind of Feavers are often terminated even by Nature her self, by bleeding at the Nose; and they do somtimes cause Frenzies, and other Inflamations: and finally, because Blood-letting doth potently refrigerate, doth rather stop than further the Ebulition, or boyling and working of the Blood, and Choller comes away as wel as Blood when a Vein is opened; so that in that Mass of Blood, which is in the greater Veins remaining, there is the same proportion of blood to Choller which there was before. Nay verily, when a Vein is opened, if the sick party be any thing lusty, and the blood flow amain, only the putrid Blood which is offensive to Nature is voided, the purer remaining in the Veins; which few Authors have taken notice of, although it be in the course of Practice every where observa∣ble. For if the Blood flow out of the Vein drop by drop, it is the purest Blood, because it comes out of the Vein by its own proper motion. But if it spring out with a forceable stream, it appears foul and corrupted, Nature expelling the worser part of the Mass of Blood. Howbeit Blood is more sparingly to be taken from such as are of a very Chollerick Constitution, in the middle of Sum∣mers Heat, and the Dog-Daies, than in other Natures and times. But in Flegmatick and Melan∣chollick Feavers, Blood must be taken away in lesser quantity: and evermore great regard is to be had to Coindicants, and Contraindicants; forasmuch as Quotidian Feavers do for the most part happen unto Children, or old Persons in cold Countries and cold Seasons of the yeer; which conside∣rations do lessen the Quantity of Blood, which otherwise the Disease, or its Cause require, should be taken away. When the Feaver is caused by over much labor, blood must be taken away more sparingly. If a Feaver happen by over great use of Carnal Embracements, Blood-letting is perni∣cious.

Concerning the time of Blood-letting, it is to be noted, That a Vein must not be opened pre∣sently after the Patient hath eaten; but after Digestion is past, and after the Patient hath been at stool. Again, Blood is to be let when the Feaver is most remiss, and not in the vigor thereof, for then Nature is not able to bear both the violence of the Disease, and the loss of Blood. As for the repletion of Blood-letting, if the same be necessary, to cause Evacuation, it must be repeated the same day; if for Revulsions sake, on another day. For where Evacuation is necessary, especially in a∣cute Diseases, the Body must be suddenly changed into another condition; also it often happens, that a Disease is quickly past its first time or beginning, so that afterward we cannot so conveniently open a Vein. But in Revulsion we have respect to the motion of the Humors, which is then best ordered, when it is done at divers times, some space being interposed, whereby Nature becomes accu∣stomed to a contrary motion. For in the space between Bleedings, the Blood which was shed into the parts regurgitates into the Veins, and by another Blood-letting is profitably drawn forth. We understand that Blood-letting must be iterated, if that blood which was first drawn forth, were very much corrupted; and there is reason to think, that there is yet a great quantity thereof abiding in the Veins.

Yea verily, Although the Blood at first seem pure, and uncorrupted, yet must we not desist from taking the same away, but continue so doing until it appear more impure and corrupted. And tru∣ly that Precept delivered by Hippocrates, in his 4. de Victus Rat. in Morbis acutis, in the Cure of a Pleutisie, may very profitably be observed in acute Feavers, viz. That Blood-lettings be so long con∣tinued, til the blood change color; so that if at first corrupt blood come away, we must let it run till it appear more pure; and on the other side, if at the first the blood appear laudable, we must suffer to flow, til that which is impure and corrupted be come away.

Yet is there some diversity to be observed in both Cases. For if at first good Blood come away; blood ought to be again taken from the same Vein; that putrid blood residing in the innermost parts of the Body, may the sooner be drawn forth. But if at first corrupt blood be taken away, blood is next time to be taken out of the other Arm, and afterwards out of the former again, and so in course as oft as need shal require.

But if the Symptomes declare, that the Putrefaction is in the inner branch of the Vena Cava de∣scendent; as heat and pain in the Loyns, redness and thickness of the Urine: after two or three Blood-lettings in the Arms, it wil be convenient to draw Blood out of the Vena Saphena, two or three several times.

If in the latter Blood-lettings, some part of the Blood seem laudable, and not so putrid as before; it's a sign that Nature doth repair and restore new good blood instead of the corrupt blood which hath been taken away. Contrarily, If the more is taken away, the worse it comes, its a sign the Dis∣ease grows worse, and that Putrefaction is encreased; whence there is reason to fear a stupefaction of the Internal Parts.

The Vein in the bending of the Arm, or the Basilica, of the Mediana, is for the most part to be ope∣ned, in the right Arm most commonly, somtimes in the left, viz. when more distention is felt under the short Ribs on the left, than on the right side. Yet somtimes a Vein is profitably opened in the Foot, if Revulsion be necessary and the Patient weak, the Matter of the Disease being in the Head, and the sick person molested with Head-ach, and want of rest.

Frictions are seldom used in putrid Feavers, unless it be in the Swooning Feavers; the Cure of which we shall set down in the Cure of the Symptomes of Putrid Feavers, towards the end of the next Chapter.

But Cupping-Glasses are more frequently used, as being the Substitutes of Blood-letting, in whose stead they serve, when Weakness or Age of the Patient will not permit a Vein to be opened.

Medicinal Remedies are comprehended under a double kind; whereof some are Evacuative, others Alterative. Under the Evacuative, we comprehend Purgatives, Vomitories, Sudoroficks, and Diureticks. Under the Alterative, we comprehend Coolers, Attenuaters, Cutters, Openers, and Strengtheners. Of all which we shal set down the Composition and use in order, according to the usual Method of Practice.

And that we may begin with Purgatives, its a great Question among Authors, Whether or no they ought to be used in the beginning of Feavers? Which Controversie, omitting all Circumlocu∣tions, is thus determined. In respect of the Matter immediately producing a continual putrid Fea∣ver, which is contained in the greater Veins, Purgation is not convenient in the beginning; unless the said Matter do heave and work, being so stirred by Nature, provoked by the ill quality thereof, and endeavoring to expel it, that thereby it becomes more disposed for expulsion, and there be danger by the foresaid working thereof, lest it rush into some noble part; howbeit this seldom happening, for the most part the Concoction thereof is to be expected, before we undertake to evacuate the same by Purging Medicines. But in respect of the Matter contained in the first Region, if it be very much, and do encrease the Feaver, oppress Nature, and divert her from concocting of that which is in the Veins; Purgatives may be given the next day after Blood-letting, but they must be gentle, such as evacuate only the first Region. Now that naughty Humors and Excrementitious do abound in the first Region, that is to say, in the Stomach, Guts, Mesentery, or about the Midrif, may be known by Stomach-sickness, Bitterness of the Mouth, Thirst, Pain of the Stomach, or some other part con∣tained in the lower Belly, Loosness of the belly, and other Symptomes; in regard of which Purga∣tion is somtimes to be practised before Blood-letting. Now the Medicines for this intent, must be Cassia, Manna, Tamarinds, Catholicum, Electuarium lenitivum Diaprunum simplex, Syrupus Rosaceus, de Cichorio cum Rhabarbaro; which may divers waies be compounded after this manner:

Take Cassia newly drawn one ounce: Tamarinds half an ounce. With Sugar make it into a Bolus. Or,

Take Catholicum six drams: Elect. lenitive, or Diaprunes simple, half an ounce: Cream of Tartar one dram. Make all into a Bolus. Or,

Take Leaves of Endive, Cichory, Sorrel, of each half a handful: Tamarinds half an ounce: Boyl all to three ounces. In the strained Liquor dissolve Catholicum half an ounce: Manna and Syrup of Roses, of each an ounce. Mix all into a Potion.

If you desire your Medicine a little stronger, you may ad a dram or four scruples of Rhubarb infu∣sed in Endive or Cichory Water with yellow Sanders. Yea, and somtimes if the Feaver be not very strong, two or three drams of Senna may be added to the Decoction.

Some reject Rhubarb, because it heats; also Manna, and Syrup of Roses, because being sweet, they are soon turned into Choller. But with cooling Waters or Decoctions Rhubarb being infused, or Manna and such like dissolved, can do no hurt; especially if to the said Decoctions, Tamarinds be ad∣ded, which are much commended to this intent, or if the Pulp thereof be given dissolved in the Po∣tion.

Some in Chollerick Feavers do use the Whey of Goats Milk, and that very pertinently; for it tempers the heat of the Feaver, evacuates Choller, and strengthens the Bowels. In a Cup of Whey they steep all night one dram, or one dram and an half of Rhubarb, or they add two or three ounces of Syrup of Roses, and so give it in the morning; and afterward they give the Patient a quart of Whey more to drink, that all the Whey may not be infected with the tast of the Medi∣cament.

That kind of Purgation which is practised in the beginning of putrid Feavers, the Vulgar Phy∣sitians call Minorative purgation; and that which is practised when the morbifick matter is concoct∣ed, they call eradicative purgation: which is also convenient in the beginning (as was said) in the Judgment of Hippocrates, if the matter be turgent. Now this same turgescence▪ and boyling as it were of the matter is known hereby, because the Patient perceives in divers Parts light Pains which soon go away and shift suddenly from place to place; and hath divers collours of the Face and other Parts, so that somtimes there is a redness and then again a paleness in some Part of the Face. And in a word the Patient is exceedingly tormented with anxiety and unquietness, continually tum∣bling and tossing.

Howbeit that Rule of Hippocrates touching the use of Purgation, when the morbifick matter doth ferment and work in the Patients body, is not observed in ordinary Practice: but when the Humors appear in their fermentation and Motion, we do more safely apply our selves to Blood∣letting; and by that means we do more readily present the rushing of the stirred Humors into any noble Part, which being agitated by the Purgation may more easily flow into the said Parts.

Somtime also in the beginning of these Feavers Vomit is to be procured, viz. when the Patient is much vexed with illness of stomach and with vomiting for then Nature endeavours to evacuate the morbifick matter upwards, and the Physitian ought to assist her endeavours. And many times it falls out, that great Quantity of matter is conteined in the stomach and Parts thereabout, which must be Evacuated as soon as possible may be, by Vomit; seeing no concoction can be expected of such excrementitious matter in so great a Quantity; and what ever the Patient eats or drinks is changed into such a like Humor and encreases the Matter which is cause of the Disease. For Fer∣nelius hath well observed in his third Book of the Method of Healing, Chap. 3. that all superfluity of Humors in the stomach, spleen, Pancreas, Mesentery, and the Cavity of the liver; is conveniently emptied out by a Vomit, which somtimes wil not be removed with Medicines that work down∣wards, though divers times administred. And it comes often to pass, that the Matter being Vomited up, the Feaver is taken away at the first, which otherwise would have proved long, in case that matter had been transmitted into the more inner Parts of the body, and very wel mixed with the blood.

Now of the three degrees which we reckon of Vomitories, the mildest is to be Chosen, as Barley Water Luke-warm with Oyl of Almonds or common Oyl, or with a little Quantity of white Vine∣gar. Also Syrup of Vineger, or Oxymel simple which Chicken broath or a Decoction of Dil Seed, Raddish or Orach, whereunto also Oyl may be added. All which are to be given to the Quantity of a pint or more; for in a less Quantity they abide in the stomach. And seeing these weaker sorts of Vomits are of little efficacy, we may somtimes apply our selves to those of the middle Rank; which shall be propounded hereafter, in the Cure of a Tertian Ague

And not only in the beginning of the Disease before Blood-letting, but also the whol Course thereof, Clysters must be given every day or every other day, if the Belly be not of it self very free, made of a Decoction of Emollient and refrigerating things, such as French Barley, Prunes, Mallowes, Violet Leaves, Mercury Leaves, Beares-Foot, Orach, Lettice, Endive, Houseleek, Water-Lillies: dissolving therein Catholicum, Cassia, Diaprunum simple, Red-Sugar, Honey of Violets, and Honey of Mercury; Oyl of Water-Lillies, Violets &c. But in a violent hot Feaver, it is better not to add the Oyls, because they are easily enflamed.

Observe in the first place, that not above three or four blades of Houseleek must go into one Clyster, because it cools most potently, and being taken in greater Quantity, may hurt the Guts.

Observe secondly, that in all Feavers of Choller, Clysters are not to be injected actually hot, but only Blood-warm.

In Feavers that spring from flegm, Decoctions for Clysters are made of the Emollient Herbs with Annis Seed, Seeds of Fennel and of Carthamus; flowers of Chamomel and Melilote; dissolving there∣in Hiera Picra, Diaphoenicum, Honey of Roses, Honey of Mercury, Oyl of Chamomel, Dil, or common Oyl.

And because, as we noted before, absolute and perfect Purgation, which they cal Eradicative, is not to be attempted till the Morbifick Cause be ripened and digested; the Physitian from the be∣ginning of the Disease, after the first Blood-letting, and when the passages nearest the stomach are clensed, ought to use such Medicaments as prepare crude Humors for digestion and Evacuation, and withal temper the Feaverish Heat, hinder Putrefaction, and open obstructions; such as are Juleps, broaths, Emulsions and other things which shal be hereafter described.

Juleps are compounded in a Chollerick matter offending, of Syrups of Lemmons, Pomegranats, Sowr-Grapes, Vinegar simple, of the Juyce of Sorrel of Cichory simple, with Waters of Endive, Sorrel, Grass and Cichory.

Or better, of the Decoction of the Roots of Sorrel and Cichory, of the Leaves of Sorrel, Maiden-Hair,

Garden Endive, Dandelion, the four cool Seeds, Tamarinds, with the Syrups aforesaid.

And sometimes that we may cool more effectually, a dram of Sal Prunella is added, for every Dose of the Julep, or so much spirit of Vitriol or Sulphur, as shall suffice for a moderate sharp∣ness.

Sowr things are never to be omitted in Feavers springing from Choller; because bitter things are sweetened by Sowr and acid things: which if they are Sowr in an high degree, as spirit of Vitriol and of Sulphur, they deface the bitterness even of Aloes and Coloquintida. Now yellow Choller being plundred of its bitterness, i•• dead. And Harmles.

Juleps also of great Virtue, may be made of Juyces and which are very grateful to the tast, after this manner.

Take Juyce of Apples that smel sweet, newly drawn out and setled four ounces: Juyce of Lem∣mons three ounces: Rose-Water two ounces: Juyce of Pomegranats one ounce: finest Sugar half a pound: Make of al a clear Julep for three Doses.

If very thin Choller and sharp be in motion and cause either a Loosness or some other greivous fluxion; Juleps must be compounded which thicken, of Waters of Lettice, Purslain, Plantan, flowers of Water Lilly, Red Poppy and Violets with the Syrups aforesaid.

Yet we must observe that Syrup of Violets and other of the sweeter sort of Syrups, are not to be given alone; both because they loosen the stomach; as also because, ere they can Pass into the Veins, they are turned into an hot Vapor, which doth afterwards cause thirst to encrease. And therefore there must evermore some Quantity of sharp Syrup be mixed with the sweet Syrups aforesaid, that they may more easily peirce into the Veins, and the better resist the Heat of the Feaver.

In the Progress of the Feaver, when Coction begins to appear, to the foresaid Decoctions must be added Roots of Asparagus and Liquoris; Leaves of Agrimony, Pimpernel, Liverwort and Maiden-Hair.

In Flegmatick and Cronick Feavers, things more cutting, attenuating and opening are prescribed be∣ginning with the more weak, such as are Syrup of Vineger, of Maiden-Hair, Syrupus Bizantinus, with a Decoction of Egrimony, Maiden-Hair, Betony, Liquoris, Raisens. And in the progress of the Feaver unto the former we add Syrup of the opening Roots, Vineger compound, of Hyssop, Oxy∣mel simple, and compound. And to the Decoction we add the five opening Roots, Leaves of Hyssop, Carduus benedictus and (if the matter be very impact, Clammy and roapy) of Germander and Centory. Whereunto if Salt of Tartar and spirit of Vitriol be added, they work more hap∣pily.

In Feavers springing from Melancholy, such things are added which do moisten, as Syrup of Vio∣lets, of bugloss, of Borrage and Apples, towards the Beginning: and afterwards Fumitory, of Epi∣thymum, of the five opening Roots, Oxymel of Squils; with a Decoction, first of Bugloss, Borrage, Cetrach or wall-fern, Maiden Hair, Fumitory, Hops; and afterward Dodder, Scordium, Cen∣tory, Bark of Capers, of the Ash-tree and of Tamarisk.

And finally in bastard Feavers, which arise from the mixture of different evil Humors, the Me∣dicines aforesaid must be mixed together; yet so that such as respect the most predominant Humor be put in the greatest Quantity.

For the more nice and dainty soft of Patients, Medicinal broaths are prescribed instead of Juleps: and also that the sick may not grow weary of the same kind of Medicine too long used; and these broths are made of such of the Roots and Herbs aforesaid as are most pleasant to the tast with a chick, or part of an Hen of Capon: unto which somtimes may be added one dram of Sal Prunella, or some drops of spirit of Vitriol, when we would have it more cooling than ordinary.

Howbeit in slow and long lasting Feavers, caused by rebellious obstructions hard to be cleared, Germander though bitter and Cichory, Endive and Dandelyon, though bitter, may be boyled in Broaths; and Montanus in his Counsels, doth cry up Cichory and Germander boyled in Broaths as an admirable Remedy for such as have a long Feaver with obstructions.

In Feavers from flegm a Decoction of Chamomel is excellent. Zacutus Lusitanus. Observat. 26. in the third Book of his Praxis admiranda.

Also emulsions or Almond-Milks are very good in putrid Feavers, and are commonly more plea∣sing than Juleps. They are most in use when the Feaver is Joyned with a dry distemper of the Bowels, or a thin Catarrh, or an Inflamation of the Lungs and Parts serving to breath withal; or for variety, least the Patient should be over tired with continual use of Juleps. Now the Composition of these emulsions, hath been described in the foregoing cures.

Cold Water given in great Quantity in continual putrid Feavers, was wont to be in use among the antients, and is commended by very many latter Physitians. But as we said the use here of was dangerous in the simple Synochus; so in this Case, we think the discreet Physitian shal do best to for bear the same, for the reasons we delivered, in our Chapter of the simple Synochus.

Yet will it be somtimes good, in extream heat of a Feaver to give a good draught of cold Water,

to ten or twelve ounces with a few drops of Spirit of Vitriol: For hereby somtimes the same effects are wrought, which Galen attributes to cold Water being drunk, the quantity of three or four pints at a time; When as notwithstanding there are none of those dangers to be feared, which Galen him∣self confesseth did somtimes happen upon the preposterous drinking down of so great a quantity of cold Water as he adviseth. For the Spirit of Vitriol causeth that the Water breeds no Obstructions, but rather opens the same, quickly piercing and passing through the Bowels, not biding in the Hypo∣chondria's as plain and single cold Water is wont to do; but is very like the acid Mineral Fountains and Wells, which though they are drunk in great quantity, do not lie heavy in the parts about the short Ribs, but are quickly pissed forth, and very good against Obstructions.

To strengthen Nature, which in every violent Feaver is much dejected, Electuaries are good, and strengthening Conserves and Preserves, compounded of Conserve of Roots of Bugloss, Leaves of Sor∣rel, Wood-sorrel, Stalks of Lettice, Flowers of Bugloss, Borrage, Violet, Cichory, and Roses, Pulp of Citrons. Whereunto are added the Pouders of Coral, Pearls, Ivory, Harts-horn, Diamargari∣tum frigidum, Diatriasantalon, Diarrhodon Abbatis, Confectio Alkermes, & de Hyacintho; which are commonly after this manner compounded:

Take Conserve of Flowers of Borrage, Bugloss, Roses, of each an ounce: Confectio Alkermes one dram and an half: Pouder of Diamargaritum frigidum, Ivory, Coral prepared, and Pearls prepared, of each ten grains: Sugar of Roses, the weight of all the rest: three Leaves of beaten Gold. Make of all an Electuary covered over with Gold, of which let the Patients take often by it self out of a spoon, drinking a little of their ordinary Drink after it, or mingle s••me of it with their ordinary Drink, and with their Broths.

Take Conserve of Cichory, Sorrel, Lettice, and of the sharp Pulp of a Citron, of each half an ounce: Pouder of yellow Sanders, and of Pearls prepared, of each one scruple: Spirit of Vitriol half a scruple. With Syrup of Violets make all into an Electuary.

Take Conserve of the Flowers of Bugloss, Roses, and Violets, of each one ounce: Waters of Endive, Sorrel, and Borrage, of each three ounces. Mix them together, let them stand over the warm Embers and heat; then strain the Liquor through a searse; then add Confectio Alkermes two drams: Pouder of the Electuary Diamargaritum frigidum half a dram: Coral prepared, Pearls prepared, and Shavings of Ivory, of each one scruple: Syrup of Lemmons and Pomegra∣nates, of each three ounces. Mix all; give one spoonful at a time.

For the more dainty and nice sort of People, in great debility of Natural strength, this following Julep very pleasant to the tast may be compounded:

Take Waters of Sorrel, Orange flower, and Roses, of each one ounce and an half: Syrup of Lemmons and Pomegranates, of each one ounce: Confectio Alkermes one dram: mix them. Let the Patient take hereof frequently in a spoon.

Altering Medicines having been used for some daies together, and such as prepare bad Humors, when the Feaver begins to decline, we must set our selves to purge out the said Humors, when the signs of Concoction do appear, avoiding the Critical daies. And this must be done with Medicines a little stronger than those which were given at the beginning; of which sort are, Senna, Rhubarb, Agarick, Catholicum duplex, and such like; whose Matter and Dose must by the skilful Physitian be accommodated to the Humors offending, and the Nature of the Patient. And some Physitians are so bold as to proceed to Scammoniate Medicaments, as Diaprunum solutivum, Diaphoenicon, Electuarium de succo, Rosarum & Diacarthamum. Which notwithstanding are very seldom to be used in continual Feavers, because Scammony is wont very much to inflame the Humors, and to cause vehement thirst; and that especially in burning Feavers, in which Scammoniate Medicaments are very hurtful. Yea verily, and Rhubarb it self, although a gentle and most excellent Medica∣ment, is by some suspected as not safe in very Chollerick Feavers, because of its notable heating and drying faculty. Howbeit the hurtful faculty thereof may in great part be corrected, by infusing the same in Cooling Waters, and by mingling therewith a Decoction of Tamarinds and cooling Herbs; and by adding thereto Cassia, Syrup of Roses, Syrup of Cichory with Rhubarb, and such like.

If the Feaver do stil continue, Purgation must be ever and anon repeated, using between whiles pre∣paratives & digestives, til the whol seminary of evil humors be taken away. For otherwise, if we cease Purging before the Feaver be perferctly abated and gone; the Patient wil be in danger of a Relapse. Yet this Rule needs some restriction. For if after many Purgations, a lingring feaver continues, which doth by little and little pine the Patients, and seem to cast them into a Consumption; it will be the best course to leave Purging, and seek to conquer the Feaver only by Alteratives and Dier. For it somtimes falls out, when there is some evil disposition of the Bowels, causing a protraction of the Feaver, that so long as Medicaments are given, so long the Disease continues, because that Nature is weakened. Which afterwards (Purgation being omitted) gathers strength, concocts the Cause of the Disease, and being concocted, expels the same.

But if a lingring Feaver arise from Obstructions, as is often seen in Children, frequent and very gentle Purging, which draws away the Humors by little and little, is wont to remove the Disease; e∣specially if the Purgation be compounded with Rhubarb, which both opens obstructions, and streng∣thens the bowels. The Commendations whereof celebrated by Montanus in his tenth Counsel of Feavers, is worthy to be set down in this place. He setting down the Cure of a Boy that had a lin∣gring Feaver arising from Obstructions: Among other things, I shall commend (saith he) one which I have by long Experience found never to fail, viz. That he take every day the Infusion of Rhu∣barb in Endive Water. For I never knew Feaver from Obstructions, which was not cured by this Medicament, provided it were constantly taken without weariness, or giving over. For I have somtimes seen most gross Humors impacted into the narrow passages of the Body, and such Obstru∣ctions, as by reason of the weakness of Natural heat could hardly be removed, cured by Rhubarb. My Course therefore hath been to take one pint of Endive Water, and therein to infuse a dram of Rhubarb tied in a thin piece of Linnen. Of which Infusion, having lightly pressed out the Rhu∣barb, I give four ounces in the morning; and this is the Dose for Children. Neither do I cease gi∣ging this Medicament, until I see the Feaver and Obstructions wholly gone. For they will doubt∣less be cured, if all other things be rightly ordered, and suitable to the Cure. So far Montanus. But we are wont ordinarily to use a Diet Drink made with Rhubarb, which to such Children as are troubled with a lingring Feaver and Obstructions, I am wont to give for their ordinary Drink with good success. It is thus made: Half a dram or a dram of Rhubarb (according as the Child can en∣dure the tast thereof) grosly poudered and tied in a Rag, is infused in two or three pints of smal Beer or Ale an whol day, cold: Of this the Child drinks for a month together, or longer if the stub∣bornness of the Disease require the same. Whereunto, if the Feaver be very remiss, and the Child flegmatick, a little Wine, or stronger Beer or Ale may somtimes be added, to qualifie the unpleasing tast of the Rhubarb.

After Purgation of the Morbifick Matter, Nature is for the most part accustomed in the declinati∣on of the Disease, to purge away the reliques of the Matter offending by Urine, which we may dis∣cern, because the Urines are then more thick, or more plentiful than ordinary; which endeavor of Nature must be assisted by Diuretick Medicaments which are most temperate, such as are Emulsions, and the Openers formerly set down in Juleps or Broths; whereunto, if the Feaver be very gentle, some Roots of Fennel and Parsley, or Leaves of Wormwood, may be added, and that especially in Feavers of Flegm, and continual Quotidians.

But if Nature do expel the Reliques of the Morbifick Matter to the habit of the Body, Sudoroficks are to be used; not those hot ones, which are more properly called Sudoroficks; but others more temperate, which are the same in a manner with the Diureticks, and being of an attenuating faculty, do dispose the Humors in such sort, as Nature may more easily expel them by what place or way so∣ever she is most enclined. Howbeit, to these may be added, Carduus Water, Spirit of Vitriol, and other things which shall be more fully described, when we shall treat of Malignant Feavers.

Besides inward Medicaments, divers things are also outwardly applied, to temperate the Fea∣verish heat, to confirm the strength of the principal parts, or to open the Pores of the Skin, and draw out the smoaky Vapors, and Feaverish Heat: viz. Epithems, Liniments, and other things to be ap∣plied unto the Region of the Heart, Liver, and other parts. Which are invented to mitigate the Heat, and are not to be applied save in the state or declination of the Disease, when the Heat diffu∣seth it self to the exterior parts; not in the beginning or augment, while it resides yet about the bo∣wels; nor yet when the Crisis is at hand.

An Epithem to be applied to the Region of the Heart may be thus compounded.

Take the Waters of Bugloss, Sorrel, Water-lillies, Roses, of each three ounces: Vinegar of Ro∣ses, or juyce of Lemmons one ounce: the Pouders of Diamargaritum frigidum, and Triasantalon; of each one dram: Camphire and Saffron, of each five grains: mix all. Make hereof an Epi∣them to applied warm with Scarlet Cloth.

For the more strengthening, and to make it smel the sweeter, ad three ounces of Orange flower Water, and one dram of Confectio Alkermes.

Where we desire yet more potently to strengthen, solid Epithems are applied unto the Heart, made after this, or the like manner:

Take Conserves of Bugloss and Roses, of each one ounce: Confectio Alkermes two drams: Pouder of Diamargaritum frigidum one dram and an half. With Juyce of Lemmons, or Rose Water, make a solid Epithem, to be applied after the liquid one aforesaid.

Or one yet more Cordial, may in form of a Liniment, be thus made:

Take Confectio Alkermes, and de Hyacintho, of each three drams: Pouder of Triasantalon, and Diamargaritum frigidum, of each two drams. With Water of Roses make all into the form of a Liniment or Oyntment, wherewith smear the Be••ion of the Heart.

Also to strengthen to and drive out the Sooty Vapours and the Feaverish heat, young Pidgeons are very good, being split through the Back bone, and applied to the Region of the Heart, which likewise are oftentimes sprinkled with cordial Pouders as Diamargaritum frigidum and Triasantalon. Or before they be applied, the Region of the Heart is smeared with Confectio Alkermes and the cordial Liniment aforesaid.

Also to the Liver, Epithems are wont to be applied, which are made commonly after this man∣ner.

Take Waters of endive, Cichory, Sorrel and Roses of each three ounces: Lettice Water two ounces: Vinegar of Roses half an ounce: Pouder of the Electuary Triasantalon one dram and an half: Spodium half a dram: Camphire ten grains: Make of all an Epithem.

For to cool more powerfully, an Epithem may somtimes be made of Juyces, after this manner.

Take Juyce of Cichory and Endive of each half a pound, Juyce of Lettice and Vinegar of Roses of each two ounces: Pouder Triasantalon two drams: Mix all and make thereof an E∣pithem.

Now it is very profitable to apply cooling Epithems not only to the Liver, but to the whol Re∣gion of the Hypochondriaes; for they do not only further Coction, but also help the distemper of the bowels; and hinder the principal Parts from a deadly Consumption.

The Region of the Liver may likewise be anointed with this following Oyntment, which also may be applied to the Reins and Loins.

Take Oyntment of Roses one ounce and an half: Ceratum Santalinum one ounce: Juyce of Endive one ounce and an half: Oyl of Roses and Wax, as much as shall suffice, to make a Lini∣ment. Whereunto add a little Vinegar of Roses, at the time of anointing.

Also cooling things are profitably applied to the stones because of the great consent between them and the principal parts of the body; they therfore being cooled, the heat of the whol body is in great measure extinguished. To which purpose such an Epithem as this following may be made.

Take Waters of waterlilly, Plantain, Roses, and Cichory of each three ounces. Vineger of Roses one ounce and half. White wine two ounces. Mix all and dip a cloath therein cold, and warp the same about the Stones.

Also the cooling of the hands and feet doth great good, because of the Consent they have with the whol body, by reason of the Arteries Veins and Nerves, which end in those parts.

Neither need we fear least it should hinder the voidance of excrements by the pores, because they are few that come that way; so that there comes more good than hurt by the cooling of those parts.

The Patients may therefore hold in their hands balls of marble, Ivory, Brafs or Lead. Or they may hold their hands in cold Water, with a little Wine and Vineger mingled therewith. To the soales of their Feet may be applied the Leaves of Lettice, of Water Lilly, wet in Water and Vineger Or to wash both, Hands and Feet, the following Decoction may be provided.

Take Leaves of Lettice, Violets, House-Leek, Purslain; Vine Leaves, and Willow-Leaves of each one handful. Heads or Leaves of Poppy (if the Patient rest not) an handful: Vineger one ounce: white Wine two ounces: Fountain Water as much as shal suffice. Make of al a Decoction. Hereunto may be added, if you please, a little Quantity of Lie, for to strengthen the Joynts. Herewith let the Hands and Arms, the Legs and Thighs of the Patient be washed warm, twice in a day, or once at bed time.

We are furthermore to note, that the Antients frequently used baths of fresh Water to cure pu∣trid Feavers, as we may see in Galen in his Book de Marcore. Cap. 7. and in the 11. of his Method Chap. 9. and 20. and in his 1. to Glauco Chap. 9. and those baths were either cold in a vehement Feaver such as is an exquisite burning Feaver; or Blood warm in the declination of Feavers when the signs of Concoction appeared. But in this Age of ours, these kind of baths cannot be used, without danger, and they are convenient only in one Case; viz. when the Feavers become very lasting and possessing a body hot and dry and lean, seems likely to turn to an Hectick.

And onething yet more I shal ad for a Conclusion of all, that if the Feaver terminate with some Crisis, the reliques of the Morbifick matter, must be taken away with a Purge; especially if the Crisis were by way of Sweat or bleeding. For by those Evacuations only the thinner portion of the matter is voided forth, but the thicker being left behind, as afresh inflamed and brings the Patient into a Relaps. Only therefore that Critical Evacuation which is wont to proceed by way of Stool, is secure from a Relaps. Yet must we not so confide therein as to abstain usually from al Purgation. For the Parts about the Midriff are yet foul, and do corrupt the nutriment which comes into those Quarters, from whence proceeds either a relapse into the former, or some new Disease. Therefore it is for the best way (as some latter Physitians have observed) by repeating once and again a gentle Purge, so to clense away al the remainders of the morbifick Cause, that all fear of a Relapse and al occasion of another Disease may be taken away.

Chap. 2. Of the Symptomes which accompany Putrid Feavers.

ALL Authours in a manner who have writ of Feavers, have described those Symptoms which either accompany or follow upon them, with their Cures at the end of their work, that so they might be best accommodated to al kinds of Feavers. Which Counsel of their though I shal not disallow, yet I have thought it much more commodious for the service of Practitioners, to Joyn them immediately after the Doctrin of putrid Feavers, seeing in those kind of Feavers they are wont to be most vehement and frequent, and require peculiar Remedies.

So that although very many Symptoms are wont to be Cured by the Remedies aforesaid, accom∣modated to the Cause and the Disease: yet very many there are more offensive than the Disease it self, which are here breifly to be discribed.

Head-ach, Want of Sleep and Ravings, are Cured in a manner with the self same remedies viz. Revellers, repellers, derivers, resolvers and anodines. Revellers are emollient Clysters and such as are Laxative, Gentle Purgations, Blood-letting, Cupping-Glasses, and washing the Feet. Repellers are frontals, Vinegars, Roses, Unguents. Or Liniments; Derivers are opening of the forehead Vein, and Vesicatories. Resolvers are certain Oyls, and certain Live Creatures applied to the Head, which likewise are Anodines. And while the foresaid Remedies are used, Juleps are given and Emulsions, to temper and qualifie hot and sharp Humors. After all these come narcotick Medicines, which are not to be used, but upon extream necessity when other things wil do no good. The matter of al which Medicaments, is set down in our Chapters of the Phrensy and Head-ach proceeding from an hot Cause. But in the administration of the said Medicaments, one thing must be diligently noted, that they be not to be used, when the Crisis of the Feaver is near: for they would then disturb the motion of Nature and hinder the Crisis. Which is to be understood as of al the rest, so more especially of the narcoticks.

Against want of sleep and Ravings, a Cataplasm laid to the Soals of the Feet wil be very good, being made of fresh gourds beaten, the Leaves of the larger HouseLeek, of Lettice and such like. As also to wash the Feet with a Decoction of refrigerating Herbs. For by this means the Coldness is communicated through the Nerves unto the Brain.

Convulsions in Feavers, especially Malignant ones, do somtimes happen, by reason of Malignant Vapors which vex and fret the Skins which cover the Brain called Meninges. Against which con∣vulsion fits we must use revelling Clysters and Cupping-Glasses; also often give in Juleps or broaths Epileptick Pouders and finally anoint the Patients Back-bone with Oyl of Chamomel, Violets, Sweet Almonds and of the Jndian Nut.

When profound sleep happens to such as are in Feavers the same Remedies are given which have been described in the Cure of sleepy Diseases, only observing this one thing; that we give no very hot Medicine inward.

The thirst of Persons Feaverish is cheifly allaied with refrigerating and moistening drinks. But if thirst be so Violent that moderate drinking cannot asswage it (and to drink over much doth much hurt and oft times endangers the Patients Life) we must by other means deceive and asswage the same.

First therefore, let the Patients draw in the cold Air, and abide in Silence not speaking a word, let them keep their mouths close and breath through their Nostrils, and give themselves to sleep.

Let them wash their mouths with Barley Water Blood-warm, or with Water wherein hath been boyled Jujubees, Sebestens, Prunes, Lettice, Purslain and such like.

Let them hold in their Mouths a peice of Liquoris Scraped and steeped in Vineger and Water, or let them wash their Mouths with Barley Water either simple or with a little Vineger in it, or a little Juyce of Lemons, Pomegranats, or a little spirit of Vitriol.

Or let them hold in their mouths the Kernels of Pomegranats, or a Slice of a Citron, or a Lemmon, or an Orange, Steeped in Rose-Water with Sugar; or Stalks of Lettice, Endive, or Purslain; Leaves of Sorrel, Bits of a Gourd, Cowcumber or Melon first Steeped in cold Water; Or Acid Cherries, or red Currence, or Res-berries, or Tamarinds, or a peice of Chrystal, or the Stones of sharp Prunes upon which a little of the Pap Hangs, and such like.

Also Sugar Dissolved in Rose-Water with a little spirit of Vitriol, and dried again, is very good to quench thirst.

If thirst cannot be taken away with these lighter things they must be permitted to drink, not in the beginnings of the Exacerbations, or fits nor in the Augment, but very spareingly, but in the Vigor and especially when it is towards declining: for then large allowance of drink doth carry the heat out∣wards,

and somtimes moves sweat; especially in the fits of Agues, in the declination of which, it is many times good for the Patient to drink unto satiety. Several Materials convenient to make Drinks in these kind of Feavers, are set down in the foregoing Chapter.

But if thirst be caused by a Chollerick Humor contained in the Stomach, the said Humor must be voided by Vomit or Stool. Vomit may be procured, if the Patient be Stomach-sick, with an ounce and an half of Syrup of Vinegar Simple, with five ounces of Barley Water, or of the Decoction of Rhadishes. If that will not do, purge the Patient with a Bolus of one ounce of the pulp of Cassia, and three drams of the pulp of Tamarinds, or with two ounces of Manna, dissolved in a Decoction of Prunes or Tamarinds; or the following Potion may be given.

Take Cassia new drawn six drams: Mucilage of the seeds of Flea-bane half an ounce: the De∣coction of Barley, Prunes, and Tamarinds, four ounces: Syrup of Roses one ounce. Mix all into a Potion.

The Heat, Dryness, and Roughness of the Tongue and Throat, is cured by divers Remedies, ap¦applied to those parts, and contained in the mouth, compounded after this manner:

Take of the Mucilage▪ of Quince seeds one ounce: the seeds of Mallows half an ounce: Pouder of Diatragacanthum frigidum, and Sugar Candy, of each one dram: white Sugar, as much as shall suffice. Make of all a Lohoch. Or,

Take of the Mucilage of Fleabane seeds, or Quince seeds extracted with Rose Water, or Lettice Water half an ounce: Syrup of Violets, Lemmons, or Pomegranates, an ounce and an half: mix them. Let the Patients take now and then a little, and bold it in their mouths. Or,

Take Cucumer seeds half an ounce: Quince seeds two drams: Gum Tragacanth one dram and an half: Beat the seeds and dissolve the Gums in the white of an Egg. Mix all, and make thereof little Cakes, for the Patients to hold in their mouths. Or,

Take Seeds of Fleabane, and of Quinces, of each one dram and an half: Gum Tragacanth half a dram: Sugar Candy three drams. With Mucilage of Gum Tragacanth make all into little Cakes. Or with a thin Rag make Nodules, which shall be steeped in Rose Water, and held in the Patients Mouth.

If the roughness be very hard to remove, make a Gargarism of the Decoction of Barley, Roots of Marsh-mallows, Leaves of Lettice, Purslain, Violet flowers, adding thereto Honey of Roses, Sy∣rup of Violets, or Sugar Candy, or Oxymel simple, and such like.

If filth cleaves to the Tongue, as it most times happens, it must be oftentimes wiped with a rough Cloth dipped in a mixture of Water and Vinegar. Whereunto also somtimes may be added, the Juyce of Housleek, and Sal prunella.

If the Heat be more vehement, with great blackness of the Tongue, more refrigerating Medicines must be mixt with the moistening ones, after this manner:

Take Juyce of Lettice, Housleek, and Lemmons, of each an ounce: Mucilage of Quince seeds and Sugar Candy, of each half an ounce: white Sugar as much as shall suffice. Make all into a Lohoch. Or,

Take Green Housleek one handful: Vinegar of Roses three ounces: Barley Water one pint: Boyl all till the third part be wasted away. In the strained Liquor dissolve of Sal prunella one dram and an half: Allum a scruple: Syrup of Violets and Mulberries, of each one ounce: Make of all a Gargarism. Or Sal prunella alone may be dissolved in Housleek Water, and the Tongue and Throat washed therewith, which is very good; also some Portion thereof may be swallowed to cool the mouth of the Stomach, when it is likewise inflamed.

Also outwardly; let the Neck and Throat be anointed with Oyl of Violets, and fresh butter, washed in Rose Water, with which the Throat being as it were scorched and parched, may be moi∣stened.

For Cooling, the Oyntment of Roses, and Galens cooling Oyntment may be used, with others of like Nature. But the Leaves of Lettice and Purslain being bruised and enclosed between two Linnen Cloths, and so applied to the Neck and Throat, are much more effectual. Also those kind of Bugs which we call Sows, may be bruised and laid on in the same man∣ner.

In great Heat of the Breast, such as is wont to happen in Feavers, the whol Breast must be anoin∣ted with Oyl of Violets, Water-lillies, and of sweet Almonds. Yea, and if the Heat be very vehe∣ment, Fomentations ought to be applied to the said part made of a Decoction of French barley, Lettice, Water-Lillies, Borrage, Violets, and such like; after which, irrigations ought to be used of the Oyls aforesaid. Seeing that, according to the Prescript of Galen and Avicenna, in such like Feavers, great care is to be had of the breast, as of the Furnace of Heat. Now these kind of Reme∣dies, according to the Rule of Trallianus, are seldom to be cold, because they drive the Heat inward; nor luke-warm, because they relax; but such things ought to be applied to the breast, as are actually hot, and potentially cold.

Pain in the Loyns is caused in Feavers by hot and plentiful blood boyling and working in the Vena Cava, and it must be eased by Emollient Clysters and Cooling, and Emulsions made of the Cold Seeds, adding Sal Prunella; and by anointing the Loyns with Galens Cooling Oyntment, with Juyce of the larger Housleek, and Camphire, or Ʋnguentum Populeon, or Oyl of Roses, Lillies, and Poppies; or with an Epithem made of Plantane Water, Rose Water, Vinegar of Roses, and Cam∣phire; or with a Mixture of Rose Water, Oyl of Roses, and Vinegar: all which are to be applied actually cold in the Summer, and a little less than blood-warm at other Seasons of the Yeer.

Disquietness, and tumblings, and tossings, which are wont to happen in the Feaver Assodes, and in the Fits of a Tertian Ague, are best cured by purging away the Chollerick Humor which vexes and frets upon the Stomach, and other sensible parts, and that by Vomit or Stool, according as Na∣ture seems more or less to affect the one or other way; also it may be drawn downwards by Clysters, and presently all Art is to be used to make the Patient rest, and cold Drink is given, as also cooling Juleps, whereunto somtimes Syrup of Poppies, or a little Laudanum may profitably be ad∣ded.

Swooning Fits are wont to happen in those kind of Feavers which are commonly called Febres Syncopales, or Swooning Feavers, of which there are two kinds, as was said before; and the one is called Minuta, the other Humorosa. The Cure of which Feavers, much differing from the Cure of other Putrid Feavers, we have reserved unto this place, in regard of the said Symptome of Swooning.

The Minuta Syncopalis, which is bred of Chollerick Humors, sharp and venemous, must be cured after this manner. Let the Air be cold and moist, and a little astringent, that dissipation of the substance of the Body, may be thereby prevented. Let the Patients Diet be thin, cooling, and restorative, of the Broth of Chickens boyled with Sorrel, Purslain, &c. To which may be added, Rose-water, Juyce of Pomegranates, and a little Sugar. Bread steeped in the Juyce of Pomegra∣nates, or of Oranges may be given, if a more liberal Diet is to be granted, as also Cream of Barley, or Panada's with Juyce of Lemmons or Pomegranates. Also Restorative Broths of pressed Flesh with the foresaid Juyces. To the stronger sort are given the Yolks of Eggs with Juyce of sowr Grapes, the Stones of Cocks, the Flesh of Pullets, Hens, Partridges, qualified with the aforesaid Juyces.

Let the Patients drink with their Meat, if they have no Inflamation of any bowel, thin Wine not very old, nor yet new and windy; or Beer that is indifferent strong, not new, or very stale. When they eat not, or otherwise if there be Inflamation, let their Drink be Barley Water, or Water in which a piece of a Loaf hath been boyled, with Syrup of Pomegranates, Lemmons, Citrons, Julep of Roses, &c.

Sleep is good out of the Paroxysm, but in the same it hurts. And finally, special Care must be taken that nothing provoke the Patient to Anger, Sadness, and the like Passions.

In the Paroxysm, Resolution of the Spirits must be prevented by blowing cool Air with Fans up∣on the Patients, and by sprinkling them with sweet smelling Waters. Their Face must be sprink∣led with cold Water, or Water of Roses, and Vinegar minled. With which the Stones of Men, and the Dugs of Women must be bathed cold.

If Heat and Spirits will not be revoked from the Heart to the outward Parts of the Body, it is to be revelled and forced back by binding of the extream Parts, and by nipping and pinching them; also pluck the Patients often by the Nose, pluck them by their Hair, and call upon them often by their Christen Name. Give of the Crum of White-bread steeped in the Juyce of Pomegranates, of thin fragrant Wine, tempered with Rose-Water; and when necessity urges, some Cinnamon Water min∣gled with Rose Water. In the mean space, Restorative Broths are not to be omitted, wherewith Confectio Alkermes, and such like may be mingled. Also Cordial Potions are often to be given out of a Spoon, made after this manner:

Take Water of Roses two ounces: Orange flower Water one ounce: Cinnamon Water half an ounce: Confectio Alkermes one dram: Pearls prepared, and Coral prepared, of each half a scruple: Sugar Cakes made with Pearl six drams: Mix all, and make thereof a Julep, or Cordial Potion. To these may be added the Electuaries, and Conserves, and Preserves, described in the foregoing Chapter.

Also the inner side of a Loaf hot out of the Oven sprinkled with Rose water and Vinegar, may be applied to the Patients Nostrils, and Mouth.

To the Heart, Cooling and strengthening Epithems may be applied.

To straiten the Pores, and prevent the Evaporation of the Patients strength and Spirits, wrap them in Linnen sprinkled with Pouder of Roses, Balaustians, and Sanders; or let their shifts be sprinkled with Rose water, and a little Vinegar.

Let their whol Body, especially the Back be anointed with this following Liniment.

Take Oyl made of unripe Olives, one ounce and an half: Mirtles, Quinces, and Mucilage of▪

Seeds of Flea-bane, of each six drams: Gum Arabick dissolved in Rose-Water two drams, white Wax as much as shal suffice make all into a Liniment.

A special regard is to be had of the stomach, because the Humor offending is cheifly there collected. Now the region there of must be anointed with Oyl of Roses and Quinces: and then also may be laid on a Toast of Bread, wet in Juyce of Quinces and unripe Pomegranats. Or if it be afflicted with great heat, soment the stomach blood-warm, with a Decoction of Purslain and Roses, o•• with Juyce of Night-shade, Purslain, Sowr-Grapes adding thereto Oyl of Roses and Quinces.

The Swooning Fits being removed and the Patient strengthened, we must bend our minds to remove the Feaver and its Cause. Which may be done, by Alteratives and Evacuators proper for turning Feavers, which we have described in their proper place: viz. Where the Cure of burning Feavers is set down.

The Cure of the second sort of Swooning Feavers, which is called Febris Syncopolis Humorosa, which is caused by abundance of Flegmatick and crude Humors, is in a manner contrary to the Cure of the Minuta newly described. For the Air ought to be temperate, inclining to heat, light, pure and dry. Meats, of good Juyce easily digested, prepard with Hyssop, Fennel and such like Herbs. Let their drink be thin and not very strong. Let their sleep and Watchings be Moderate.

But Frictions or artificial Rubbings of the Body, and by Galen much extolled in this Case. In the 12. Method Cap. 3. They must be used from the beginning of the Disease, with Course Cloaths, beginning above and so Rubbing downwards; first on the Thighs and Legs; afterwards on the Arms, shoulders and Back. Let the Cloaths with which the Frictions are performed be first Smoaked with Storax, Lignum Aloes, Frank-Incense Cloves &c. When after friction the Limbs are lustily warm, anoint them with Oyl of Dil, of Chamomel, of Orice, of Castus and others of a resolving Faculty. Such Frictions as these are highly commended, because they call the natural Heat and spirits together with the Humor offending which did Choak the natural strength, into the outward Parts.

In the fit the Sick-party must be rowzed, by pulling the Nose, Rubbing the Eares, plucking off of Hairs, Loud calling &c. Also sweet Smelling things must be Applied to the Mouth and Nostrils; as Cinnamon and Orange flower Water, Vinegar wherein Cloves have been steeped, inside of a white Loaf dipt in Hippocras alone, or Cinnamon Water, or the following cordial Water.

Take Waters of Bawm, Rose-Mary and Orange flowers of each one ounce; Cinnamon Water half an Ounce: Confectio Alkermes one dram: Syrup of preserved Citron Peels and of Gilly-flowers of each one ounce: Mix all into a potion or Julep, which the Patient must often take of, by a Spoonful at a time. Also Electuaries may be made after this manner.

Take Conserve of flowers of Bugloss, Rosemary, and of Citron Peels preserved, of each half an ounce: preserved Nutmeg three drams: Consectio Alkermes two drams: Species of Diambra and Diamoschum dulce of each one scruple: With the Syrup of preserved Citron Peels, make all into an Electuary.

Unto the Heart Epithems may be applied and young Pidgeons to the stomach and Stones; Fo∣mentations may be applied, and other things administred, which have been propounded in case of de∣cay of strength.

While these things are in doing, frictions must ever and anon repeated, which must in this Dis∣ease never be omitted.

When the Patient hath a little gathered strength, the Morbifick Matter is to be drawn out by Cly∣sters and Purgations (in which Hiera cum Agarico, in regard of the stomach, is very profitable) which ought to be gentle and frequent, yet so as fitting Preparatives be administred between Purge and Purge.

Want of Appetite is common in a Manner to al Feavers: for when the stomach is inflamed, thirst is encreased, but Appetite of eating diminished. Yet somtimes Appetite is so dejected that the Patients can hardly sup a little broath. Which Loathing of Meat is caused by Vicious Humors collected in the stomach or soaked into the coats thereof; or of corrupt and Malignant Vapors which infest the stomach. It ought to be Cured by Evacuation of the Morbifick Matter by Vomit or Stool, and first with an infusion of Rhubarb and Tamarinds. But in the declination, if the Feaver be not strong, with Hiera Picra dissolved in a Decoction of Barley, Vetches, Wormwood and other detergent things. Afterwards we must use Clysters, which occasionally do revel from the stomach. Also acid and refrigerating things are frequently to be given, as Syrup of lemmons, Pome∣granats, some Cherries &c. given alone or with cold Water. In the declination or when the Feaver ceases, Syrup of Roman Wormwood may pofitably be given, either alone or mixed with acid Juyces or Syrups. Let Meats that are grateful be presented to the sick. For as Hippocrates teaches in Aphor. 38. Sect. 2. The Pleasanter Meat and drink, though somwhat the Worse, is to be preferred before that which is bitter and not so pleasant. Also let them eat but little and seldom, for much

and frequent eating causes Want of Appetite even in those which are wel. And let their Meats be sauced (provided they have no cough) with Juyce of unripe Grapes, Vinegar of Roses and Juyce of Lemmons. If the sick do so abhorer al Meats that they can take nothing at al, let them have nourishing Clysters given them twice or thrice in a day; the excrements being first avoided by a clensing Cly∣ster. When the Feaver is wholly allaied and gone, if want of Appetite do remain, let the sick person Moderately excercise, and use Capers, Saxifrage, Olives; let him change place and go into a colder Air. And finally if these helps suffice not let the Patient use Wormwood Wine and pils of Hiera Picra, which do powerfully clense away such Humors as are fast sticking in the Coats of the stomach.

Hiccupings and Vomitings which betide persons in Feavers are opposed by divers Medicaments, the materials whereof are to be sought for in our cures of those Infirmities of Vomiting & Hiconping & to be Judicially accomodated to such persons as in Feavers are troubled with those Symptomes. But speci∣al care is to be taken that a critical Vomiting be by no Means stopped. Hiccoughing somtimes proceeds from immoderate use of refrigerating things, as Lemnius witnesses, whose words Schenkius doth thus relate. Hiccoughing in Feavers doth somtimes follow over abundant use of Refrigerating Ju∣leps; and I have seen many so affected by the unadvised Rashness of Physitians, which Symptom contrary to the expectation of all Men, I Cured by giving the Patient Wine to drink.

A Loosness befalling one that hath a putrid Feaver, if it be critical (that is proceeding from the Conquest of Nature over the Morbifick Matter and tending to expel the whol or Part thereof) it must not be stopped; neither must a Symptomatick Loosness be presently stopped, at the very first, if it do not very much weaken the Patient, least the Vitious Humor do flow back again to some prin∣cipal Parts. When it is seasonable to stop it, it must be done with a gentle astringent Purge, with clensing and Corroborating Clysters; by Medicines taken in and outwardly Applied, which do thicken, strengthen and bind. All which may be taken out of our Cure of a Diarrhoea or Loosness: beginning with the gentler and proceeding if need be to the more strong by Degrees.

Sweats if they be not Critical (that is caused by Nature expelling the Humor offensive) but Symp∣tomatical [that is, caused by the vehemency of that Disease dissolving the Body, and hunting the Hu∣mors through the Skin] and doth very much weaken the Patient, they must be suppressed by cool∣ing the Air, with sprinkling cold Water and the leaves of the Willow and Vine-tree upon the pave∣ment; and if need be by opening the Windows; the Body being cooled and ayred by little and lit∣tle, the Cloths being light upon the Patient, and a Flock-bed being put instead of a Fether-bed: al∣so by often sprinkling the Patients Face with Water and Vinegar mingled together, and finally by the use of cooling Astringent Medicaments; such as are cooling Epithemes applyed to the Heart, Liver, and whol Belly, and often changed. Oyntments made of Oyl of Roses, of Mirtles, of Mucilages, and Astringent Pouders, are to be anointed upon the whol Body; but especially upon the back∣bone. Pouders of Roses, Balaustians, Pomegranate rinds, Myrtle, Mastich, Terra Samia &c Must be sprinkled upon the Neck, Throat, under the Arm-pits, and in the Groins. Or let the Patient be wrapped in a Linnen Cloth, sprinkled with a mixture of Vinegar and Water, and the aforesaid pouders strewed thereon; being in the mean time careful that no Inflamation, or Tumor be in the parts about the short Ribs: for then we must abstain from Astringent things, at least such as are strong. The Sweat must not be wiped off, but suffered to dry about the Pores of the Skin, so to stop them that more may not follow.

Also we must give in at the Mouth, Medicaments that thicken and strengthen, as Barley Water boiled with Lettice and cooling Seeds; Restorative Broths, with Juyce of Pomegranates, sowr Grapes, Pouders of Corals, Pearls, shavings of Ivory, Sanders, or Baulaustians. Juleps of the Waters of Roses, Lettice, Purslain, with Syrup of Pomegranates, dryed Roses, or Quinces. Conserved Electuaries, of Conserve of Roses, Corals, Pearls, Terra Sigillata, pouders of Diamargaritum fri∣gidum, and such like.

AN APPENDIX.

In the Cure of most acute and pernicious Feavers, one thing is diligently to be noted that such Feavers seldom happen without some inward and peculiar disorder and commonly Inflama∣tions of some of the inward Bowels as Liver, Spleen &c. So that we must evermore be careful of the Parts under the short Ribs, of the Head, the Breast, the Womb; Reins and Bladder: that by al means possible we may hunt out, which of those is much out of order, and as much as may be restore the same to its Natural Constitution.

Chap. 3. Of a Tertian Ague.

AN Ague, or Intermittent Tertian Feaver, is caused by an Excrementitious Chollerick Humor, contained in the first Region of the Body, and there putrefying.

A Tertian Ague is either Legitimate and Exquisite, or Illegitimate and bastard.

A Legitimate or Exquisite Tertian Ague, is terminated in twelve hours, and is caused by the pu∣trefaction of Natural Choller. But a bastard Tertian hath fits that last above twelve hours. But if it exceed twenty four hours, it is termed Tertiana extensa, a stretched Tertian. And it is caused ei∣ther by Preternatural Coller putrefying, or by Natural Choller mingled with other Humors, espe∣cially with flegm.

Also Tertian Agues are Simple, or Double, or Triple. A Simple Tertian, is that whose Fits come every other day. A Double Tertian is that whose Fits come every day. And although here∣in it differ not from a Quotidian or every day Ague, yet they are known one from the other by their proper Signs, shewing the abundance of Flegm or Choller in the Patient; of which Signs in their place. Somtimes notwithstanding in a double Tertian there are two fits in one day, the other day remaining free; and this some latter Physitians do call two Tertians, and make it to differ from a double Tertian. Which Distinction notwithstanding is of smal moment. A Triple Tertian is when there are three fits in the compass of two daies. This is a most rare and seldom seen sort of Feavers. Yet Galen propounds one single Example thereof, and I saw another in the yeer 1637. in a certain Gentleman, who once in sixteen hours had a fit of a Tertian Ague. And all the fits did every one of them terminate in the space of ten or twelve hours, by sweat. Now these divers Parox∣ysms are made by a different matter putresying in different places, so that each one hath as it were its peculiar Chimney where it is first kindled.

Now the Humors causing Tertian Agues, are collected chiefly in the first Region of the Body, viz. In the Liver, the bladder of Gall, the Stomach, the Mesentery, the Pancreas, or in the Veins of those Parts.

Their Causes, are all such things which ingender Excrementitious Choller, viz. An hot and dry distemper of the Spleen, youthful Age, Hot Constitution of the Air, Watchings, Cares, Anger, Fastings, use of hot Meats, over much Exercise. To these are added, for the breeding a bastard Ter∣tian, such Causes as engender Flegm and Melancholly. Hereupon, such as have hot Livers, and by Glutinous and bad Diet, do breed many Crudities, are subject to bastard Tertians, by reason of the mixture of Choller with crude Humors. And hence also it is, that in Summer time, crude Hu∣mors bred through weakness of the Natural Heat, by eating of Fruits, and over much drinking, being mixed with Choller, do breed bastard Tertians.

The Signs to know an Exquisite Tertian by, are these: That this Feaver alwaies begins with great shaking Fits, whereas in a Quotidian Feaver or Ague, there is only a light shivering or cold∣ness. After the cold shaking Fit, follows great Heat, sharp and biting, Intollerable Thirst, great and frequent breathing, want of Sleep, Head-ach, and somtimes Ravings. After the shaking fit, somtimes there follows a vomiting of Chollerick Humors, or a purging by Stool. The Urine is somtimes Yellow, Yellowish-Red, or Red. The Fits last not above twelve hours, and they are terminated by Sweat. Also the Causes fore-cited, breeding Choller, have preceded.

In a bastard Tertian, all the foregoing Signs are more remiss than they are in an Exquisite one, but more intense than in a Quotidian Ague. And according as there is more or less flegm mingled with the Choller, the Fits come neerer to those of an Exquisite Tertian, or of a Quotidian; but in re∣spect of the vehemency of the Symptoms, and the length of the Fit it self. So that the Paroxysms of a bastard Tertian may be lengthened out to sixteen, eighteen, or more hours. Although they may be somtimes shorter, because of the paucity of the Matter, and be terminated within the space of eight, ten, or twelve hours.

The Prognostick of this Disease, is taken out of Hippocrates, in Sect. 4. Aph. 59. Exquisite or exact Tertian Agues last but for seven fits at most. And in Aphor. 43. of the same Section, All Intermitting Feavers are void of danger. Which is to be understood only of such Tertians as are void of all malignity. For there are Malignant and Pestilent Tertians, which though they have e∣vident Intermissions; yet do they often kill the Patients. Furthermore, many things fall upon the Neck of a Tertian, which may breed danger, although the Feaver of it self be not dan∣gerous.

Haly writes, and common Experience shews, That if such as are sick of a Tertian Ague, have Ul∣cers, Scabs, or Pustles breaking out in their Lips, it is a token the Ague wil leave them. For it is a kind of Critical Evacuation in those parts.

A Loosness befalling one that hath a Tertian Ague, the matter being digested, ends the Disease. And this is the way by which alone Nature doth perfectly expel the Cause of these Feavers. For seeing the Original Cause of these Feavers is contained in the Gall-Bladder, or the Liver, or the Me∣sentery, and other Parts in the first Region of the Body; although that which steems and vapors therefrom in every fit, do get into the habit of the Body, and is purged away, either by Sweats, or by insensible Transpiration, or by Pushes and Pimples; yet the gross parts and setlings of the Humor abiding in their place, which unless by the benefit of Nature, or Medicaments it be purged away by stool, it is wont to be the Cause either of a long Ague, or of Obstructions, or of a Relapse, or of o∣ther stubborn Diseases.

Agues are wont to be of smal durance and little danger, if the habit of the whol Body be good, if the bowels be wel affected, if it be Spring or Summer, if the Patient eat little, and drink sparingly. And contrary wise, they are wont to be long and more rebellious, if there be an evil disposition of the Liver or Spleen if the Patient abound with flegmatick Humors or Melanchollick, if the Winter or Autumn be in their full force, if the Patients do eat much, or by much drinking do oppress their Na∣tural Heat.

The Cure, as in other Feavers, is to be directed to the Feaver, its Cause, and strength of the Pa∣tient. The Feaver calls for Coolers; the Cause requires Coolers likewise, and withal such things as digest and purge the Humor offending; the Patients strength calls for things that corroborate and vigorate the same.

And in the first place, A Cooling Diet must be appointed, and which moistens; it must be the very same in an exquisite Tertian, which we before prescribed in our Cure of Continual Feavers. But in a bastard and single Tertian, a fuller Diet somwhat, is to be enjoyned, especially if the Dis∣ease prove to be long; for then solid Meats are to be given on the wel-day, and five or six hours before the fit. But in a double Tertian, as in an exquisite Tertian, the Sick must be nourished only with broth, and other supping things.

This is a most pleasant Drink out of Forestus, for those which have a third day Ague.

Take Fountain Water two pints: Cinnamon half an ounce: Sugar three ounces: Let all be strained cold and raw, through an Hippocras Bag.

The Patient must not eat when the Fit is coming, according to that saying of Hippocrates, in Aphor. 11. Sect. 1. For Nature (as Galen shews in his Commentary on that place) by Conco∣cting of newly eaten Meat, is called away from Concoction of the Morbifick Humors. Add hereunto, That in the fit of an Ague, the whol body is filled with a filthy vapor, which doth mar, and for the most part corrupt that meat which is eaten neer the fit. But if the fit prove so long, or the Patients body so hot and dry, so lean and thinly woven together, with wide pores, that it is soon dissolved and dis∣sipated, and cannot hold out to the end of the fit; the Patient in such a case may be allowed to eat in the fit, and it wil be better to eat when the fit is in the state or height, than at any other time. How∣beit, in the beginning also, and in the augmentation, necessity compelling, Meat may be given. For so Galen in the tenth of his Method, Chap. 5. was compelled to give Meat even in the beginning of the fits, unto such as had this kind of Ague, being of a hot and dry temperature, unto whom fasting is ex∣treamly hurtful, lest they should fall into swooning fits. And in imitation of him, Amatus Lusita∣nus in the 68. Cure, of the fourth Century, to one that was full of, and vomited pure Choller, and by that means fell into swooning fits, he gave bread dipt in water, and sprinkled with Juyce of sown Grapes in the beginning of the Ague fit; by which means he hindered the aforesaid Symp∣tomes.

There is one thing yet further to be observed both in this, and all other Agues, That the Patient do neither eat, drink, nor sleep, before the fit. But it wil be good that the Patient go to stool, by means of a Clyster, provided the same be administred before the beginning of the fit.

Having therefore ordered a convenient Diet, we must forth with proceed to evacuate the Morbifick Matter, which seeing it sticks in the first Passages, it must be voided not only by Clyster, but by Pur∣ges and Vomitories.

Clysters in an exquisite Tertian, must be made of an Emollient and Cooling Decoction, with Cassia, Catholicum, Diaprunum simple, and purgative. But in a bastard Tertian, let the Decoction be of Emollient and Cutting simples, dissolving therein Diaphoenicon, Honey of Roses, &c.

Purgative Medicaments in an exquisite Tertian, must be the same which have been propounded in continual Feavers. But in a bastard Tertian, there must be added Agarick, Senna, Catholicum, Dia∣phoenicon, and others, such as the Judicious Physitian shall conceive most suitable to the constitution of the sick. And in every sort of Agues, Cream of Tartar may profitably be added to the Medica∣ments, because it opens Obstructions, is potently clensing, and yet cools withal. Purging Medi∣cines are to be given on the day of Intermission, and that in the morning, as commonly is used; if the time of Intermission fall within those hours: if not, the middle space between the two fits must be chosen. And at any hour of the day or night, we may give a Purge, provided it be far from the Fit, and the Stomach have digested what was last eaten.

But in a double Tertian, 'tis an hard matter to choose a convenient time to give a Purge, because many times, not above three or four hours do fal between two fits. Yea, And somtimes the fits are so long, that the one begins before the other be ended, which makes them be called Febres Subintran∣tes, encroaching or intruding Feavers. For then the speediness of the occasion or opportune time, requires the uttermost diligence of the Physitian. Now the more commodious hour of giving the Medicine, is thus to be chosen. In a double Tertian not encroaching, the Medicament must be given in the end of the Fit, at such a distance from the following Fit, that the working of the Physick may be over ere the other Fit come. But in an encroaching Ague, when the latter Fit interfers with the former, the Medicament must be given in the beginning of the declination, as soon as it begins never so little to remit. And in both Cases the Patient must drink Broth, three hours after the Medicament is taken; yet so, as that there must be remaining three hours from the Broth-taking before the next Fit begin. So that the Medicament, is to be given at least six hours before the next Fit.

As for Vomits, What was said of them in the Cure of Continual Feavers, may be here very com∣modionsly applyed; because the abundance of evil Humors conteined in the Stomach, Mesenterie, and Cavity of the Liver, which is wont to cause these Feavers, is brought away by Vomit; which somtimes cannot be moved by purging Medicines given again and again, as Fernelius hath well ob∣served. And therefore, If in the beginning of the Fit, the Patient be vexed with Vomitings, the Physitian shall do well to follow that motion of Nature. And seeing the gentlest sorts of Vomits, will not ordinarily serve the turn, we must proceed to the middle sort, such as is especially Asarum, of the pouder whereof, half adram, two scruples or one dram, is given in Broth, or some other con∣venient Liquor. Others give the Decoction thereof, which is made of three drams of Asarum Roots, boiled in Chicken Broth, or in Barley Broth made with Raisons. The Chymists do give white Vitriol prepared, and Salt of Vitriol, and also Aqua Benedicta, which is made of Crocus Metal∣lorum. Which, as other Medicaments made of Antimony, as they do somtimes happily rid away such morbifick Matter as is lodged in the first passages about the Stomach and Mesenterie, &c. So do they require a prudent and skilful Physitian to administer them; otherwise they are like a sharp Knife in the hand of an Infant, or like a Sword in the hand of a Mad-man.

The first passages of the Body, or first Region thereof, being purged, at least with one Purge, a Vein is to be opened in the Wel-Day. Yea verily, And if the Patient be Plethorick, the Urins red and thick, the Cure is well begun by Blood-letting, for the Purge will afterwards work the better.

If the Blood appear very Hot, Adust, or Putrid, Bloodletting must be repeated; which yet is left to the Judgment of the Physitian, according as he finds the Patients constitution.

After Purgation and Phlebotomie, we must endevor to prepare the Humors, by Juleps such as were set down in the Cure of Continual Feavers; the matter whereof must be varied, according as Flegm or Melancholly is mingled with Choller, as was observed in the place aforesaid.

In the mean time, whilst the Medicines aforesaid are making, the Feaverish heat is to be allaied with cooling Epithems applyed to the heart & Liver, such as were propounded in Continual Feavers, with this Caution, that they be never laid on, but in the height of the Hot-Fit, or rather when it first begins to abate.

To the Liver also and the Loins, Oyntment of Roses, or the cooling Oyntment of Galen may be applyed.

Also Emollient and cooling Clysters, will be very good at the end of the Fit, as well as in the beginning.

The matter being prepared certain daies, by the use of Juleps, Purgation must be again used, with Senna, Rhubarb, Catholicum, Syrup of Roses; adding thereto Agarick, if Flegm abound. And And if the Patient be strong; we may add Diaprunum Solutivum, Electuarium de Succo Rosa∣rum, or Diaphaenicon.

The Body being again purged, after the use of Juleps, if the Fits return and seem longer than they were before, it is a sign that gross Humors, and such as stick fast in the Body, do nourish the Fea∣ver, and breed Obstructions: In regard of which, clensing, opening and cutting things are to be used The Principal of which is Wormwood, which is exceedingly commended by Galen. In his 1. Book ad Glauconem Chap. 9. and Century, which in regard of the rare vertues it has in curing Agues, is called Febrifuga, that is to say Ague-Queller. But because these Herbs are hot, they may be qua∣lified by the Commixture of cooling things, after this manner.

Take Roots of Grass, Cichory, Asparagus, of each one ounce: Leaves of Agrimony, Sorrel, Ci∣cbory, Endive, of each one handful: vulgar Wormwood and Centaury, of each an handful: Boil all to a pint. In the strained Liquor dissolve three ounces of Syrup of Lemmons. Make all into a Julep for to be taken at three times in the morning.

The Juleps being finished, a Purgation must be again administred or a Vomitory, if Nature affect to discharge her self that way. For then, the signs of Concoction appearing, these Feavers are

somtimes happily Cured by Vomiting. And Galen in his first Book ad Glauconem Chap. 10. Writes that many are Cured of this kind of Ague only by a Vomit yea verily and daily experience shews, that Aqua Benedicta doth eradicate these Feavers or Agues for the most Part, unless some con∣tumacious obstructions of the Bowels do hinder. Many Experiments hereof are propounded by Martinus Rulandus in the Centuries of his Cures. But, it is, as was said before, a vehement Medicament, and not to be given without extream Caution. Some give an ounce of Aqua Be∣nedicta with the Infusion of half an ounce of Senna, and so it works more by Stool than by Vomit.

Others use Cambogia, others Mercurius Dulcis with Scammony. Which Medicaments, seeing they do potently Evacuate, do often Pluck these kind of Feavers away by the Roots, but they are to be given only to such as are strong of Constitution.

To these Medicaments exquisite Tertians and Bastard ones too, are wont to give place. But if the Agues do yet stubbornly resist (as it ofttimes fals out) Solemn Purgation must be made with an Apozem to be taken three daies, made of the Materials of the foresaid Juleps, adding thereto Senna, Rhubarb, Agarick, Syrup of Roses of Cichory with Rhubarb and such like. Yea verily and al∣though the Ague be gone before the use of this Apozem, if a Voluntary Loosness do not befal the Patient. For the solution of an Ague by Sweat or insensible Transpiration, as not to be trusted unto, gives suspition of a Relapse; because by them the thinner Part only of the Humor is Evacuated, the thicker being left behind: which can no other waies be Evacuated, save by Stool.

Before the Apozem aforesaid be used, if there be a Distension in the Parts under the short Ribs, let this following Emollient, attenuating and strengthening fomentation be applied.

Take Roots of Marsh-Mallows, Grass and Asparagus, of each one ounce: Roots of Enula Campana and the middle Bark of Tamarisk of each half an ounce: Leaves of Mallows, Violets, Agrimony, Maiden-Hair and Wormwood, of each an handfull: Lin-Seed and Faenu-Greek Seed, of each one ounce: Flowers of Chamomel, Melilot, Roses of each a pugil: Boyl all in three Parts of Water and one of white Wine, put in towards the conclusion, with two ounces of Vinegar: with this Decoction foment the Parts under the short Ribs Morning and Evening, for two daies before the use of the Apozem.

After Fomentation, anoint the said Parts with this following Oyntment.

Take Oyl of Lillies, Sweet Almonds and Tamarisk of each one ounce: Oyntment of Marsh-Mallows two ounces: and a little Wax. Make all into a Liniment.

If after al these remedies, the stubborn Ague do yet lengthen the time and keep its ground; and the Patients Face appear swoln, and palish, also their Lege swel towards night: they are to be plied with such Medicines as are commonly prescribed for obstructions of the Liver. Among the rest, Montanus doth very much commend the Decoction of Cichory and Germander in Broath; which he saies is admirable in long Feavers that are caused by obstructions.

Yet, it is to be noted; that the length of a Tertian Ague is some times caused by an hot and dry distemper of the Liver, whith perpetually produces a Chollerick Humor, the Cause of new Fits. Which is often observed in many, which being of a dry and meagre constitution of body and wholly Chollerick, have had a Tertian Ague three or four months together, especially in the more hot season of the yeer, without any tension of their Bowels, or any aboundance of Humours. To such as these, strong purgers, and strong aperitives or heaters do hurt. But such as these are to be plied with a cooling and moistening diet, with Juleps and Broaths of the same Nature. And the super∣fluous Humors are to be Purged away by little and little with Emollient and Refrigerating Clysters, with Cassia, Tamarinds, Catholicon and Syrup of Roses. But in this case especially great miracles are performed by a bath of Blood-warm Water, which doth extinguish the hot and dry distemper which is imprinted upon the Bowels. Let the Patient use these baths, on the Well-day, but without sweating.

Somtimes also the Length of Tertian Agues arises from the evil disposition of some of the Bowels, especially of the Liver and Melentery; which cannot be Cured by purgations though never so oft repeated, because that evil Quality remaining stil in the Liver, causes new Morbifick Matter daily to breed, which produces new Fits. Which evil Disposition or Quality of the Bowels, is taken a∣way by Diureticks, Sudorosicks and other resolving Medicaments.

With which faculties these following simples are endued viz. Wormwood, Centory, Carduu••, Roots of Dictamnus, of pimpernel, Tormentil &c. Of which are made Decoctions, Pouders, and such like, which must be given for divers daies together before the Fit.

A dram of Uenice Treacle is ordinarily given with white Wine, before the Fit, three times one after another.

Some give a walnut preserved in Sugar or Honey after the same manner.

When the Heat of Uenice Treacle is feared, it is at first given by it self, and a draught of Plantain-Water

is given after it. My Master Ʋarandaeus did often use this as a Specifick Medicine.

A Cup of Hippocras given before the Fit wil work the same effect, with which pleasant Medicine many have been Cured.

Yet must it carefully be observed, that these remedies must not be given, till the Patient hath been diligently Purged.

Zechius Frequently used these following Pils, which are most effectual for opening Obstructions, streng••hening the Liver, and taking away the distempers of the Bowels.

Take Treches of Rhubarb, of Eupatorium, and of Wormwood, of each half a dram: Pouder of Diarrhodon Abbatis one scruple: with Syrup of Wormwood make a Mass of Pils. Of which let the Patient take one dram in the morning three daies together, drinking after them a draught of Broath made with Cichory and Maiden-Hair.

Montanus was wont to give many daies together a scruple of Troches of Rubarb or of Worm∣wood, with Broath in which Barley, Parseley Roots, Cichory and Borrage have Boyled.

Let the Region of the Liver be anointed morning and evening before Meals, with a Liniment made of two ounces of Ceratum Santalinum, Juyce of Cichory half an ounce: Juyce of Wormwood two drams: and a little Vinegar of Roses.

In l••ke manner let the Region of the stomach be anointed with this Liniment.

Take Nard Oyl, Oyl of Wormwood and of Quinces of each half an ounce: Gallia Moschata one scruple: white Wax as much as shall be requisite. Make al into a Liniment.

Besides the Medicaments hitherto propounded, which respect a regular and Methodical Cure; there are many other specifick and Empirick Medicaments, both internal and external; both com∣mended by Practitioners, and frequently used by the common People; out of the almost infinite number whereof I shal here set down such as are the choicest. And among these Medicines may be reckoned, such things as were before propounded, to amend the evil Quality of the Liver and Me∣sentery which is wont to make long Agues: whereunto, these things following may profitably be added.

And in the first place, Spirit of Sulphur in a Legitimate Tertian, or one very neer Legitimate, after bleeding and Purging, being given with Purslain Water in the vigor of the Fit, doth power∣fully extinguish the heat of the Feaver; and if the Humor be thin, drives the same out by sweat, that there remaines no matter for a new Fit, and so is the Disease Somtimes pluckt up by the Roots. It is given from half a scruple to a scruple, with four ounces of Purslain Water.

And somtime the said spirit is mingled with Salt of Wormwood, which is also of great Efficacy in the Cure of Agues the Composition is thus.

Take Salt of Wormwood half a dram: Spirit of Sulphur a scruple: Carduus Water four ounces: Mix them. Let the Patient take it when the Fit Approaches and he covered with many Cloathes.

Some Affirm that the Juyce of Plantain Clarified and drunk to the Quantity of four ounces, an hour before the Fit, doth Cure a Tertian Ague. Some give it with Vineger and Saffron after this manner

Take of the Juyce of Plantain four ounces: Vinegar of Roses half an ounce: Saffron three grains: Mix them and give the Patient to drink, two hours before the Fit.

Manardus prefers a Decoction of Chamomel, or the distilled Water thereof, to the Quantity of four ounces, two hours before the Fit.

A Medicine commonly used, and often successful, is, a little Potion made of Rose-Water, Plantain Water and Aqua Vita of each a spoonful; given before the Fit.

These following are outwardly applied.

Take Leaves of Hyssop and Tansie cut smal, of each a pugil; Mirrh two drams: Mace, Nut∣megs, Cloves and Cinnamon, of each half a dram: Ʋenice Turpentine and Juyce of Tansey, of each one ounce: Mix all and spread them upon a Rose-Cake, fried in a frying Pan with Canary Wine, which being covered with a Linnen Cloath must be applied hot to the Region of the stomach, an hour before the Fit. Or,

Take Wormwood and Green Mint of each a pound: Crust of Bread toasted and steeped in Vine∣gar half a pound: pulp of Quinces, or Conserve of Quinces made with Honey two ounces: Mastich half an ounce: Mace and Nutmeg of each two drams: Let al be beaten and lustily wrought together, with Oyl of Quinces. Make hereof a Cataplasm to be applied before the Fit. It provokes sweat and takes away the Pains of the stomach. Or,

Take Nutmeg, Cloves, Cinnamon, of each three drams: Mirrh and Ginger of each two drams: Make al into a Pouder; mix it with Liquid Pitch and make thereof a Plaister for the stomach.

Also this following Cataplasm may profitably be applied to the Liver.

Take white Sanders and Red of each one dram: Barley Meal two drams: Aloes half an ounce: Flowers of Violets and Roses dried of each one dram: With Juyce of Wormwood and

Vinegar make a Cataplasm, to be applied to the Region of the Liver one hour before the Fit.

Neither are those Medicines wholly to be rejected which the common people are wont to apply un∣to the Wrists of such as have Agues. For not only the Opinion of People is hereby satisfied, who conceive that many are cured with these Remedies; but somwhat they may effect, by communica∣ting their vertues unto the Heart by those notable Arteries which are scituate in the Wrists. The chief of which kind of Medicines are these that follow.

Take Leaves of Plantane, Celondine the great, of each one handful: Cobwebs, Nettle Seeds, Soot from the Chimney, and common Salt, of each one dram: the strongest Vinegar as much as shall suffice. Make of all a Cataplasm to be applied to the Wrists a little before the fit, and to be repeated fresh three or four times.

Mous-Ear beaten with Salt and Vinegar, is by some accounted of great efficacy, being applied to the Wrists before the fit.

Of some, the smallest sort of Housleek or Mous-teat is commended, being used after the same manner.

Others commend the Leaves of Shepheards-purse beaten with Salt and Vinegar.

Platerus applies unto the Wrists the inner bark of the Nut-tree sleeped in Vinegar; which he saith, had been by him used with success.

Finally, Others apply such things as are apt to blister the Skin, as Garlick, Onions, Crow-foot, and the like; which are less safe than the former, and very troublesom to the Patient.

Chap. 4. Of a Quotidian Feaver.

A Quotidian Ague is so called, because its fits do return every day. Wherein it agrees with a double Tertian, and a triple Quartan, but is distinguished from them by signs proper to it self. This Feaver is most rarely seen, so that among six hundred Patients that have Agues which come eve∣ry day, scarce one of them is troubled with a Quotidian or every day Ague.

This Ague is caused by flegm putrefying in the first Region of the Body: And therefore all such things as multiply flegm in the Body, may cause this Ague, such as are, a cold and moist distemper of the Bowels, old Age, Childs Age, an idle life, Autumn Season, Meats cold and moist, long Sleeps and such like.

The Diagnostick Signs are such as testifie flegm to abound in the Body; as greatness of bulk, soft∣ness and fatness, white color, or pale, dull sence, profound sleep, and dreams of Waters. Also this Feaver for the most part comes in the night, and that without shaking, only with a coldness or light shivering, because the Morbifick Matter being benign, and not much an Enemy to Nature, doth less provoke her; and therefore the heat is not suddenly drawn inward as in a Tertian Ague, but retires by little and little. The time of Coldness being over, Heat is slowly and unequally kindled, so that the Patient feels somtimes heat, and then cold, and then heat again. Also the heat is mild, and not at all scorching, and thirst little. The Urines are at first white, thin, and undigested; and in the pro∣cess they appear more thick, and better colored. The Pulse is smal, seldom, and slow. The Parts about the short Ribs do swel, and are commonly puffed up, and distended. The fits do commonly last twelve hours, and do not end but so as to leave some Feaverish heat behind them; because this Feaver is like a fire of green wood, which is both long in kindling, and leaves much smoak behind it. Som∣times the sit is extended to twenty four hours, and it seems to be a continual Feaver.

Now these Signs are very variable, and appear more intense or remiss, according as the flegm is ei∣ther simple, or mingled with other Humors; and likewise according to the different kind of the flegm which putrefies. So that, according to Galen in his Book of Plenitude, Chap. 11. Salt flegm makes the Patients thirsty; acid or sowr flegm makes them hungry; sweet flegm makes them sleepy; tastless flegm makes them without appetite to Meat: and likewise Feavers which are caused by acid or Glassie flegm, are wont to come with a shaking fit.

This Feaver is wont to be perpetually long, because of the thickness and contumacy of the Morbi∣fick Matter, and lasts forty daies, and somtimes three or four months. Neither is it without danger, seeing it may degenerate into a Cachexy, Dropsie, Lethargy, and other grievous Diseases. The lon∣ger or shorter durance of this Feaver, is known by the signs of Crudity and Concoction, and also by the Evacuations, which for the most part Nature endeavors by Vomit, Stool, or Sweat: For those Evacuations appearing, shew the Disease shorter: but if Nature endeavor no Evacuation, the Dis∣ease wil prove the longer.

A Quotidian Ague that comes in the day time, is less dangerous than that which comes a nights, as Hippocrates doth teach us in 3. Epidem. Sect. 5. T. 64. He calls the former a Diurnal, the latter a Nocturnal. The reason of which Prognostick, is because that the Diurnal have longer fits; for teaching unto night, in which the pores of the Skin are closed, the putrid vapors are kept within, not

having freedom to breath forth by which means, the fits are lengthened, and as Hippocrates himself saith, do very often bring the Patient into a Consumption. Ad hereunto, That seeing the Intermis∣sion happens in the night, we are forced to give the Patient Meat in the night, which is un••easonable, and hinders the Patient from sleeping; by which means great weakness is caused, and the Patient is much hurt, and the Functions of the Body quite put out of frame.

The Cure must be in a manner the same with that which was propounded for a bastard and lingring Tertian, yet so as that among such things as prepare the Humors, and open Obstructions, we make choyce of such, which have a greater power to attenuate and cut the Humors. Also in this Feaver a special care is to be had of the Stomach, which for the most part is grievously afflicted; and therefore must be recreated with strengthening Medicaments, both given in, and out wardly applied, The Ca∣taplasm of Mint and Worm wood, propounded in the Cure of a Tertian Ague, is very good in this case.

Zacutus Lusitanus propounds two Medicines, with which he glories that he had vanqui∣shed most stubborn Quotidian Agues. The one is a Decoction of Chamomel, made after this manner:

Take Flowers of Chamomel three pugils: Tops of Roman Wormwood two pugils. Boyl all in three pints of Water to a pint and an half. Add to the strainings four ounces of Sugar. Let the Patient drink five or six ounces every morning.

The other is a Decoction of China and Guajacum drunk twenty five daies together; which though Physitians are afraid to use in such Feavers as these, because of the over-great heating and drying Fa∣culty; yet is it mightily commended by such as have writ whol Books of the Spices and Drugs of India. Yet we must remember that Zacutus Lusitanus practiced Physick in a Country cold and moist, where these Medicines may more safely be used. And therefore in other Countries that are hotter, they must not be given save unto very Flegmatick and Cachectical bodies.

Chap. 5. Of a Quartan Ague.

AQuartan Ague is that which hath its Fits returning every fourth day, and it is caused by Me∣lancholly putrefying in the first Region of the Body.

Now Melancholly is of two sorts; Natural, and Preternatural. The Natural is bred of the thic∣ker and more earthy part of our Nourishment, being cold and dry. The Preternatural, is caused by adustion of Choller, and is therefore hot and dry. Hence arise two sorts of Quartan Agues; for that which is bred of Natural Melancholly, is called a legitimate Quartan; that which is bred of Preterna∣tural Melancholly, is called a bastar Quartan. Howbeit, the bastard Quartan may also come of Na∣tural Melancholly, being mingled with some portion of Choller.

Again, A Quartan Ague is either Single, Double, or Triple. A Single Quartan is when one Fit alone comes every fourth day. A Double is when two Fits happen upon two daies one immediately after the other, and the third day is free. A Triple Quartan is when the Fits come every day, as they do in a Quotidian, and in a Double Tertian. Now these Double and Triple Quartans come of Me∣lancholly putrefying in divers parts of the Body.

The Signs to know this Ague by, are first, such things as argue that Melancholly abounds in the Patient. Unto which must be added the coming of the Fit upon the fourth day, which is the pecu∣liar sign. Also the form of the fit differing from the fits of other Agues, doth discover this Disease. For it begins with yawning and stretchings, together with heaviness of the whol Body; after which follows cold, and then shivering and shaking, in which the Patients seem to have their bones broken. Also the heat is kindled by little and little in a cold and thick Matter. The Pulse is seldomer and slower than in other Feavers. The Urines are at first white, thin, and watry; but in the progress they are more colored, and thicker. Now these signs appear in a legitimate Quartan. But in a ba∣stard Quartan, the vehemence of the Symptomes being greater, doth argue the Humor to be thinner and hotter. But a bastard Quartan is not distinguished from a legitimate, herein alone, in that in a bastard Quartan, the heat, thirst, watchings, and other Symptoms, are more vehement; but in that the legitimate begins of it self, without any Feaver foregoing; but a bastard Quartan succeeds other Feavers and Agues, by reason of the adustion of the Humor which caused those Diseases, by means of which adustion, it degenerates into Preternatural Melancholly.

A Double Quartan is easily known by the Course of the fits. And a Triple Quartan is distingui∣shed from a Double Tertian, and a Quotidian, not only by the Signs of Melancholly abounding, and by the form of the Fits; but also because it was first a Single, or a Double Quartan before it came to be a Triple Quartan. For very rarely, or never doth a Quartan Ague begin with a Triple; but a Simple or Double Quartan degenerates into a Triple.

As for what concerns the Prognostick; this kind of Ague is wont to be longest of all o∣thers; and that which begins in the fal of the leaf continues al Winter commonly, and goeth not away til the Spring come. Yea and some Quartans continue a yeer or yeers. Summer Quartans are the shortest. In al of them we must have a continual eye to the signs of concoction which signifie the solution of the disease to be at hand; and with these, for the patient to make black urine is a good token.

A legitimate Quartan is longer than a bastard Quartan because the former proceeds from a thic∣ker, the latter from a thinner Humor

This kind of Ague is wont to be very safe from danger, especially the legitimate, being accom∣panied with no grievous affection of any of the bowels. But the bastard Quartan is more dange∣rous. and if the Liver, Spleen, or any other part be grievously damnified, it degenerates into a Dropsie,

Aged persons above sixty years, being taken with a Quartan Ague, do for the most part dy of it: because their naturall heat is too weak to overcome so contumacious an Hu∣mor.

An intermitting Quartan, being changed into a continual, is for the most part deadly. Because that Feaver whose motion was outward, is changed into one whose motion is inward. Which mostly falls out in the Winter, the cold meeting with the humours which were but outward and beating them back into the innermost Closets of the Body. The which also come to pass by unseasonable use of sharp and vehement purges. For thereby of simple Quartans, double, triple, and continual are generated.

A Quartan Ague coming upon one that hath the falling sickness cures the same, according to Hippocrates in the 70 Aphorism of the 5 Section. Those that have Quartan Agues are not much troubled with Convulsions. And if having first Convulsions, a Quartan Ague follows, they are freed from their Convulsions, Now the reason which Galen in his Comment gives here∣of, is; because the thick matter which caused the Convulsions is by the long heat of this Ague, attenuated and digested. Also by the shaking of the Body in the cold Fits, the said Humor is more easily ejected. We must also add, that the evil Humors lurking in the Brain and other parts, as also in the veins, is transferred to the Hypochondria and more ignoble parts, where the Melancholly Quartanary Humors are seated, and so leaves the parts aforesaid.

A bloody flux coming upon a quartan Ague, tends to health, according to Hippocrates in the 48 Aphorism of the sixt section. To such as are splenetick a Dysenterie is good. Now in a quartan Ague, commonly the Spleen is misaffected, and a melancholly humor is common to a quartan Ague and a misaffected Spleen▪ but this must be understood of a short dysenterie, for a long one is wont to be mortal; as we have it in the 43. Aphorism of the said section. Such as being troubled with the Spleen have a flux of the Belly with pain, if it turn into a long Dysen∣terie or Bloody flux, they fall either into a Dropsie or a Lienterie, and dy.

To bleed at the nose in a quartan Ague, is a very bad sign. Because the Humor which causes a quartan is too thick and too cold to be voided that way; and because such bleeding is symp∣tomatical, and if it continue wil breed a dropsie; it must presently be stopped by opening the basilica vein, out of which the putrid blood may flow, because the pure blood comes from the Nose.

The quartan Ague hath a double cure according to the two kinds thereof. For the remedies used in a bastard quartan, must be far different from those which are used in a legitimate one.

And that we may begin with a Legitimate quartan: we must presently set our selves to van∣quish the cause thereof, not regarding the Feaver. And seeing the cause thereof is an humor cold and dry, thick and earthly; we must use medicaments that do heat, moisten, and atte∣nuate. Also the Peccant Humor must be at seasonable times evacuated, which notwith∣standing will require a long time to do; because of the extream contumacy of the Humor and length of the disease. But before these medicines be used, we must appoint the patient a convenient diet. Let the patient therefore use meats of good juyce, easy to digest, of thin substance, and moderately heating and moistening; as the flesh of young Animals and mountain Birds, new Egs soft boiled, Fishes that are taken in stony Rivers. In the state of the disease we may allow the pa∣tient Salt Fish, Capars, and Olives▪ Galen 1. ad Glauco. Grants likewise Pepper and Mustard. A∣mong Herbs Borrage is commended and Bugloss, Pimpernel and Spinach, Fennell and Parsly Roots, but especailly Turneps, which must be first boiled in water, and afterwads in fat broath which is very good for such as have the quartan. Crato in his Councels collected by Scholtzius, brags that he had cured many of the quartan Ague by the second broath of turneps seasoned with Butter and Sugar. Of fruits, Apples, and stewed Prunes, Raisons of the Sun, fat Figs, Al∣monds,

Dates, Pine-kernels are good. And finally, to Spice their Meats, let them use Cinnamon, Nutmeg, and Saffron.

Let the Patient abstain from Meats which are thick of substance and clammy and are long in pas∣sing through; such as the Flesh of Swine, Beef, Deer, Hares and Water fowl, from Pease and Beans, Colewort, Course Branny Bread, Cheese, Nuts, Walnuts and Chastnuts; from Flesh much Salted, or dried in the Smoak; from fruits, Raw Herbs, from Vinegar, Verjuice, because they are thought as al other sowr things to ferment Mellancholy and make it work

Let their drink be smal Ale or bear of moderate strength and meanly hopped neither new nor hard, Pure and wel Clarifiedwhite Wine or Cla••ret that is not strong, with Water in which the Bark of Tamarisk or the Leaves of Egrimony have been steeped, or a Decoction of Salsa Parilla, or Barley Water that hath Steel quenched in it.

Let them eat sparingly, no more than may barely preserve strength; for too larg feeding breeds crudities which makes the Disease of long continuance. But above al, they must be very spare in drinking, because nothing makes this Disease more rebellious and hard to Cure than over much drink and moist things, for they fil and Swel the spleen. Crato forbids al use of drink in the fit, which to forbear doth much as he saies help the Cure. On the fit-day, the Patient must eat six hours before the sit comes. And afterward nothing must be taken til the fit be over. Long sleep is good, because it moistens, but it must be forborn in the beginning of the Fit. On the daies of Intermission light exercise before Meat, is good; or in place thereof, frictions of the whol Body, after the Pati∣ent hath been at Stool. If thee Patient be costive, a Clyster or Suppository must be given. Final∣ly let the Patient be as cheerful as may be and avoid sadness

The Patients Diet being thus ordered; first a gentle Purgation must be administred, by a Clyster and a purging Medicament. the Clyster may be thus Made.

Take Roots of Bugloss two ounces: of the four Emollient Herbs, mercury and beetes of each one handful: Fat Damask Prunes five Pair: of the four larger cool Seeds and Annis Seed of each two drams: Epithymum three drams: Boyl all to a pint and an half: in the strained Liquor dissolve Catholicum one ounce: Oyl of Violets and Chamomel of each one ounce and an half: Red Sugar one ounce: Make of all a Clyster, which must be given the day before the following Potion, at a seasonable time.

Take Senna half an ounce: Annis Seed a dram: Leaves of Borrage and Fumitory of each one handful. Liquoris three drams: Boyl all to three ounces: in the strained Liquor dissolve Manna and Syrup of Roses of each one ounce: Make all into a potion.

Galen in I. ad Glauco. Ch: 11. Bids us give only gentle and benign Medicaments in the begin∣ning of this Ague, otherwise, it is to be seared, that if we use stronger Medicaments, of a simple Quartan, we shal make a double, a triple or a Continual Feaver.

After the first Purge aforsaid, Blood must be drawn from the Basilica Vena of the left Arm. Yet, if the Liver be affected, it may be drawn from the right Arm. And their Opinion is Ridiculous, who say that we must expect Concoction before we let Blood, because then the Blood will be more thin and apt to flow: for it is better digested and prepared, if first some Quantity thereof be taken away. Neither must we give eare to them which say, that Blood-letting is not to be allowed of in a Quarran Ague, unless redundancy of Blood do shew it self by the Swelling of the Veins and by other signs. For there is evermore at the beginning a Plethora ad Vires viz. Such a fullness of Blood as the Strength of the Patient cannot mannage, unless a Quartan do follow some other long Feaver. But that Precept of Galen formerly mentioned in I. ad Glauconem, is worthy of al Commendation, which saies that if the Blood which first comes away be Black and impure, that then the greater Quantity is to be taken away: but if it be Red and Pure, little must be taken, and the Patient must not be let Blood any more. The wel daies are fittest both for Bleeding and purging. Yet some let Blood upon the fit day, five or six hours before the Fit. which is not Ammis, because the Humors beginning then to be moued, are more easily drawn out. Zacutus Lusitanus saies, that it is very good to let Blood when the Moon is in the ful. For then, by reason of the Moons influence, that earthy Melancholick Humor doth Boyl and become more fluid and Apt to come away with bleeding. And he doth Testifie that many have by bleeding at that time been helped, and some perfectly cured, who could not by any other means receive Help. But Botallus contrary to the mind of Galen and al other Physitians, doth aver that frequent Blood-letting doth cure the Quar∣tan Ague, yea when it threatens a Dropsie; and he endeavours to confirm his Opinion by reasons and examples. Which notwithstanding is to be rejected as a Paradox, seeing the Refrigeration of the whol Body caused by much Beeding, makes the Morbisick matter more thick and contumaci∣ous.

The flux of the Hemorrhoids, is very good in Quartan Agues, and many are thereby Cured. For seeing the Hemorrhoid Veins are branches of the Mesaraick Veins, in which the matter of this Disease is conteined, when they are opened they Evacuate the immediate cause of this Disease. If

therefore a flux of the Hemorrhoids happens in such as have been accustomed thereunto, it must not be stopped. If it be too sparing, it must be furthered. As also if Nature seem to incline that way (which is known by itching of the Fundament, and by some drops of blood coming that way) the Blood must be made to come by application of Leeches.

But in such as have not been used to have their Hemorrhoid Veins opened, after bleeding in the Arm, it is good to let them blood in the Ankle Vein; by which oftentimes the Ague ceases; or at least that Bleeding, with other Remedies, will hasten the Cure; especially in Women whose Courses are stopt, or flow not sufficiently.

The opening of the Vein between the little Finger and the Ring Finger, called Vena Salvatella, is approved by the Antients, and many later Physitians, who said it cures the Quartan Ague. But ve∣ry many others reject this Conceit, as being founded upon no reason, because the foresaid Vein is a Branch issuing from the Arm Veins. Yet being commended by others with many Experiments, I conceive it ought not wholly to be neglected. Some hold, it ought to be opened in the Conjunction of the Moon with the Sun; others when the Moon inclines two hours before the Fit, at three several times, in three immediately succeeding Fits, which in some persons hath happened very well.

After these first Evacuations, we must bend our study to concoct and prepare the Humors, with certain Juleps, compounded after this, or some such manner:

Take Roots of Asparagus, Bruscus, Cichory, Bugloss steeped in white Wine, of each one ounce: Bark of Tamarisk half an ounce: Leaves of Borrage, Bugloss, Ceterach, Maiden-hair, Fumi∣tory, Germander, Ground-pine, of each one handful: Liquoris one ounce: the three Cordial Flow∣ers, of each one pugil. Boyl all to a pint and an half. In the strained Liquor dissolve Syrupus Bi∣zantinus, and Syrup of Maiden-hair, of each two ounces. Make thereof a Julep to be taken at four times, four mornings together. Which must also be continued many daies, for the Matter being contumacious, requires long preparation. Or if the Patient be nice, and squeezy, Broths must be made of part of the foresaid Simples, chusing such as are most grateful to the tast, whereunto, as also to the Juleps, Cream of Tartar may profitably be added.

With these Preparative Medicaments, between whiles, Purgatives must be given; so that every third or fourth day the Patient must take a Purge, with this Caution, That as long as the Matter is very crude, we use mild Purgatives: and when Concoction begins to go well forwards, we must then give such Purgers as are a little stronger. Now the Materials for these Purgations are very wel known, so we need not reckon them up.

It is somtimes good to prescribe an Apozem both Purgative and Preparative, for four or five Do∣ses, that a good part of the Morbifick Matter may be clensed away. Which Apozeme may be made of the Materials of the foresaid Juleps, adding Purgatives thereunto. But if the thickness and contu∣macy of the Humors, with the cold distemper of the Bowels, do seem to threaten that the Disease wil be long and bring a Dropsie, we must then fly to such Medicaments as do powerfully cut and di∣vide the said Humors; of which this following Apozeme may be compounded.

Take of the five opening Roots steeped in white Wine, of each one ounce: Enula Campana, Gentian, Aristolochia, and Asarum Roots, of each half an ounce: Leaves of Germander, Agri∣mony, Hops, Borrage, Ceterach, Wormwood, and Centaury, of each one handful: Liquoris, and Raisons stoned, of each one ounce: Senna one ounce and an half: Epithimum one ounce: Aga∣rick newly trochiscated three ounces: Ginger and Cloves, of each one dram: Boyl all to a pint and an half. In the strained Liquor dissolve Syrup of Cichory with Rhubarb five ounces: Troches of Capars, and Salt of Wormwood, and of Tamarisk, of each one dram. Make of all an Apozeme, for five Doses to be taken in the morning.

In this Chronick and lasting Disease, an obstinate Perseverance is necessary, that the perpetual vicissitude of Medicines may concoct and purge away the Cause thereof. For this is in a manner the only Cause why many that have Quartan Agues remain uncured, because after the use of a few Medi∣cines they grow weary, and wholly reject and disdain all the rest.

For a continual Use therefore, certain Purgatives are alwaies to be in a readiness. Which may be made in the form of a Magistral Syrup, or of Pils, or in any other form.

A Magistral Syrup may be made of the Materials of the Apozeme Aforesaid, adding a triple quan∣tity of the Purgative Ingredients.

Pils for frequent use may be thus compounded:

Take Aloes diligently steeped with the Juyce of Wormwood, half an ounce: Gum Ammoni∣ack dissolved in Vinegar, and afterward thickened, two drams: choyce Mirrh a dram and an half: Gummy, Turbith, and Agarick newly made into Cakes, of each two drams: Diagridium one dram: Salt of Wormwood and Tamarisk, of each two scruples: Saffron half a scruple. With Oxymel simple, make all into a Mass of Pill-stuff. Let the Dose be half a dram, or two scru∣ples, twice in a week.

If the Patient be of an hot Constitution, these following Pills may be used.

Take Polypody of the Oak half an ounce: Roots of Asarum, and seeds of Broom, of each one dram: Cristal of Tartar one dram and an half: Flowers of Bugloss and Borrage, of each half a pugil. Boyl all in a sufficient Quantity of Water, Of the Liquor strained, and very well clarified, take half a pint: Juyce of odoriferous Apples very well clarified four ounces. Infuse therein Sen∣na one ounce: Turbith and Agarick, of each three drams: Mace, Cloves, Cinnamon, and Epi∣thimum, of each one dram. Let them digest together three daies in Balneo Mariae, then strain and press them out. And add yet of Extract of Aloes made with Endive and Sorrel Water one ounce: Mirrh dissolved in Wine over the fire and strained two drams: Salt of Tartar one dram: Let all evaporate and thicken over a gentle fire, adding towards the conclusion, of the Pouders of Diarrho∣don Abbatis, and Laetificans Galeni, of each one scruple: Salt of Wormwood and Tamarisk, of each half a dram: Extract of Saffron half a scruple. Make a Mass of Pill-stuf for the use asore∣said.

Also a Purging Medicament very familiar, and most easie to prepare, but very profitable, may be made of three ounces of the Decoction of Wormwood, wherein two drams of Senna hath been infu∣sed, which must be taken now and then.

These Purging Medicines are wont to be given the day before the fit, because the Patients are then stronger than at other times. Yet many contend that they ought to be given before the fit, because the matter being agitated by the fit, is made more apt for Expulsion. This Opinion they underprop with the Authority of Hippocrates in his Book de Affectionibus, who would have a Medicine Pur∣ging downwards to be given at the beginning of the Fit. And although in Galens Judgment, that is none of Hippocrates his writings, but of his Son in Law Polypus; yet they conceive it ought not therefore to be of no Authority, seeing Polypus also was a very Learned Man, and frequent Experi∣ence confirms this Opinion; as the said Experience is set down by Arculanus, Genitilus, Amatus Lusitanus, and others, who have ordered that the Purging Medicament should be given four hours before the Fit. Which practice notwithstanding, hath need of much wariness and prudence in the Physitian, seeing the shaking fit intercepts the evacuation, and in the Ague Fit the Humors are mo∣ved with a motion quite contrary to that wherewith the Purge doth move them; by which means great disturbances may fall out in the Patients Body. Wherefore this course is not to be followed but in strong Bodies.

The Consent of Physitians is greater and more general touching the giving of Vomits in the be∣ginning of the Ague Fits, because Nature is at that time more prone to that kind of Evacuation. Neither is it to be doubted, that a Vomiting caused in the beginning of the Fit, and at the same time often repeated, doth make the Disease gentler and shorter. The Materials of Vomitories are set down in our Cure of a Tertian. But in a Quartan Ague, Asarum is preferred before the rest, one dram being given in Pouder, in white Wine, and three or four times repeated.

In the Intervals of purging, Clysters must frequently be given, which do accustom Nature to expel the hurtful Humors into the Guts, and do by little and little bring away some of the morbifick mat∣ter contained in the Meseraick Veins.

The Disease continuing (as for the most part it is long and lasting) we must somtimes rest, and abstain from Physick a month, or thereabouts; that Nature in the mean time may gather strength, be wearied with continual use of Medicaments, and may set her self to concoct the morbifick matter. And afterward we must return to our Preparatives and Purgatives.

Howbeit, in a long Ague, we must not alwaies use the same Medicaments; lest Nature be over much used thereunto, and the Patient become weary of them. Also because from more gentle Ape∣ritives and Purgatives, we must pass on to such as are stronger. Various sorts of Purgatives have been already propounded. And these following Aperitives besides the Apozems aforesaid, and the Juleps, may be used in the progress of the Disease, when the Signs of Digestion begin to ap∣pear.

Take White Wine three pints: Enula Campane Roots three ounces: Bark of Capar Roots half an ounce: Tops of common Wormwood dried one ounce: Infuse them three daies in Balneo Mariae. Reep all together without straining, and give of this Wine to the Patient two or three ounces in the morning, two hours before meat. And these following Pils may be used either alone, or with the said Wine.

Take Roots of Gentian two drams: round Birthwort Roots one dram and an half: Mugwort one dram: Briony dried three drams: Mirrh and Saffron, of each one dram: Asarum Roots two drams: Aloes one ounce: With Oxymel of Squils make all into a Mass of Pill-stuf. Let a dram be given every day by themselves, or a little before the taking of the Wine aforesaid.

To these Pils, Steel prepared may profitably be added, if the Patient be able to walk after the ta∣king of them. For the use of Steel in all Chronick Feavers is very profitable, because it potently o∣pens Contumacious Obstructions, which are wont to foster those Diseases.

Or to open and strengthen at once, the following Electuary may profitably be prescribed.

Take Conserve of Elecampane Roots, Conserve of Wormwood, and Maiden-hair, of each one ounce: Preserved Citron Peels▪ half an ounce: Confectio Alkermes three drams: Preserved Myrobalans, two: Pouder of Diarrhodon Abbatis two drams: Salt of Wormwood and Tama∣risk, of each one dram: Saffron two scruples. With Syrup of preserved Citrons, make all into an Opiate: of which let the Patient take the quantity of a Chestnut every morning, two hours before meat. Or if in the morning the Patient take some other Medicine, then may the Electuary be ta∣ken two hours before Supper.

To the same intent is commended as a most excellent Remedy, the Extract of Germander mixt with Salt of Tamarisk made into Pils.

Add hereunto, Discussers, and Diaphoreticks, which are very useful to discuss the reliques of the declining Disease, when signs of Concoction appear. For they do not only discuss the said reliques, but they do likewise correct that distemper which is bred by so long a Disease, and amend the ill ha∣bit of the Body; and strengthen the Stomach, Liver, and other Bowels, weakened by the length of the Disease. Among these Medicaments, Venice Treacle challengeth the first place, being by older and later Physitians commended to this Use. It is given one hour before the fit, one dram in weight, with Wine, or in a Decoction of Germander. Or if its heat be feared, it may be given with a Deco∣ction of Agrimony, or with the Juyce or Water of Plantane. This Medicine must be repeated be∣fore divers Fits one after another. It may also be given in the mornings for some daies together on the well-daies. But a little before the fit, it operates happily, because it hinders the encrease of cold, and doth more commodiously discuss the Humor, which is cause of the fit, now beginning to work in the Veins, and by this means it diminisheth the fit, and if the morbifick matter be little, takes it quite away. Here, notwithstanding, great Caution is to be used, lest Treacle, or other such hot Medicines, should be given when the Humors are yet crude; for they dissolve the putrid Humors, from whence ariseth a confusion in the Body, and an encrease of the Ague Fits; so that a single Quartan comes to degenerate into a Double, and Triple, yea, into a Continual Feaver. As it happened to Eudemus the Peripatetick, as Galen relates in Lib. de Praecog. ad Posth. Cap. 2. & 3. in whom was a single Quartan, the Physitians of Rome having given him Treacle unseasonably, was changed into a Tri∣ple. Howbeit, afterwards when the Signs of Concoction appeared, Galen gave him of the same Treacle, and cured him.

Among other Diaphoreticks, some commend the Roots of China, and Salsa parilla, whose first and second Decoction being given twenty daies together, doth somtimes cure contumacious Quartans. But they work more effectually, if with the Primary Decoction, Purgatives be ming∣led.

Other Remedies are also given before the Fit, which are accounted specifical, and appropriate to this Ague, and being given towards the declination, they do very often keep back the fits, and cure the Quartan. The chief of this sort, are these which follow:

Take Green Leaves of Plantane one handful: Green Sorrel half a handful: Vinegar and Treacle, of each three ounces. Distil them, and let the Patient take of the distilled Liquor three ounces, half an hour before the fit. Or,

Take Sugar-candy three drams: Ginger two drams: Camphire one dram. Make all into a Pouder. Give one dram in warm Water.

Ten Grains of Saffron in pouder, given with white Wine before the fit, doth much weaken the same.

Seed of wild Rue given before the Fit in white Wine, cures.

Heurnius assures us that with the following Troches, many have been cured, even in the Winter, with once taking.

Take Seeds of Rue, Parsley, Mirrh, and new Andromachus Treacle, of each one dram: Opium half a scruple: Make all up into little Cakes or Troches. And let the Patient take one of those Cakes in Water, before the fit. Narcoticks do indeed much abate the fits; but unless the greatest part of the morbifick Humor have been before abated, and the Obstructions much lessened, they may do hurt, because they may retain the vitious Humors in the Body, and breed Obstructions, and o∣ther worse Diseases. But given in a smal quantity, and mingled with things which open and cut, as in these Troches, they can do less hurt.

Also to restrain the Fit, gentle Purgers are profitably given an hour before it comes, which do revel the Humors, more by soliciting and provoking Nature, than by their purging. To which intent, such as these which follow are prescribed.

Take Senna, Polipody of the Oak, Time, Epithimum, of each one dram: Borrage flowers a pugil. Make a Decoction to three ounces. Give it an hour before the Fit.

Or,

Take Senna three drams: Turbith one dram: Cinnamon half a dram: Saffron and Ginger,

of each ten grains: Sugar, the weight of all the rest. Make of all a Pouder, divide it into three parts. Give the Patient one part before the fit, in white Wine.

Quercetanus in his Dispensatory, doth exceedingly commend Camillus his Pils of Sagape∣num; of which he gives only one at the beginning of the fit, for divers daies together; and a little af∣ter he anoints their Back-bone with a Liniment composed of Treacle, Aqua vitae, Oyl of Bays, or of Spike. And two or three hours after the Pils are taken, he gives Broth with opening Roots, Bor∣rage, Bugloss, Time, and an odoriferous Apple boyled in it.

Now those anointings of the Back-bone, are very good to mitigate the cold fit, and must often be used, although the foresaid Pils are not used. For they are frequently useful, when the shaking fits are vehement and importunate. And these Anointings are made, not only with the foresaid, but with very many other Medicaments; as with Oyl of Dill, Chamomel, Orice, Costus, Rue, the Pep∣pers, and other hot things, with Aqua vitae, Treacle, Cloves, Castoreum, Mustard seed, Pepper, and other things mixed therewith. Now these Liniments are more effectual, if the back-bone be a∣nointed therewith by the fire-side, an hour before the coming of the fit; and the sick party be pre∣sently thereupon conveighed to a hot bed, and hot Tiles sprinkled with odoriferous Wine, and wrapped in Linnen Cloths, be applied to the Soals of the Feet, and Palms of the Patients Hands.

While the aforesaid Medicaments are used, a special care must be had of the Spleen, because that part is alwaies affected in this Disease: And therefore those Medicaments which ordinarily are pre∣scribed for Obstructions of the Spleen, viz. Fomentations, Liniments, and Plaisters.

Yea verily, and somtimes a Bath of luke-warm Water, after many Evacuations have been celebra∣ted, is good, not only to mollifie the Spleen, but also to moisten the whol body, and to further the Coction of the morbifick matter. The bath may be used on the daies of intermission, giving dili∣gent heed that it be no other than luke-warm. For if it should be hotter, it is to be feared, lest the Humors being thereby dissolved, should run on a sudden into divers parts of the Body, and breed dangerous, very dangerous Imposthumes.

Finally, Such things as are wont to be laid to the Wrists, are not to be neglected, seeing Authors of good account do make some reckoning of them. For Rondeletius affirms, That he hath used this following Medicament, with great success.

Take Leaves of Elder, Sage, Doves-foot, Rue, of each half a handful: Marigolds a third part: a handful of Salt, and a little Wine. Beat all together, and apply to the Wrists before the Fit. Crato applies the Roots of Nettles being beaten and moistened or steeped in Vinegar, to the Arteries of the Wrists, and of the Feet. And Sennertus relates that a certain Citizen having had a Quartan Auge the whol Autumn and VVinter, and at last being afflicted with most sharp pains in his left shoulder, by the perswasion of a certain woman, he applied Crowfoot to his wrist, which raised a Push, and freed him both from his pain and Feaver.

A Bastard Quartan is cured with the same Medicines in a manner, which have been propounded for the Cure of a Tertian; adding to the Decoction of Juleps and Apozems, such things as do peculiarly regard Melancholly adust. Whereunto may be added al the more temperate, and less heating Medica∣ments, which have hitherto been propounded for a Legitimate Quartan.

In the beginning therefore it is good to use Borrage, Bugloss, Fumitory, Hops, Sorrel, Cichory, Ceterach, Scolopendria, Agrimony, and Odoriferous Apples. Whose Decoctions, distilled Wa∣ters, and somtimes their clarified Juyces may be prescribed in the form of a Julep, an Apozeme or Magistral Syrup.

But in the Progress of the Disease, it will be good to add unto the Simples afore∣said, the Bark of Capar Roots, of Tamarisk, Enula Campana, Polypodie, and Worm∣wood.

While the Patient useth these Preparatives, Purgatives are frequently to be interposed; which are to be given the Day before the Fit, and to be repeated twice a Week. To which Intent Various Forms may be prescribed. But for such as are Delicate, a Laxative Ptisan, Syrupus de Pomis Saporis, or the Broth of a Chicken, qualified with Borrage, Bugloss, Pim∣pernel, and three drams, or half an ounce of Senna, may profitably be given.

Blood-letting in the beginning must not be omitted, and so such quantity of blood must be taken away, as shal correspond unto the Quantity and Quality of Blood, and to the Age and Constitution of the Patient.

If the Disease prove long, when the fervor of the blood is abated, Vomits may profitably be ad∣ministred; especially to such Patients as are troubled with Stomach-sickness and Vomitings in the beginning of their Fits. Among Vomitories good for a Quartan, Asarum (as was said before) is the principal, being given to the quantity of a dram in white Wine, and divers times repeated, if the Disease shal not after once or twice giving, be discussed.

Hereunto ad fomentations and liniments applied to the parts under the short ribs, to cor∣rect the evil disposition of the bowels (which continually affords new matter for the fits) and to soften and make thin the fast, setled and impacted Humors: which may be prescribed after this manner.

Take Roots of Marsh-mallows, of Lillies, of Enula campana, Barks of capar Roots, and the middle rind of Tamarisk, of each one ounce; Leaves of Mallows, of Marsh-mallows, of Pellitory of the wall, of Borrage, Bugloss, Pimpernel, Wormwood of each one handfull; Lin-seed and Parsly seed, of each an half ounce; flowers of Chamomel, Melilot and Dill, of each one pugil: make a decoction in three parts of water, and one of white wine added towards the end. With which decoction foment the Hypochondria, twice a day, far from meals.

Take Ointment of Marsh-mallowes, one ounce and an half; Oyl of Lillies, Chamomel, Roses and Wormwood, of each an half ounce: make al into a Liniment, which must be used after the fomenta∣tion.

Or Oyls alone may profitably be applied to the same Parts, laid on with wool.

And finally a bath of warm water either alone or with emollient and qualifiing things boil∣ed therein, or of Barly and Almonds as is usual, will be very convenient to cure this dis∣ease. For it corrects the distemper of the bowels, rectifies the heat and dryness of black Choller, mollifie that which is hard, opens the passages and widens them, and digests crude Humors. Wherefore the frequent use thereof will be most convenient, using the caution before specified.

Now the operation thereof will be exceedingly advanced, if preparative Medicaments and such as open obstruction be given to the patient, upon entrance into the bath. Among which the chief is a decoction of Wormwood and Enula Campana, which is exceeding good to di∣gest all contumacious Humors. provided the over great heat of the Bowels, do not dis∣swade the use thereof. In which case it may be tempered by the mixture of other things fore re∣cited.

And while these things are doing, gentle purgations must be repeated, as we advised before. And when the disease doth indeed decline, those specified medicaments propounded in the Legiti∣mate Quartan, may here also be brought into use.

In the whol course of the disease we must be carefull of the Breast, least a Consump∣tion betide the same, for the Humor offending in this Disease is of a corroding quali∣ty

Chap. 6. Of Compounded or Complicated Feavers, and particularly of a Semi-Tertian.

GAlen in his second Book de Crisib. cap. 7. and 9. and in his second Book de Differ. Feb. Cap. 7. and Avicen. Fen 1. Lib 4. Tract 4. Cap. 16. Do propound many compositions of Feavers. Namely when putrid Feavers are compounded with non-putrid, as when an hectick is joyned with a putrid; or of a putrid with a putrid, which is done many wayes viz. Either con∣tinuall Feavers being complicated with continuall or intermittent with intermitent, or continu∣all with intermitent.

The Composition of two continual Feavers, is a thing controverted among authors, and a man shall hardly observe it in the course of his practice.

An intermitting Feaver or Ague is complicated with another intermittent, either of the same kind, or different: compound intermittents of the same kind are a double and triple Tertian, and a dou∣ble or triple quartan, which have been expounded in their proper places. Of several kinds are when a tertian is compounded with a Quotidian or quartan; which also is very rarely seen in Practice.

Intermittents are complicated with continuals two waies viz. An intermittent tertian with a continual Quotidian, or a Quotidian intermittent with a continual tertian. and each of these is termed a Semi-tertian, constituting Species or sorts thereof.

Yet that is properly and truly a Semi-tertian which is made of an intermitting Tertian and a continual quotidian: and consequently is caused from choller putrefying without and flegm putrefying within the vessels. By Hippocrates and Galen in 1 Epidem. it is named Horrifica, or the shaking Ague because it causes the patient to shake, not only at the first coming of the fit, but in the whol cours of the disease and especially in the beginning and augment, two fits being met and joyned in one, viz: Of the tertian and quotidian Ague, with many reduplications, which are nothing else but unequal shaking and shivering motions, returning divers time in one and the

same Ague Fit, by reason of the mutual fight of the two Feavers; in which, if Flegm overcome, there will follow shiverings, and coldness of the extream parts. And then again, when Choller doth van∣quish, the Body becomes warm, and the Feaver seems to tend towards the vigor; whenas flegm a∣gain getting the better, they are again brought into a cold and shivering condition; and this Con∣tention is wont to last til the Feaver comes to its height. Hence it is that those shaking fits come only every other day, viz. When the fit of the Tertian Ague is upon the Patient, being joyned with the Quotidian.

But while the Quotidian alone is present, there is wont to be no shivering Fit. Yet we must take notice, That there are some Malignant Feavers, which without a commixion of a Tertian and Quo∣tidian, without that same fight of Choller and Flegm, do shake the Patient; in which the Shive∣verings come from sharp Vapors, and malignant, which do arise out of the corrupt Matter of ma∣lignant Feavers, and do beat upon, and pull the sensitive parts, and nip or twitch them as it were.

Now this Semi-Tertian properly so called, is either exquisite, wherein an equal portion of pu∣trefying Choller and Flegm is redundant, such as hath been now described; or it is a bastard Semi-Tertian, which is again two-fold: For either it hath Choller abounding, or Flegm. In the former there are more Symptoms of a Tertian; in the latter of a Quotidian. And so if Choller abound, the whol Feaver is more horrid, and somtimes it hath a shaking fit accompanying the same; also it proves more fervent, and some portion of Choller is voided forth by vomit, stool, or sweat. But when Flegm prevails, a more vehement cold doth possess the extream parts of the Body, and there are few shiverings; and the pulse it more and longer depressed, and the fit is longer before it grow towards its height, and remains in its consistency a long time; yet doth it cause no great thirst, nor burning.

This Feaver is known by what hath been said thereof, being continual, and cold, with many re∣duplications, and very great Symptomes. Because it comes every other day with a shaking cold fit; but upon the even daies it comes only with a coldness in the extream parts of the Body. The Urines are crude, thin, and without color; somtimes troubled, with no Sediment, or that which bodes no good. The Pulse is frequent and unequal. The Differences are known by the Signs of more or less of Choller and Flegm, propounded.

As for the Prognostick of this Feaver, it is a dangerous Disease, and therein the Stomach and Ner∣vous parts are very much affected. And it is attended with dryness of the Tongue, Thirst, Swoo∣ning, Watching, and somtimes with Ravings, and dead Sleeps. Hippocrates reckons it among acute Diseases because of the Choller; and among Chronick Diseases because of the Flegm, in 1. Epidem. And Avicenna saith, That it lasts somtimes seven months, and somtimes ends in Chronick Diseases, and an Hectick.

The Cure of this Feaver is to be taken from what hath been formerly said of the Cure of a Tertian, and a Quotidian Ague; and seeing it is continual, it must be handled with the same Method which was set down in the first Chapter of this Section, as common to all putrid continual Feavers. So that when Choller chiefly bears sway, we must use most of those Simples which respect Choller; and when as flegm prevails, we must principally use such things as do prepare and purge that Humor. And finally, When both Humors are equal, the Remedies proper to each must be used in equal pro∣portion likewise.