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

Chap. 1. Of a Pestilential Feaver.

That Feaver is termed Pestilential, which does afflict Nature not only by a bare distem∣per, or by heat arising from putrefaction, but also with a Maliguant and venemous quality. This is wont to be for the most part Popular and Epidemical; so that many are at the same time sick thereof: yet somtimes it is sporadick or single afflicting but here and there one, which arises from evil Humors that have attained a venemous quality.

It is likewise Contagious, so that it may be caught not only by means of the common Cause, Viz. Corruption of the Air or Diet; but also by Conversing with those that are sick.

It is also commonly called a Malignant Feaver, whereas many diseases are termed Malig∣nant. by reason of their evil and cruel symptomes in which no venemous quality is found, in which alone the essence of a Pestilential disease consists.

In what Feaver soever therefore, this same venemous quality is found, whether it be a di∣ary, an hectick, or a putrid Feaver, it is rightly termed Pestilentiall: although a dairy and hect∣ick are much controverted, touching which consult the Authors.

Now this same venemous quality ariseth from the corruption of Homors, which consists not in a bare change of the temperament, or in ordinary putresaction, such as is found in putrid Feavers; but in a destruction of the whol Nature and Essential substance of the same Humors. As Wine when it is turned an iosipid tastless Liquor, is totally and essentially corrupted; but when it becomes vinegar, it is said simply to putrefie.

And a Pestilentiall Feaver differs from the Plague as a species or sort differs from the genus or kind, because there may be a Pestilence without a Feaver, as Hippocrates hath taught us in his third Epidem, in many places; and also Galen in his Exposition of the said Book. and in his ninth Book, de Medic. Facultatib. Cap. de Terra Samia. And this is sutable to Reason forasmuch as the venemous Quality is not necessarily attended with putrefaction, which is the Cause of a Feaver. For that same venemous qualitie may be produced in the Humors, by a perfect corruption of their substance, and introduction of a new form, of which that vene∣mous qualitie depends. And certain it is, that so oft as a new from is introduced, the former is corrupted; unto which mutations there are requisite preparatorie alterations, but not putrefaction so that Humors may undergo such a corruption without putrefaction; but because the Hu∣mors of our body are very liable to putrefaction, they can rarely undergo so great a corruption, without the Intervention of putrefaction likewise; wherefore those Pestilences are very rare, which are not accompanied with a Feaver: Yea verily and by an intense, profound and for∣did (as they are wont to say) putrefaction, such a Corruption as that of the Plague is wont to

be raised. So, many Feavers, which at first were not pestilentiall, if by the Ignorance of the Physitian or negligence, the disobedience of the Sick, or the fierceness of externall causes, they have been mis-handled, the putrefaction becomeing more intense, they turn in the end to malignant and Pestilentiall Feavers. And that corruption does often precede Putrefaction is collected from such as are infected with the Plague by contagion; in whom a malignant, and venemous qualitie is first transfus'd, and therewith the Humors are corrupted, which corruption is followed by putrefaction, whence it comes to pas that such as have the Pestilence have sometimes no feaver for the first daies of their ilness; but afterwards the Feaver begins to shew it self, when putrefaction is bred; some such things we see in a part that is affected with a Gan∣grene, which is first corrupted, and afterwards puertfied.

A pestilentiall Feaver is caused, when the Humors being corrupted and haveing attained a venemous quality, doe come to putrefie: And so it affects the Heart by those two meanes Viz. By a putrid heat and a malignant qualitie.

Now this corruption of Humors, is not alwaies after one sort, but somtimes it is more intense and somtimes less and according to its divers degrees, the venemous qualitie arising therefrom is more or less pernicious; from whence proceeds the greater or less Malignity of Feavers. And hence arose that common distinction of Pestilential Feavers among Physitians, into a Pestilential feaver simply and properly so called and into a Malignant Feaver; calling that a pestilentiall Feaver properly so termed wherein is the true Plague; having this peculiar, note or character, that more die than live and recover; and calling that simply a malignant Feaver which being less pernicious, more live than die of it.

The differences of a Pestilentiall Feaver are taken either from the matter wherein that venemous Quality is produced; or from the place wherein the said matter is contained: and so they follow the difference of putrid Feavers, which in respect of the matter of putrefing are divided into the Feaver Sunochos, Tertiana, Quartana, and Quotidiana, according as the matter pu∣trefiing it, Blood, Choller, Melancholy, or Flegm. And in respect of the place wherein the Humors putrefie, they are divided into continuall and intermittent; according as the aforesaid Humors are lodged within or without the veines: even so pestilential Feavers, some are termed Synochi, others Tertians, Quartans or Quotidians; some continuall, others intermittent: though Hippocrates hath said in the 43. Aphorism of the 4 Section, That intermitting Feave•• are void of danger however they intermit, which only is to be understood of such as are void of all malignitie; for we see almost ▪every year (in our country at least) tertian intermit∣tent Feavers, which being extreamly malignant, doe at the third or fourth fit kill the pa∣tients: others which bring them into great danger, especially by the crueltie of the Symp∣tomes.

There are other Differences of a pestilential Feaver taken from the intensnes of their degree or Remissness; namly, as some ate greater, other lesser, some partake of greater malignitie some of lesser. They are said to be simply greater or lesser, according as the Putrefaction is greater or less, or as the preternatural Heat ariseing therefrom, is more intense or remiss; more ma∣lignant or benignant, according to the greater or less intension of the venemous quality Hence it comes to pass, that sometimes a pestilentiall Feaver hath extream putrefaction, and malignancy at the highest; and then it is wont to be most fierce, and therein in regard of the malig∣nancy the vital faculty is exceedingly afflicted; and in regard of the extream putrefaction, the other faculties are likewise hurt, and cruell symptoms follow thereupon. But sometimes in this Feaver the putrefaction is very high, and the malignant qualitie remiss; and then the Feaver is trouble-som by reason of the putrefaction; but the vital faculty is less afflicted. Contrarilie somtimes Putre∣faction is little, but the malignant quality intense: and then the Feaver in regard of putrefaction shews no such bad symptoms & seems remiss; yet the strength of the patient is more than ordina∣rily weakned. For somtimes the putrefaction is so remiss that it is in a manner none at all; but the malignant quality in a very high degree: and then we have a Feaver, which seems neither to the Pa∣tient nor by standers any thing troublesom; but it seems at first sight mild, as mild can be, when as indeed and intruth it is very mortall; for when the malignant qualitie is increased, the patients strength is dejected, and the Heart wholly overwhelmed: and this kind of Feaver doth not only deceive the Patients and by-standers, but somtimes the Physitians themselves are thereby cheated; whiles there being no sign present either by crudity or pravity of Humors, the Pulse being in a manner in it's natural state, and the heat of the Body at first appearance seeming mild and gentle, it leads unto destruction. Som such thing is likewise wont to happen in the first difference, viz. When it is joyned with the highest degree of malignity: for putre∣faction being by convenient medicaments subdued, and the signes of recovery appearing; death notwithstanding somtimes ensues by reason the malignant quality did remaine uncorrected.

And finally the differences of a Pestilent Feaver are taken from its adjuncts, and they are very

many and most evident, for there is no evil symptom, nor kind of deadly disease which is not somtimes joyned with this Feaver. The symptomes are Head-ach, Watchings, Raveings, Dead sleepes, Thirst, Stomach-Sickness, and Vomiting, want of Appetite, Swooning▪ Fainting, Hiccoughing, Unquietness Loosness, Sweats and such like, which are common also to other kind of Feavers.

But there is one Symptom proper and peculiar to a pestilential Feaver, which doth not happen in other Feavers; viz. Purple Specks, or Spots on the whol Body, but especially in the Loyns, the breast and back, like unto Flea-bitings for the most part; which the Italian Physitians name Peti∣culae or Petechiae; and these Feavers which have these Symptoms, are commonly named Purpura∣tae or Petechialis, Purple or Spotted Feavers. For these Purple Spots do not appear in all Pesti∣lential Feavers; but when they appear, they are a most certain Sign of a pestilential Feaver. Now we call them Purple Spots, because they are for the most part of a Purple colour. Yet they are ma∣ny times of a violet colour, Green, blewish, or black, and then they are far worse, and do signifie greater Malignity. And although these Spots are for the most part like Flea-bi••ings: yet they ap∣pear somwhat greater: So as to represent those black and blew marks which remain after whipping, and then they are worse. And somtimes they are very large, and possess whol Members, and a great part of the body; viz. the Arms, Thighs, and back, and then the parts appear tainted with redness; which in few hours oftentimes vanisheth away, and then returns again, as it were by Fits, whilst the Feaver undergoes it's Fits, or Exacerbations; wherein the blood boiling, doth send forth it's thinner Exhalations to the surface of the Skin, by which the Skin is not swelled; but only infected with a red Color. Oftentimes notwithstanding, by these Ebullitions, the Skin is in divers parts puffed up with a certain redness: and makes certain broad and soft tumors in the Skin, which in a few hours vanish away, and are commonly called Ebullitions of the blood. In these, and the afore∣said, there is alwaies some Malignity, but so light, that it threatens no danger; unless in the pro∣gress of the Disease it prove more intense. Now the Spots aforesaid like to Flea-bitings, do differ from those Pushes, which are wont also somtimes to appear in these Feavers, and are mentioned by Hippocrates in Epidemiis, which have an Head, and are a kind of Tumors, which come somtimes to Suppuration, or Exulceration. But the Purple Spots, have (as was said) no eminence or Head, and were unknown to the Antients, being described only by later Physitians of after Ages.

As to those Diseases which are joyned to a Pestilential Feaver, we may affirm what hath been said of the Sym ptoms; viz. that many deadly Diseases are joyned with these Feavers; namely, Phren∣sies, Squ•• i••es, Pleurisies, Inflamations of the Lungs, Inflamations of the Liver, bloody Fluxes, and very many more. But the chief Diseases which shew themselves in a Pestilential Feaver, are two, viz. a Pestilent Bubo, and a Carbuncle, which declare the venemous quality to be in the highest degree, and are not found but in the true Pestilence, and are wont commonly to accompany the same: So that the common People call them by the very name of the Pestilence.

The Causes of Pestilential Feavers, are some Internal, others External: and the Internal are some Immediate, others Mediate.

The Immediate Cause of this Disease, as we hinted before, is a corruption of the Humors, joy∣ned with putrefaction. From the Corruption they acquire an evil and venemous Quality and from Putrefaction the Feaver is bred.

The Mediate Causes are a Plethory, Cacochymie, and Obstructions. Now we understand such a Plethory, or fulness of Blood; not as distends the Vessels, but such at least as the strength of the Patient cannot master, which not being regulated by Nature, doth easily undergo Corruption, and Putrefaction. Now a Cacochymie, or abundance of evil Humors, is easily corrupted and putre∣fied. Finally, Obstructions are apt to breed all kind of Feavers: forasmuch as Humors being close shut up in an hot and moist place, wanting free transpiration, do casily putrefie. The Internal Mediate Causes, are by Authors commonly called Morbosus Apparatus, a sickly Disposition of Bo∣dy; and the efficacy thereof is so great, that it alone is somtimes sufficient to produce a gentle Pesti∣lential Feaver, such as is commonly called a Malignant Feaver simply, or a Purple Feaver, without the Intervention of any External or common Cause. For we oft-times see, when the year is not Pe∣stilential, and there is no Epidemical sickness abroad, some persons through the evil Condition of their Humors, fall into such Feavers, which are accompanied with many Symptoms of Malignancy; yea, and with other Purple spots.

Concerning the point of Obstruction, we must observe, that it doth necessarily concur as the principal Cause in Malignant Feavers, which proceed from Internal Causes, and are not Epidemical: but that Epidemical Feavers▪ which proceed from a common Cause; viz. A Pestilent constitution of the Air, or are gotten by Contagion, have not necessarily any Obstructions for their Cause. For the venemous quality is received only by breathing in the corrupt Air, or only by Infection from o∣thers, by which venemous Quality the Humors of the Body, declining from their own proper Na∣ture, do of their own accord putrefie. For even as Fruits that will not keep, and other things ap••

to corrupt, though they have never so much freedom of the Air, yet cannot be preserved from Corrup∣tion: Even so the Humors, when they have conceived that pernitious Quality, are apt to Corrup-tion: so that though there be no Obstruction present, they necessarily fall into a Putrefaction, and a Feaver. Howbeit, Putrefaction being by this means brought into the Humors, when Nature doth no longer rule them, they are wont for the most part to breed Obstructions, whereby the Fea∣ver is augmented; so that in these Feavers Obstructions may Concur, which though in the begin∣ning they were not the Cause of the Feaver, yet do they follow the same, being cherished by the Causes of the Feaver, and being infected with Pestilential Venom.

The External Causes of Pestilential Feavers, are the six Non-natural things, which as they are necessary, so do they necessarily alter our bodies: and when they are far departed from their Natu∣ral condition, they breed in us Malignant and venemous Qualities. Among these, the Air holds the chief place: which as it is a most common Cause, so Diseases that are common doth for the most part proceed from some fault thereof.

Now the Air becomes vitious and hurtful to men, for the most part by a threefold means. First, If it be not blown through with wholsom Winds. Secondly, If it be polluted with the Infection of putrid and stinking Exhalations. Thirdly, If by an excess or preposterous condition of the first Qualities, it doth so alter Men, that thereby evil and malignant putrefactions of the Humors be in∣gendred.

The first is evident enough. For if the Air be not blown through, and stirred with Winds, it is easily corrupted. Whence Hippocrates in the 3. Epidem. Describing a most grievous Pestilential con∣stitution, saith; This year had no Winds.

And the Second is most effectual and frequent, viz. When Putrid, Filthy, and malignant vapors are mingled with the Air, and do infect the same, which is wont to arise from divers things, viz. Lakes, Pooles, Fi••h-ponds, and other quiet and still Waters, or such as are full of mud, or wherein Flax, or Hemp have been steeped. Or from the stink of Privies, Dung-hils, and nasty Allies. Or from the unburied bodies of such as have bin slain in battle. Or out of Dens or Caves or Caves (wherein the Air having been longshut up, hath gained a filthy putrefaction) being opened by an Earth-quake, or some other ••asualtie.

But the third Reason, which consists in the Excess, Inequality, or Preposterous condition of the first Qualities, may happen divers waies, and especially when there is a great excess of Heat and moisture. For those Qualities, when they are extranious and adventitious, and encreased above their Natural condition, they are the principles of putrefactions. Hence a Southern Wind lasting long in the Seasons of the year, according to Hippocrates in Epidem. was the principal cause, of all Pestilential Feavers there described.

But a dry Constitution of the Air, though in the Opinion of Hippocrates, it's more wholsom than a moist; yet because excess of Qualities, is hurtful to our Nature; certain it is that a very dry Constitution of the Air, more than ordinary, doth produce Pestilential Feavers; especially if it be joyned with Excessive Heat. A cleer example wherof we have in Livy in the first Book of his Histo∣ry Decad. 4. viz. How by over great dryness, a Pestilence happened at Rome, because there had been little or no Rain that year: neither was there scarcity of Water from Heaven alone; but the Earth was scarce able to continue her Springs. Now this dry Constitution doth therefore Cause the Pesti∣lence, because the Humors being above measure burnt & dried up, degenerate into the Matter of Biles, Carbuncles, and consequently of a Pestilential Feaver; and being very much thickned, they produce grievous Obstructions; wherby in a matter otherwise wel disposed therunto, Malignant putrefaction is easily bred. Add hereunto, That this immoderate dri••ess of the air, doth corrupt the Corn, hindring it from attaining its due maturity. For it brings the Corn sooner out of the Earth, and it gives it at first plentiful nourishment, and afterward Scanty, whereby the Corn is unequally digested, being Burnt without, but within qui••e Raw; like Flesh scorched with an over violent Fire: and so it proves a Cause of indigestion, and divers Crudities.

It is proved also from Hippocrates, That immoderate Cold doth produce a Pestilence 1. Epi∣dem. Sect. 5. tempest. 1. where he saith. In the Country of Thasus, a little before the appearance of Arcturus (a Star or Constellation) and whilst He appears, the North Wind blowing, there are ma∣ny and great Rains. In which places he fetches the Cause of a Pestilential Season, from over great Coldness. Also we may read in Livy Lib. 5. Decad. 1. That a Pestilential Season was caused by vehement Cold; in these Words. The year was remarkable for a Cold, and Snowy Winter, so that the Wayes were stopped up, and the River Tyber was unnavigable. So sad a Winter was follow∣ed by a grievous and Pestilential Summer, Mortal to all kind of Living-Creatures; whether i•• were occasioned, by the sudden change of the Air from one extream to another, or by some other means. And the reason of this Accident is at hand, viz. That by reason the Pores of the Skin are closed up by the extream Cold, so that the vapors cannot steem forth so as naturally they should, there follows the greater putrefaction, and more grievous poison; whereupon follows more dange∣rous

feavers, than in the Summer, in which the condition of the air, although in some sort it gives beginning to the Disease, yet doth it make the pores and passages wider, Through which that which putrified does exhale, and the natural and preternatural evaporations doe readily breath out.

Inequality of the Season is wont also to be the Cause of this kind of Feavers; viz. when it is sometimes Hot, sometimes Cold; sometimes wet, sometimes dry in a short time; or when these various seasons doe endure longer one after another. As when after long vehement Hot weath••••, a freezing cold claps in, or after long rains, an extream drought steales upon us, or contrary∣wise. Or when after a preposterous fashion, it is hot in Winter and cold in Summer. Now these inequalities of Seasons may help the production of Pestilential Feavers; because in them, the humors are exceedingly disturbed, by which means they arrive unto an evill condition, far from their natural stare and fit to produce malignant Diseases especially in those bodies which du∣ring the Course of the Seasons aforesaid, by disorderly Course of Diet and liveing, have con∣tracted either a Plethory a Cacochymy or some notable obstructions.

To this kind of Causes may be added the malignant Influence of the Constellations, which by changeing the Ayr, are wont diversly to affect the Bodies of Liveing Creatures. Such they say are, the Conjunction of the superior Planets, Saturu, Jupiter, and Mars, in humane Signes, such as Ʋirgo and Gemini, and especially when Mars is Lord. Which do bring Diseases in otherwise they by change of the Ayr, so far as to corrupt the Nature and substance thereof. And that change is wrought two waies; and is by the manifest qualities, as when by the Influence of the Stars the ayr is so long and so far changed by excess of the first qualities of Heat, Moisture, Cold and Dryness, that at length it's proper Substance becomes vitrated the other is by occult quali∣ties, when by the secret power of the Stars, without any notable excess of the first qualities the substance of the ayr is so changed, that it receives a certain degree of corruption contrary to our Life. Touching the first, no man doubts, seeing it is clear by Common Consent of Phylosophers that inferior Bodies are governed by the Heavenly Constellations. And as the alterations of the Ayr, which happen in the four seasons of the yeer, do arise from the yeerly motion of the Sun: so the great diversity of yeers, whereby one proves very moist, another exceeding dry the Sun holding every yeer the same Course in the Zodiack; can depend on nothing, but the various aspects of the Constellations. The other way because it is occult, is not so freely granted by all. How be it by common Consent of Astrologers, it is held for certain, that the Stars do act upon inferior Bodies in a three-fold manner, viz. by their Motion, Light, and Influence The light and beat do alter these Sublunary Bodies according to the first qualities and especially Heat. But the Influences doe induce both the first qualities for example the cold which Saturn causes, cannot depend upon his Motion nor his Light) and also the hidden and occult ones. For seeing Pestilential Diseases doe ostentimes happen, no great mutation being made in the ayr in regard of the first qualities; but when they rag••, the 〈◊〉〈◊〉 app••ares exceeding pure, and puret sometimes, than it is wont to do when there is no pestilence stirring; neither have very hot and moist seasons preceded, from which great putrefactions are wont to arise, it to be coniectured, that these pestilential Diseases doe arise from some malignant Influence of the Stars. Ad•• hereun∣to, that Pestilences are wont to rage even in the depth of Winter, which no remarkeable alteration of the first qualities hath preceded. For in such a Case▪ these diseases are to be attributed to the hidden power of the Starrs which have (as Astrologers teach) a power of corrupting the Air; no ex∣traordinary mutation of the first qualities being made therein. And this is that divine prin∣ciple in diseases, which Hippocrates acknowledged, and according to the Exposition of Gal∣en is in the Air, but is produced by the Celestial Bodies and hidden causes. It is also hint∣ed at by the same Hippocrates, in the second Epidem. Sect. one. When he saies. The time and the Diseases doe answer one another, unles some innovation happen in the Superior Pow∣ers

Neither does that hinder which is brought as the opinion of Plato, out of his Epinomis, that the Course of the Heavens and heavenly Bodies have alwayes good influence here below, and from them nothing but preservation and benefit doe flow. And Aristotle in the ninth of his Metaphisicks Chap. 10. Saies that in those Bodies which are eternall and aethereal, neither error nor corruption is found. And Averrhoes saies in his 1 De Caelo. cap. 24. The Hea∣venly Bodies doe containe the Elements, preserve them, and universally are unto them instead of a form. whence it's collected, they cannot infect them with a poysonous and malignant qualitie. Ad hereunto that if pestilential diseases should be raised by influence of the Starrs, they would at one and the same time in••ect the whol World almost, seeing those influxes are universal causes, and by the circulation of the Heavenly Bodies, doe affect all the quarters of the World. But these diseases doe peculiarly invade som one Region onely. And finally if the

Stars were said to be malefick and of an evil disposition; God the Author of them would be account∣ed the cause of Mischief, which is full of Impiety. These objections, I say, doe not a whit pre∣judice the truth propounded, which may thus be answered. All created substances are con∣sidered two waies; either as they are things in being and do concur to the compleating and per∣fection of the Universe, and in that respect, they are all good: for to be and to be good are one and the same, neither hath the High God blessed for ever created any thing which ought to be termed evil, simply considered. or they are considered in regard of their operations, and then they may be termed evil, forasmuch as they may damnefie some other things by reason of the anti∣pathy & inbred Enmity of Nature. And although almost innumerable contrarietyes of nature are found in the world, yet must they al be termed good in respect to God their maker, & in regard of the Univers, whose perfection consists chiefly in variety. Furthermore the operations of things created, may be termed evil two wayes absolutely or simply considered in themselves, or in respect of somwhat else; They are absolutely evil when at all times, in all places and upon all occasions they doe perpetually evil; and in this sense no Creature can be found which is evil; in respect of some other thing, the operations of things may be termed evil when they hurt one and doe another good; and so there is nothing in the whol universe so hurtful, but that it hath some other ways its uses & benefits, for which it was created: So al poysons though most hurt∣ful to men or other Animals, yet conveniently us'd they doe a great deal of good to them. And in the Art of Physick there is scarce so deadly a poyson found, but that out of it, by skil of Art, an health∣full medicine may be drawn. And finally the actions of Stars upon these inferior Bodies are considered two waies, either in respect of the whol sublunarie world containing the Elements and al mixed things: and so the action of the Heavens and Stars is simply benign, ingendering, con∣serveing, vivifieing all things, & doing al other good offices which tend to uphold the univers; & in this sence most true it is, that these inferior Bodies are cherished & susteined by the influence of the Heaven and Hevenly Bodies, or they are considered in respect of the proper nature of this or that Element, or this or that living creature: and then it is no absurd••••••e to say that there are some influences hurtfull to som Element or living Creature in such or such a part •••• and so affected which depends not of any fault of the stars (for they are of a most perfect nature) but rather of the imperfection of sublunary things which cannot suffer any consider••ble mutation without the corruption of their proper substance: now these divers natures and qualities of the stars, produced in sublunary Bodies by their divers concourse and influence were ordained by the great Architect of this universe, for the Conservation of the whol world which being 〈◊〉〈◊〉 up of so divers and so contrary natures, had need of as g eat variety in the influence of the Stars, that all things might be preserved, as it were in an even balance out of which diversity of in∣fluences notwithstanding, it could hardly come to pass but that som parcel of things so diffe∣rent should sometiems suffer, not in any whol kind o•• sort (which should tend to the destruction of the universe) but only in some individuals that were less able to resist and for the most part misaffecred, and only in some part of the Air more disposed to receive malignant influences. From whence we may conclude, that those corruptions doe chiefly depend upon the defect of sublunary bodies forasmuch as many places are in the world, where the air is so perfectly constituted and the inhabitants ••o evenly tempered, that let never so malignant Influences of Starrs show•• upon them, yet are they never infected whith other pestilence.

To the same kind of Causes must we refer the Defects and Eclipses of Sun and Moon, unusual Meteors and especially Blazing Stars: which are never wont to appear but that Epidemical and Pe∣stilential Sicknesses, and Divers changes in the World do follow, as is Consirmed by the experiments of many Histories: whence that usually Cited verse of Claudian is become as a Proverb.

In Caelo nunquam Spectatum impune Cometam.

A blazing Star does not appear. But some Beholders plagued are.

A most evident witnes whereof was that hairy Comet which appeared Anno 1618. Towards the East on the 27 of November and was afterwards seen near upon the whol Moneth of December, moving and shining. It's thicker and more solid part being turned towards the Sun, did behold the East, and did far exceed Ʋenus, both in the clearnes of its shining, and in its largnes, thickly com∣pacted and conglobated together. The remaining part, being more thin, and less enlightened by the Sun, because of its thinnes did move like fairly spred beard and stretched towards the West. This Comet first appeared under the sign of Libra nere the Aequinoctial Line; but by a private and peculiar motion of its own, it was carryed from thence, through the feet of Ʋirgo, the middle of Bootes and the tail of the greater Bear. And at length, its light decreasing by little and little and the matter whereof it consisted being dissipated, it vanished betwen the great Bear and the Dragon.

It was carried with the common motion of the Stars from East to West, but it seemed to be moved som what swifter than the Stars, for in the first Daies of its Apparition, it was wont to rise a little before five in the morning; and afterwards it rose about four a Clock and before four, and so sooner and sooner, till it prevented the Midnight, and Bed-time. And we have reason to believe, that this Comet was the Prognostick and sorerunner of malignant and pestilential Diseases, and also of those Wars, wherewith whole Europe in a manner, hath since that time been laid Wast.

And although the Air be chief among the mediate Causes of malignant and pestilential Feavers: yet sure enough other non-natural things do concur to their generation, as I shall particularly and berifly declare.

The next to air are Aliments, because bad Diet Causth a sickly disposition of the body, which is an internal efficient, and Causasine qua non, or malignant and Pestilential Feavers. Whereupon Galen in his Book De Cibis boni et mali Succi, and in the 1. de Differ. Feb. Chap. 3. Does demonstrate, that from bad and corrupt Diet Pestilential Diseases do arise. Now meats are said to be evil and the Causes of those diseases in many respects.

And in the first place, when the Fruits of the Earth and of Trees, by reason of a bad constitution of the year viz. Over moist or over dry, or corrupted by mists, or some tempestuous weather, or some malignant influence of the stars; do, being eaten, produce bad Juices in the body.

Secondly, when there is great Famine and scarcity of Corn: From whence came that Proverb Ho loimos meta limon, the Plague follows famine. For then the poor common People are forced to fill their bellies with such meats as are cheap and bad, whence arises abundance of bad Humors. And which is much worse, when a plenty presently followes famine, they do then suddenly cram themselves with much meat, which by the languishing heat of their internal parts cannot be well digested, and thereupon those meats come to participate of a malignant putrefaction.

Thirdly, VVhen Aliments, which in their own Nature are good do by some way or other, gain putrefaction or some evil qualitie, such are wheat, barly, beans, and pease, and other kind of grain, which being either overlong kept, or ill laid up in a moist place, or otherwise misaffected, do come to be musty, or have some other putrefactive qualitie. Such is flesh over long kept, or stinking or such as is of beasts that were not killed, but died of some disease: as Julius Obsequens relates, that in the Isle called Lipara when the Sea was made hot, the fires which by meanes of an Earth-quake were forcibly vomited out of the Mount Aetina, and had boiled the Fishes casting them upon the sho•••••• the Inhabitants eating greedily of those Fishes, a sore Pestilence followed.

Neither is there less power in drinks, when putrid and corrupted wines or beer or other liquors are drunk; or when water is drunk out of putrid and muddy Lakes, or otherwaies infected. As good Histories do ••••sti••ie that numerous Armies, have been destroied by pestilential Diseases, with drinking such waters.

These non-natural things mentioned viz. Ayr and Meates and drinks, have the greatest force to engender malignant Feavers. but the four remaining viz. things voided or retained Motion and Rest Sleep and waking, with Pamons of the Mind, are of less efficacy, and do only concur as adjuvaut Causes, or such as dispose the body to conceive a malignant pucrefaction; as in our exposition of them shal pre••ently app••ar.

The ••••tention of Courses in women, or of some other accustomed evacuation Men, as of the Hemorrhoides, blee••••ing at nose, and Loosenes, which betides some persons, at certain seasons; when they happen in a pestilential year, they are wont to produce a malignant disease. For those things which are wont to be avoided as superfluous and burdensome to Nature, if they be retained in the body, they do easily conceive putrefaction so likewise over great evacuations either of blood or other humors, do much weaken the Body, and do Cause that Natural Heat being weakned, it is soon infected by the vitious and pestilential impurities of the Air.

As for motion and rest, certain it is, that overmuch Idleness is a Cause, that Natural heat is not sufficiently e••entilated, and consequently the Humors conceive putrefaction: so over great exercise does very much open the pores, and dissolves the Heat; whereupon the body becoming weak and more apt to take impression, does easily receive the Infection.

And too much sleep, makes many Excrements and fils the body with Humidities, which easily putrefie, but too much watching does engender Crudities, and they easily putresie, because Natural Heat cannot wel master them: and because by them, many obstructions are caused, by which Tran∣spiration is prohibited, and at length putrefaction engendred.

And finaly, passions of the Mind, are wont vehemently to exagitate the body and to disturb the humors: and so they much Dispose the body to receive infection; and especially fear and Sadnes which Drawing the vital Spirits inward, do as it were choak and smother them, whereby the vigor of the Heart is so broken, that it cannot sufficienly resist the venom and first assaults of pestilential Sicknesses, yea verily and the Humors being stirred in the veines and vehemently disturbed, are thrust out of their Natural constitution, and do conceive a malignant putrefaction. Insomuch that

some have conceived, that Pestilential Diseases are bred in Camps and at Sieges of Towns, not so much through bad Diet and stink of dead Carcases, as through Terror, Fear, Anxiety and dread of Death, which do exagitate the Humors, and put them into a tumultuary Combustion and Fluctuation.

The Signs of a pestilential Feaver do some of them foretel the disease when it is coming; others declare it to be present; and others witnes where it has bin. All which must be set down, because the first tend to Preservation, the second to Cure, and the third sort to be a Caveat to such as are not yet infected.

The Signs which foreshow a pestilential Feaver, are taken from three things viz. From the the Disposition of the Body, from the Presence of Causes, and from some intermediate dispositions.

Those bodies are disposed to receive pestilential Infection, which have collected evil Juyces through bad diet, and by a preposterous use of the six non-natural things aforesaid. Or such as being ple∣thorick do gorge themselves and inordinately and unseasonably replenish themselves. Furthermore some that are neither plethorick nor cacochymical, do dispose their bodies to the reception of this disease, while they torment their minds with most troublesome passions, or give themselves im∣moderately to carnal embracements; for from these two Causes, the pestilential feaver is very or∣dinarily produced, forasmuch as by them corruption is easily introduced even am••ngst good humors for Passions of the Mind do distract and draw away the spirits, from their proper operations and overmuch Carnal embracement, does weaken al the powers of the body▪ but, the Spirits being distracted, and the vertues weakened, the Humorrs change their Nature, and grow corrupt.

Finally, those whose principal Members are weak, or some waies tainted, either from the womb, or by bad diet or any other external Cause; which have an hot and moist temperature; which have a very thin or very compacted habit of body, are al disposed to pestilential Feavers, for hot and moist bodies are subject to putrefaction, thin bodies are liable to al 〈◊〉〈◊〉, compacted constitutions, have no free transpiration.

The presence of such Causes as can breed a pestilential feaver do portend the same: and conse∣quently il seasons and unnatural temper of the year, Dearth, and Scarcity of Victuals, Wars and other Causes, reckoned up before, when they appear, they declare the Plague to •••• approach∣ing.

Those intermediate dispositions are, when such a disposition o•• body and the Causes aforesaid being present, wee see a Man more ••ad than ordinary, an unexplicable fear in him without good ground or cause, the Colour of the face changed; is not rightly disposed in point of die; is disturbed with bad dreames; infested with wearines which comes without labor, thirst, watchings, stomach∣sickne••; it is easily conjectured, that man wil have the Pesttilence: for al there thing do declare, that the humors do attain another nature, and do corrupt▪ from whence comes a pestilential Feaver.

Such Signs as declare the Pestilence to be present are exactly to be propounded and therefore al the Heads of Signs must be run over out of which this Disease may be known▪ which Heads of signs, are taken from the three kinds of symptomes, because the symptomes are the Effects of Diseases, and Causes can no way so conveniently be known as by their effects. And therefore, some signes are taken from the Actions hurt, some from Excrements voided, and others from qua∣lites changed. Unto which Heads a fourth must be added taken from supervenient Infirmites. To the right understanding of which, these things following must be premised.

Frist, we must know that the same signs in a manner doe shew a pestilental Feaver properly so called, and a Feaver simply malignant, and that the signes of the one and the other doe differ on∣ly according to more and le••s; so that in the pestilential Feaver the symptoms are more, and in the malignant Feaver less cruel; yet there are some adjuncts more proper to the one than the other which we shall declare in their proper place.

Secondly, we must note, that there is no true, proper and Pathognomonick sign of these Feavers viz. Such an one as wherever that signe is, there is the pestilence, and where that sign is not, there is no pestilence; no not the Bubo or swelling in the Groyn nor the Carbuncle; seeing that many have them not though they have the plague, and many have Buboes and Carbuncles that have no malignitie in them: neither are those purple spots any such pathognomonick sign, although a malignant Feaver is from them termed the spotted Feaver, forasmuch as many have a malignant Feaver without any such spots; & those spots doe sometimes appear on women that want, their courses, and in some Children by reason of a light ebullition of ••lood, without any Feaver, which I have often seen in both. Howbeit by a Concurrency and collection of all signes and tokens these Feavers may certainly be known,

Thirdly, we must mark, that al the signs which shall be propounded, are not found in al sick persons of these Feavers; but only a part of them, which notwithstanding will be sufficient, punctually to discover the kind of the disease. For according to the variety of patients bodies

& the intention or remisnes of the disease, now these kind of symptomes, & anon those do; chiefly shew themselves.

Finally, it must be known, that the signs of a pestilential and malignant Feaver (although they are also found in other Feavers) yet are made in some sort pathognomonick in this Feaver in a two-fold respect. First, because in these Feavers, they are so conditioned as in other Fea∣vers they are not. For the Head-ach, Ilness at Stomach, Vomiting, the manner of the Heat and other signs, when they accompanie pestilential Feavers, they have a peculiar malignant condition whereby they differ from themselves when they accompanie other ordinarie Feavers; which is wel known to them that are but indifferently exercised in the Practice of Physick. Se∣condly, because the symptomes do not observe the same proportion among themselves in these Feavers, which they doe in ordinarie ones. So that the heat being gentle to the touch, the pulse not much changed, doe shew a smal Feaver: yet with them is joyned mighty Head-ach, wat∣chings and somtimes raveings, and other symptoms which are wont to accompanie a burning Fea∣ver. These things being thus premised, we shal decribe the order of signs, beginning from the actions hindered.

Because therefore, the Heart is cheifly afflicted in these diseases, by the malignant and vene∣mous quality thereof, therefore its action viz. The Pulse, is diversly changed, according to the varietie of times and the divers condition of the diseas••▪ For somtimes at the first, it is in a manner natural, and very like the pulse of persons in health, as Galen shews in the 3 de presag. cap. 4. but in the progress and augmentation of the disease, it is little, weak and unequall. Al∣so the frequentness of the pulse is alwayes more than the increas of heat can require, because the Heart being provoked by the malignant qualitie, doth in that regard disturb it self more than the necessity of eventilation doth require. Likewise the signs of this Feaver are.

Cardialgia, Heart burning or pain of the mouth of the stomach, which Hippocrates condemns as a sign of malignity 1. Progn. in these words, Pam of the mouth of the stomach, with distention of the Hypochondria and Head-ach, are signs of malignity.

Somtimes great thirst, exceeding the measure of the Patients heat and somtimes want of thirst, with a vehement Feaver, and dryness of the Tongue, for both are signs of maligni∣ty

Great want of appetite which make many abhor al kinds of meat, as much as if they were the most loathsom medicines. Now this is wont to arise from malignant vapors which vex the sto∣mach.

Stomach Sickness and vomiting arising from the same Cause, especially when it happens in the beginning of the disease, and is so divers that some presently vomit what they eat; other vomits as soon as they have taken broath, but they vomit not the broath which they took, but divers kinds of Humors; some keep any kind of meat, but vomit their Drinks, Iuleps, Emulsions and whatever drinking matter is given them, presently; great thirst notwithstanding remaining, with dryness and blacknes of the tongue.

A frequent and inordinate shivering, which comes divers times in a day, springing from sharp and biting exhalations of an adverse qualitie to our natures, which are carried unto the sensitive parts: which kind of shivering does rarely happen in other putred Feavers, because the vapors in them have not the like malignitie. In malignant intermitting tertians, somtimes a sign of malignitie is taken from the shaking and the cold. For it somtimes happens, that in the beginning of the fit, with a light coldness or shivering, the heat doth so much retire inwards, that the flesh of the patient is very cold and the face is like that of a dead person, and the pulse so little as if it did not beat at al. After which follows an Heat, which neither in the Augment nor in the state, doth to the touch feel great or sharp; yea and the flesh of the patient is either lukewarm to feel to, or coldish even to the decl••nation. The pulse, when the heat comes, doth more appear, yet it is small, unequal, frequent and very weak: and many other symptomes of a pestilential Feaver are present, which may sufficiently prove, that there are intermitting malignant Feavers as well as continual; as was hint∣ed before.

Wearyness of the whol bodie, Heaviness, and a breaking as it were of the members appear in the beginning of the disease, by reason of the foresaid vapors, dispersed through the whol Bo∣dy

Paines of the Head, Watchings and Raveings, which al come from the same causes, viz. from sharp and venemous vapors; which when they lodg themselves in the membranes of the Brain, they cause head-ach and in as much as they heat and dry the very substance of the brain, if the alteration be but small, they cause watchings, if great they cause ravings. And to these symp∣tomes, besides Heat and Dryness, the venemous quality contributes much, because in the vulgar Feavers such symptoms do not happen, unless the distemper be much more than ordinarie. And paines in this Feaver, have a peculiar property to be very diverse, & to shift places. For somtimes only

the fore part of the head, otherwhiles the hinder part, now the forehead, anon the eyebrowes are cu••a••under as it were with pam, and sometimes other parts as the shoulder-blades, the sides, the back, &c. Somtimes it is fixed in one part, otherwhiles it changeth place and vexes now this, now that part of the body.

In some patients drousie and sleepie dispositions happen, viz. In such as have their brains ful of flegmatick excrements: which flegmatick excrements, are desolved by hot vapors ascending from the inferior parts, and doe hinder the functions of the Brain.

The urin in these pestilential Feavers, is sometimes like the urin of sound persons, namely when the humors doe more offend through a malignant Qualitie, than by putrefaction; & somtimes it con∣tinues so for the first days; afterwards it becomes thick & troubled. Somtimes in the state of the disease, it appears concoct, though the sick are in a perishing condition. sometimes, it is thin and crude, haveing no sediment, or such a sediment as is more like an excrement than a sediment. But most com∣monly it appears thick and troubled, and of an high colour; and hath a thick, red, distrubed and scattered sediment. And finaly al evil dispositions of urines, doe happen in this disease, accord∣ing to the divers alterations of the putresieing and corrupted Humors.

Chollerick fluxes of the belly, which either comes of themselves or through some like occasions by some gentle Clyster or medicament; which bring many to their end, So Hippocrates re∣lates in 3. Epidem. In a pestilential Constitution there described, that many died of the loosness and Bloody-flux: For the Humors being made more furious by the malignant qualitie which is in them, doe exceedingly provoke Nature, so that she indeavors to drive them out the neerest way: Now in these Stooles, there is wont to be a mighty stink, by reason of the extream cor∣ruption of the humors.

An abundance of Worms is wont to be avoided in this disease, especially at the beginning: For the great Putrefaction doth very much dispose the Humors to breed Worms.

Frequent sweates, small, short and unprofitable doe break forth in the beginning of the dis∣ease.

The Heat is mild and gentle to feel to, so that they searse seem to have a Feaver, whereupon Galen 9. Simp. cap. de Bolo Armen, & Avic. fen 4. lib. 1. cap de febre pestilenti. Doe teach that pestilential Feavers have of••times a mild and gentle Heat; and the reason is, because these diseases are rather caused by a malignant and venemous quality, than of an ordinarie distemper and Pucrefaction.

Readness of the eyes isoften seen in pestilential Feavers, because the membranes of the Brain are in a sort inflamed by sharp vapors ascending into the head, which they easily commu∣nicate to the Tunica adnata or skin of the eyes so called, which is propagated from the said mem∣branes

Finally, purple spots like Flea-bitings, called by later Physitians Peticulos or Petechiae, are the proper and peculiar Signs of a malignant Feaver. For they are found in no other kind of Fea∣ver; forasmuch as they do arise from a vitious quality of the blood or other humors, joyned with malignity. Yet there do appear in other diseases, spots very like unto those aforesaid, but springing from a far different Cause; viz. From the over thinnes of the blood, which being ex∣agitated by the heat or the expulsive faculty, does sprout forth of the Capillary Veins into the Skin. These spots, are wont for the most part to appear in such as have some flux of blood, be∣cause the blood in such is more thin and watry: and also in splenetick persons, in such as have the Jaundise and old obstructions of the Bowels, and (in a word) in al such, who by reason of the weaknes of their Bowels, do breed watry blood and are apt to fal into a Cachexy. For in such persons, the blood being made thinner than ordinary, sometimes flows out at the Nose, somtimes at some other part, and somtimes it comes out of the Capillary Veins into the Skin; where being retained, it losethits own coluor, and becomes either blewish, or black, or light red, and causes great variety of spots; which notwithstanding are very far dif∣ferent from the spots of pestilential feavers, and do argue nothing but the watry thinness of the blood and weakness of the Liver. Now those spots which come out, in Pestilential feavers, do arise from Humors putrefiing and infected with an evil quality. Furthermore, those spots do break out somtimes critically and somtimes Symptomatically. Critically, when as Nature haveing either in Part or in whol overcome the putrefaction and corrected the bad quality, does drive the corrupt humor to the external parts; And then the disease is evermore abated. Symptomatically when Nature is pricked forward by the quantity or evil quality of the morbifick matter, does trans∣mit a portion thereof unto the Skin, before it be concocted, or the evil quality thereof amended. And from thence the Patient receives no Ease, but rather, Nature haveing unprofitably wrastled with the disease, it is a token rather that shee is conquered than conquers.

The Colours of these spots are divers▪ and do show the Diversity of the humors by which they are bred. For the red spots are bred of the purer sort of blood, and the black from chollerick blood more or less adust. As for the store of these spots, somtime they appear in greater numbers and

somtimes in less. They begin to appear somtimes on the fourth, fifth, seventh, or ninth, or some other critical day, if their coming out portend any good; somtimes on other daies, when there is little good to be hoped for thereby. Somtimes they are seen in al parts of the body, but most frequently in the Loynes, brest and Neck.

Now the Diseases which come, upon a pestilential feaver for the most part are, somthing coming out like Pox called Exanthemata; Pushes and Ulcers of the Mouth; Carbuncles; Risings in the Groyn and behind the Ears.

The Exanthemata aforesaid, differ from the purple spots, because in the spots there is only the color changed, but here is a certain rising in these Exanthemata to an head. Somtimes they are like warts, and somtimes less, resembling millet seed. Somtimes they are red, being caused by blood somtimes white, proceeding of flegm or Serosities; yellow from choller; purple from adust Choller; blewish or black, by reason of great burning or Mortification. Some break out Symptomatically, others Critically, others in a middle way. Some dry away, others come to matter, others grow to be ulcerous.

To these may be referred pushes appearing in the Mouth which have al the differences of the forsaid Exanthemata, and are somtimes so malignant, that the sick can hardly endure to eat and drink. From Children they often Cause Death because they wil not endure the pain of eating and drinking. These pushes do somtimes degenerate into Ulcers, which breed very great trouble to the patients, hindering the motion of their tongue and especially their swallowing.

But somtimes Ulcers are bred in the Mouth immediately without any pustules or pushes foregoing which the Greeks cal Aphthe: of which there are many sorts. For some are superficial, others profound; some clean, others foul; some benign, others malignant; some with a Crust, others without. And the Crust is somtimes white, somtimes yellow, somtimes blewish or black. Those which are deep, filthy and malignant and that have a black Crust, are the most dangerous.

Carbuncles and Buboes, are wont to rise in divers parts of the body, but especialy where the Glandules are; because the expulsive faculty being provoked by a malignant quality does expel the pernicious matter from the internal parts especially the more noble ones to the external: so that from the Brain shee sends it to the Glandules or kernels behind the Ears; from the Heart, to the Arm-pits; from the Liver to the Groyns; whence swellings under the Ears called Parotides, & those in the Groyn called Bubones, do arise. Which kinds of tumors do cheifly appear in a true pestilential feaver, especially those in the Groyn, which therefore the common people call the Pest or Plague. But Carbuncles and Parotides orrisings behind the Ears, do also break out in malignant Feavers, but in such as are at the top of malignity, and come very neer the Nature of true Pestilential Feavers.

Signs commemorative, are chiefly in request when Physitians are called to view the Corps of the dead, at ••uch times as there is a Plague abroad, or some suspition thereof, that it may be known whether the party died of the plague or not.

And first of al, in such dead bodies there do somtimes appear those spots of which we spake before and somtimes marks, or stripes, as it were after whipping: for these are the tokens of a Pestilential disease and venemous, seeing those that are poysoned have also these signs. And those spots do especially denote the Pestilence, when they are of a lead Color or black. Also those Exanthe∣mata spoken of before, do shew the same, especially if they have a bad Color: but much more the Buboes, Tarotides and Carbuncles whereunto may be added such signs as have appeared in the Course of the disease: for the recounting of them wil make a certain demonstration.

The Prognostick of Pestilential Feavers is so uncertain, that nothing can be certainly affirmed touching their Event, until certain tokens appear either that Nature or the disease hath gotten victo∣ry; which is not wont to happen, unless about the end of the state or the Beginning of the Decli∣nation. Where the discreet Physitian ought to delay and suspend his Judgment touching the Issue of the disease in the Beginning and the Augment

Wee must nevertheless propound the chief tokens out of which we may draw a great Conjecture, whether the disease wil end in Death or Health, by help whereof we may foresee, what is to be hoped or feared. yet not being over confident: for Experience hath taught us, that many have escaped, with most mortal signs; and others have perished under al the tokens of Recovery. But we shal pass over al such prognostick signs which are common to al acute diseases, of which Hippo∣crates hath discoursed largely in his Prognosticks, Coick, Predictions, Procheticks, and Epidemicks and likewise in his Aphorisms, which may have a place likewise in this disease. But wee wil propound only such as are proper in a special manner to pestilential Feavers, from which a more certain Pre∣diction may be drawn.

Now these may be drawn from the same fountains from whence wee drew the Diagnosticks.

First Therefore, in these Feavers, if the pulse keep a tenor and equality, be the Feaver never so great, it gives alwaies some matter of hopes. Contrarily an inordinate, unequal and contracted pulse, is dangerous, especially if it appear weak from the Beginning. But those differences of

pulses are not so dangerous in malignant Feavers, as in ordinary ones. For although an intermit∣ting pulse in a young man, be so deadly a sign, that Galen testifies, though he had seen many old folks and children escape having an intermitting pulse divers daies and yet escaped. Pulses like those of persons in Health are very dangerous: for they signifie that Nature out of weakness abstains from the Concoction of Humors. For where by an evil and pernicious quality, the strength is exceedingly weakened, Nature being weak, does not set her self to digest the matter, not meedling with the Humor which hath caused the disease: so that no endeavor of coction being used, no labor follows, and there is either no Feaver, or a very little one. Wee have an example hereof in external tumors, in which so long as the Part is almost overwhelmed by the plenty or il condition of the matter, there is neither Pain nor Terror; but whereas Nature begins to fight against the matter and to turn it into quittor then the feaver is much increased. Even so in malignant seavers, the Patients seem somtimes freed from their feaver, whereas they grow worse and draw towards death: as we may see in Hippocrates 3. Epidem. Secti. Aegr. 2. where Hermocrates from the twentieth day to the twenty fourth seemed to have no Feaver, and yet on the twenty sixth he died.

Raving is very common in this Feaver. neither is it to be feared, if it be lessened by sleep, and especi∣ally if it vanish away with a plentyful sweat: for tis a sign that the matter is drawn from the Brain, into the habit of the Body. But a persevering dotage, is pernicious, because it's a token that it de∣generates into a true Phrenzy.

The contractions and hoppings of the Members, which do often happen in this Feaver, are Convusive motions and very pernicious, and that the more if joyned with raveing, for they signifie the brain to be extreamely hurt

Trembling motions of the hands and Tongue are wont to be deadly and are by Hippocrates much condemned in the 1. Prognost. For they shew great weakeness, and that Nature is overcome by the disease.

Deafnes though in the beginnings of occult diseases it be exceeding dangerous, according to the Doctrine of Hippocrates; yet if it appear in the State of a disease it portends health, especially in malignant Feavers. And I have observed a thousand times, that such as being sick of Pestilential Feavers, were taken Deaf in the State of the disease, did al escape, though the other symptomes were never so dangerous; for it is a token that the brain, being sufficiently strong does thrust the humors from the internal to the external parts.

Sneezing, according to Hippocrates, even in deadly diseases (provided the Lungs be in good Case) do give Hope of recovery. But in malignant Feavers, be the symptomes otherwise never so dangerous, they promise Recovery.

Frequent Heart-burnings or Hiccoughings, do portend danger, and signifie that the stomach is grievously afflicted by the venemous quality.

Extream aversness to meat, is very dangerous for it signifies the Stomach to be mastered by the malignant quality of the Humor, and that its temper is wholly overthrown, so that it refuseth and abominates laudable nourishment, which it most familiarly affecteth in time of Health.

Suppression of al evacuations in the beginning and augment of the Disease, is counted a good sign. For it shews that the morbisick matter is not so malignant, as to provoke Nature to excretion before the due time but that Nature does yet conquer, and wil in due time expell the matter, provided there be no sign that the Humor wil settle in the Head, Belly or any principal part. But in the state of the disease for nothing to be evacuated, but for worser signs to appear in some principal mem∣ber; is bad. For it's a sign the disease wil either last long, or give little hope of Life. For the matter which in divers daies could not be overcome, does bring some great dammage in the same member, as a phrenzy, Lethargy, and others which arise after the eleventh of fourteenth day, which can very hardly be cured by al the Medicines imaginable.

Blood that is drawn by Phlebotomie, if it appear no waies faulty, but pure and according to Nature, tis a dangerous token. For it is a plain argument that there is more of a venemous qua∣lity, than of putrefaction; or that putrefaction may lurk in the Veins next the Heart, which cannot be drawn away by Phlebotomy.

From Urines in a Pestilential Feaver, there is scarce any, or a very uncertain prediction to be made. For not only the confused, troubled, thinner, and thicker Urine▪ are bad, as in other Feavers: But also that Urine which is like the Urine of a healthy Person. Yea verily, and many have died, after the Urines have shewed signs of Concoction, and then became crude again.

Howbeit, Concocted Urines, and which have a laudable Enaeorema continuing many daies; and daily more uniting it self▪ and descending by little and little into the bottom of the Urinal, doth perpetualy promise certain recovery, even in malignant Feavers. For it cannot be, that a lusty and strong natural Faculty, which discovers it self plainly in these Urines, should not rise••s against the malignant Quality, and at length overcome the same. And therefore I have oftentimes with great confidence foretold a good event from the signs of Concoction persevering in the Urines

in such as have had malignant Feavers, attended with most grievous Symptoms, so that all the By-standers were in great fear of their Lives.

A Fat and oyly Urine, black or livid, with a black or blewish settling, doth certainly betoken death.

Very much Urine being made, and no abatement of the Feaver thereupon is dangerous, be∣cause it signifies a melting of the Body.

Sweats in this Feaver, although they come well conditioned, and in the Critical day, doth seldom perfectly judge the Disease. And somtimes the Feaver is abated by Sweat on the first day; and then the Symptoms grow high, and after many Sweats the Patient dies. For plentiful Sweats, not diminishing the Disease, doth arise from the melting of the whol Body. Neither must we there∣fore beleeve, that Critical Sweats doth never any good in these Feavers. For by how much less Venom there is in the Disease, they do so much the more good; as it happens in ordinary Fea∣vers. And we find by Observation, that 'tis far the better for the Patients to Sweat often at the beginning of the Disease (provided they be not worse after their Sweats) for 'tis a sign that Na∣ture doth attenuate the Matter by little and little, and expel the same by Sweat.

Loosness of the Belly is a very uncertain sign. For oftentimes a Loosness at the beginning of the Disease hath been good, which yet experience shews, is somtimes a deadly token. Again af∣ter some Coction, we have seen the Patient killed, by a loosness, and somtimes by the same reco∣vered: Yet we must thus distinguish. When a venemous Quality hath the mastery, the more the Matter goes away by Stool at the beginning of the Disease, the less danger. But when the Disease arises most part from putrefaction of the Humors, they are worse that are loose, at the beginning of the Disease.

Purple spots▪ when they are many and large, and of a benign color, and break out Critical∣ly they foretel that Nature wil Conquer. But if they be few, smal, & of a bad color, and are Symp∣tomatically put forth, they signifie that Nature is never worsted. And further, If they go in a∣gain, its the worst sign of all; for it shews that the morbific Matters reflux into the inward parts.

Exanthemata, or wheels appearing in divers parts of the Body, are effects of greater malig∣nity than Purple Spots, and consequently portend greater danger.

Carbuncles and Buboes, or risings in the Groin and some other parts, doth witness greatest ma∣lignity, and threaten most danger: seeing they are wont to follow those Feavers whose peculiar Character it is, that more die of them than recover.

Carbuncles & Buboes, by how much they are the further from the Heart, grow faster and come quicker to ripen, by so much the less dangerous are they. But if Tumors encrease suddenly with bad Symptoms, 'tis ill. Carbuncles very great, of a filthy color, with an eating Ulcer, or which turn into a Grangrene, are deadly: as also those which are neer the Heart, or rise upon the Throat Experience hath taught that many Carbuncles are more dangerous than few; and contrarily many Buboes or other risings are more safe, than few. Perotides (or risings behind the Ears) in ma∣lignant and Purple Feavers, are in the Augment and state deadly. But if they appear when the Disease doth never so little decline and come to Suppuration, they are a good token.

The Cure of a Pestilential Feaver is divided into two parts. The first contains the preser∣vation of those that have it not; the second contains the healing of those that have it.

The preservation from the Pest consists chiefly in taking away of those Causes, which make Bo∣dies fit to receive the Pestilence, and breed it in them. And they are Internal or External; the Internal are a Disposition of the Body apt thereto, a Plethorie, a Cachochimy, and Obstructions. The External are especially, a vitiated Air, and a wandring Contagion. Bodies disposed to this Disease, are such as either Naturally or Accidently, are more moist than they ought to be; Weak lax and rare, dense and compact. Moist bodies must be dryed; drie must be preserved in that temper; the former must avoid full diet, much drinking and all moist nourishments; such as are especially Fruits that wil not keep, Hearbs, Fishes, Meats made of milk; the South air, such as comes from lakes, and especially the air of the night, Idlenes, long Sleep, especially Sleeping after dinners, Batheings and whatever else can moisten the Body.

Let weak bodies be strengthened, with a restorative diet and with strengthening me∣dicaments. Those of a rare lax and thin constitution, need the same waies of prevention with the moist. But the dense and compacted constitution▪ because it is most of al disposed to a pes∣tile••••ial disease must more carefully be freed from a plethorie, Cacochymie and from obstruction; which causes, seeing in all bodies they may breed this kind of Feaver, as internall causes, we m••st perpetually studie their removal.

A Plethory requires Phlebotimy provided nothing do advise the contrary, as a very cold or hot season of the year, and a pestilential Constitution of the Ayr in which a vein must not be open∣ed,

unless a Plethora ad vasa do manifestly urge the same; or some usual evacuations of blood by courses, hemorrhoids, or nose-bleeding, have been stopped. For the blood being ex∣haust the air which is breathed in will more easily imprint it's pestilential qualitie, and in case the disease happen, the Patient will the hardlier escape, for being weakened by blood-leting even as they who drink poison after blood letting, it penetrates the more and they are with more difficulty recovered. Also when we fear poyson, we let not the patient blood, so Galen Lib. 7. de diff. Feb. Cap. 4. Where he propoundes a preservation from a pestilential Feaver, he pre∣scribes indeed Purgation and opening of obstructions; but he makes no mention of Phleboto∣my

To Cacochymy we must oppose purgeing, such as is proper for the bumors offending, con∣venient preparation being premised if it seem necessary: with this caution, that benign medica∣ments be only used, abstaining from such as have a malignant and deadly qualitie. with which it will be good to mix some Bezoarticks and such things as are Alexipharmical.

Obstructions are caused by the multitude of humors their thickness and clamminess. The multitude will be helped by such urin as evacuates the thickness; by such as attenuate the cla m∣miness by things that are abstersive or clensing.

In respect of externall causes, Precaution must be made first by correcting the excesses of the air viz. By cooling that which is too hot, as we taught in continual Feavers; by drying that which is over moist, with sires both in streets & in private houses, and that as much as may be made with sweet woods as Juniper, Bayes, Rosemary and such like. Secondly by removing al the caus∣es above recited which do infect the air. Thirdly by consuming and dissipating the infections in the air. which may be don by kindeling of fires, as was said in correcting the moisture of the air, and the perfumes of sweet smelling and Alexipharmical materials. Also by vehement agitation of the ayr, to which end the frequent discharging of great Guns will be very ef∣fectuall.

But if the ayr shal be very much infected, so as therefrom a Feaver truly pestilential shal arise, the best kind of preservative is to change the air, and they that are forced to continue, or to converse in places infected and among the sick: have need of many other cautions and they must often use Antidotes. All which are at large set down by such Authors as have treated expresly of the Plague, and from thence the reader must fetch them; because my design is but briefly to touch such things as are requisite to the cure of the true pestilence; because few Physitians of any note dare hazard themselves in the cure of the true Plague: & contrarily seeing both in England & in France and whol Europe over; al Physitians in a manner have imployed themselves in the cure of spotted and malignant Feavers; I have thought it most worth my paines to direct this cure to that kind of pestilential Feaver, which is simplie called malignant and the spot∣ed or purple Feaver. Yet so that it may serve for the cure of the true Plague; seeing as we said at the beginning, the same Medicines and the same Indications, will serve for both.

The Cure therefore of those which are actualy sick must be directed unto the Feaver, the putre∣faction and the malignant qualitie. The Feavers must be opposed with Coolers and Moi∣steners, the Putrefaction with Evacuators and Alterers. The malignant qualitie with Anti∣dotes. Al which intentions must be satisfied by a threefold Medicinal Meanes after the manner following.

The same diet must be appointed in this Feaver which was appointed in the continual Feavers. Only this one thing must be observed, that sharp things must be oftener used in drinks and broaths as being very fit to resist putrefaction and the malignant quality. Also touching drink this must be observed that the use of wine and strong drink is somtimes good in this Feaver, because they and especially wine are very cordial and contrary to the malignant quality. Yet many times they do much hurt and encrease the heat of the Feaver. Wherefore the prudence of a physitian, is in this case very necessary, that he may contemplate the Nature of the disease and constitution of the patient: for by this meanes he shal know whether the use of wine or strong drink be safe or no For if the Feaver be very smal, but the venemous quality very intense, and the body of the patient abound with flegm, wine wel allaied with water may be safely given and to good purpose. But on the other side in an high Feaver and a chollerick constitution, to give wine or strong drink is pernicious. This I have learned by a mutlitude of Experiments and especially in the yeer 1623. When the Purple Feaver was rife at Montpelier after the City had bin beseidged. Which Feaver was so malignant, that a third part at least of those which had it died, and it differed from the true Plague only in the point of a Bubo: forasmuch as not only whelkes and Exanthe∣mata, red, blewish and black, but also Carbuncles and swellings behind the eares did often appear. For to such Sick persons whose pulse was not very quick and like the pulse of a sound person, their

Tongue moist and they without thirst, I gave wine with good success; and I was enclined to con∣tinue the use thereof, by reason of the good the patients found thereby, and because by the use thereof the Feaver was not at al augmented, neither did any thirst or drynes of the tongue arise thereby. But in such whose Feaver was more strong, with thirst, dryness roughness or blackness of Tongue, I wholly forbad wine, and kept them perpetually to the use of cooling and tart drinkes. But it is to be remembred, that in the first daies of the disease wine must never be given, least the crude matter be too much agitared, but only about the state, when the signs of malignity do begin more and more to shew themselves. Howbeit Zacutus Lusitanus in the 93. Obs. Lib. 1. of his wonderful Cures and Cases, relates that in a pestilential Feaver, the patient being extream thirsty, with a dry and black tongue and past hope, he gave wine with most happy success, so that the pa∣tient was cured there with alone. But here that saying of Cornelius Celsus is to the purpose, Those which Reason could not, have many times bin cured with Rashness.

Diet being ordered, the cure must be begun by blood-letting, a Clyster being premised: for bleeding is very convenient, both in regard of the Greatnes of the disease, the hot distemper and the putrefaction. But in defining the quantity of blood which is to be taken away, prudence is necessary, when in regard of the malignant quality, it does no good but hurt; for thereby the vital faculty is exceedingly weakened, and those which are let blood after being poysoned, are hastned to their death. Therefore if a malignant and venemous quality be more than the putre∣faction, which may easily be known by the proper signs a foresaid, little blood must be taken away but if putrefaction be more considerable than the venemous quality, blood must be taken in a greater quantity. And consequently, if by reason of a sickly Constitution of body, and of putrid humors contained in the veins, the malignant Feaver have bin produced chiefly; blood-letting may safely be repeated, once, twice or thrice until the Burthen of vitious humors contained in the veins be discharged. And that especially if Inflamation of any of the Bowels be feared, which many times happens in malignant Feavers. Now bleeding must be used betimes and at the beginning of the disease for if the disease shall have taken progress and the malignity be diffused into the whol Mass of blood; bleeding does not only no good, but very much weakens Nature; so that very many Authors hold, that blood must not be let after the fourth day is past. And truly, forasmuch as malignant Feavers do at several times differ much one from another, in regard of the different degree of Malignity; when they begin to be rife once, diligent observation must be made, what good the Patients receive by bloodletting. For some Feavers being of the kind of Synochi, in which there is great putrefaction and little malignity, are much lessened by Phlebotomy. And others whose Nature consists very near wholly in malignity do become more pernicious by blood letting. This appeares in the true Pest, in which by the experiment of many approved Authors, it is assured, that al which were let blood died So Wierus relates in an Epidemical Catarrh which wan∣dred al Europe over in the yeare 1580. in which al in a manner recovered, so that scarce one of a thou∣sand died; yet al that were let blood died thereof. Now we must diligently observe that which Galen hath taught us in the 14. Method chap. 10. that in the Cure of Carbuncles it is good to take blood til the Patient faint away, that the boiling blood which causes the Carbuncle may be plenti∣fully evacuated. Whenas the same Galen, Lib. de Curat. per venae, S. Cap. 14. Com∣mands that in Phlegmonous tumors blood be taken away, till the Color Change, unless the Patient be weak, or the Phlegmone malignant. Whereby is intimated, that Galen admits copious blood∣letting in a simple Carbuncle that is void of malignity but not in a malignant and Pestilent one; which agrees to an hair with the former Precept propounded by us.

As concerning the times and intervalls of blood-letting wherein it is to be iterated, this is to be noted: that if the disease proceed slowly, the blood-lettings must not be hastened: for the pa∣tients strength is too soon weakened; so that it cannot hold out, til al the morbisick matter be ex∣pelled. According therefore as the disease is moved; so the Physitian ought sooner or later to let the Patient blood.

And there is a great Controversie, whether Purple spots or wheales appear; Phlebotomy is to be used. For some account it to be an hamous Crime to let blood when the Exanthemaia appear, because at that time the humors are moved from the Centre to the Circumference, which motion must be by al meanes furthered; and by blood-letting the humors are put into a clean contrary motion, and the blood is drawn from the Circumference to the Centre, when as the inner parts being emptied, it must needs be that the blood contained in the outward parts, should run inwards again; which Galen plainly teacheth in his 9 Desanit. Tuend. Cap. 10. viz. That the Blood when a vein is opened, does flow back from the whol bulk of the body into the internal parts. And the same Galen in his Comment upon the 9 Epidem. Does conjecture that Simon. of whom Hippocrates spake haveing broad pushes came out, had no good from his vomit, because such juyces were thereby to be evacuated, which took their Course to the Skin. Howbeit, by the more sound Advice of Doctors it's concluded, that the Purple spots appearing in the beginning of the disease and on those

dayes in which a vein is wont to be opened, if blood were not sufficienly taken away before, it must even then be drawn in immoderate quantity; Nether is there any danger to be feared by so doing; seeing that same Eruption of wheals, which comes in the beginning of the disease, is not critical but Symptomatical only, arising from an exceeding ebullition of blood, and from the fervency of malignant and putrefying Humors; and therefore the Motion of Nature cannot be hindered, when there is more to hinder. For in Case the Pacients body being Plethorick, the Urme thick and red, you shal not let blood because of the Exanthemata or wheales breaking forth; Nature wil scarce be able to Master such a quantity of Humors, and it is to be feared least they should rush into some internal part of the body and breed therein a pernicious inflamation. Howbeit, blood at such a time must be sparingly taken away, not so as the veines may be emptyed, which might cause a retraction of the evil humors inward again but only so as to take away their over great abundance, which being taken away, the veines draw no new blood, but only fal a little together as it were and become a litle loosened so as to purse themselves the better, and consequently to be the better able to rule the remaining blood. And so is the motion and expulsion of Nature furthered which she endeavours towards the Surface of the body, for she being eased of part of her load wherewith she was oppressed, does more easily cast off the remainder, and drive the same out. Which we doe every where behold in our practice, whiles the very same day oftentimes, in which a vein is opened, yea verily som∣times a few hours after, pleantiful sweats, critical and healthy doe break forth. And in truth, though nature were so strong that she could sufficiently rule al the redundant blood, seeing that in plet horick bodies the blood is wont to be thick and by these eruptions into the Skin, the thinner part of the blood only is evacuated, and the thicker abiding in the veines does more and more putrefie, and makes the disease much more dangerous. But I hold the most advised Course to be a little after the Blood-letting, to fasten many Cupping glasses, that the motion of the humors to the outward parts, may be hereby the more assisted; of the Admonstration of which cupping-glasses, we shal speak by and by. Now it must be diligently noted, as we said before, that we observe the time in which the Exanthemata do begin to appear. For if it be in the beginning of the disease and before the fourth day, in which time their breaking forth cannot be critical, and no help comes to the patient thereby; but the symptomes do rather grow more vehe∣ment, in which regard blood-letting ought by no meanes to be hindred. But if they break forth after the fonrth day and that in great quantity, so that the sick party is thereby bettered, and the symptoms lessened; it is much betteer to abstain from blood-letting, and to fix many Cupping-glasses with Scarrification, that the motion of the Humors out wards may thereby be wel furthered.

What wee have hitherto said of blood-letting, is to be understood of opening a vein in the Arm, which does quickly diminish the blood. Howbeit somtimes, tis very profitable to open the inferior veins viz. if the patient be weak, and cannot suffer a reiteration of the former phlebotomy. But this is especially good in women; for it is as Ribasius saies Lib. 7. Chap. 10. proper to women and very efficatious, because it imitates the manner of their Natural evacuations. Yea verily & when they want their courses that kind of bleeding is proper for women, because naturally they have much blood in these veines which are high the womb. Also it is good for such, in whom we fear a translation of the matter into the brain, which is often wont to happen in these Feavers and to cause a Phrensie. Which may be perceived easily (as we said in the prognostick) by the Urins thin, white, and void of Color; and when the Urins are so, it wil be very good to open the inferior Veines. Also Oribasius relates in the forecited place that he was taken with a pestilential Feaver, and having two pound of blood drawn from his inferior veines, he recovered: and al that used the like bleeding, were recovered.

The opening of the Hemorrhoid veines by Horsleeches workes the same effect. For seeing by this meanes the blood is drawn out by little and little, there follows little abatement of strength. Yet is the blood revelled from the in most bowells, where is wont to be the Heat and the Matter which foments the disease. and this is special good for Melanchollick persons, because in such, Nature is wont to evacuate earthly blood, by these waies.

After Sufficient blood-letting, Revulsions must be celebrated by Cupping-glasses, both dry and with Scarrification. Dry ones, when we would only revel: but Scarrified ones when the redundancy of blood is not wholly taken away by blood-letting, which the patients strength could no longer bear. For, blood is drawn by Cupping with much less expence of strength and besides the vene∣mous spirits lurking within, are thereby drawn to the Surface of the body. But Authors agree not touching the places where Cupping-glasses are to be applied: for some and especialy al Italian Physitians very neer do hold they ought to be applied to the inferior parts viz. to the thighs and but∣tocks and no where else, that the venemous matter may be drawn from the Heart to the most distant parts: but that they are not good to be fastened to the shoulder blades or the Back, because they draw hurtful humors from other parts towards the Heart. Others are of a contrary opinion, that Cupping-glasses are best to be applied to the shoulders and back, viz. that poisonsom humors and vapors may be drawn from the Centre to the Circumference which motion is most suitable to the

motion of nature in this disease: But I am of opinion that Cupping. glasses should be fastened to each and every of the places aforesaid; and that is is good to set them first upon the lower parts, that som portion of malignity may be drawn back unto the more remote parts: But be∣cause the Glasses fixed in those parts, cannot sufficiently draw back the venemous homors and va∣pors from the heart and its neighboring parts; it is good to fasten them likewise to such parts as are neer the heart viz. To the shoulders and back. For by this means the motion of nature is very much furthered, seeing that experience doth teach that the eruption of the spots is commonly in those parts which by frequent fixing of cups is much furthered. Which Mercatus hath most elegantly delivered in these words. Howbeit in the mean time, while the Body is plied with other medicaments, small cupping-glasses must either many at once, or a few frequently be applyed. And if the venom of the disease or the weakness of the Patient be much, they may be fixed without any, or with very little scarrification. In which kind of use and upon that occasion, it is the best course to scarrify those which are set upon the Back over against the heart which experience hath taught to be of such moment that. Anxieties & Inequalitie of the Pulse, and other grevious accidents have thereupon ceased. Wherefore we must not cease applying of them, until the venemous accidents are mitigated or whol∣ly taken away.

But the Reason urged by those of the former opinion, is of small moment for the fear lest ill humors should be drawn from other parts unto the Heart. For this reason might peraduenter be of som force: if they should be used at the beginning of the disease the whol body being ful of humors. But after an universal evacuation sufficiently procured by blood-leting they can cause no such danger; which is made manifest by a clear example drawn from a pleurisie, in whose be∣ginning, if the pained side should be cupt, doubtless it would bring the Humors more and more to the greived part. But when after often blood letting a cupping-glass is fixed upon the pained side, it doth not only draw nothing from other parts to the place affected, but that humor which is fixed and wedged into the part is thereby powerfully drawn out, so that ofttimes the disease is thereby perfectly cured. Although in this disease, there is more danger of drawing Humors to the part affected, because it is in a manner externall and neer the Cupping∣glass

Zacutus Lusitanus in Observ. 13. Lib 5. Praxeos admirandoe doth very much commend cups with scarrification, fastened neer the groins and armpits. for by such cuppingglasses so fixed the vitious humor is drawn to the ignoble parts and to those common Emunctories, unto which nature is wont to expel the same.

Among revulsive remedies, Frictions may very will be reckoned, being often exercised up∣on the extream parts of the Body with a cours cloth. But that Friction is most commend∣ed. which is made upon the whol Body with the Liniment of Aetius, which is thus com∣pounded.

Take of sweet Almonds and fountain water of each three ounces: Sal nitre two drams. Boil them together til the water be consumed, and with this Oyl warmed, let the patients body be rubbed al over with the hands being dipped therein. Aetius doth prescribe Oyl of Savin, but because it is too hot. Oyl of sweet Almonds was by Baptista Montanus, fitly substituted in its place. This oyntment doth open the pores of the Skin, that nature may more fitly expel the venemous vapors thereby.

Vesicatories do likewise powerfully draw out evil and venemous juyces and serve for revulsion being applied in divers parts of the body: Commonly they are applyed to the hinder part of the neck; for they do both draw out the matter, and drive it from the head, and serve well to cure such sleepie symptoms as are usual in these diseases. But where great malignity doth posses the whol Body and grevious symptoms afflict the patients, one vesicatory will not suffice but more must be laid on: I am wont when the disease is very violent to lay them on in five places viz. The Neck, both the Arms on the inside between the bending of the Arm and the Shoulder, and to both the Thighs, in the space between the Groyn and the Knee, with happy success.

The great profit of this Remedy we may learn from Galen, who in Lib 5. Method. Cap. 12. relates, that of pestilential Feaver al recovered, who happened to have exulcerations in divers parts of their Bodyes; because the morbifick matter was evacuated by those ulcers. And because the use of these Vesicatories do often caus the Strangury (for the Canthari∣des do by a peculiar propertie affect the Bladder) it wil be good when they are ap∣plied, to give the Patient emulsion, that may temper the acrimony of the urine. This symptome may likewise be prevented by mingling the poudered Seeds of Ameos with the vesicant plaister, which seeds have the faculty to keep the Cantharides from hurting the bladder

Amongst Revulsive Medicines may likewise be mustered, the Cataplasm of Radishes commended by Crato: The Radish (saies he) because it powerfully drawes the malignity of matter it is good to apply the gross pouder or scrapings thereof to the feet, having first clensed them with salt and vine∣ger. And the following Cataplasm may be better for the same purpose.

Take scrapings of a radish and the two Briony Roots of each two ounces, seeds of Garden Cres∣ses one ounce. Grains of Paradise half an ounce, Sea Salt three drams, Mix al and sprinkle them with the strongest Vineger, and make them up into a body, with a sufficient quantity of soft sope, til it become like a Cataplasm, & apply it warm with tow to the soles of the feet, when the patient is disposed to sleep.

To this Cataplasm may profitably be added leaves of Rue, Nettle, Sage, Scordium, Pidgeons dung, juice of Rue and Vinegar.

A Cataplasm of Snails beaten hath the like Efficacy, and powerfully drawes unto the nether parts hurtful humors and vapors, as Galen highly commends the same, for powerfully attracting and disscussing the waters of Hydropic Persons.

These revulsory Remedies have place during the whol Course of the disease after universal eva∣cuations viz. Phlebotomy and Purgation: of the use whereof we are now to speak, that so we may pass from Chyrurgery to Pharmaceutick Remedies.

Now it is much controverted among Practitioners, whether we ought to purge in the beginning of malignant Feavers. Many reject purging at that time, not only because of that wel known pre∣cept of Hippocrates, that Concocted humors are to be purged, but crude humors not: but also because in this disease the malignant humors are too much exasperated by purgations, and diffuse their malignant quality the more abroad, and by sharpely provoking or Nature, they produce pernicious fluxes wheras otherwise of themselves in these Feavers, melting fluxes. do often arise and bring the patients to their long home. But others contend, that sometimes there is such plen∣ty of evil and venemous humors in the first passages, that unless they be first removed by purging, or very much lessened, they infect the rest of the humors, so that Nature cannot master them, how∣ever assisted by antidotes and corroborating medicaments.

We conceive this Controversie may be thus composed; viz. that in the beginning of this disease we must abstain from purgations for the reasons fore alleaged; and that the sink of putrid humors which lies in the first passages (which the truth is do very much hinder the Cure) be drawn away rather by frequent Clysters, than purging Medicaments. Howbeit, if their be so great a quantity of il humors in the first Region, that it seemes imposible sufficiently to evacuate the same by Clysters (which chiefly happens, when evil humors abound in the stomach, and then there is great loathing of meate, bitterness in the mouth, stomach sickness and vomiting) or when there are many worms, it is very good in such a Case to draw away the matter by a purging medicament that the morbifick matter contained in the veines, may afterward bee the more easily subdued. Which matter it is that cannot be purged before concoction, and of that must the saying of Hippocrates be understood, that onely concocted humors must be purged. But the matter contained in the first region and that mass of excrements may be drawn away without any preparation or concoction premised, and is ordinarily purged out only by Clysters, as we said before. Now those Medicaments which we give to purge the first Region, must be chosen from amongst the most be••igne and gentle purgations, avoiding the most vehement, yea and the middle sort too, so that we may safely use Ca••••ia, Manna, Tamarinds, syrup of Roses, and Cichory compound. And it is Scarce lawful to arise to Senna and Rhubarb, or at least to mix them with the others in a smal quantity, when a great abundance of evil humors do afflict the patient. The former of these Medicaments were propounded in our cure of continual putrid Feavers, and how we should purge in the beginning of them.

But Clysters are to be used, not only in the beginning of the disease, to free the first region from excrements; but they are to be given in the whol Course of the Disease, if the patient be not looss∣bellied, and that every or every other day. For by those the daily excrements are brought out, and some portion of the Morbifick matter is also by little and little drawn away, Likewise the humors mounting upwards, are broug•••• down to the places more suitable to the intent of Nature. Now these Clysters must be composed of an emollient and refrigerating decoction, adding gentle laxa∣tives; for sharpe ones and scammoniated, do over much irritate nature to excretion and often pro∣duce perricious fluxes.

And the truth is ••is best in the vigor of the disease to put no purgers into the Clisters, least a Looseness be caused which is very incident to this disease, so that they are rather to be of the nature of an internal fomentation, then of a laxative Medicine.

But if in the Course of the disease the belly seem to be loose: we must not therefore abstain from Clysters, but we must use such as do moderately deterg and refrigerate, and in Juleps we must dissolve syrup of Pomegranates with pouder of Corral prepared.

While the foresaid Medicines are using, wee must endeavor to correct the Feaverish Heat, Pu∣trefaction and malignant quality, with these following Medicaments.

And first of al the altering Juleps which were propounded in the Cure of continual putrid Feavers wil be very convenien••, of the decoction cheifly of the Rootes of Sorrel, Cichory, Grass, Bugloss, Sharpe-pointed Dock; the leaves of Endive, Cichory, Sorrel, Pimpernel, Maiden-hair and Tama∣rinds. Whereunto must be added such things as by a Specifick property do fight against the venemous quality, commonly called Alexipharmaca or Antidotes, as rootes of Cinkfoyl, Tormentil, white Thistle; leaves of Scordium, Carduus, Scabious, Scorzonera, Meddow-sweet; Flowers of Mary∣golds, Vetonica rubra; bitts of Lemmons or Citrons and their seeds; Skinns of odoriferous apples, Shavings of Harts-horn &c. with the Syrups of Lemmons, Pomgranats, Vinegar, of the juyce of Sorrel &c. and we must frequently mix tart things with them such as juyce of Citrons, or of Lemmons, Spirit of sulphur or of vitriol: for they do mightily resist the putrefaction and the venemous quality.

Touching the Pome-Citron Athenaeus reports, that once in Aegypt certain condemned men were exposed to death by biting of beasts, and they were bitten indeed by the Aspes, but had no harm thereby: because as they were led to executiou, a Woman out of Pitty gave them some Pome-Ci∣trons to refresh them & quench their thirst: which having eaten, they received no hurt by the biting of those venemous Beasts. Now al parts of the Pome-Citron have an antidotary quality; and therefore it is profitably cut in pieces rind and al, and boiled with Rootes and Herbs aforesaid to make juleps; and it is likewise to good purpose steeped in smal drink which the patient ordinarily uses, unto which it gives a fragrant smel from its rind and a tartnes from its pulp: howbeit the juice only hath a cooling faculty.

The acid spirits of sulphur and vitriol are highly extolled especially by Chymist, and their rare vertues approved by long experience have caused that long since they have bin entertained by Ga∣lenists, and ordinarily prescribed. And that it may appear how highly the Chymist esteems of them let it suffice to cite the words of Mindererus alone in his 18 Book De Pestilentia, where treating of spirit of vittriol and sulphur, and of other Medicaments made of sulphur: There is (he saies) no putrefaction whose neck they break not; no infection which they do not overcome; no pravity of Humors but they can conquer. Verily (to deal clearly) if I should be for bidden or hindered from the use of vitriolated medicaments, I should never come to cure the Plague, or alwaies without my weapons.

To the same Juleps may somtimes be added Sal prunella because it powerfully cooles, and extin∣guishes the Feaverish heat; and it hath besides a kind of diaphoretick faculty, by means whereof it is excellently fitted for malignant Feavers.

In place of Iuleps for the more delicate sort of Patients, may be substituted somtimes medicated Broaths, made with the Leaves of Borrage, sorrel, Pimpernel, and other hearbs that are not offen∣sive to the palate, with Skinns of fragrant apples, with the pulp and juyce of Citrons and a chick; and to them sal prunella may somtimes be added, for to cool more effectually.

Also Emul••ions may be made of sweet Almonds, and the greater cool Seeds, with the Decoctions of the Juleps. And for the greater quelling of the venemous Quality, to the aforesaid Seeds may be added Seeds of Citrons, of Navew or Turnep, and of Carduus Benedictus. And to commend the tast, the aforesaid Syrups may be mingled therewith.

Now in the whol Course of the Disease, Antidotes must be used, not only mingled in Juleps, Broths and Emulsions, as was said before, and shal be further declared: But also contrived into other forms. And because al are not to be used indifferently, nor at all times of the Disease; that their right Use may be wel distinguished, they must be sorted into four Tribes. The first conteins those, which besides the Specifical Quality by which they resist poyson, are cold and dry and moderatly a∣stringent; and consequently they hinder putrefaction, strengthen the Heart, bridle the Venom, that it cannot be so easily spred into the whol Body, and hinder the dissolution of the parts thereof by a kind of compression; as Bole-Armoniack, Terra Sigillata, Coral, Cinkfoyl Roots, and the Roots of Tormentil. The second Tribe contains such as by their coldness and the tenuity of their substance do resist putrefaction, and restrain the venemous Quality; as Juyce of Lemmons, Spi∣rit of Sulphur and of Vitriol, as al acid things, and Vinegar it self. The third comprehends hot & Dia∣phoretick medicaments, which expel venemous Humors and Vapors from the Heart, and bring them from the Centre to the Circumference; as Angellica, Zedoary, Dictamnus, Meddow-sweet, Scordi∣um, Carduus, Scabious, Treacle, Mithridate, Treacle water. The fourth contains such as by a Spe∣cifical vertue, without any excess of the first Qualities, do oppugn the venemous Quality; as Bezoar stone, Harts-horn, Unicorns-Horn, Troches of Vipers, and such like.

The Medicines of the First, Second, and Fourth Tribe, do best agree in the beginning and the Augment; and those of the Third Tribe in the state and Declination. Now these medicaments must be exceedingly varied, and diversly mixed, according to the different degree of malignity or putrefaction; according to the various Intention or Remission of the Feaver; and according to the divers temperaments, Sex and Age of the Patient; and according to other Circumstances: the

determination whereof depends wholly upon the Judgment and Prudence of the Physitian, and can∣not be determined by any certain Rules. Only one thing I shall advice you of, which is very well known, viz. That when there is a vehement burning of the Feaver, we must chiefly use Refrigerating & cooling things; but the hot and Diaphoretick must not be medled with; which notwithstanding wil be very proper, when the Feaver is more remiss and the malignant Qual••ty is that which most of∣fends. Of these Tribes therefore, divers medicaments m••y be Compounded, according to the judg∣ment of the Physitian. But least yong Practitioners should be wholly destitute of some forms, I shal ad a few, in imitation whereof, they may devi••e a thousand others, as the occasion of practise shal require.

Take Roots of Sorrel, Bugloss and Tormentil of each one ounce. Leaves of Endive, Cichory, Sorrel, Pimpernel, of each one hand u••. Tamarinds one ounce. Boil al to a pint. In the strained Liquor disolve syrups of Pomegranats and Lemmons of each an ounce and half. Makes of al a Julep to be taken at thrice: adding to every dose a drant of Confection of Hyacinths bezoar∣stone six graines.

This form of a Julep, may do wel in the beginning of the Feaver. But if the Feaver be very high and the Patient of a Chollerick constitution, a dram of Sal Prunella may be added to every dose, or as much spirit of vitriol or sulphur, as may suffice to make it moderatly tart, or both of them to∣gether. ••u•• in a Feaver not very high may be added to the decoction, Rootes of the white-Thistle and of Cinkfovl, Leaves of Scordium and Scabious.

Take sweet Almonds blanched one ounce: Seeds of Melones, Gourds, Navew, Citrons and Car∣duus of each two drams: Beat them together in a Marblemorter, pouring on by little and little a pint and half of the a••oresaid Decoction; Syrup of Lemmon three ounces; Sal prunellae three drams. Make an Emulsion for three Doses, to be taken twice or thrice in a day.

In the whol cour••e of the Disease, let the Patients use in their Broaths the Confection of Hya∣cinths, or the following pouder, which is not unpleasant.

Take of prepared 〈◊〉〈◊〉, Pearls prepared, shavings of Ivory Harts-horn, and Bezoar, of each one scruple. Mix them. Make of all a pouder, of which, give half a scruple in every mess of Broath.

The Innovators of this Age, who endeavor to banish Gemms, Pearls, Coral, and al Cordial things from the use of Physick; and cure all Feavers, even those that are malignant, with Blood-letting and meer refrigerating Apozemes; may be convinced wi••h this one Experiment, at least touching Coral and Pearls: which being poudred, if they be infu••ed in Vinegar, Juyce of Lemmons, Spi∣rit of Vitriol, or Aquafortis; they take away all the Acrimony of those Liquors. Whence we may gather, that the same Medicaments taken into our bodies do sweeten and molifie the acrimo∣ny and malignant quality of humors and reduce them to a moderation. They which have tasted the solutions of Pearles and Corals, made in juyce of Lemmons or di••••illed Vineger, do know the truth hereof very wel.

Where the malignant and venemous quality is very rise Alexipharmaca or Po••on-quellers, are to be given in Juleps, broths the ordinary drink of the Patients, and 〈◊〉〈◊〉 they take in, that by a per∣petual and incessant Conflict, the troublsom Enemy may be oppo••ed.

Bezoar stone is given alone to the quantity of five or six graines, with water of Mead-sweet, Scor∣zonera, Carduus, or such like not only to oppose the malignant quality, but also to help the Dia∣phoretick motion; for this stone is reputed for a sweating Medicament, which notwithstanding many approved Authors doubt of, because they could never see any sensible effect, by the giving thereof. And truly (to speak out my mind) there can no great Confidence be put in this stone; because although we may allow to the true and genuine bezoar stone, those faculties which are here∣unto ascribed; yet because the great price thereof Causes that many Traders take a world of paines to sophisticate the same, we can now a dayes hardly get any but counterfeit. A clear testimony whereof is, that the writers of the Indian Histories do aver that Bezoar stone is very scarce and of great price among the Indians themselves; when we have plenty of them and cheap enough.

More credit should of right be given to that same Root, which the Spaniards have in this Age of ours brought out of Italy; which they cal Contra yerva which signifies the Poison-pelting or An∣tidotary Herb, because the pouder thereof is a present remedy against poisons, and drives them out of the body by sweat, or insensible transpiration. And they Conceive that Plant to be the Common ordinary food, of Those beasts in which the Bezoar stone is found, and that the stone hath its vertue primarily from thence. A scruple or half a dram of this Root poudered may be given in Carduus matter, or other medicaments.

Mendererus cries up this following pouder.

Take Sugar Candy three drams, white-ginger two drams. Camphire one dram. Make al into a pouder; the dose one dram in some convenient liquor. But the Author doth advise that in great paines of the head or stomach, Camphire is warily to be used; which yet he highly commends in pestilential diseases; and avouches that seasonably given, il doth more good than the most pre∣cious bezoardick medicaments. I conceive the pouder is too hot because of the Ginger, and I have

Composed this following in imitation thereof, Which I have vsed with happy success.

Take mineral Bezoar three drams: Sal prunella two drams: Camphire one dram. Make of all a pouder: Give one dram at a time in Carduus water, or som other convenient Li∣quor.

Pouders may likewise be made of the fragments of precious stones whose vertues many deride & others as much admire; so that from the times of the Arabian Physitians to our days many composi∣tions are prepared of them in the shops, as Electuarium de Gemmis, & Confectio de Hyacintho. But in pestilential and venemous diseases many have extolled the great vertu of the Smaragd, amongst the rest Avenzoar, Mindererus, and Zacutus Lusitanus. Avenzoar 2 Teisir. tract. 1. Cap. 5. That himself being poysoned, was thereby cured. Mindererus Lib. de Pestilentia Cap, 15. Relates that to a woman in a Pestilential Feaver who abhorred al Physick, he gave the following Pouder which she might easily swallow haveing neither tast nor smel; which when shee had taken the conbustions of cruel symptomes being allaied, and the disease turning to health, she was cured.

Take of the Smaragd stone prepared, East-india Bezoar of each six grains: Hyacinth prepared three graines, mix them. Make of all a pouder for one Dose.

And Zacutus Lusitanus, relates that a Portugal Gentleman, haveing through poyson fallen into a loosness and a Consumption, from which no abstersives, astringents or Antidotes could free him; he was cured only by the Smaragd, the pouder whereof to the quantity of twelve graines he tooke every other day in conserve of quinces, and when he had taken it five times he was cured of his Loosness.

The Physitians of Mountpelier, doe use in this Feaver as a most profitable Antidote, no ways heating; the Troches of Vipers, which are usually prepared as an ingredient into An∣dromachus Treacle, which they give from one scruple to half a dram in cordial waters or Ju∣leps.

Yet the flesh of vipers were better being dried, which hath no venemous quality (as people imagine) but is rather a potent Antidote; which is much abated by boiling; for it is boiled in wa∣ter to make the troches. So that we see greater effects wrought only by the heart and Liver of vi∣pers, being dryed, without any other preparation

The Alexipharmick Medicaments of the third Tribe viz. The Diaphoreticks and sweaters must be given only in the state or declination of the disease, as was said before. which is to be understood, when they are given in a feaver simply malignant or spotted: for in the true Plague they must be used at the very beginning▪ that the venemous qualitie which would quickly kill the Patient may be suddenly and potently opposed, and the malignant vapors discussed. Yea ve∣rily and in simple malignant Feavers, if the venemous quality seem to be greater than the pu∣trefaction they are likewise to be given at the beginning in small quantity; making choyce of such as are least hot, mixing them with Juleps and other cooling medicines formerly pre∣cribed.

Now of these Diaphoretick medicaments there are divers degrees, for som are more hot, as Angelica, Zedoary, Dictamnum, Treacle, Mithridate, Treakle water; which are never to be giv∣en when the heat of the Feaver is at the highest, but only when the same is much abated, and when the signs of malignity do very much prevail. But others are less hot, as Scabious, Carduus Mead-sweet, Scordium, which may safely be given, though the Feaver be in it's height. And these distinctions are carefully to be observed in practice. and as for the formes of particu∣liar medicaments, every Physitian can vary them, according to the different degree of the Feaverish Heat and of the Malignitie. But I shall here discribe such as are most effectu∣all

Take water of Mead-sweet and Carduus of each two ounces: juice of Lemmons one ounce: old Treakle half a dram, two scruples or one dram, according as the fear of heating the Patient is more or less. Mix al into a potion. give it warm and cover the patient somwhat more than or∣dinary. if there be great vehemency of symptoms, new Treakle wil be more convenient, be∣cause of the vigor of the Opium by means of which the vehemency of the symptoms will be allaied, and the boyling of the Humors wil be restrained: yea and somtimes when it seems unconvenient to use Treakle as in the beginning of the disease especially, Laudanum Opiatum given to two grains & mingled▪ with Antidotes, do much good. For by the Narcotick and congealing power thereof those fervent Spirits so vexatious to the Heart, are as it were fixed; and the morbifick matter (which is most pernicious while it is in motion) is thereby stopped and remains in a manner unmoveable, whence it comes to pass, that Nature not being provoked by the malignant humors and spirits, recollecting her strength, doth more easily apply unto her self the vertu of Antidotes

Aqua theriacalis seems fit to be preferred before Treacle it self. For seeing it is exceeding thin and spiritous, it doth more easily and suddenly peirce into and pass through the whol body and Cause sweat. And because there are many descriptions of Treacle water, their dose ought to differ accord∣ing as they are compounded of Simples more or less healing. I shal in this place propound the chief.

And first of al, the Treacle water of Bauderon is most excellent, because it is exceeding temperate. For there goes no other Liquor thereinto than Vineger and Juyce of Lemmons, by which the hot Ingredients are very much tempered, and therefore it may be given from half an ounce to an ounce in Sudorofick decoctions or waters. And although this is less heating than any of the rest prescribed by divers other Authors; yet have I invented another, easily made, which is more cooling, and does no less oppose the Feaver than the malignant quality, and may consequently be used in the whol course of the disease, at any period thereof. Its composition is as followeth.

Take twelve fresh and juycie Lemmons. Take away the bark or rind and the seeds and press out the fuyce, and ad thereunto the said rindes and seeds; and three pints of juyce of Scordium, juyce of sorrel, of Goates Rue; of scabious, and Carduus, of each one pint. Shavings of Harts-Horn four Ounces. Old Venice Treacle six ounces. Let the rinds of the Lemmons be cutt into thin chips, let the seeds be beaten, and such herbs as have little juyce, let them in the beating be moistened with the juice of Lemmons and let al be distilled in balneo Mariae. Of the water give one ounce by it self or mixed with other Liquors.

The hotter sort of Treacle waters are made with white Wine or with spirit of wine; which must be warilly given and in lesser quantity; yet they pierc more than the other and move sweat, and are cheifly used in the true Pestilence. Howbeit in some Cases they may by the prudent Physitian be used. Among the many Descriptions of such Treacle waters, I wil propound in this place, two of the most excellent.

Take roots of Angelica, White-Thistle, Gentian, Tormentil, Zedoary, Harts-Horn, of each one ounce. of the three sanders, of each half an ounce. Treacle three ounces, Camphire a scruple. beat al and steep them three daies together in two Pints of strong white-wine, in a warm place. Then distil Them in Balneo Mariae, and keep the water for use, the dose is, from two drams to half an ounce, in refrigerating Juleps, adding spirit of vitriol to correct the Inflamation thereof.

Take Spirit of Wine, very wel rectified one pint and an half. old Treacle eight ounces. Elect Mirrh four ounces. Oriental Saffron one ounce. Camphire half an ounce. Infuse al for twenty four hours in Balneo Mariae. afterward stil them in the same Bath; and you shal have a very effectual water.

The Chymists do exceedingly cry up their Bezoardica Mineralia, because they are Sudorofick or Diaphoretick at least and yet do not at al heat: which they endeavor to prove by their having no taste, in which regard they are easily taken even by the most nice Patients, that loath unpleasant medicaments. They also commend their Medicine which is called by them Mixtura Simplex or Mixtura Spiritalis, made of Treacle Water Camphorated, spirit of Vitriol and of Tartar: and they mingle a dram hereof in Juleps and antidotary Potions.

A Physitian that undertakes the Cure of malignant Feavers ought to have divers Antidotes in a rea∣dynes, and to change them ever and anon, least nature be too much accustomed to one and the same, and slight the virtue thereof. Also the nature of the venemous quality is not alwayes one and the same but very divers according to the diversity of the patients bodies. So that what hath helpt one, wil do another no good; so that when he hath for some time used one antidote, he must try another and another.

While the foresaid diaphoreticks are using, if we have a Mind at any time to help their Operation, that they may more powerfully bring out the poison into the surface of the Body, some external helpes may be used: viz. Cupping-glasses, both dry and with scarification, many and often set on and Vesicatories, of which we spok before; which are most convenient in the state of the disease and at what time Sudorofick Medicines are given; as also Oyl of Scorpions of Matthiolus, which is much commended by al Practitioners; for it calls forth the poyson residing in the profound parts of the body unto the external parts, And therefore the Emunctories of the body, as the Groines and Arm∣pits, with the Pulses of the Templs, Hands and Feet, ought frequently to be anointed with this oyl warm; viz. thrice or four times in a day, or else every third hour. Where this Oyl is not to be had, a Liniment may be made of Treacle dissolved in Juyce of Lemmons adding a little saffron and Camphire.

If at any time Nature being oppressed with the malignity of the Poyson and overcome, and seem not to act, but as it were to submit her self with hands bound to the mercy of the humor. The strongest diaphoreticks, are then to be given, in a large dose, that the daunted mettle of the heart may be as it were spurred up, And then the strongest sorts of Treacle waters and Bezoardicks which have greatest force to penetrate, must be used: and the addition of Camphire wil much help their penetra∣tion and outwardly, at such a time this following fomentation, wil wonderfully assist the operation of

such things as are taken in, and wil help to drive out the malignant vapors. For by this Method, many have bin reduced from the Gates of Death.

Take roots of Angelica and Gentian, of each two ounces, Leaves of Bawm, Origanum, Scordi∣um, of each two handfuls. Seeds of Carduus benedictus one ounce. Flowers of Chamomel, Mullien, Melilot, St. Johns wort, Centaurie the less, Staechados, Rosemary, Marygold, of each two pugills. Make a decoction of all in water, adding towards the end a little white-wine, where∣with foment the feet, Groins, Armepits, and sides warm with sponges.

If drynes of the tongue, thirst and other signes do shew that the Feaver doth prevail as much as the malignant quality, we must abstain from the fomentation, and instead thereof let a Hen cut down through the Back, or the Lungs or Caul of a Wether new killed, be applied to the patients Belly.

In the whole Course of the Care, the greatest Cure of al must be to preserve the patients strength, which is much dejected by the Venemous quality. It is best kept up, first by Convenient broths made with a Capon, unto which, when necessity urges may be added the distilled broaths of flesh, and especially the Aqua Caponis which is made in Balneo Mariae per Descensum, as the common manner is now to make it. Consection of Hyacinths given in broaths, doth repaire the strength, and doth oppugn the malignant quality. In the same broaths Gelly of harts-horn, doth satisfie both Endications. If the strength of the Patient be very much decaied; we may make bold with Confectio Alkermes, provided the Heat of the Feaver be not very violent. And finally, wine is the most cordial thing in the world, of the use whereof in this disease, I spake before, treating of the Patients Diet. The only smel of wine doth much refresh the Patients strength, and much more a toast dipped in Canary and Rosewater and so held to the Nose.

And in this Case also Confectio Alkermes and de Hyacintho are wont to be put into alexiphar∣mical Potions. Or in extream dejection of strength, Potions merely cordial may be thus made.

Take Orenge-flower water and Rosewater of each one ounce and an half. Confectio Alkermes one dram. Syrup of Apples one ounce. Juyce of Lemmons three drams. Make all into a potion. If the Feaver be not intense Cinnamon water may be given to the quantity of one dram or three drams. and sometimes Amber Griese may be added, to the quantity of five Granes or Seven. Neither in extream Weaknes of the Patients must we so much fear those hot cordials, that we should resuse to save the patient from present death, for fear of augmenting the Heat of the Feaver for we must alwaies regard that which is most pressing, and when the patient hath a little recovered strength if the hot cordials have made some increase of Heat, it may afterward be tempered by potent coolers, as Sal Prunella, and Spirit of vitriol, mixed in juleps and ordinary Drink. This Method being observed by the discreet Physitian, in his administration both of Strengtheners and of hot Antidotes and sweaters; wil prove happily Successful.

After these things, must follow the Application of Epithems and Liveing Creatures to the Region of the Heart; fomentation of the Genitalls with Confectio Alkermes dissolved in Wine; Bags to be laied upon the stomach, and other both internal and external Medicaments, largly by me described in my Chapter of Weaknes or Decay of strength.

As for Epithems, there is Caution to be used in their application, Because very many Authors do wholly reject the use of them; because they are wont to be compounded of refrigerating and repelling things; viz. of the waters of cooling herbs and Vinegar, by which the venemous quality is beaten back to the heart, and the transpiration thereof, which ought alwaies to be promoted, is hindered. But this reason cannot hinder the use of Epithemes, seeing we may compound them of cordial and diaphoretick waters that have repelling no or astringent quality in them, and without Vinegar (which some do yet allow) adding cordials thereunto; and by these things mingled to∣gether, Epithems may be made, not only which strengthen the heart, but also open the pores of the skin, that through them the malignant vapors may more easily transpire. Of such Epithems this may be an example.

Take waters of scabious and Carduus, of each four ounces. Oreng-flower water two ounces. Con'∣fectio Alkermes two drams. Powder of Diamargaritum frigidum one dram. Saffron and Cam∣phire of each six grains. Make an Epitheme and applie it warm to the Region of the Heart fre∣quenly.

Take Confectio Alkermes half an ounce, Powder of Triasantalon and Diamargaritum frigidum, of each one dram and half, a little Orengflower water. Make of al a Liniment to be applied to the part after aforesaid the use of the foresaid Epitheme.

Neither must we here omit such Epithemes as are to be applied to the parts under the short ribbs, because of the reasons of their use propounded in the Cure of putrid Feavers, from whence the Materialls must also be fetcht.

At length whenas the malignant and venemous quality is mastered by the Remedies afore∣faid,

and the Feaver abated and the Disease begins to decline, and the signs of Coction do mani∣festly appear; pargation must be used, which by the experienced Physitian may be accomodated to the strength and constitution of the Patient. I shal here, for the sake of Beginners propound only one example.

Take Senna half an ounce. Annis seed one dram. Leaves of Scabious and Scordium, of each half an handful. Liquoris three drains. Boil al to three ounces. In the strained Liquor dis∣solve the infusion of four scruples of Rhubarb Made in bugloss water with yellow Sanders. Man∣na and Syrup of Roses of each one ounce. Make all into a Potion.

And for the most part one purge is not sufficient in the declination of the disease when the Patient begins to recover health; but purgation must oftentimes be repeated twice or three times at conveni∣ent distances, that the evil humors may be perfectly rooted out. Otherwise there wil be danger of a Relapse, or at least the Patient wil be long in Recovering prsecte health. Because though nature; be str••ng enough to master the reliques of the Morbisick matter yet can she not do it but in a long time and in the mean space the body is long in recovering its former strength.

For the perfect Compleating of this Cure, it remaines onely that we speak something of the Correction of such symptomes as happen in this disease. Now their cure is very near the same which hath bin propounded in the second section of this Treatise Chap. 2. where we delivered the Cure of such symptomes as attend putrid Feavers. And the symptoms of this Feaver are the same in a manner with those of putrid Feavers, the difference being only in degrees of more or less; and therefore the same Remedies wil sute with both. Howbeit I shal here set down such things as have bin frequently tried in the taming of such symptomes as attend malignant and Pestilential Feavers, and which have proved most successful. And wee shal withal declare the Cure of such diseases as do Supervene upon these Feavers.

And first of al, In Paines of the Head, Want of sleep, and Raving, at the beginning Revellers of al sorts must be used, as opening of the inferior veins and of the Haemorrhoids; emollient Cly∣sters, frictions of the nether parts, Cupping-glasses, first set upon the Calves of the Legs, after∣wards upon the Back and shoulders, both dry and with scarification; and Vesicatories, which in a simple Delirium or Dotage arising from a Chollerick matter, must be applied to the Armes and thighes. But if with the Raving there be joyned a dullnes and sleepvnes, a Vesicatory must be applied also to the Neck; and then Repellers must be applied unto the Forehead and Oxyrrhodines; of which it is to be noted, that they are not so good in malignant as in meer putrid Feavers; because the venemous vapors must by al meanes be expelled, and at no hand be kept within the body. And there∣fore first gentle repellers must be applied, and if the vehemence of the foresaid symptomes shal com∣pel us to fly to the stronger, we must not use them long together.

Among Repellers of the gentler sort is reckoned that common frontal of the flowers of water Lilly Violets and Roses, the greater cool seeds and Chermes berries, bedewed with the Vapour of vineger, And if that wil not suffice, let this following be laid on.

Take Unguentum populeum one ounce, Conserve of Roses and violets of each half an ounce. Oyl. of Roses six ounces. Vinegar of Roses two drams. Mix them all and receive them in tow and put them between two cloaths and apply them to the forehead.

Mean while the Emulsions of the four greater cool seeds may be used, from which cool and gentle vapors are wont to be carried unto the Brain, which are wont to mitigate the foresaid symp∣tomes. Which if they suffice not, narcoticks may be added, which do wonderfully hinder the ascent of sharp and malignant Vapors unto the brain, and procure sleep. Yet they must be given in a smal quantity, as half an ounce of Syrup of poppies; or if necessity compel, two graines of Lau∣danum opiatum with conserve of roses may wel be given; or they may be dissolved in some Julep; or in stead there of new Treacle may be given to the Quantity of half a dram. Howbeit these nar∣coticks are seldom to be given and in smal Quantity, because they Concentre the poyson, howbeit they are by some accounted sudorosicks.

After repellers have bin used a day or two, we must come to derivers, among which is reckoned a vesicatory applied to the Neck of which before, whereunto must be added blood-letting from the forehead vein to the quantity of five or six ounces: which is very successful provided blood was before sufficiently taken from the veins of the Arm. Also horseleeches may be fastened behind the Eares. which is a good remedy but less effectual than the former, because by leeches the thinner part only of the blood is drawn away; whereas by the forehead vein sometimes in a phrensie more corrupt blood is drawn away; whereas by the Arm. At length, in the state of a Phrensie, or at the beginning of the declination, resolvers are to be applied, especially liveing Creatures and their Parts, as the Lunges of a wether which is better than young prdgeons or whelpes, because it doth safely en∣compass the whol Head. Now these Animals do partly resove evil humors contained in the brain, and partly ripen and digest them, that Nature may afterward more easily expel them, Some do unadvisedly apply them in the beginning of a phrensie, because by encreasing the Heat, they encrease

the Flux of Humors to the Brain, and encrease the Raving.

In the Inflamation, Dryness, and Blackness of the Tongue, Remedies propounded in the afore∣said place are convenient; especially such as are composed of Water, or the Juyce of Housleek, and Sal prunellae. Whereunto this following of Mindereus may be added, because Experience hath taught, that it is very effectual.

Take fresh butter washed in Rose-water, two ounces: Sal prunelloe half a dram. Mix them, and keep the mixture in cold Water. Give the quantity of an Hastifer or bean, oftentimes in a day, and let the Patients hold it as long in their Mouths, as they can possibly. It is a sign that the Cure goes wel forward, if the black Sootiness go away, and the dry chopped Tongue begin to grow moist, and pselings come away, and the dry chopped Tongue begin to grow cough up the peelings of their Throats. But then their palate is pained, and that very thin Skin where with it is covered, can hardly bear any thing in regard of its tenderness, but its offended with every light tartness, and the least Acrimony imaginable, because the former Inflamation having left it in divers parts Flaid, it must be covered with new Skin; and so it requires to be perfectly cooled and healed. To this purpose the following Gelly wil be most convenient.

Take Seeds of Flea-bane and Quinces, of each one dram and an half: Gum Tragacanth one dram. With Water of Roses draw out a liquid Mucilage, whereunto ad the like quantity of Syrup of Violets. Make it in manner of a Gelly; of which let the patients take often in a Spoon and hold it long in their Mouth.

Warm Milk does mitigate the pain Caused by Gargarismes, tempers the Inflamation, moistens the Tongue and Throat, and attracts the Venom to it.

These following Pills may conveniently be used.

Take Seeds of Cucumbers picked and bruised, one ounce: White of an Egg as much as shall sus∣fice. Make Pills, which let the Patients often hold in their mouths. Or,

Take Seeds of Gourds and Melones clensed, and of white Poppy, of each one dram. Liquoris and Gum Tragaganth of each one dram and an half. Beat all to pouder, and with the Mucilage of Quince Seeds drawn with Rose-water, make Pills to be held in the mouth.

And because this Inflamation, Dryness, and Blackness of the Tongue, proceeds from the burn∣ing that is within. Juleps very Refrigerating are good to cool the same; unto which may be ad∣ded, Sal prunellae, and Spirit of Vitriol. Also they may be mingled with the Patients ordinary drink.

The Cure of extremity of Thirst was sufficiently propounded in the aforesaid place. But in a malignant Feaver, it will be happily extinguished, with these two Medicines newly commended, viz. with Sal Prunellae, and Spirit of Vitriol, taken in Juleps, and in the ordinary drink of the Pa∣tient.

Want of Appetite, Stomach-sickness, Vomiting, and Hiccuping, must be cured according to the Method delivered in the aforesaid Chapter. Yet we shall ad one thing touching vomiting; that it doth somtimes so vex those that have malignant Feavers, that they presently vomit what ever they take, and though they have Thirst, with Dryness and Blackness of Tongue; yet can they bear no kind of Liquor or drink: but vomit all their Juleps, Emulsions, Ptisans, and their smal Beer pre∣sently after they have drunk them. This most grievous Symptom is suddenly cured, as it were by a miracle, with a dram of Salt of Wormwood, given in a spoonful of fresh Juyce of Lemmons, as I have learnt by Experience.

A Loosness is very frequent in this Disease, and herein the wisdom of the Physitian is very ne∣cessary. For if it be unseasonably stopped, the venemous Matter is kept within. And if it be let a∣lone, it weakens the Patients, and many times brings them to their deaths. In the Cure of this Loosness, we must therefore thus proceed. If it be so moderate that it weaken not the Patient, it must not be stopt, but only moderated by Strengthening Clysters, But if it be immoderate, and do very much weaken the Patient, it is wont to be a melting Loosness, that Thawes the Patient as it were away, and must be boldly stopped; which new Treacle to the quantity of half a dram, or Lau∣danum Opiatum, to the quantity of two or three grains, will effectually perform. Yet I have of∣ten seen a pernicious Flux which threatned to kill the Patient, stopped as it were in a Moment, by giving of powerful Diaphoreticks in a great Dose; which did expel by the Skin that venemous Mat∣ter, which by vexing and grating upon the Guts, and other Bowels, did cause such a melting and con∣suming Loosness.

Worms do very often vex those that have these Feavers, and are plentifully bred by the great pu∣trefaction of the Humors. These are conveniently drawn away by sweet Clysters, and by potions against the Worms; especially such as are made of a Decoction of Seordium. For Scordium is e∣qually good against the malignity and the Worms. And to temper the heat thereof, it must be boi∣led with Purslain, Sorrel, and Harts-horn. Also burnt Harts-horn is profitably boiled against the

Worms. For Forestus in the fourth Observ. of his sixth Book, that no Remedy did so much good to such as having a malignant Feaver were troubled with Worms and a Loosness, as burnt Harts-horn given to the quantity of a dram in convenient Juleps.

When the malignant and venemous Quality bears great sway in these Feavers, that they come neer the Nature of the true Pest; in such Patients there are commonly risings behind their Ears, and Carbuncles. Wherefore we will here subjoyn their Cure.

In the beginning of a Parotis, or Rising neer the Ear, as soon as it begins to appear, the Part recipi∣ent must be relaxed and widened as it were, and if the swelling rise but slowly, the motion of Nature endeavoring to expel the morbifick matter that way must be assisted, by applying drawing things to the swelling, and by giving Antidotes and Diaphoreticks. To relax the Part, make an Injection of Oyntment of Marsh-mallows, and lay on afterwards moist Wool which is greasie, from the Sheep. Attraction may be caused by applying Whelps, or yong Pigeons, by which also the pain will be mitigated. Plaisters made of Leven, Figs, Onions, Doves-dung, adding thereto butter, Hens∣grease, fresh Hogs-grease, and Oyl of Lillies, or sweet Almonds. If by these Attractives the Part be over-heated, and the pain be too much encreased; they may be omitted by fits, laying on in the mean time the Cataplasm made of the Crum of White-bread; or nointing with the aforesaid Oyls, being laid on with unwasht Wool; or with Oyntment of Marsh-mallows, as was said before. And because the part is not sufficiently capable to receive the morbifick matter; to derive another way a portion thereof, a veficatory must be applied to the hinder part of the Neck, and also the Diaphore∣tick formerly cited must frequently be given. The Matter being called forth into the external parts, let Suppuration be endeavored, by laying on a Cataplasm made of the Roots of Marsh-mallows, and of Lillies with Figs, Meal of Linseeds, and the Oyls and several sorts of Grease aforesaid. When Suppuration is made, let the Tumor be opened; let the rest of the Matter be digested, by continu∣ing the Cataplasm, or by laying on a Plaister of Diachylon. Let the Ulcer be clensed with that common Digestive made of Turpentine, Yolks of Egs and Oyl of Roses. Let the Ulcer be kept long open with a Tent, that all the Venom of the Disease may sufficiently be purged out, and at last heal it up and Cicatrize it. Yet this oue thing is to be observed; That if the Tumor doth so en∣crease as to cause danger of Suffocation, or Choaking, it must be opened before it be perfectly ripe: For so some portion of the matter being drawn ••orth, the Tumor will fall somwhat, and the danger of Suffocation will be avoided. In like manner, If the malignity be very intense, that the Patient seems likely to miscarry before the Tumor be ripe; then also it must be opened before its due time that the force of the Venom may expire▪ whence oftentimes the Patient recovers. And upon this Account, in the Pest the Buboes or swellings in the Groin, are wont to be opened, before they come to Suppuration.

Finally, It were a Wickedness to pass over in silence a rare Experiment, which happened to me in that same Epidemick Feaver, which cruelly raged and ranged at Montpelier, in the year 1623. So that neer half of those that were sick died of the Disease. But especially, So many as had swellings by the Ears (which was wont to happen about the ninth or eleventh day of the Disease) they al died within two daies after; there preceding or happening at the same time Raving, Stupidity, Convulsi∣ons, with an unequal, frequent, and very small Pulse, as it were the creeping Pismire-Pulse. And after I had seen divers in this condition, who could not be helpt by Antidotes, or by drawing things laid to the swelling; musing with my self it by any means possible, they might be delivered from so certain destruction: I began at last to think, that therefore these swellings proved to fatal, because the Part in which they happened was not capable to receive all the Morbifick Matter, which being re∣tained within kills the Patient, and that therefore the work of Nature being only begun in those swellings, might be supplyed by evacuations, viz. Blood-letting, and purgation; whenas also Ga∣len in his 3. de Comp. Medic. Secund. Loca. Cap. de Parotidibus, In the Cure of these swellings pre∣scribes Blood-letting. But this advice was contradicted by the extream weakness of the Patients, which was so great that they seemed to be even now in the pains of death, which also it self soon fol∣lowed. But Galen in the forecited place, when He prescribes Blood-letting in the Cure of such Tumors, does propound two conditions, viz. If blood abound, and the strength of the Patient will bear bleeding. Both which Conditions were absent in these Cases, for blood had been before suffi∣ciently drawn, both by repeated Phlebotomies, and Cupping-glasses: Also the Patients were ex∣treamly decaied in their strength. Weighing all these things with my self, I conceived that golden saying of Cornelius Celsus, was in this Case if ever seasonable, viz. That many things are done right∣ly in time of eminent danger, which were otherwise to be omitted: And that its better to Experi∣ment a doubtful Remedy in one or two persons, than to leave so many persons to undoubted Destru∣ction. I was also encouraged by conceiving, that this great weakness of the Patients, was rather from oppression of the Morbifick Matter, than dissipation or dissolution of their strength. For there∣fore their strength did suddenly decay, because Nature was not able to cast off her heavy burthen, and I hoped when that burthen was made lighter, she would be freed. Add hereunto, That blee∣ding

might be so ordered, that no danger should be feared therfrom, viz. If two or three ounces only were taken away at first, for tryall sake, and if the success were good, a greater quantity might be taken away afterward I resolved therefore upon this course. And a Merchant of Montpelier named Bernardier being the first I met with, and a tumor arose behind his left ear on the eleventh day of the disease with such a puls & other symptoms as aforesaid; I prescribed bleeding to the quantity of three ounces which the Chyrurgion being an Antient and experienced man re∣fused to do for fear the patient should dy under his hands; afterwards being emboldened by my presence & authority he took away three ounces of Blood, after three or four houres, I visit my pa∣tient again, & find his puls a little stronger & not so unequal; then I caused him to bleed six ounces, after which his puls was beter and stronger. The Blood was very corrupt: The day following I prescribed him a Purg of Senna, Rhubarb and syrup of Roses: and so the patient was recovered from the jaws of death. And afterwards all the sick that had usings behind their ears, first I Bled severall times a little at a time, and the day following Purged them: and so all of them (to God be the Honor and Praise) so many as were thus ordered happily recover∣ed; and never any afterwards that had those risings behind their ears, died in the whol year

Howb it it is to be noted (which we hinted in the prognosis) that the swelling doth often appear critically and profitably, and thereby the sick are recovered of their diseases; viz, So oft as they appear in the declination of the disease▪ and this is easily seen by the abatement of the symptoms which follow upon the risings; and such are wont to happen in Feavers of less malignity But in the time aforesaid. such was the malignity of the epidemical Feaver▪ that the tumors behind the Ears would often break forth in the state of the disease and symptomatically and deadly; until by the remedies aforesaid, their o••structive facultie was taken away.

In a carbuncle superveneing upon a bu••••ing Feaver, if before its appatition, Blood were not sufficiently taken away. If the patient can bear further blood-letting open that vein which is nigh the carbuncle, that the greater attraction may be made of the veremous matter to the part affected. Afterward let the Tumor be scarrified on every side round about and that with prety deep gashes and foment it a while with warm salt water, that the corruption of the blood may be hindered, and the ••fflux thereof promoted. A while after apply a grain of a Caustick to the midle of the Pastle, and upon the whol swelling, lay this following Cata∣plasm,

Take leaves of Rue, and Scabious bruised of each one handfull: three pair of dryed Figs bruysed; sharp Leven an ounce; Pepper poudered one dram; two yolkes of Eggs: Mix all into a Cataplasm, which must be applied for two dayes together.

And then lay on this following.

Take Juices of Comphry the greater, Scabious, Marygold of each one dram; old treacle four scruples; Salt one dram; two yolks of Eggs: mix them all and apply it to the tu∣mor.

Also at the beginning may be applyed the Cataplasm de Arnoglosso described in the Dispensa¦tory of Bauderon.

But to the Eschara after the application of the Caustick, apply Ʋnguentum Basilicum, adding thereto Treakle, Oyl of scorpions, and the yolk of an Egg.

When the tumor is grown, lest the malignant matter should flow back again to the in∣ternal parts let the compass thereof be anointed, with ointment of B••lus, twice or thrice in a day: And upon the Eschara or Crust, that it's falling off may be hastened, ••y Vnguentum Basilicum with butter, and Sows grease mixed therewith after the crust is com away, let the ulcer be clens∣ed with this folowing ointment.

Take juice of Marygolds, wormwood, Scabious, and Smalladg of each one ounce; choyce of Mirrh, Florentine Oris, Aloes, Sarcocolla, of each one dram; Honey of Roses two ounces: Make of all an ointment, to be used till the sore be perfectly cur∣red