The London practice of physick, or, The whole practical part of Physick contained in the works of Dr. Willis faithfully made English, and printed together for the publick good.

CHAP. X. Of the Passions of the Heart, and their Remedies.

AFter Cordial Medicines, vulgarly, though improperly, so call'd, it now follows for us to treat of the Passion of the Heart, in which the Heart is really ill affected, and therefore requires true Cordial Medicines: Under that name two affects, somewhat dif∣fering betwixt themselves are commonly denoted, to wit, The trembling of the Heart, and its panting: In both affects the motion or beat of the Heart seems to be disorderly, and in a manner Convulsive; but the irregularity of the first consists in the frequency of its Vibrations, and of the other in their vehe∣mency.

As to the Cure of the panting of the Heart, since its Causes are various and manifold, its Cure also must be various; for what some affirm, that those sorts of Remedies vulgarly call'd Cordials, which are reputed to revive the Heart, and to relieve it when ill affected, are proper in any of all these Cases, it is con∣trary both to reason and common experience.

We say then that the palpitation, or panting of the Heart, proceeds either from the fault of the Blood, or of the Arteries belonging to the Heart: If it happens through the fault of the Blood, the chief intent of Curing must be to raise the Blood to a better Crasis, it being then become too watery and unmeet for accension and fermenting, and to exalt or encrease its active principles which are then depress'd or diminish'd; for which end spirituous Medicines, also saline Medicines of all kinds, Sulphu∣reous and especially Chalybeates conduce: And to this place may be referr'd those things which are wont to be prescribed in the Pica or longing Disease, in the Leucophlegmatia, and in the cold Scurvy.

Take Conserve of Sea Wormwood, the outward yellow Coats of O∣ranges and Limmons, of each two Ounces, Powder of Winters Barke two Drams, Species of Diacurcuma a Dram, Steel prepar'd with Sul∣phur three Drams, Salt of Wormwood a Dram and a half, with a suf∣ficient quantity of Syrup of Citron Pills: Make an Electuary, the Dose is the quantity of a Nutmeg in the Morning, and at five in the Af∣ternoon, drinking after it of the following Julape three Ounces, and walking upon it.

Take water of the Leaves of Wake Robin a pound, of Pennyroyal and Hyssop, of each four Ounces, Sugar an Ounce: Mix them, make a Julape.

Take of the Tincture of Antimony an Ounce; the Dose is from twenty to five and twenty drops twice a day, with the said Julape. Moreover, amongst these we may place the Tincture of Steel, and its Syrup, also Elixir proprietatis, with many others.

Secondly, The panting of the Heart, which is more frequent, and much more violent, happens through some fault in the Arte∣ries belonging to the Heart, which fault is either an Obstruction, or a Convulsive affect.

The first default for the most part is continual, and often in∣curable, but especially if it arises from Consumptive Lungs, or because the Roots of the Arteries are half stop'd, or compress'd, by reason of some Tuberculum, or bony Excrescency in them: And in this case all that can be done, is to give some ease now and then by Hypnoticks.

Moreover, it is not improbable that the Arteries sometimes are almost fill'd up with Polypous Concretions engendred in them, and sometimes within the Cavities of the Heart it self, and that thereby the free passage of the whole current of Blood is hin∣dred; but as it is diffcult to be satisfied when this is so, so it is as rare to find a Cure for it. When there is a suspicion of it, Sa∣line Medicines seem to be most proper, and of those we must give such as have a Volatile, or Acid Salt; but we must not give them together, but for a time those (which failing of success) try the others.

Take Spirit of Sal Armoniack Compound, viz. distill'd with Mille∣pedes, or with other Anti-Asthmaticks three Drams, the Dose is from fifteen drops to twenty thrice a day, with the Julape, or some proper distill'd water: After the same manner you may try the Spirits of Hartshorn, Soot, Blood, and of an old Scull.

Take Spirit of Sea Salt, or of Vitriol distill'd, and often Cohobated with the Spirit of Wine, impregnated with Pneumonick Herbs three Drams; the Dose is from fifteen drops to twenty after the same man∣ner; for these purposes the Spirits of Tartar, Guaiacum, and of Box are often us'd.

The panting of the Heart is very often a Convulsive affect, and wont to be produc'd from the like Cause, and manner of affect∣ing, as other Hypochondriack and Asthmatick affects; and its Cure also ought to be attempted by Antispasmodick Remedies; but a cholce of them must be made with some difference, ac∣cording as the Disease happens in a hot or cold temperament.

In respect of the former, the following Medicines may be prescrib'd.

Take Spiritus succini Armoniaci three Ounces; the Dose is from fifteen Drops to twenty twice a day, with the Julape, or some proper distill'd water. After the same manner may be given interchangeably the Tincture of Tartar, of Steel, or of Antimony.

Of the trembling of the Heart, and its Cure.

THe trembling of the Heart is an effect distinct from its panting or Palpitation, and of a different nature from it, for in that its carneous and moving Fibres seem affected by them∣selves, nor does the Morbifick Cause, as in the other affect seem to lie in the Blood; or in the Arteries of the Heart.

The trembling of the Heart may be well describ'd to be a Spas∣modick Convulsion, or rather a trepidation of its flesh, by which the moving Fibres hastily, and only half contracted cause most swift turns of the Systoles and Diastoles, but broken, and as it were at halfs; so that the Blood is brought into, and carried forth of the Sinus's of the Heart, only in very small Portions.

As to the method of Cure to be us'd in the trembling of the Heart, since this affect is meerly Convulsive; therefore they are not Cordial Remedies, but rather Cephalicks, and Nervous Medi∣cines that are Indicated; which nevertheless according to the temperament and constitution of the Patient, must be either more hot or moderate, or, now of this, now of that nature. To comprehend all in a few words, since there are three sorts of Me∣cines, that are wont to be mighty successful in this Distemper, viz. testaceous Medicines, Chalybeates, and such as are endow'd with a volatile Salt: I shall here briefly set down certain forms of each of these and their use. Therefore in the first place a provision be∣ing made for the whole by evacuatives, and a choice being made of that sort of Medicine which promises best, you may prescribe as follows.

Take Coral prepar'd, Pearl, of each two Drams, both Bezoars, of each half a Dram, white Amber two Scruples, Amber-greece a Scruple: Make a Powder, the Dose is half a Dram twice or thrice a day, with a distill'd water, or some proper Julape.

Take Powder of Crabs Claws Compound two Drams, Powder of Male Peony Roots, and of Mans Scull prepar'd, of each a Dram, Flow∣ers of Male Peony, of Lillies of the Valley, of each half a Dram: Make a Powder to be taken after the same manner.

Take Ivory, red Coral powdered, of each three Drams, Species Diam∣brae a Dram, double refin'd Sugar, dissolv'd in a sufficient quantity of water of Navews, and boil'd to a consistency for Tablets seven Ounces: Make Tablets according to Art, weighing half a Dram; let one or two be eaten often in a day, as the person pleases.

Take Conserve of the Flowers of Lillies of the Valley six Ounces, Powders of Coral prepar'd, Pearl, Ivory, Crabs Eyes, of each a Dram and a half, Vitriol of Mars a Dram, Syrup of Coral what suffices: Make an Electuary; the Dose is from a Dram to two Drams twice a day, drinking after it a draught of the following Julape.

Take the water of Navews, and of whole Citrons, of each six Oun∣ces, of Orange, Rines distill'd with Wine two Ounces, Sugar half an Ounce: Make a Julape.

Take of our Syrup of Steel six Ounces, the Dose is a spoonful in the Morning, and at five in the Afternoon, with two Ounces of the Ju∣lape before written, leaving out the Sugar, or with distill'd water.

Take Powder of Ivory, and of Coral, of each two Drams and a half, Species Diambrae a Dram, Salt of Steel two Drams, Sugar eight Ounces, Amber-greece dissolv'd half a Scruple: Make Tablets weith∣ing half a Dram, the Dose is three or four Drams twice a day.

Take fresh Strawberies eight pounds, the outward Coats of twelve Oranges, fresh Filings of Iron half a pound, being bruis'd together, pour to them eight pounds of Wine; let them ferment in a Pot close cover'd for twenty four hours, then distill it in common Organs.

Take Spirit of Hartshorn, or of Blood, or the like, three Drams: The Dose is twenty drops twice a day, with a fit Vehicle.

Take Flowers of Sal Armoniack, Coral prepar'd, of each two Drams: The Dose is a Scruple twice a day.

Take Crystal Mineral two Drams, Salt of Amber a Dram, Salt of Hartshorn a Scruple: Mix them, the Dose is from fifteen Grains to twenty twice a day, with the distill'd water.

Of the intermitting Pulse, and its Cure.

AMong the Passions of the Heart, the intermitting Pulse may justly be numbred, because in this affect, or at least in some kind of it the Heart it self labours, though in somewhat a different manner than in its panting, or trembling; for in these it is ill dis∣pos'd, and irregular as to its motion, but in that, as to its rest, this being sometimes twice longer than it uses to be in its ordi∣nary course.

This intermitting Pulse, or over-long Cessation of Motion in the Heart does not proceed from the mixture or Crasis of the Blood, but only from the irregular dispensation of the Animal Spirits, from the Cerebellum into the Nerves that pass to the Heart, and thence into its Tendons, which irregularity happens, because those Nerves are somewhat obstructed.

Although this Affect being very often without present hurt or danger, does not require an over-hasty Cure; yet for preservati∣on sake, lest some great Diseases follow it, Remedies and a me∣thod of Cure ought to be used; at least for the whole remain∣der of the Persons Life, let him keep to a Diet well ordered in all respects.

Moreover, let some gentle Course of Physick be prescrib'd him to be constantly observ'd Spring and Fall; viz. That all the Seminal Roots of Diseases founded in the Brain, or apt to be there engendred, may be taken away, as much as may be; for this end we here direct you to the Prophylactick method, with the Medicines prescrib'd by us elsewhere, against the Fits of the Apoplexy.