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. VI. Of the Cure of the Pestilence.

IF in any disease in the world, certainly in this an exact way of cure is to be used, * 1.1 since that the smallest fault being com∣mitted by any, may become an irreparable damage: But be∣cause the right reason of Cure depends on indications, and see∣ing that the Plague is an occult disease, and its nature consists in an occult quality, which by its peculiar force is mischievous to the heart, and is very contagious; but that is introduced by a cause endued with the same quality; Hence 'tis manifest, that that occult quality indicates a medicine alexipharmacal contrary to it, and shews that the cause in the body, whether taken by breathing in, or contact, or by what means soever contracted, should be removed and eradicated; But how that ought to be done, is controverted amongst Physitians.

For first, since that neither Phlebotomy, * 1.2 nor Purgation are indicated by the pestilence, quatenus 'tis the pestilence, whether they are to be used or not is controverted.

First, Concerning the opening of a Vein, since that it nei∣ther cures the disease, nor takes away the venome, nor the cause, 'tis rarely to be used, and in that Pestilence which is occasioned by evil Diet, 'tis wholly to be omitted, as also in that which ari∣seth from a pestilential constitution of Ayr, unless there be very

great store of blood which must be diminished, and its heat mi∣tigated: But if the Plague come by infection, and there be that plenty of blood as may cause us to fear lest that a putred Fever should happen, which may become no less dangerous to the sick then the Plague it self, or that it be observed that the blood flows violently to inconvenient places, and that the strength is rather oppressed by its plenty, then dissipated, you may breath a Vein, yet only bleed what the strength can well bear with; and that should be in the beginning, for when twelve hours or more are passed away, 'tis safer to omit bleeding, because the strength be∣ing debilitated with the violence of the poyson, it cannot well bear it. Concerning the place for breathing of a Vein, such a place is to be chosen, as may help the motion of Nature, not hinder it, and may together divert the pestilent matter from a noble part; Therefore if a Parotis break out behind the ears, or a Bubo under the Arm-pits, or a Carbuncle in the superiour parts, a Vein should be opened in the Arm on the same side; but if a Bubo come in the Groyn, a Vein should be opened in the foot on the same side. But if a Carbuncle should arise in either of the Legs, seeing that useth to cause an inflammation, and great pain, by which the strength is weakned, 'tis convenient to open a Vein in the contrary leg; for neither is the motion of nature hindred by this means, but the matter is drawn from the superiour parts towards the inferiour, and a great flux to the part affected, and the increase of the inflammation is hereby pre∣vented.

Moreover Purgation also is not indicated by the pestilence, * 1.3 nor can the seeds of the Plague be eradicated by any purging medi∣cine, unless perhaps a great disturbance of nature being made, which must then be joyned with danger: and for as much as Nature for the most part expels the pestilent venome to the out∣parts of the body, this motion of Nature by Purgation is hin∣dred, and the pestilent venome is drawn into the internal parts, and is more mixed with the humours, and the motion of hu∣mours being stirred up, most dangerous, nay deadly vomits and sluxes are occasioned: And therefore not in purging, but in medicines that resist poyson, principally, and next under God the hope of health and safety is to be placed.

Wherefore it will be safest for any one that shall think himself to be infected with the Plague, * 1.4 having first implored the assistance of almighty God, to fly to those medicines resisting venome, mentioned in the fifth chapter before, and to take some one ex∣perienced and approved medicine; and in case it be vomited up

at the first, then 'tis best to take of it again forthwith; nay, in case it be retained, it will not suffice to take of it but once, but the Alexipharmacal medicine should be repeated thrice in the space of four and twenty hours, and so to continue for two days, until that the force of the poyson shall be broken. The medi∣cine being taken, the sick should forthwith compose themselves to sweat, especially the second time after taking, they should keep out the cold Ayr, and if the strength will bear it, they should continue their sweat for two hours space: The sick should by no means sleep, until he hath sweat twice, and between the sweats should be refreshed with Conserve and Syrup of Roses, Sorrel, acetos. Citri, of Pomgranates, red Gooseberries, with cordial and odoriferous waters applyed to the Nostril, and sprinkled about the Bed-chamber. It shall be profitable also to take warm bread out of the oven, and fill a hollow part of it with Treacle, and apply it to the Navel, or to the Arm-pits, that it may draw the venome to it; The sweat being ended, the body should be rub∣bed and dried with clean warm linnen clothes, being careful that no cold ayr be admitted, and the sheets and coverings of the beds should be changed. After the sweat, the sick should be nourished with meats that afford good juice, and easie of concoction, yet taken but in a small quantity.

When the sick hath sweat once, if there be need of opening a vein, let it be done in that manner as is already heretofore ex∣pressed: And when the Alexipharmicks have been taken of two days by the sick, and the body is Cacochymick, or the Plague depend upon some internal default of humours, and that great danger of a Fever be to be feared, it will be convenient to admi∣nister a purge, that some part of the matter putrifying and in∣creasing, the Fever may be abated; so that Nature may over∣come the rest more easily: they should be gentle, as Syrup of Ro∣ses solutive Tamarinds, Rhubarb, Agarick, Pestilential Pills, Tryphera Persica, Syr. Diasercos.

Afterwards if it be not needful to cause sweat (which never∣theless ought not to be hindred if it come on a critical day) such medicines are to be continued as hinder putrifaction, resist a ma∣lignant Fever, and extinguish the flames in the bowels and hu∣mours.

And then we must be wary how we use Treacle, or any of the other hot medicines, without any respect of the disease, nature, age, and other circumstances; wherefore when the Fever hath set upon the body, such things are not to be exhibited, unless they are mixed with cold things, or else cold things alone may be

given, such as Syrup, acetos. Citri, of Sorrel, Pomgranates, red Gooseberries, rubi Idaei, as also Pearl, Coral, precious stones, Bezoar.

But since that Nature for the most part useth to send the most venomous part of the matter to the out-parts of the body, * 1.5 and occasions Buboes and Carbuncles: If the venome perfectly, or most part of it be driven out into a Bubo, which may be known by the remission of the Fever and Symptomes, we must expect ripe∣ning, although not perfectly, as in other tumors, yet it must be helped by all means; for if either a Bubo come not enough out, or be encreased over-much, and still the Fever and symptomes abate not, and the sick no ways mends, we must endeavour that a way may be opened for the letting out the venome.

Therefore either vesiccatories must be applyed, or the skin must be scarrified, that the poyson may freely expire, and the pesti∣lent humours fly out; a young chicken also, or pigeon, the fea∣thers about the rump being pull'd off, should to the great advan∣tage of the sick be applyed to it, although no incision be made, and that should be often repeated; or a dryed Toad being moist∣ned with wine, should be applyed: afterwards we must endeavour that the rest of the matter may be brought to maturity by proper medicines described every where up and down; into the place opened by Incision, convenient digestives should be put; and if the incision be not made deep enough, and the quitture be still therein detained, the tumour must be opened with an Incision knife, and the Ulcer mundifyed with proper medicines, and it must not be healed up, until all the venome be come out.

But Carbuncles are forthwith to be scarrified, * 1.6 and that deep enough, that the pestilent and corrupt humour may come forth, afterwards some convenient plaister must be applyed, such as may be of the soot of a chimney, and others, described up and down in Authors: Some apply the plaister de Magnete Arsenicali, 'tis proper to apply a dryed Toad also, being first powd'red, in wine, to the places adjacent, lest the venome should return to the inter∣nal parts; some defensitive of cooling, drying, and binding things must be applyed; some make a circle with a Saphire stone about the Carbuncle, lest the poyson should creep farther, and thereby extinguish the same; and if the Carbuncle be too much encreased, and cause great pain, a vein should be opened under the same, that so the corrupt blood may be evacuated, and to abate the heat, a plaister of Houndstongue is to be applyed.

When an Escar shall be generated, it must be taken away with a convenient Unguent, and the Ulcer must be mundified and

cured in due manner; but during the whole time of the cure, twice every seven days a potion of the temperate medicines that resist venome should be drunk, lest any of the malignity should remain in the Body.

Notes

• * 1.1

  Cure.
• * 1.2

  Breathing a Vein.
• * 1.3

  Purgation.
• * 1.4

  Use of Ale∣xiphar∣micks.
• * 1.5

  Cure of Buboes.
• * 1.6

  Cure of Carbuncles