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. XIII. Of the Spotted Fever.

MOreover, another sort of malignant Fever is, * 1.1 when certain spots like the biting of gnats appear in the skin; There are of divers colours, but principally red, called by Authors Puncticulae, Peticulae, and Patechiae, whence the Fevers are also called Peticulares, Patechiales, Lenticulares.

These spots are without all itching, extuberancies, and ul∣ceration, as in Poxes; and these spots in these Fevers appear principally in the back, arms, legs, and breasts, namely in pla∣ces through which the most eminent veins and arteries do pass, but in the face they do seldom appear, because it is alwaies ob∣vious to the external Ayr.

These spots have their original from the thinner parts of the putred and corrupt humour, * 1.2 whence they suddenly come out and vanish; but although they are made by the expulsive faculty, driving this part of the corrupt humour to the extre∣mities of the body; yet that seldom happens critically, because they come out for the most part at the beginning, the matter being not as yet concocted, neither is there any notable eva∣cuation of the matter made by them, nor the sick are not the better for them, but for the most part by how much the more plentifully they come forth, by so much the greater store of corrupt matter is indicated, which notwithstanding as is said already, is not sufficiently evacuated by those spots.

There are of those spots several differences; for first, * 1.3 they differ in colour, some are red, arising from the more temperate blood putrified; others yellow & green, when choler is putrified; others, Pomgranet colour and black, when melancholy, putrifi∣eth. Moreover they differ in quantity, for some come out more plentifully, others more sparingly; some are greater, others less, according to the quantity and thickness of the humour, and strength or weakness of nature: some come out at the be∣ginning, others in the progress of the disease.

This Fever is known by the signs of Malignant Fevers in general already set down; and when the spots joyn together, * 1.4 they shew malignity more plainly.

But what event of these Fevers may be hoped for, is mani∣fest

by the prognosticks of malignant Fevers in general. * 1.5 Con∣cerning the spots themselves, although it be good that the pec∣cant matter be carried to the extremities of the body, yet by these spots they cannot sufficiently be evacuated; therefore al∣though if they are plentiful, they shew that store of matter is present; yet they shake it not of, and therefore they portend danger rather then health: Neither is their paucity always good, and although it signifie no store of matter, yet it also denotes debility of nature: These spots (if they lie hidden) are evil signs; because they shew that the matter which before was coming to the outside of the body, does now tend inwards, and go to the head, heart, or some internal part. Red spots are most safe, yellow and green worse, and pomgranate colour and black most dangerous. Although such as come out at the first appear symptoma••••cal, yet those that break forth the seventh day, or thereabouts, are critical: yet unless other good signs are present, put no confidence in them, because they do not sufficiently evacuate the matter; but if they come out slowly, 'tis evil; for that happens either by reason of the thickness of the matter, into which if the malignity fall, 'tis not easily overcome, or else by reason of density of the skin, which hin∣dreth free transpiration.

Lastly concerning the cure, * 1.6 those things that are spoken a∣bout the cure of malignant Fevers, are here also convenient, namely, the belly is to be loosned either by Clister or lenitive medicine; or if the matter tend upward, and the sick be in∣clinable to vomit, a Vomit must be given.

Then if occasion require, * 1.7 a vein is to be opened before the fourth day, or else afterwards to be omitted; but whether the spots now coming forth do hinder the breathing of a vein, is shewed in the Institutions lib. 5. part. 2. sect. 1. cap. 17.

But since nature it self strives to protrude the matter we see to the extremities of the body, and 'tis profitable in all ma∣lignant diseases to drive out the matter from the greater to the lesser vessels, and to free the bowels from vitious humours, the endeavours of nature is here to be assisted, * 1.8 and the matter tending to the outmost parts of the body, is by it to be eva∣cuated; because that otherwise that which is malignant will admit of no concoction.

Therefore let the sick be kept in a place moderately hot, and forthwith some Sudorifique medicine, and which also may re∣sist malignity given, such as are before propounded for the

plague and malignant Fevers in general, and for the Measles and small Pox; yet those are to be selected amongst them that may not increase the feverish heat; and the Fever and the malignity are to be weighed together, and of that which most requires it, regard must be taken.

Somtimes a looseness happens in this Fever, * 1.9 which unless it be too great, should not be stopped, but the business should be committed to nature, and in the interim, only with al∣tering medicines, and such as resist malignity, the morbifique cause must be resisted.

Afterwards to fortifie nature, Pearls, Coral, Hartshorn, juice of Pomgranates, Citron, Confectio de Hyacintho, Al∣kermes, and such like are to be exhibited.

Externally likewise medicines are to be applied to the region of the heart, and to the pulses, * 1.10 which draw venome from the heart, and resist malignity, and some use an unction ex Hy∣draeolo, and niter to relax the skin, and draw out humours.

Neither is it unprofitable to apply vesiccatories to the arms, * 1.11 especially if the external parts are cold, and the internal burn, and that pains in the head, deliriums, a lethargy, and other symptomes in the head are present; for so both the humours are called from within outwards, and are likewise refelled from the head.

Notes

• * 1.1

  Patechiae
• * 1.2

  The cause.
• * 1.3

  Difference.
• * 1.4

  Diagno∣stick signs.
• * 1.5

  Progno∣sticks.
• * 1.6

  Cure.
• * 1.7

  Bleeding.
• * 1.8

  Sweats
• * 1.9

  When a looseness comes, what must be done.
• * 1.10

  Topical medicines.
• * 1.11

  Vesiccato∣ries.