Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP. XI. Of the Cure of Malignant and Pestilential Fevers in general.

COncerning the cure of pestilent and malignant Fevers, * 1.1 since there are two things in these Fevers contrary to na∣ture, venome, or malignity, and the Fever; by what means the Fever may be resisted, is manifest from those things that have been said hitherto concerning Fevers: how malignity also may be resisted out of those things which are already spoken concerning the pestilence, is plainly shewed.

The greatest difficulty here is in this, to which of them we must have an eye first, and which last, and how the malignity may be taken away without increasing the Fever, and on the contrary, the Fever may be regarded without increasing the ma∣lignity. Which that it may rightly be done, the pestilent ve∣nome and malignity, and the putrifaction and Fever are to be considered and poised together amongst themselves, and regard to be taken whence the greatest danger may arise; and in the first place look to that, yet so, as that the other may not totally be neglected.

Wherefore in a pestilential Fever, * 1.2 as being that wherein ma∣lignity most troubleth, presently we should fly to Alexipharmicks and Sudorifiques; yet those are to be rather chosen which are the more temperate, such as were formerly proposed against the pesti∣lence; afterward if need be, a vein should be opened, and that timely, and scarce after the fourth day, before all things shall be disturbed in the body, and the strength be weakned, namely, when blood doth either abound in quantity, so that it distendeth the vessels, or it is a burthen to the strength, or is stirred by some motion, that it may be feared lest it should be carried to some principal part; but if the disease have made some progress, and the strength now labours, the breathing of a vein is more safely omitted then untimely appointed; but in case the strength will not suffer a vein to be opened, cupping with scarrifying is fit to be used to the inferiour parts.

But purging at the beginning of these Fevers is not conveni∣ent, * 1.3 unless such as may purge only the first ways without any manifest agitation of the rest of the humours; but stronger are not convenient, because they stir the humours, and mix the venome with them the more, and often cause dangerous fluxes of the paunch.

If the matter tend upwards, * 1.4 and there be any nauseousness, vomit is to be provoked by the weaker sort of medicines causing them.

Hence we are to come again to the Alexipharmacal medicines, which notwithstanding should be such, as that the humours should not thereby be increased: Therefore those are to be exhibited that are more temperate, and together do resist putrifaction; such are Sorrel, Citrons, Pomgranates, Cinquefoyl, Tormentil, Harts∣horn, the bone of a Harts heart, Bezoar stone, Bolealmenack, Terra Sigillata, and such like, and medicines prepared of these, but principally Bezoar water is often to be administred, as being that which doth forthwith penetrate, which may be so tempered, as that it may resist the Fever and putrifaction; and therefore with such medicines, Syrup of Sorrel, Limmon, Pomgranates, Sorrel, * 1.5 and young Sorrel, and such like are to be mixed.

The matter being diminished, vesiccatories may be applied to the Legs and Wrists, * 1.6 to the advantage of the sick, since that they draw the venomous matter from the interiour parts to the exteri∣our, without any trouble or weakning of the strength.

But if it be a malignant Fever in particular so called, and the putrifaction more then the malignity, the first passages are first to be purged, and not only with lenitive Clisters, but lenitives

also are to be given, as Syrup of Roses solutive, Manna, Cassia, Tamarinds, Agarick, Rhubarb, Tryphera Persica, especially if the matter swell: But we must wholly abstain from the strongest, as Scammony, Coloquintida, Turbith, and such like. And indeed, if the putrefaction presently increaseth, and a more vehe∣ment Fever is thereby kindled, and especially if the humours swell, presently that is to be done, and that before the third day.

But these things in general cannot sufficiently determine; these tracts in particular of these Fevers, shew the way more clear∣ly; for such pestilent and malignant Fevers are somtimes propa∣gated by infection, when it is most safe that the pollution in what manner soever taken, should be expell'd by Sudorifiques and A∣lexipharmicks out of the body, and afterwards, if occasion do require, to appoint purgation and Phlebotomie; somtimes like∣wise nature it self expells the matter to the circumference of the body, as it useth to happen in the Measles and small Pox; but then Nature is also troubled in her work, and the matter which is thrust out to the exteriour parts of the body, ought not to be called in again by purging, but 'tis rather to be helped by Sudo∣rifiques and Alexipharmicks in its work; but somtimes the Fever is occasioned by vitious preparation of the humours, or is che∣rished thereby, and the peccant matter in the Stomack, near the Midriff and first passages, manifesteth it self by vomit, pain, heat, bitterness of the mouth, anxiety, and other tokens, which neces∣sarily should be avoided by vomit or purgation.

The first passages being opened, and the body evacuated, * 1.7 pre∣sently the opening of a vein is to be appointed, if it be needful, and that before the fourth day.

After purging the body and opening a vein, * 1.8 if occasion re∣quire, 'tis convenient to use some Sudorifique, but such as may not increase the Fever, such as we have already proposed; and although sweat doth not always follow, yet such medicines are to be continued and exhibited daylie, that so the body may by de∣grees be apt to sweat, and that nature at length of its own ac∣cord, in its own time, may expel peccant humours by sweats; but the stronger Sudorifiques at the first, debilitate Natures strength; and since the humours in these Fevers are not alwaies so disposed that they can be discussed by sweats, yet the thinner are dispersed, and the thicker remains behind. * 1.9 Wherefore pre∣paration and alteration of the humours is to be ordered by those medicines which open, and if occasion require, may cut those humours, and may resist ebullition and putrifaction, extinguish

the heat of the Fever, and resist malignity, and may by degrees dispose nature to sweats; such are Sorrel, Scordium, Carduus Benedictus, Scorzoneca, the seed of Citron, Roots of Tor∣mentil, Cinquefoyl, juice of Citron, Pomgranates, and Syrups of these, Spirit of Vitriol: when the humours are sufficiently prepared, unless Nature expel alone, they are to be evacuated by a convenient passage, but then also lenitive medicines must be used, and purgation scarce to be ordered before the fourteenth day.

If Nature tend to evacuation by urine, * 1.10 it is to be helped by an emulsion of the seeds of Melons, Citron or Limmon, Car∣duus benedictus, with the water of Sorrel, Mayden-hair, and such like.

But during the whole time of the sickness, * 1.11 as well in ma∣lignant as in pestilent Fevers, medicines are to be applied to the Pulses and heart, such as strengthen the heart, and resist ma∣lignity, which are very where extant; Symptomes also, if any urge and debilitate the strength, are to be taken away and miti∣gated, as in their own place shall be shewed.

Concerning Diet, * 1.12 the meat should be of good juice, and of easie digestion; and to beware that when the strength languisheth Nature be not over-burthened; the meats also should be mixed with such things as resist this Fever, we must abstain from wine, unless swooning fits happen, but 'tis more convenient to use small beer, a decoction also of Harts-horn may well be given, with such a quantity of Spirit of Vitriol as may render it grate∣ful to the taste, to which also some Juleps of Roses and Violets may be added: It allays thirst, likewise opens obstructions drives away putrifaction, and resisteth malignancy; of Aegyptii, as Prosper Alpinus in his fourth book of Medicines Aegypt. chap. the fourth. Pulp. of Tamarinds and Barberries, the fruits being dryed, with the seeds of Fennel or Limmon, they pour them in∣to abundance of fair water, and so prepare a Drink, which they administer to the sick during the whole time of the disease in ma∣lignant and pestilent Fevers, and confide much in the use of this Drink, since that it is found that Tamarinds and the fruit of Barberries do exceedingly resist putrifaction in Fevers.

Notes

• * 1.1

  Cure.
• * 1.2

  The Cure of the plague in particular. Sudorificks Bleeding
• * 1.3

  Purging.
• * 1.4

  Vomits.
• * 1.5

  Vesicato∣ries.
• * 1.6

  Cure of a malignant Fever in particular. Purging,
• * 1.7

  Bleeding.
• * 1.8

  Sudori∣ficks.
• * 1.9

  Altering preparing medicines.
• * 1.10

  Causing Urine.
• * 1.11

  Topical things.
• * 1.12

  Diet.