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

THE SEVENTEENTH BOOK OF THE PRACTICE OF PHYSICK. Of FEAVERS. (Book 17)

The PREFACE.

WE find by many Authors great Volumns written touching the Theory and Cure of Feavers; in which, innumerable Controversies, and difficult Disputations are handled. Which as they are in the Schools very useful, yea, and necessary; so are they tedious to most Physitians, who having left the Ʋniversities, do give themselves unto the Practice of Physick: For they desire a short and cleer Expli∣cation of the Theory of Diseases, which may suffice to declare their Nature, Cau∣ses, and Signs, both Diagnostick and Prognostick, with their right Method of Curing, which is the only thing they regard. It being my endeavor in this whol Work to satisfie their Desires, I have banished all Controversies, briefly expounding the decision of Questions only which seem most nices∣sary for a Practitioner. This we have likewise done in our Doctrine of Feavers; and letting pass all tedious Controversies, which are continually handled in the Schools, usque ad Nauseam; we have declared only such things as principally regard Practice. And this Book for better Methods sake, I have distributed into three Sections, following that General Division of Feavers, into Sim∣ple, Putrid, and Pestilential. So that the first Section of this Book shall treat of Simple Feavers: The second of Putrid: And the third of Pestilential.

SECT. I. Of Simple Feavers.

The PREFACE.

THat which we call a Simple Feaver, is subdivided into three sorts; of which, one is called Ephemera; another Synochus simplex, or Imputris; and another Hectica. And therefore we shall divide this Section into three Chapters: The first of Febris Ephemera: The second of Synochus simplex: The third of Febris Hectica. Wherein we shall declare their Nature and Cure.

Chap. 1. Of the Feaver Ephemera.

THis Feaver is commonly bred of external Causes, and of vehement Motions of Body and Mind, as Anger, Cares, Labor Pain, Watching, and Fasting, by which the Spirits are inflamed; also by Sleep and Sorrow, by which the hot Humors and Vapors are kept within the Body. Also by be∣ing heated with the Sun, Fire, or Stove, by which means, hot air being drawn in with the Breath, and received by the Pores of the Body, it doth inflame the Spirits. Also by Surfetting, Drunkenness, and especially by over large taking in of Meats and Drinks, that are of an hot Nature, as Peppered Meats, and stroog Wines, by which more Vapors are raised than can exhale. Also by Retention of hot Excrements, and that not only of the Dung and Urine, but especially of those Sooty Vapors which are wont to pass through the Pores of the Skin, if those Pores be shut up with cold, an Allumi∣nous Bath, and such like Causes.

Also this Ephemera Feaver is bred of internal Causes, as from a Bubo, and other Swellings of the Thighs or Arms, especially whiles they break; from an hot fiery Swelling of the Extremities of the Body, when hot Matter shut up together in one certain place, doth offend the Heart, not by its pu∣trefaction, but heat alone. Also by some smal Obstruction of the Vessels, by which means the soo∣ty exhalations being retained do cause a Feaver; as is wont to happen in Distillations, when they arise in hot Natures, and a thick habit of Body.

This Feaver is known, both when some of the Causes specified hath gone before; and also by a swift, frequent, and great Pulse; breathing frequent and great, Headach and Heat; there is neither cold nor shaking, no sence of weariness, nor want of Appetite. Yet may there be somtimes a shi∣vering or shaking fit, namely, when the Feaver is occasioned by the heat of the Sun, or by cold. Fee∣ling the Patients Hand we find a mild and gentle heat; the Urine is concoct, like that of one in health, unless by some Obstruction or Crudity it be changed. It is commonly terminated in the space of twenty four hours, with an easie gentle Sweat; yet it reacheth somtimes unto the third day, which if it pass it degenerates into a simple Synochus, a Putrid, or an Hectick Feaver.

For the Cure of this Feaver, the Ancients did chiefly use a bath of luke-warm Water, which they did also frequently use in their Health. But seeing it is in these times out of use, neither is it in pra∣ctice in the Cure of these Feavers. Neither is it counted safe, in regard of a Plethorick or Cacochy∣mical Constitution of Body, Putrefaction, or flux of Rheum, which may be in such bodies, or may be feared wil happen.

But this Feaver is better cured by a Cooling and Moistening Diet; as Barley Cream, Cooling Broths, Smal Drink and Sugar, common Ptisan Drink, or Fountain Water with Syrup of Lemmons, Maiden-hair mixed there with.

But the Cure admits some variation, according to the Nature of the Cause. So if it spring from the Heat of the Sun or Air, a cooling Diet is good, and the Patient must be conveighed into a cool lodging; and Vinegar of Roses must be applied to his Forehead, to the Temples and former part of the Head it self, if there be pain, as commonly there is when the Feaver comes from the heat of the Sun.

If it come from being in the Cold, especially if the Patient being hot with Exercise went presently into the Cold, Sweat must be provoked, especially towards the end of the Fit.

If it come from the Skins thickness and closing up of the pores, the same Cure must be used; and to both these Causes, smal Wine very well allaied with Water may be convenient, because it opens the pores, and helps to sweat.

If the Disease was caused by Labor, the Patient must rest and be nourished more liberally with Meat of easie Digestion. If from weariness, the Patient must be artificially rubbed. Tranquillity of mind, and cheerfulness, must be opposed to Anger; and Choller must be tempered with Meat and Drink of a cooling Nature. To Sadness, Recreation of the Mind is a Remedy, and the use of thin smal Wine. If the Feaver was caused by watching, let the Patient sleep by application of things con∣venient: If by fasting, let the Patient eat cooling Meats of good Juyce: If by over eating or drin∣king, let the Patient abstain from Meat and Drink, not omitting such things as strengthen the Sto∣mach, both inwardly given, and outwardly applied: also with an Emollient and Laxative Clyster, part of the Crudities is to be taken away. If Putrefaction be feared, Vomit may be procured, or a Purge given. If the Feaver arise of Obstructions, we must consider whether the Patient be Pletho∣rick or Cacochymical, viz. Whether the whol Mass of blood be over great, or only some bad Hu∣mors abound in the blood. If the Patient be too ful of blood, blood-letting must be advised; if evil Humors only abound, a Purge must be prescribed. And if the Obstruction wil not easily be removed, this Feaver changeth into some of the other sorts of Feavers, whose Cures shal be described in their proper places.

Chap. 2. Of the Feaver Synochus Simplex.

THe Causes of the Feaver Ephemera aforesaid, if they light upon a Plethorick Body, and thick skinned, they cause the Feaver Synochus Simplex. Yet may this Feaver arise only from a∣bundance of Blood stuffing the Veins, and yielding many Vapors more than can breath through the pores of the Skin.

This Feaver is known by a thick and swelling habit of Body, the color of the Body and Face is ruddy; the Head is pained with a stretching or distending kind of pain; the Patient is sleepy, hath a beating in the Temples, is unquiet, hath a straitness in the Chest with difficulty of breathing; the Pulse is great, even, frequent, full; the Veins strut with blood, whence a stretching kind of wea∣riness doth proceed; the Urine is thick, little differing in color from a Natural Urine, only somwhat redder; the heat is to ones hand mild, tempered with a steamy Vapor; the Feaver holds an even progress, for either it holds one and the same tenor, or it lessens by degrees, or it encreaseth equal∣ly, never remitting or ceasing. Whence there are reckoned three Differences of this Feaver: For that which continually encreaseth, is called Epacmastica; That which continually decreaseth, is called Paracmastica; That which keeps one and the same tenor, is called Homotonos, or Acmasti∣ca. It lasts til the fourth day, and somtimes til the seventh; and then it is terminated by bleeding, or sweating; and if it be further prolonged, it degenerates into Synochus Putrida.

The Cure of this Feaver is performed, by blood-letting, by cooling, and by opening the pores of the Skin. Galen in the ninth Book of his Method, Chap. 4. cures this Feaver by two Remedies on∣ly; viz. Letting of Blood til the Patient faint away; and by giving a great quantity of Water to the Patient to drink.

Blood-letting is absolutely necessary in this Disease, because it is bred by fulness of blood; and a Vein must presently be opened at what hour soever the Physitian is called, unless the Patients Sto∣mach be ful of Meat, the digestion whereof must be expected for certain hours. And although Blood must be plentifully drawn, and Galen reports in the fore-cited place, That he cured the most of such as had this Feaver, suddenly, by letting them bleed til they fainted away; which bleeding was attended by a loosness, vomiting of Choller, and plentiful Sweat. Yet in these daies of ours, that same large blood-letting is out of date; which is not without danger, seeing Galen himself re∣lates in his Book of Curing by Phlebotomy, Chap. 12. That it besel three Physitians, while they were practising this large Blood-letting▪ that instead of fainting away, their Patients died out-right. It is better therefore at several times to take away so much blood, as the Nature of the Disease doth ne∣cessarily require.

Before Blood-letting, if the Patient be Costive, or the Guts abound with Crudities, an Emolli∣ent and Laxative Clyster must be given.

As for the point of cold Water, Galen orders it to be given in so great quantity, that the Patient grow pale, tremble, and be cold all over; and so he saies, it extinguisheth the fiery heat, it streng∣thens the solid parts, and drives out unprofitable Humors by stool, by urine, and by sweat. But he saies there must be many Cautions in the use thereof; viz. That it be given in the Vigor of the Fea∣ver, the signs of Concoction appearing; that the Patient have been used to drink cold Water in time of health, have strong bowels, and full of juyce, a fleshy and wel-set Body; have a constant and vigorous strength; be not full of thick and clammy Humors, have no tumor in any bowel, nor sto∣mach, throat, or sinews weak. Otherwise, if these conditions be wanting, it is to be feared lest the Patient fall into shortness of breath, Dropsie, Trembling, Convulsion, Lethargy, or some other grie∣vous Disease. This kind of Medicine is likewise grown out of date in our times, seeing it is hard to observe all those conditions, and so many dangers attend the undue use thereof. For it is better to use other more safe Medicines which cool the whol Body, and the Blood; as Juleps, and opening Emul∣sions, Epithems, Liniments, and a Diet altogether cooling. Juleps are made of the Decoction of Barley, or Sorrel, or Cichory; or with Water of Cichory, Endive, Sorrel, Lettice, adding Syrup of Juyce of Cichory, Lemmons, Pomegranates, Vinegar, &c. Whereunto also for the greater cooling and opening, may be added some drops of Spirit of Vitriol, or Sulphur. If the distilled Wa∣ters seem too crude or raw, let them boyl with a little Species Triasantalon, or Diamargaritum fri∣gidum.

Emulsions may be made after this manner:

Take sweet Almonds blanched and steeped in Rose Water, one ounce: the four greater cool Seeds, and Seeds of white Poppy, of each two drams. Beat them in a Marble Mortar, powring on by little and little, a pint and an half of Barley Water. In the strained Liquor dissolve Sugar of Roses three ounces. Make an Emulsion of Almond Milk for three Doses. Which will be conve∣ment, and is to be preferred before Juleps, if there be want of Rest.

Epithems to be laid upon the Region of the Heart and Liver may be thus made:

Take Water of Roses, Bugloss, and Lettice, of each three ounces: Vinegar of Roses one ounce: Pouder of the Electuary Diamargaritum frigidum one dram and an half: Camphire six grains. Make an Epithem, lay it upon the Region of the Heart.

Take Water of Endive, Cichory, Sorrel, of each four ounces: Vinegar of Roses an ounce and an half: the three Sanders two drams and an half. Make an Epithem for the Region of the Liver.

A cooling Oyntment may be anointed upon the Liver and Loyns, of Vinegar of Roses, Ʋnguen∣tum Rosatum, Ʋnguentum Refrigerans Galeni, or Ceratum Santalinum, washed in Vinegar, tempered with Water.

If the Disease seem to lengthen, after bleeding we must purge, lest the wheyish and Chollerick Excrements putrefie, and thereby a putrid Feaver arise. But we must use such Medicines as purge without heating and agitation of Humors, as Cassia, Manna, Syrup of Roses, Tamarinds, Catholi∣con, and such like.

Ad hereunto a convenient Diet, viz. Cooling, moistening, and thin, of Broths made with cooling Herbs, Prunes, and sharp Apples boyled, and Panadaes.

Let the Patients Drink be, a Decoction of Barley, Water boyled, and Water with Bread boyled in it, or mixed with Syrups of Maiden-hair, or of Pomegranates.

Chap. 3. Of an Hectick Feaver.

AN Hectick Feaver occupies the solid Parts of the Body, which constitute the Habit thereof, and are commonly called Spermatical, or fleshy; in regard of which parts it is more fixed and roo∣ted than other Feavers which are in the Spirits, or Humors. For which cause it is also termed Habi∣tual, because it is become Habitual, and can hardly be removed from its subject.

There are many Divisions of this Feaver. For first of all, there is a Primary Hectick, which be∣gins of it self; and another Secondary, which follows other Feavers. Secondly, an Hectick Feaver is simple and solitary, or joyned with a putrid Feaver. Thirdly, some Hecticks begin at the Heart; others from other Parts, as the Lungs, Liver, Spleen, Kidneys, Womb, and other Parts inflamed, ulcerated, corrupted, or possessed with some other grievous Disease. And this Feaver though it have its habitual seat in the Heart, and the whol Body; yet is it commonly termed Symptomatical, because of its first Original which it hath from other parts.

Galen makes three Degrees of an Hectick Feaver. The first is the very beginning of an Hectick; in which the Body is hardly extenuated; yet the moist Humidity of the Body is inflamed, consumes, and dries. The second comprehends the Augment, and therein is an evident extenuation of the Body, the fleshy and fat substance of the Body perishing. The third contains the state of the Disease, and its last age; for it never comes to a declination, because therein, viz. in that degree it is incurable: for then the fibrous and membranous substance of the Body is consumed, and the whol Body is so ex∣tenuated, that the Face of the Patient is like that described by Hippocrates, nothing but skin and bone. This last Degree is called Marasmus, or rather Hectica Marasmodes; because in a true Maras∣mus, cold is joyned with dryness.

The Causes of an Hectick Feaver are divided into an Internal, and External. To the External are referred, what ever Causes may occasion any of the other Feavers, if the Action of Heating be continual and vehement, or the Patients Body be apt to entertain this kind of Feaver. Such are, the heat of the Sun, or of the Fire, vehement Exercise, Meats and Drinks that are heating, immoderate Evacuations, as in a Loosness and bloody-flux, vehement passions of Mind; and finally, fasting in a Chollerick Body that is hot and dry of Constitution; seeing Galen affirms, that those Physitians that were wont to enjoyn their Patients to fast three daies together, did bring Chollerick Constituti∣ons by that means into burning and hectick Feavers.

The Internal Causes are, burning and pestilential Feavers, which do speedily consume the moi∣sture of the Heart; also a long slack Feaver. Also some peculiar Disease of any of the bowels, as an Inflamation or Ulcer; or putrefaction of some Humor contained therein; or finally, the corruption of the Member it self, which are wont to cause a lingring Feaver, and an hectick.

Of these Infirmities peculiarly possessing some certain Members of the Body, and causing an He∣ctick, we have Examples manifest enough. For, as for what concerns Inslamations, Galen saith he saw a woman that by reason of an Inflamation in her Midrif, fel into an Hectick Feaver. And we dayly observe in the Consumption of the Lungs, or Phthisis, a complicated Hectick Feaver. The putrefaction of Humors contained in some bowel, fals out in great obstructions, or cold swel∣lings. The corruption of some Member is often seen in the Lungs; somtimes in the Liver, in such men as are given to Wine, and who use much hot Spices; for a certain filthy corrupt blood is bred in

their Liver, by which the substance thereof is corupted. Fernelius saies, he somtimes met with this kind of Feaver, and that it is a sign thereof, when the Patients extreamly covet Wine; but abomi∣nate all kind of Flesh.

A Simple Hectick Feaver is known, because it is continual, without any ••its, allwaies alike, neither encreasing nor decreasing, save that it is somwhat augmented, an hour two or three after Meat. The heat under the short Ribs, is at first laying on the hand mild, afterward sharp, biting and dry. The Pulse, is little, frequent and quick; the sick perceive not any Feaver, they are lazy, and loath to stir, and when they stir it is with Pain, because their strength is in a languishing condi∣tion. Their arteries are hotter than the Parts circumjacent, which may be preceived by the touch after the Patient hath washed in cold Water. The Urin is like that of one in health both in point of color and sediment. In the progress of the Disease Oyly substance Swims on the top, and the sediment is like to Meal, which is sign that the substance of the Body doth melt,

More particularly, we may know not only the several degrees of an hectick, but foresee it before it comes after this manner.

An hectick Feaver at hand, is known, if the causes have preceded; viz. if there have been a burning Feaver, in a body naturally hot, dry, and of a thin contexture, in an hot season of weather, it is to be Feared, the Patient wil fal into an hectick, and such remedies as may prevent the same are to be used.

The first degree of an Hectick Feaver if it be Joyned with a putrid Feaver, is very hardly known: if it be alone, not very easily. In the first day, there are al the signes of Febris Ephemera. In the second, the dryness is augmented, not the heat. On the third day it repeats not, it is not evidently augmented nor diminished. And at length one hour or two after Meat, the Heat seems somwhat encreased.

In the second degree, the Patient perceives no Feaverishness, only some alterations after Meals. There is a manifest dryness, a smaller and swifter Pulse, with a certain hardness.

The signs of the third degree are most manifest; the Eyes are hollow, dry and have dry excrements in them, the bones evidently stick out, the lively colour of the Face is extinguished: the whol Skin is dry, the Midrif vehemently contracted, so that the Patients seem to have no Guts. Their Pulse is perceived under the stomach, in all extenuated persons.

And because a putrid Feaver is many times coupled with an Hectick, they are both exactly to be distinguished, because it is of great moment in regard of the Cure, which in this case is very much differing. Now this coupling may be known by Comparing the signs of an Hectick propounded, with the signs of a putrid Feaver, which shall be hereafter described in their proper place.

The first degree of an Hectick Feaver is easily Cured, the third is incurable; the second is of a middle Nature, and look how much the nearer it approaches to the first or third by so much is it easier or harder to be Cured. An Hectick Feaver happens most commonly from the eighteenth yeer to the thirty five, for in that Age the Heat is most intense, and soonest consumes the Body. But they who before this Age or a little after are taken with an Hectick Feaver, do more easily escape and are som∣times Cured perfectly; or by a palliative Cure their life is protracted a long time, especially if they be Women.

For the Cure of this Disease, we must first consider whether it depend upon any Diseaseof some particular Part or not: for then the Cure must be directed to that Disease: as also if it be single or combined or complicated with a putrid Feaver. And in this case the putrid Feaver is first to be Cured by Bleeding, Purging, and by Opening Medicaments and such as hinder putrefaction: the Hectick Feaver in the mean while not being neglected. But if the Hectick Feaver be single and alone the Cure must be effected only with cooling, moistening and restaurative things; the matter of must be taken from Diet and Medicine.

Diet, here, as in all Chronick Diseases, can do much; nay in this Disease it can do more than all Medicines. Therefore the Patients Diet must be by the Physitian exactly ordered, viz. That it may be directed so as to cool and moisten the whol Body. If therefore the Air where the Patient is, be moderately cold or temperate, let him use the same; if not, let it be corrected, so as that it may cline to cold and moist. For this Reason Galen in the 10. of his Method Chap. 8. in the Summer when the Air is hot, orders the sick to abide in a Room under the Ground, that is very cold and blown through with the Wind, open towards the North. By which Remedy alone, we have seen a man extreamely consumed, restored within a month. Again the heat of the Air in the Patients Chamber must be altered, by cold Water being powred out of one vessel into another, by the very noise whereof Sleepis caused; also by moistening the Pavement of∣ten with cold Water Sprinckled thereupon, or by cooling Hearbs, oftentimes fresh strowed therein: and by forbidding any number of people to come in, which among other things, doth likewise heat the Chamber. And Galen gives order that when the Air is coldest it should be received by the sick namly by drawing it in by the mouth, because it exceedingly cools the heat of the heart; but it is not good for the Body of the sick, least it stop the pores of the Skin and hinder the breathing forth of

excrements. But Galen affirmes that the breathing in of the cool Air doth the Patients more good, than they can receive hurt, by the stopping of their pores, if that should happen: but that may be hindered by warm cloathing of the Body. Yet it is to be observed, that if the Hectick Feaver ari••e from an Ulcer in the Lungs; that the cold Air is not good in that respect, but rather temperate, a little inclining to heat, and dry. For which Cause Galen sent those that had consumptions of their Lungs to the Mount Tabias where the Air was more dry than ordinary.

The Meates of the Patient must be cooling and moistening and quickly nourishing, as Chicken-Broaths and Broaths of Hens, Capons, Veal, Kid, Wether Mutton; Yolks of Eggs, with French Barley, Lettice, Purselane, Endive, Borrage, Sorrel; The flesh of Calves, Kidds, Piggs, Phea∣sants, Partriches, Young Hares and such like. Panadaes, Barly Cream, Water-Gruel, Rice-Pottage, with Sugar and a few Almonds or rather with the greater cooling Seeds. Boyled Meats are fitter than Roasted which are sooner Inflamed and turned to Choller; the boyled do more moisten. But if the Patient be more delighted with Roast-Meats; they must be very moderately Roasted, and tempered afterwards with Juyce of Lemmons, Citrons, Orenges, or of unripe Grapes, without Salt.

Fishes may be eaten, because they cool and moisten but such as are taken out of stony places are to be preferred, and such as have a tender friable flesh, haunting the Sea or Pure Waters.

Among fruits, Apples are commended because they breed cold Blood. also Pears are convenient, Damask Prunes, and French Prunes boiled in Sugar; also Raisons clensed, which being prepared after this following manner, do nourish the body without heating.

Take Raisons of the Sun clensed one Pound: Let them be tempered in endive, bugloss and Rose-Water and very diligently washed, that the Laxative power may be taken away. Afterward let them be lightly boyled in the same Waters, adding a little Sugar, wherewith let them be preserved for use: let the Patients take of them in the mornings and allwaies after Meat.

And because Persons that are Hectical, have the Feaverish heat fixed in the solid Parts of their bodies, by which the Nutriment is easily and suddainly consumed and dis••ipated: therefore Pra∣ctitioners are wont to prescribe unto them, Meats solid and of a clammy substance, as the Feet of Living Creatures, The flesh of Snails, Crabbs, Tortoises, and of Froggs. For seeing these sorts, of flesh are moist and clammy they easily adhere unto such Parts of the body as want nourishments neither are they easily consumed by the Feaverish heat: and so they hinder the drying up of the solid Parts of the body. Yet some do reject these Meats, because hard of digestion and trouble••om to the stomach. But this difference is thus reconciled. In the beginning of an Hectick, while the digestive faculty is yet strong, these thick and clammy nutriments are convenient: but in a confirmed Hectick they are not to be given because hard to digest. Add hereunto, that they may be so pre∣pared and qualified, as that they may easily be digested; as by being boyled to a gelly, or giving only what is strained out of them being beaten into a mash. Among other things the land Tortoises are mightily praised for an Hectick, not only for a single Hectick, but when Joyned with a Consump∣tion; and they are prepared divers waies. For either they are boyled in Water till they are dissolved then casting away the shells, the flesh is separated from the bones and boyled again with Cichory, Sorrel, Borrage, French barley, and prunes in a single Hectick: but in an Hectick of the Lungs it is Boiled with Bramble Leaves, Purslain, and Plantan. Let the Patient drink the broath and eat the Flesh twenty daies together. Or the Juyce is pressed out of the Flesh being beaten. Or little Loaves are made of the Flesh of the Tortoises boiled in Barley Water, with sweet Almonds, pine kernells, the cooling Seeds and Sugar. Which are lightly baked in an Oven and are given the Pati∣ent at Dinner and Supper. They may be thus made.

Take of the Flesh of Land-Tortoise Boyled in Barly-Water four ounces: sweet Almonds steeped in Rose-water six ounces: Pine-Kernells so steeped two ounces, of the four greater cool Seeds, of each one ounce: Annis Seed not Poudered, but lightly baked in an Oven one dram and an half: Cinnamon two drams: Sugar dissolved in Rose-Water, to the Quantity of all the rest. Make thereof little Morsells.

Instead of Tortorises the Flesh of a Capon is used and of a Partridg, and March-Pane is made thereof, good to restore Hectick Persons, after this Manner.

Take Pulpe of a Capon and Boyled Partridg of each three ounces, sweet Almonds steaped in Rose-Water four ounces: Pine-Kernells one ounce and an half: Seeds of white Poppy two drams: Gum Arabickand Traganth of each one dram and an half: Pearled Sugar Cakes two ounces: with a little Rose-Water make a March-pane, and gild it with Gold.

To such as have weak stomachs, Gellies, broaths, and Restorative stilled Waters are given. A Gelly may be made after this Manner.

Take a choise Capon, a Knuckle of Ʋeal, or a Wethers Thigh, two Calves Feet, or six Wethers Feet. Boyl all in fountan Water, till it be ••ufficiently wasted. Strain and squeese out the Juyce and Broath and take off the Fat. In the strained Liquor dissolve a pound of white Sugar, six whites of Eggs, a little saffron or Cinnamon. Stir them together let them Boyl lightly, and

strain them through an Hippocras bag twice or thrice. At length put it into Porrengers, or other Vessels in which it will become a Gelly. If the tast of Saffron or Cinnamon be displeasing, or you desire to have your Gelly more cooling, add instead thereof the Juyce of a Lemmon, or of one Citron.

Restorative Broths may be made divers waies; this is far the best of all, which follows:

Take a well fleshed Capon; pull, draw, and cut him in pieces, and take away the fat and skin: add, if you please, some Veal, or Weather Mutton cut into bits, and freed from the Fat. Put them into a stone Vessel well glazed; in which, about the middle, there must be a grate of Wood, or other materials, on which the pieces aforesaid must be so laied that they may not come at the bottom. Then cover the Pipkin with its cover, and close it up well with paste, and let it stand in boyling Balneo Mariae five hours. There will drop into the bottom a cleer transparent Liquor; of which three of four spoonfuls, may be given in Broth, or by it self, three or four times in a day.

Such Distillations of Flesh by Descent, are very convenient for Hectical Persons; but those that are made by Ascent, although they refresh the Spirits, yet do they very little nourish; neither do they restore the solid substance of the Body.

Let the Patients Drink be, Barley Water, either by it self, or with Syrup of Vinegar, or Pome∣granates mingled therewith, or Water in which a piece of Bread hath been boyled, sweetened with a little Sugar. But if the Patients Stomach be very weak, weak Wine wel allaied with Water may be allowed, which helps the concoction and distribution of Nourishment. Galen, Meth. 10. Chap. 5, 6. gives cold Water, with which he boasts he had saved many from the Marasmus. Howbeit, great Cau∣tion is to be used in the giving thereof; for when the Body is very much pined away, it is to be sea∣red lest the smal heat of the Patient should be wholly extinguished. And therefore it is only good when an Hectick is feared, or in the beginning thereof, and to such as are accustomed thereunto, and while the Body is yet sufficiently ful of blood.

Motion of the Body is not good, but the Patient must be enjoyned to rest; howbeit before Meat, if strength wil bear it, some light exercise wil be good; or instead thereof, a few light frictions or rub∣bings may serve turn, especially presently after sleep, beginning at the inferior parts of the Body; for they provoke the Humors outward. And the Patient must be rubbed no longer than til a light red∣ness begin to appear upon the Skin; for to rub longer would dry the Body. Carnal Embracements must be above al things avoided, which do very much consume the substance of the Body.

Let the Patient sleep, neither very long, nor very little. For long sleep encreaseth the heat of the Bowels, by the retiring of the Natural warmth inwards: too short sleep dries the body more. But there is less inconvenience from sleeping a little over largely, than too scantily, because sleep doth exceedingly moisten, which in this Feaver is very much to be desired. Let the Patient sleep in a soft bed, and that a Flock-bed, not a Feather-bed, and large enough. Let the Patients Linnen be often changed, which must be sprinkled with Rose-Water before they be put on.

If there be Costiveness, the Belly must be provoked with a Suppository, or a Clyster of Chicken Broth, with Barley, Mallows, and Violet Leaves boyled in it; adding Cassia, Honey of Roses, But∣ter, and the Yolks of Eggs.

Finally, The Mind must be preserved in peace and cheerfulness, avoiding vehement Perturbations, as Anger, Sadness, Fear.

As for point of Medicaments fit for Hectick Persons, they are Internal or External. Among In∣ternal, in the first place Purgers must be considered; and because addition is more necessary than detraction in this Disease, Purgers can hardly be convenient, unless a putrid Feaver be joyned with the Hectick. Yet if the first Region of the Body seem filled with Excrements, because of Crudities arising from a weak Stomach, Purgation may safely be used with Cassia, Manna, or Syrup of Roses. Nay verily, if strength be not deficient, the Infusion of Rhubarb may be given, with a Decoction of Prunes, Tamarinds, Myrobalans, Bugloss, and Violets.

But Altering Medicines may be reduced into the form of Juleps, Broths, and Emulsions, after this manner:

Take Waters of Endive, Lettice, Sorrel, of each four ounces: Syrup of Violets, Water Lillies, Apples, of each one ounce. Mix all into a Julep for three Doses, to be taken at several times in one day, and to be continued for divers daies together. Or,

Take Whol Barley one pugil: Leaves of Endive, Cichory, Lettice, Pimpernel, of each one handful: Flowers of Borrage, Bugloss, Violets, and Water-lillies, of each one Pugil: Damask Prunes three pair: Boyl all to a pint and an half. In the strained Liquor, dissolve simple Syrup of Cichory, and of Water-lillies, of each two ounces. Make of all a Julep for four Doses.

Of the same Simples with a Chicken or a Pullet, may be made a Broth for the same use. Or,

Take Roots of China one dram and an half: Entire Barley two pugils: the four greater cool Seeds half an ounce. Beat all together, and therewith fill the Belly of a Capon, or yong Pullet, and make Broth; to which add Sugar of Roses half an ounce. Let the Patient take of this broth a long time together. It restores flesh and fatness.

Take sweet Almonds blanched and infused in cold Water one ounce: the four greater cool Seeds, and of white Poppy seeds, of each one dram. Beat all together in a marble mortar, powring on by little and little a pint of barley Water. In the strained Liquor dissolve Sugar Cakes made 〈◊〉〈◊〉 Pearl four ounces. Make hereof an Almond Milk for three Doses.

If we be minded more powerfully to cool, we must add to every Dose of the Julep or Emul•••••••• two scruples or one dram of Sal prunella.

In the use of Refrigerating things, this is to be observed, That we use not the more 〈…〉〈…〉 of a sudden, or frequently; for they might extinguish a weak heat. But it is better to 〈…〉〈…〉 and little, than suddenly. And Moisteners are alwaies safer than Coolers, because they exerc•••••• 〈◊〉〈◊〉 Operations slowly.

While the foresaid Remedies are using, we must be careful to strengthen the Bowels, by a c••••••••∣nient Opiate, which may be made after this manner:

Take Conserve of the flowers of Borrage, Bugloss, and Violets, of each one ounce: Conserve of the flowers of Water-lilly half an ounce: Pouder of the Electuary Diamargaritum frigidum four scruples: Shavings of Ivory, Bones found in hearts of Stags, of each half a dram: Pearls pre∣pared, and Coral prepared, of each one scruple: three Leaves of Beaten Gold: With Syrup of Apples, make of all an Electuary.

In extream consumption of the Flesh, nourishing Clysters are frequently to be injected, of the Broth of a Chicken, or Weathers Head, with Sugar and the Yolks of Eggs. But their Quantity must be smal, or else compressing the Guts, they wil provoke the Expulsive Faculty to drive them out.

But among other Medicines most convenient for Hectical Persons, Milk is a principal one, it being endued with all the qualities which can desired in this Disease, namely, of cooling and mostening; it nourisheth much, and is easily distributed into all parts of the Body. In the use whereof, the same Cautions must be observed, which were set down in the Cure of a Consumption.

Among External Remedies, a Bath of fresh Water is principal; for it powerfully cools and moi∣stens, and relaxeth the external Parts that they may more readily receive Nourishment. Among the Ancients the use of Baths was most frequent, and there were four parts of the bathing place: In the first somwhat warm, they put off their Cloaths: In the second there was a bathing Vessel of hot Water: In the third a bathing Vessel of cold Water: In the fourth the Sweatiness and Moisture was dried off. Galen in 10. Meth. Chap. 19. doth thus moderate the use of these parts of the Bath; That the Patients should be brought into the first part of the Bath, which was heated with the vapor of the bath, that the pores of their bodies might be opened; then being anointed with fresh sweet Oyl, they were to be plunged in the hot Water to moisten their bodies; and then they were of a sudden to be thrown into the cold Water, quickly to be taken out again, and to be dried and a∣nointed with Oyl, that the pores being closed, the moisture may be received from the hot bath, might be retained. But inasmuch as the Industrious Diligence of the Ancients in the use of bathing, is long since out of use; and our Practitioners have likewise left this Method of bathing Hectical persons, which they judg unsafe, seeing it is to be feared, lest by the sudden receiving of the cold Water, the Patients Body should be hurt, and the Patient not be able to endure the sudden sence of contrary qualities. So that our Practitioners do more advisedly, and more compendiously, whiles they con∣veigh the Patients into a bath of Water moderately hot, in the morning, after a stool procured by Nature, or by Art, and two or three hours after they have eaten some broth, or milk, or the Yolks of Eggs; wherein they abide solong, till it grow luke-warm of it self, and at last cold. For seeing Galen conceives the use of a cold hath after an hot to be so necessary, that without it the hot bath doth no good: the use of a cold bath is supplied, if the Patients stay so long in the bath til of it self it grow luke-warm, and cold. But this Caution is to be observed, That whereas a three-sold quality may be had in the same bath, the Patient must abide in the hot a little while, in the luke-warm longer, in the cold least of al.

And although the Ancients were wont to make their baths of simple Water; yet is it good to make them more moistening by boyling therein Emollient and moistening Herbs, as Mallows, Marth-mal-lows, Violet Leaves, &c. or with barley and beaten Almonds, especially in the Summer, because a bath of Decoction of Herbs is sooner corrupted. After bathing, the sick is softly to be wiped with hot Cloaths: then to be anointed with Oyl of Violets, sweet Almonds, with fresh Butter; and after some time of rest, let the Patient eat some broth, or other food.

A bath of Water and Oyl, is exceedingly cried up by Zacutus Lusitanus, in the 35. Observation of his third Book of wonderful Cures; where with he saies a yong woman was cured, when a bath of simple Water and Goats Milk could not help. The reason of which great good, he renders to be this; Because bath made of fresh Water, with store of Oyl in it, doth soften the distended stiff parts, doth moisten the dry and withered: and by opening the pores obstructed, and through dry∣ness contracted, it draws the Nourishment to the outmost, and most distant parts of the body.

When the Patient cannot use baths, apply an Epithem to the Heart and Liver, in this manner com∣pounded.

Take Waters of Roses, Water-lillies, and Purslain, of each three ounces: Juyce of Pome-Gra∣nates an ounce: Pouder of Diamargaritum frigidum two drams: Bones out of the Stags Heart one scruple: Camphire four grains: Make an Epithem for the Heart.

Take Waters of Endive, Lettice, Cichory, of each three ounces: Vinegar of Roses one ounce: the three Sanders, of each two scruples: Burnt Ivory one scruple. Make an Epithem to be appli∣ed to the Liver.

Also the Region of the Liver may be anointed with Oyntment of Roses, or Ceratum Santalinum. But Oyls and Unguents must be sparingly used, because they may somtimes encrease the Feaver.

Among the Symptomes which are wont to come upon this Disease, the chief is a Loosness, which is wont to bring the Patients to their death. This is to be bridled with a Decoction of French-bar∣ley toasted, for their ordinary drink, Syrup of Quinces, dried Roses, Chalybeate Milk, Rice boyled in Milk, and such like.

SECT. II. Of Putrid Feavers.

The PREFACE.

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

Chap. 1. Of Continual Putrid Feavers.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

AN APPENDIX.

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

Chap. 3. Of a Tertian Ague.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

These following are outwardly applied.

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

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

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

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

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

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

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

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

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

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

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

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

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

Chap. 4. Of a Quotidian Feaver.

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

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

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

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

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

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

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

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

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

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

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

Chap. 5. Of a Quartan Ague.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pils for frequent use may be thus compounded:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Or,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SECTION III. Of Pestilential Feavers.

The Preface.

All Authors (very neer) who have writ of Feavers, do distinguish a pestilential Feaver from a malignant, and doe treat of each of them severally in divers Chapters; so that by the name of a pestilential Feaver they doe understand the true Pestilence or Plague; and by a such malignant Feaver, they mean that which is commonly called the sp••••ted Feaver, or such a Feaver which though it be epidemical and contagious, yet it is not so dangerous but that more live then die of it: whereas the true essence of the Plague consists in this that more die thereof than recover. But for as much as these Feavers differ one from another only according to the greater or lesser degree of malignity, and must be cured with the same Medicaments; we have thought it more convenient to include al these kind of Feavers in one Chapter, and to han∣dle them all under the name of Pestilential Feavers. and consequently this last Section shall con∣sist of two Chapters, the first of which shall treat of the Pestilentiall Feaver; and the later of the Measles and small Pox: For seeing a Malignant Feaver does allwaies attend them all Authors doe justly treat of them in this place.

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

Chap. 2. Of the Measles, and small Pox.

THat Feaver which is commonly attended by the Measles and small Pox, may justly be reckon∣ed among Malignant and pestilential Feavers; seeing it is Epidemical and contagious, and kills very many children, to whom it commonly happens

What is the difference between the Measles and small Pox, Authors are not yet well agreed. But custom hath obtained that those same larger pustles or Whelks like unto Warts (from whence

they have their name) should be called in latin Varioloe, in English the small Pox; but those little pus∣tle•• and as it were asperities of the Skin with a deep redness like St. Anthonies fire or the rose, which are discussed within five or seven daies without suppuration, are called in latin Morbilli and in English Measles. There is also another kind of pustles common to Children like unto the small Pox in respect of the fashion and size; but herein it differs in that the small Pox begins with redness and inflamation; but these are white and as it were bladderes full of a wheyish humor, which within three daies break and dry up and are wont to cause no danger, and commonly break forth without a Feaver. It is described by Vidus Vidius, in these words; Som besiáes the two for∣mer sorts do ad a third which they call the Crystalls, For so they term certain Bladdrs full of mat∣ter, which shine like Christall, wherewith the Skin is in divers parts diapered; the common people call them Ravaglione. unto which all men are not so subject as unto the small Pox and measles, neither are they so greviously afflicted under them. wherefore these bladders ought not to be re∣ckoned as a third sort with the small Pox and Measles

Touching the smal Pocks, and Measles Authors dispute much, and especially whether these be new diseases, or if they were known unto the antients, and what is the next and immediate Cause of them. But since I affect al possible brevity in my Lectures, I have bin wont to omit al controver∣sies, propounding onely the plain and naked decisions of them; and accordingly, I shal breifly unfold what is to be thought of the foregoing questions.

And in the first place I conceive the smal Pocks and Measles to be no new diseases, seeing they rise from a most antient Cause, viz. the impurites of the maternal blood; which when the Arabians observed, they accounted it no new disease. But if they had first come abroad in their times, they would have mentioned their novelty. And although, they were the first that exactly described them; and Hippocrates and Galen with the rest of the Antients, have scarce mentioned them; we must suppose that therefore the Antients did not write distinctly of them, because they are only accidents of a malignant Feaver and critical eruptions, which do not make a distinct disease by them∣selves. Or because in Greece through the mildness of the Ayr these disease were so light, as not to deserve the Care of a Physitian. Even as in the Western Indies, in regard of the great temperatnes of the Ayr, it was wont to be to be light, that it was scarce taken notice of before the coming of the Spaniards into those parts. But a Blackmore which was brought thither, being taken with Pesti∣lential smal Pocks, the malignant and venemous quality being spred by Insection, the disease began so to range and rage, that a great part of the Indians were slain thereby. For whereas before, those impurites of their Mothers blood remaining in them, were wont easily to be discussed, throught the Clemency of the Ayr; now when a venemous quality was added to them, they caused grevious Diseases.

Now that the Mothers blood is the true Cause of the Smal Pocks and Measles, is hence cheifly gathered, because among many thousands of Men, it is hard to sind one, who once in his Life hath not had these diseases. But a disease common to al Men, must needs depend upon some common cause: such as are the principles of Generation viz. the seed and Mothers blood.

But the seed cannot be the cause of the smal Pocks and Measles, because from it come hereditary dis∣eases, such as last a Mans Life time; it remaines therefore that these diseases spring from the Mothers blood, with which the Child is nourished in the Womb. For therein, be it never so pure, some impurites are found, which communicate their pollution to the parts of the Child; and that pollu∣tion of the parts, doth defile the Mass of blood; and being provoked by some occasion, doth make the same to boil, by help whereof, the blood ferments and becomes purified, both it and the parts aforesaid. This the Arabians do mannifest by a cleer example of Wine, which being powred whiles it is new into musty or otherwise il-qualited Vessel receives that il quality from the Vessel but when it begins to work and puresie, it clenses both it self and the Vessel. Now this working doth commonly happen to Children; howbeit somtimes to those that are elder and have attained Mans estate, because it is evermore set on work by some external Cause, such as is especially a cer∣tain disposition of ayr proportionable to this disease whence it comes to pass that somtimes the smal Pocks, somtimes the Measles are rise, because the Ayr is somtimes enclined to the one and som∣times to the other.

Neither can those impurites of the Mothers blood, infect her and cause in her the same diseases, althought Hippocrates saies in his Book de Natura Pueri that there are three parts of the blood, one most pure, with which the Child is nourished; another impure, wherewith the Mother is nourished; and another, most impurer, which is kept in the Veins of the Womb, the whol time of Going with Child, and after the Birth is purged away in the Child∣bed purgations. For first, seeing the Mother hath parts more hard and solid, they do not so soon take impresion as the tender and soft body of the Child. Again that most impure part of the blood which is kept in the Veins of the womb and of the After-birth, the whol time of belly-bearing, doth infect the blood in the passage, which is carryed through those parts to Nourish the Child: whence the Child contracts and evil quality, which in its time is the Cause of that ebullition in the blood of

the Child. But that impurest part of the blood remaining in the foresaid places, doth not infect the body of the Mother.

Furthermore, its not to be wondered at, that the breaking out of the smal Pocks and Measles, is somtimes so long deferred, as that some have them at Mans estate. For those impurites do not substantially remain in the body as many imagine: for they would be corrupted by long stay and acquire a most grevious putrefaction. But only an evil quality is by them imprinted upon the parts of the Child, which in process of time infecting some part of the humors, becomes offensive to Nature; which then rowsing her self, doth drive those infected portions of the humors, into the Skin.

And forasmuch as in the Mass of blood a twosold excrement is found, the one thick the other thin: of the thick, the smal Pocks are bred, of the thin, the Measles. And although the evil and malig∣nant quality be one and the same, insecting both excrements: yet because the Nature of the excre∣ments is different, the Analogy of the external Cause unto them both is Different. whence it comes to pass that sometimes the smal Pocks and somtimes the Measles are Epidemically spread abroad.

And although the smal Pocks are wont to break forth in the whol body, yet are they wont to appear in greatest quantity in the face, feet and hands; which is otherwise in the purple spots of the Purple Feaver, for they appear most on the breast and back. The Cause of which difference is this, that inasmuch as the smal Pocks arise from an ebullition of the blood, by help whereof an Ex∣cretion is made of the excrements lurking therein, unto the Skin; and the Liver being the Foun∣tain and original of blood, whose Emunctories are the Face, Hands, and Feet, whence it comes that such as have hot Livers, have red and rubied faces, and feel intense heat in the palmes of their hands and Soals of their feet; it follows that the smal Pocks and Measles must come out there more than any where else. Contrarywise the purple spotts which appear in malignant Feavers, do arise principally from the Misaffection of the Heart, and therfore they break out chiefly in parts near the Heart, and especially about the Loines; because in them the Vena Cava ascendens and the Ar∣teria aorta which are annexed unto the Hair, have their Course,

Also another difference is to be noted between the smal Pocks and Purples; because the smal Pocks and Measles appearing on the third or fourth day from the beginning of the Feaver, are wont to be critical, and for the most part void of danger: but the purple spots, though they appear on the seventh day are commonly Symptomatical, and render the disease worse; whenas a man would think it should be otherwise, for a disease is more crude on the fourth than the seveuth day. But the Cause of this difference consists herein; that in the smal Pocks and Measles the Feaver commonly begins at the highest; so that not only on the third and fourth day, but also on the first or second daies, excretions may be in them critical. But malignant Feavers proceed more slowly, and their beginning is commonly Extended to the seventh day: so that Excretions which then happen cannot be critical. Now that the Pox and Measles come so soon to their state and not the malignant Fea∣vers, is hence; because the Pox and Measle-Feaver comes from the lightest putrefaction, and ra∣ther from an Ebullition of the blood than from any intense putrefaction of the matter; and therfore Nature by help of Coction makes it to cease before the seventh day, because it was a light Feaver and rose from the slightest Causes. But in malignant Feavers, so great and fordid is the putrefaction that it cannot be corrected in the fourteenth nor somtimes in the twentieth day. And therefore the spotts breaking out before that time, the disease is exasperated; because Nature was forced to expel them, without Concoction and symptomatically.

The expulsion therefore of smal pox and Measles is caused, by an Ebullition of the blood: which Ebullition according to Avicennas doctrine, is twofold; the one perfective, the other corruptive. The perfective or depurative is that, in which only the impurer and excrementitious parts of the blood, are by Nature purged forth, that the whol mass may afterward remain pure; and then the smal Pocks are innocent, which are cured without any help of Physick. But the corruptive is, wherein not onely the excrementitous parts of the blood, but the sincere blood it self is putrefied whence arise dangerous and deadly pox, and according as there is more or less putrefaction, in more in more or fewer parts of the blood, so is the danger more or less. This corruptive Ebullition doth cheifly happen, when those diseases are epidemical being occasioned by a malignant Constitution of the Air, by which an ebullition of the humors and a malignant putrefaction is caused; whonce many and dangerous smal Pocks are caused; which are somtimes (according to Rhasis) the Forerun∣ners of the Plague.

Pocks and Measles are reckoned among acute diseases because ordinarily they are terminated with∣in the space of fourteen daies. Now som do wittily observe a double order of times in times in this disease viz. the time of ebullition and the time of eruption: the time of ebullition is commonly terminated in four daies; so that the first day is counted the beginning, the second the Augment, the third the state, and the fourth the declination: for then the Feaver and other symptomes are wont to remit.

But the beginning of the Eruption of the Pox is the fourth day it self, the Augment reaches to

the seventh, the state until the eleventh, the declination unto the fourteenth, at which time the Pocks are dried. Howbeit oftentimes they are not dry until the twentieth day.

Differences of sinall Pocks and Measles, are taken either from the substance, in regard of which, some are more or less Flegmatick, Bloody, Chollerick, or Melanchollick: or from the Quantity, in which regard they are more or less in number; greater or less; profound or Superficial; or from the Qua∣lity, in which respect some are red, others white, yellowish, Violet colored, Livid, black, accor∣ding to the diversity of Humors of which they are compounded; or from the time, in respect where∣of some come quickly out, others slowly; some are soon, others late ripe, or dissolved: or from the place, in which respect, some occupy only the Skin. others do seaz upon the internal Parts also, as the Throat, Lungs, Guts, Liver, Spleen, and other bowels.

The Diagnosis respects either the Disease present or at hand. The smal Pocks and Measles, when they are present, are subject to the outward Sences, and need therefore no other signs. But these signs following declare them to be at hand.

Pain in the Head with Pulsation in the Forehead, and Temples; great Sleepiness: Terrors in Sleep; sometimes Ravings, Tremblings and Convulsions: Sneezings; frequent Yawning; Hoars∣ness, Cough, Difficulty in breathing. Heat, Redness, and Sence of pricking over the whol body. Pain of the back which comes sometimes alone, or appearing with few other Symptoms in a Synor∣chus Feaver, it shews the smal Pocks will come out. For seeing through the back are carried the great Vein and Artery, in which the malignant blood boiling, does send forth sharp vapors to the Nerves, and neighboring Membranes; it must needs be, that pains should be felt especially in those parts. Great Anxiety and unquietnels. Tears flowing of themselves. Shining before the Eyes, and their Itching, a swelling of the Face with some Redness. A vehemency of the Symptoms at first, so that the Disease seems of a sudden to have attained its vigor.

All which are caused, eather by many and thick vapors sent up by the boiling of the blood, into the Head, Diaphragm, and other parts; or from the Nature of the Pocks themselves, now beginning to in∣vade, the parts; or by a Fluxion caused by heat, which dissolves the Humors in the Brain.

It's of great Moment to foresee the smal Pox; but much more to foretel their event, which the following Prognostick Signs wil declare.

And in the first place those smal Pox are wont to be void of danger, which come out soon and ea∣sily, and do quickly ripen.

In which the Feaver is moderate, without great Symptomes, which ceases after they are come out or is very much abated. In which the voyce is free and breathing easie.

Smal Pox, which at first are red, and white, soft, distinct, few, round, pointed, coming only in the Skin and not inwardly, are wont to be safe.

All the Signs aforesaid do signifie the paucity of the Morbifick Matter, it's Obsequiousness, Benig∣nity, and the strength of Nature, lustily expelling.

Contrary wise dangerous and deadly Pox are known, by a great Feaver, which lessens not after they are broak forth; for it signifies the malignant and venemous humors are not sufficienly expelled unto the Skin, but that the greatest part of them remains yet in the Veins. Great anxiety and un∣quietness; which comes from the same humors boiling in the Veins. Difficulty of breathing, which signifies either pustles or Impostumes in the Lungs; or a Squinsie, or great decay of strength. Great thirst which declares the inward burning; and if with the thirst, shortness of breath be encreased, Death is at hand. A Loosness or bloody Flux, which shews the malignant humors have their recourse inward, which is a course quite contrary to that of Nature and therefore deadly, so that few of those which after the Pox coming out, are taken with such a Loosness do escape.

A Bloodie Urine is a most deadly sign; and likewise if by stool pure and sincere blood be voided. Somtimes also by the Nostrils, Gums, and other parts of the body blood is voided, which are com∣monly deadly Signs. For they signifie the extream Acrimony and malignity of the blood: which doth vehemently provoke Nature, and compells her to a preposterous excretion thereof.

Also Pox long a coming out are very bad, which signifie the contumacy of the matter, or the weak∣nes of Nature, Many, Great, Double and united Pox, do shew an overabundant quantity of Mor∣bifick matter, and are bad. So are hard ones shewing the thickness and incoctibility of the said mat∣ter. Also flatt ones which shew the weakness of the expulsive faculty, and they are worse, if they have a black spot in the middles of them, which argues extraordinary malignity. And green, blewish and black which spring from that sort of choller called Bilis porraca, or Atra Leeke-green or black Chol∣ler are a bad sign.

They are worst of al which when they are come forth do presently vanish, and the tumor of the parts falls: for they signifie the retirement of the Humor inwards; and none of those escape who have the Pox on this manner going in again, but they die commonly within twenty four houres.

They are also dangerous, when sports like those of the purple or spotted Feaver, are mingled a∣mong the pox; especially if those spots be livid or black. For they signifie not only that same

light putrefaction, which is wont to happen in the small Pox by means of the ebullition of blood: but also that intense and profound Malignity is peccant; from which much greater danger is threatened to the Patient.

Dung or Urines in this Disease livid or black do portend great danger: for they signifie that Melancholly abounds in the Veins, and infects the whol Mass of Blood.

The cure of the small Pox & Measles is performed in the satisfaction of four Indications. where∣of the first consists in the Evacuation of the peccant humors. The second in assisting the motion of nature, or helping to expell the Pox. The third in the opposition of the malignant and venemous quality. The fourth in correction of symptoms. All which that they may be conveniently effected, first a convenient diet must be appointed, which must be the same which was ordered in the cure of putrid Feavers: howbeit some things must be particularly no∣ted.

First that the patients be kept in a warm room, to the end their pores may be kept open, & the breaking out of the smal Pox may there be furthered. therefore they must be kept in a Cham∣ber well shut, which the cold air must in no wise enter into. For many Children that had be∣nigne Pox, have been killed by letting in the cold ayr upon them, viz. the morbifick matter be∣ing thereby driven back into the inward parts. And for the same cause they must be mode∣rately covered with Cloathes; but so that the heat of the air or the weight of the Cloathes may not augment the heat of the Feaver, The foresaid coverings are wont commonly to be made of red cloaths, because they are thought by som Analogy to move the boiling blood to the externall parts. Many are also wont to keep an Ewe or Wether in the chamber or on the bed; because those Creatures are easily infected and draw the venom to themselves, by which meanes som Ease may happen to the sick persons.

A decoction of Barly, or of the roots of Sorrel, or of Harts horn is profitably used for drink, in the beginning of the disease especially, and when the Feaver is vehement. But if the Feaver be not▪ very violent, a decoction of Barly and Figs wil be very profitable, viz. Effectually driving the Humors to the Skin; and Forestus and Amatus did continually use the same with good success.

Furthermore, Whereas in the whol Course of the Disease, Sleep ought to be moderate, yet in the Augment when the Pocks break forth, long Sleep is hurtful, and it is better to watch more than ordinary.

That therefore the aforesaid Jndications may be fulfilled, the Cure must be begun by Blood-let∣ting (if Blood in any sort is redundant, and the Age of the Patient is like to bear it) and a Vein must be opened as soon as may be. But if the Physitian shall not be called the first day, yet he shal do well to take blood before the breaking forth of the Pocks or while but few are come out; which time is wont commonly to last until the fourth day, from the first onset of the Feaver. In which Case notwithstanding, diligent heed is to be taken. For if upon the breaking forth of the Pocks, the Feaver and its Symptoms be abated; it is better to leave the business to Nature wor∣king well, which will sufficiently expel the whol Morbifick Matter to the Skin. Also Blood-let∣ing is not in this case necessary, since experience shews, that an infinite company of children haveing gentle Pox, and not Plethorick are happily cured without bleeding. Nay rather in the former case somtimes blood-letting may do hurt, because the expulsion of the smal Pox is caus∣ed by an ebullition of blood: which ebullition if it be small, it will by blood-letting be lessened very much, and so it will becom insufficient perfectly to purge the mass of Blood from it's im∣purities. Contrarywise, if upon the Eruption of the Pox, the Feaver becomes more strong, there be anxiety, difficult breathing, an urin thick and red, and other symptoms seem greater it's a sign that naure is opprest, with the over great burthen of humors, and that she cannot govern them conveniently; and that therefore Phlebotomy is necessary, that a part of the burthen being taken away, nature may be the better able to expel the rest. In one word, when there is an Ebullition perfective meerly and depuratiue, blood is not to be taken away, but in a corruptive blood-letting is extreamly necessary yea even in that which hath less malignity in it, whose de∣grees have been specefied before, And so necessary is blood-letting in dangerous Pox, in which the corruptive Ebullition is wont to happen, that the tender age of infants must not hinder it. For it is grown into a custom to let children blood when they are four years old and somtimes when they are three. The physitians of Paris in their tender age and while they suck do let children blood. Which yet the tender age of infants doth hardly admit, with that light nourishment of milk, and the plentifull efflux of their humors by transpiration; neither can this new licence of letting such yong ones blood be justified by any countenance from the wise Authors ••f Physick.

In prety big children, many times once blood-letting wil not serve the turn, but it must be repeated

if the Feaver remain intense or if Raving or any other grevious Symptome do urge, Yea verily when the Pox are perfectly come out, which for the most part is within nine daies, if the Feaver be very urgent, blood must be again let and the Patients ordered, as those who have a putrid Feaver.

If blood-letting be suspected because of the tendernes of the Childrens Age, or because the fitting season is now past; the superfluous blood may be diminished by Cupping-Glasses with Scarifica∣tion, applied to the back, shoulders, and things, which may also wel be used in the state of the dis∣ease, seeing the Motion of Nature from the Centre to the Circumference, is by them promoted. But care must be taken that in young Children the Scarifications be not too deep: for it happens somtimes that an unadvised Surgeon cutts so deep, as to cut asunder some Veins and let out the fer∣vent and boiling blood, so that there is great trouble to stop the same.

Purgation is suspected in this disease; for it makes a motion contrary to that of Nature viz. from the Circumference to the Centre; and to whomsoever, having Pocks, a loosness happens, the Pocks commonly strik in, and the Partie dies, as I said in the Prognostick. Yet observe, that many times purgation is to good purpose practised before the pocks come out, and before the Feaver growes vehement, viz. when the Children are in the Neutral state of Decidence. For then if il humors abound, they are profitably diminished by purging, that Nature may afterward, more Cheerfully set upon the Expulsion of the Remainder. But when the Pox begins to ap∣pear, Purging wil be pernicious: And likewise, if there be great malignity abroad, as in an epidemical Constitution, when very many Children dy of that disease; it is better wholly to abstain from Purging; because in diseases which are very malignant and Pestilential, Purgation in the begin∣ning of the Disease, is very hurtful. Now the Purgatives must be compounded of gentle Simples viz. Rhubarb, Cassia, Manna, Tamarinds, and Syrup of Roses.

In the Course of the disease, if the belly be hard and bound it may gently be removed, but not provoked; and that by a suppository of honey alone without salt; or with a Clister of Breath or milk, or a decoction of French barley, Raisons and Liquoris with sugar and yolkes of Eggs.

After blood-letting and other evacuations (if necessary) the expulsion of the pox must be helped forward, not only with specifick medicines driving the humors to the Skin, but also with diapho∣reticks and Alexipharmicks; especially if the Pox be Epidemical and being very malignant, do threa∣ten great danger.

There is a vulgar Medicine commended by Rhasis, Avicenna and al the Arabian Physitians to drive out the Pox; which also the greatest part of our later Physitians use, according to the description of Avicenna, which is thus.

Take Fat figgs seven ounces. Lentills shaled three drams. Lack two drams and an half. Gum traganth and fennel seed, of each two drams. Boil al in a pint and half of fountain water to the third part. Let the patient drink thereof. Rhasis adds Saffron fifteen grains, Raisons five drams, because Saffron opens and corroborates, and the Raisons do strengthen the Liver. And Traganth although it do incrassate and astringe, yet is it therefore mingled with the rest, that it may prohibit the over great ebullition of blood.

Lentils are by some Neotericks rejected, because they are restrictive and may hinder the coming forth of the Pox. But the Autority of so many and such noble Princes of Physick, must not rashly be rejected; but we must rather determine, that Lentils shaled are with great reason put into this composition; viz. that by their astringent and incrassating faculty, they may bridle the Fervency of the humors and hinder their falling upon any noble part; to which purpose Gum traganth was ad∣ded, as I hinted before. This is taken out of Galen, who in the 1. De Aliment. Facult. Cap. 18. Doth teach us that Lentils twice boiled do Strengthen the Natural parts, and by their astriction stop the flux of the belly. The Lentils may therfore be put in or left out according to the Judgment of the Physitian who manages the Cure as there is more or less necessity of attenuating and driving the humors into the Skin. For if the matter be subtile and the ebullition great, the Lentils may pro∣fitably be put in for the Intent aforesaid. But if the matter seem to be thick, so that Nature can but slowly drive it into the Skin then must they be omitted and the Gum traganth; and onely the other attenuating and diaphoretick things used for the drink. By which it appears, that we must not too strictly adhere to the formes of Medicaments propounded by Authors; but that in several occasions they must be variously changed. Let this following Receipt serve for an example, com∣pounded partly of the foresaid simples and partly of others that are diaphoretick and resist malignity; which may much help such as have this disease, in making the Pox to come wel out.

Take Rootes of Fennel and Sorrel of each one ounce. Harts-horn shavings half an ounce Leaves of Scabious, Scordium, St. Johns-wort of each one Handful. Three pair of fat Figgs. Gum Lack three drams. seeds of Navew or Turnep & Carduus Benedictus of each two drams. Lentils unhusked half an ounce. Gum traganth one dram and an half. Boil al to a pint and half. Of the straining take three ounces. Syrup of Lemmons one ounce. Mix them. make of them a Julep let the Patient drink thereof twice or thrice in a day.

If the Malignity be very great, as commonly it happens in Epidemical smal Pocks, we must chief∣ly use Antidotes. and consequently al those remedies which we have propounded in malignant Fea∣vers wil be good in this disease, respect being had to the Age and strength of the Patiennt. And a∣mong others, Confection of Hyacinth, Bezoar stone, Pouder of Corall, Pearles, Harts-horn; oyl of Scorpions of Matthiolus, must be used frequently, with other things, the manner of whose use may be learnt out of the foregoing chapter.

Neither must such things be omitted as do restore the Patients strength, both inward and outward which may be also learnt out of the foregoing Chapter, and by the prudent Physitian administred in due season.

And it must be heedfully remembred, that such medicaments as drive out the Pox are not to be used in al patients. For somtimes they break forth so violently, that they have need to be restrained for a while. For the great ebullition and immoderate Fervor of blood, if they be not tempered. are wont to destroy the Patients; and therfore, it is good in such a Case to use bridlers and coolers, For example, a Julep many be thus composed.

Take Whol barly one pugil. Cinquefoil rootes and Tormentil roots of each one ounce. Lea∣ves of Sorrel, Endive and Wood-sorrel of each one handful. Lentils excorticated half an ounce. Gum traganth one dram. Boil al to a pint. In the straining dissolve four ounces of Syrup of Le∣mons or Pomegranates. Make of al a Julep for four doses, to be taken twice in a day.

Amatus Lusitanus in the 18. Cure of the third Centurie propounds an example of such kind of Pox arising from boiling humors and cured only by coolers and thickeners. which example I thought good to cite in this place word for word, that the young beginners may perceive, in what cases the Cure is most to be yaried. The Boy of Altarasius (saies he) began to have the smal Pox, some of which did run together, so that in two daies they flaid his Miserable Carcase: for the pustles crept along and did only flay osf his Skin; which I have likewise observed in other Children. A∣gainst which, I thus set my self to work; First because this matter was too thin, I endeavored to thicken the same, and not only so, but to abate the evil quality of the Liver and internal parts, that no more such thin subtile Humor might be bred. This I did with refrigerating Medicaments, as Syrup of Roses, of Cichory simple, of Endive and Violets with waters of like Nature mixed with them. He was nointed with Ceratum Santalinum. But the Diet likwise helped much, which was or∣dered cold and moist. By al which the matter became thicker and the pox began to appear thick and large.

And for ordinary drink prescribe a decoction of barly and of Sorrel roots. And these remedies must be continued, until the Fervency of the humors shal begin to abate: if Nature seem to want their assistance.

These things might suffice for a direct Cure of the smal Pox. But because they may bring great dammage to divers parts, both internal and external, we must endavour the Prevention and Cure thereof.

The internal parts may especially be preserved with a decoction of Lentils, of Gum Lac and Traganth, described before. For Gum Lack defends the Liver and Spleen, Lentils the Gutts, and Traganth the breast.

But the Lungs are peculiarly preserved by Conserve of Roses and Violets, and Syrup of Violets Jujubees, Myrtils, Dryed Roses, Poppies and also these following LOHOCHS. Se in my Dispensatory (at the begining of the Lohochs) what a Lohock is; and why so called.

Take Conserve of Roses one ounce and half, juyce of Lentiles thrice boiled six drams. poppie seeds an half dram. Gum traganth one scruple. with Syrupe of dried Roses make all into a Lohoch.

Or this of Avicenna, which is commended by Guainerius and Forestus.

Take Lentils unshaled and finely poudered three drams. White Poppie seeds one ounce. Con∣serve of Roses two ounces. Julep of Roses, as much as shal suffice, Mix al into a Lohoch.

Or such a Lohoch as this following may be made only of Syrups.

Take Syrup of violets, jujubees and dried Roses of each one ounce. Syrup of Poppies half an ounce. Mix them▪ let the Patient lick thereof often out of a spoon, and swallow it down leisurely.

But if a flux be at present into the Lungs and cause hoarsness and suffocation; it must not only be stopped with the foresaid Remedies, but revelled by Cupping-glasses, both dry and Scarrfied, and by bleeding, if nothing else hinder. Also give the Patients to drink a decoction of Barly, Jujubes and Liquoris, and let them use this following Lohoch.

Take Seeds of Marsh-mallows, Melons, Cucumers, and white Poppy, of each two drams. Raisons stoned and Jujubes of each four pair. Boile al to a pint. In which dissolve conserve of Roses and Violets of each half an ounce. Pouder of Diatragacanthum frigidum three drams. Sugar Candie and Sugar of Roses, of each as much as shal suffice. Make al into a Lohoch. The Jawes and throat may be fenced against the Pox, before they break out, with this following Gar∣garism.

Take French barly one pugil. Plantane Leaves two handfuls, red Rose Leaves one pugil, Balaustians, seeds of Sumach of each two drams. Boil al in two pints of water to a third parts consumption. In the strained Liquor dissolve Syrup of Mulberries and Pomgranates of each one ounce. Mix al into a Gargarism.

If the young age of Children cannot admit a Gargle, a Lohoch may be made, of Syrup of Mul∣berries, Pome-granats, of dried Roses; either alone, or mingled with red Rose and Plantain waters. Which must often be given them in a spoon. Wherewith if the Fluxion cannot be stop∣ped by reason of the abundance of the rhume, so that there is fear of Suffocation impendent; such things must be used, which widen the passages, and help excretion, after this manner.

Take Mucilage of Fleabane seed and Oyl of sweet Almonds new drawn, of each one ounce and halfe Whitest Sugar two ounces. Mix them. Make of all a Lambitive to be given every hour.

If by meanes of the Acrimony of the flux, or the Plenty of the smal Pox, an Ulcer be berd in the Jawes or Throat; it must be clensed with barly water and honey of Roses, or with allum water. and if it tend to corruption a little Aegyptiacum Ointment must be mingled therewith.

The gutts wil be preserved by the same remedies which were appointed to preserve the Lungs. But if a present Loosens, or dysenterie be urgent, first detergent and lenitive Remedies must be used and afterwards astringents. And so Clysters must be made of calybeated Milk, of Sugar and yolkes of Eggs: and afterwards of a decoction of barly and red Roses with the yolk of an egg; and last of al, of a decoction of Plantaine, Knot-grass, and Prunella or Self-heal, and other Simples set down in our Cure of the Disentery. And it is to be observed, that a loosness in children that have Pox, is oftentimes caused by wormes, which lasts dureing the whol disease, whence they are in the danger of Death; because the expulsion of the Pox is therby hindred wholly or lessened. Which is easily known by the thickness and viscositie of the excrements, and their grey or whitish color: then must be administred such things as kill Worms: and sweet Clysters must be in∣jected.

Somtimes also the kidneys are affected and are exulcerated, whence arises Pissing of Blood. In this Case it is good to give an emulsion of the four greater cool seeds, with trochiscs of Alkekengy, de Carabe, and other things set down in our chapters of Pissing of Blood.

Among external parts, the Eyes are most of all to be guarded from the smal Pox. For being en∣dued with a soft and humid substance; the matter of the Pox is easily driven unto them: whence arise grevious calamites and somtimes total Blindness.

Before the Pox break out therefore, or when they begin to appear, the Eyes must be anointed every hour with Plantane and Rose waters, in which a little saffron is dissolved; or with the follow∣ing Eye-Salve, which doth more effectually preserve them.

Take water of Roses and Plantane, of each one ounce and half. Pouder of Sumach seeds two drams. Infuse them a little while hot. then strain the liquor hard out. to the strained liquor ad Camphire ten graines. Saffron five graines. Make all into a Water for the Eyes.

It wil be yet more effectual, if Instead of the waters, the juices of knot-grass and Sheperds-pouch be mingled with the rest.

And if some Pox begin to Peep out of the Eye it self, pidgeons blood must be often dropt in, that their resolution may be hastened. then also this following Eye-water is to be used.

Take Red Rose water two ounces. Eye-bright water half an ounce trochisci albi Rhasis one dram. Tutty prepared one Scruple. Champhire five graines. Saffron two graines. make al into an Eye-water and wet the Eyes often therewith, with a thin linnen rag.

But when the Eyes so swel that they cannot be opened, they must often be washed with a deco∣ction of Linseed, Fenugreek seed, Quince seed and Mallow seeds; and so the swelling wil fal and the Eyes open and if when the Eyes are opened, there appear cloudes in them they must be scoured off with Sugar-candie finely powdered.

And finally if the Eyes are ulcerated, they may be cured with this following Eye salve.

Take Washed Ceruss three drams: Sarcocol one dram: Gum traganth one Scruple: Opium two grains: With mucilage of Gum traganth drawn out with Plantane water make all into little cakes or trochiscs, which must be dissolved in Womens Milk, or red Rose water, when it is to be used and in all other things proceed, as Practitioners teach at large, in the Cure of Ʋlcers of the Eyes.

To preserve the Nostrills, they must often smel to Vinegar. But a Collyrium of juyce of knot∣grass, and shepherds pouch, Sumach seeds and camphire formerly praysed, wil work more effectu∣ally; let the tent be often moistened therein, and put up into the Nostrills. If notwithstanding, the Pox do grow within the Nose, they quickly become hard Scabs, which are often to be nointed with Oyl of sweet almonds, that they may the sooner fal off. And finally if an Ulcer happen in the Nose, it must be dressed with a liniment of the Oyl of Eg-yolkes and juyce of Plantane, stirred together in a leaden Mortar.

To preserve the Face, some wash it with Rose-water and other Astringents. Which I cannot ap∣prove of: for a great part of the impurities flows unto the Face. For the Skin tthereof long loose and soft, is very fit to receive Excrements. Wherefore if those impurities which Nature sends hither, be repelled, being retained within they may cause great hurt; and therefore the motion of Nature is no waies to be hindred. But this ought to be the Physitians care, to hinder that the Pocks which break out in the Face, do not leave behind them pits and Scarrs, which doth often deform the Countenance. And this he shall in good measure perform, if when the Pocks are ripe, and are high and white in the middle (which is wont to fall out upon the ninth day of the Disease) he cause them to be nointed with a Fether twice a day with Oyl of sweet Almonds, drawn without fire, until the Crusts fall off, For by this Medicine the Acrimony of Choller is tempered, the ripening of the Pocks is hastened, and the falling off of the Crusts furthered; which otherwise sticking fast, doth exulce∣rate the Skin more deeply, by reason of the Quittor which lies under them. Oyl of Nuts new drawn without fire, mixed well with a like quantity of Rose-water, till they come to the form of a Liniment, is excellent for the same purpose.

If by neglecting the Remedies aforesaid, or through the extream malignity of the Humor, there remain Pits and Pock-holes, all diligence must be used to repair the same. Which notwithstan∣ding is extream hard to do perfectly; although many have taken great pains thereabout to gratifie Virgins, and other Women, who are exceeding careful to preserve their Beauties. Among infinite Medicines recorded by Authors to this intent, I shall propound the choisest.

And in the first place, Oyl of Eg-yolks does nourish and engender Skin, and therefore is very con∣venient to fill the Pock-holes.

Wethers Suet fresh and new, melted and done out with a Fether, is effectual to the same purpose.

But the filthyness of Pock-holes is much amended, if they be washed first with Yarrow-Water, or Cows-dung-water, distilled in May, and then anointed with Mans-Grease.

Forestus does much magnifie this following Oyntment.

Take Oyls of sweet Almonds and white Lillies, of each one ounce: Fat of a Capon three drams: Pouder of Peony Roots, of Orice and Lytharge of Gold, of each ten grains: Sugar-Candy one scruple. Mingle al well in a warm Mortar, strain them through a Cloth, and noint the Pock-holes therewith morning and night. And afterwards let them be well washed with Water distilled out of Calves-feet: and when that is not at hand, use the Water of Yarrow in stead thereof.

Neither must I omit that which many Practitioners do teach, viz. That when the Pocks be ripe, they must be bored through with a golden or a silver Needle, least the Quittor tarrying long in them, should leave holes in the part. Which Practice, is notwithstanding, now in a manner grown out of use, since Experience has taught, that the Pocks being bored are longer in healing and doth longer hold their Crusts, because of the Weakness of Natural Heat, caused in the Part by boring, whereby more deformed Scars are left behind. And therefore it is better to abstain from this boring, and to commit the evacuation of the Quittor to Nature alone.

To conclude this Cure, I shall subjoyn how those dispositions of Itching and Exulceration which happen to persons that have the small Pocks, may be remedied.

And in the first place, When the small Pocks come forth, or when they begin to ripen, somtimes an huge pain or Itching does afflict the Patients; especially in the Palms of the Hands and Soales of the Feet, because the thickness of the Skin in those parts hinders the Eruption of the Pocks.

Which Symptom you shall help, if you cause those parts to be held in hot Water, or Foment them a long time with an Emollient Decoction. But when there is great Itching in the Face, which com∣pels the Patients to scratch, whence great deformity and foul Scars follow; use this following Remedy.

Take leaves of Pellitory of the Wall one handful: Flowers of Chamomel and Melilote, of each half a pugil. Boil them in a pint of Scabious Water, To the strained Liquor ad three ounces of Honey-suckle Water. With this Liquor hot, often let the Itching Pocks be moistened, by dipping a thin Rag or Cotton Wool therein, and so applying the Liquor gently to them.

Now the Ulcers which arise from deep and malignant Pocks, are to be cured with Ʋnguentum al∣bum Rhasis, or with an Oyntment of Lead made after this manner.

Take Calcined Lead two ounces: Litharge one ounce: Ceruss washed and Vinegar, of each half an ounce: Oyl of Roses three ounces: Honey of Roses one ounce: Three Yolks of Egs: Myrrh half an ounce: Wax as much as shall suffice. Make all into an Oyntment.

FINIS.