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. II. A Cure for over-working of Vomits; and Anti-Emetick Medicines, or such as stop Vomiting, with Instructions.

IF a Vomit over-works, let the Patient presently be put to Bed, and let him make use of both External and Internal Reme∣dies; and first of all to appease the disorders in the Stomach, let there be outwardly administred to it, either a warm-Fomenta∣tion of the decoction of Sea-Wormwood, Mints and Spices in Red-Wine, or let a slice of the Pith of Bread be Toasted, and dip'd in Claret-Wine warm'd and apply'd thereto: Let there be a Glister given of Milk, with Treacle dissolv'd in it. Let also warm fricti∣ons of the Members be us'd, and strong Ligatures above the Knees to keep Convulsions from those parts; let the Stomach in the mean time be kept empty, unless an inclination to faint, or swouning otherwise requires, but as soon as it is able to receive any thing of Food, or Medicine, give some Cordial Water or m•••••••• Burnt-Wine: In case the Affect be very violent, and the Pulse admit it, Venice Treacle or Diascordium, sometimes also a Solution of Laudanum or an Opiatick Tincture do well.

Praeternatural Vomiting stirr'd up from other causes, is either Critical or Symptomatical: In the former nothing must be done too much in haste or unadvisedly; that excretion so there be a sufficiency of strength ought not to be stay'd, but the discharge

of the matter to be expell'd, is either to be facilitated or hastn'd, or it is to be converted some other way; hence when a person is urg'd by a nauseousness, or striving to Vomit, you may properly give either plain Posset-drink, or with the Leaves of Carduus boil'd in it; also sometimes Oxymel or Wine of Squills, or Antimonial Wine; sometimes it may be good to use Glisters, sometimes also a gentle Purge carries away the matter offending the Stomach, by a more easie way of Evacuation through the Intestines.

Symptomatick Vomiting proceeds from a conjunct cause, either subsisting in the Ventricle, which produces that Idiopathick Affect, or fix'd in other parts, which stirs up their Convulsions, and con∣sequently Vomitive Convulsions of the Ventricle, by a commu∣nication of the Nerves; the Cure of which Sympathick Vomiting depends on the Cure of the Primary Disease.

When the Stomach is Primarily Affected, it is because its Fi∣bres are irritated to an Excretion by some matter which it can∣not duly digest or overcome, or press forwards into the the In∣testines, which matter becomes so disagreeing or refractory, ei∣ther by its own offensive quality or quantity, or through the fault of the Stomach it self, its Tome being become lax, and its Fibres so weak, that they are not able to brook or indure the Chyle it self, much less the Excrementitious humours, but cast all forth by Vomiting: There being various cases and manners of affect∣ing of both these, we shall here briefly set down some of the chief of them together with the Remedies.

The Emetick matter subsisting in the Ventricle, is either brought into it from elsewhere, or what for want of digestion, or because it is vitiated, is engendred there; in either respect, the present offensive load is first of all to be carried off, and then care must be taken to prevent any farther supply of it.

To cleanse the filthy Mass of viscous matter forth of the Sto∣mach, prescribe a gentle Vomit of Carduus Posset-drink; or of Oxymel, or Wine of Squills, or of a Decoction of the Flowers of Chamomil, or of the Roots of Eupatorium, or give a Solution of the Salt of Vitriol, or such like; then let the remainder be gently carried off by Glisters, or by a Purge of Pilulae Mastichin: or Pil. Stomach. cum Gummis, Tinctura Sacra, or an Infusion of Rhubarb.

Moreover, when an impure or rank Blood, conveying ever and anon new Stores of offensive matter to the Stomach, either by the Arteries, or by the Gall-Vessels which often overflow, causes a disposition to Vomit, Bleeding frequently affords relief, and therefore Women with Child troubled with Vomiting, are often Cur'd by this means; those things also do good which so temper the Blood, that they keep it free from breeding adust Excre∣ments: Hence Whey, Mineral Waters, Juices of Herbs, Sal Pru∣nella,

and such like, for as much as they fuse the Blood, and convey its dreggy Particles some other way, often remove Vo∣miting dispositions. These sorts of Remedies may also be us'd in case a frequent and daily Vomiting proceeds (as some think it may) from the meetings and contest of the Bilous and Pancrea∣tick humours, and from their regurgitation into the Ventricle.

The more frequent Vomiting, and harder to be Cur'd, is that which proceeds from a disagreeing matter, and consequently E∣metick engendred within the Ventricle, to wit, by reason of the vitiated ferment of the Stomach, whatsoever is taken into it de∣generates into an irritating Mass of Corruption; wherefore in this case, after that the filth of the Stomach is cleans'd forth by gentle Evacuatives, Remedies commonly call'd Digestives are generally us'd; which according as the fermenting Juice of the Stomach (being for the most part of a Saline Nature, and sometimes of a Sulphurous) is in a various state of fixtness, flowing, or adusti∣on, are variously prescrib'd, and sometimes these, sometimes the others do most good.

In Belching and Acid Vomiting, these following Medicines may be try'd, and you may fix upon your method of Cure according to what you find agrees best.

Take Powder of Aron Compound an Ounce and a half, Salt of Worm∣wood two Drams, Sugar of Roses three Drams, make a Powder: give a Dram of it in the Morning, and at five a Clock in the Afternoon, in a little draught of Beer boil'd with Mace and a Crust of Bread, or give it in the distill'd Water, or Tincture of Roman Wormwood.

Take the Powders of Ivory, Crabs Eyes, and red Coral, of each two Drams, Calcind Coral one Dram, red Saunders, Cinnamon of each half a Dram, make a Powder: the Dose is half a Dram after the same manner.

Take the Powders of Lignum Aloes, yellow Saunders, Winters Bark, of each two Drams, of white Chalk six Drams, Sugar-Candy half an Ounce, with the Solution of Tragacanth in Mint Water as much as suffices, make a Past, and let it be form'd into Troches, weighing half a Dram; let the Patient take three or four of these thrice, or oft∣ner in a day.

Take Tincture of Salt of Tartar an Ounce, the Dose is from a Scru∣ple to half a Dram twice a day in some proper distill'd Water.

In hot and sharp or tartish Vomiting, Medicines endow'd with a sharp or tartish and vitriolate Salt are more proper. The famous Medicine of Riverius in this case does well.

Take Salt of Wormwood a Scruple, give it in a spoonful of Juice of Limmons.

Take prepar'd Coral two Drams, Salt of Wormwood a Dram and a half, Juice of Limmons four Ounces, let all stand in a large Glass;

add to it of strong Cinnamon-water two Ounces, give a spoonful or two twice a day, first shaking the Glass.

Take Powders of Ivory and Coral of each two Drams, Vitriol of Steel a Dram, Sugar-Candy a Dram, mix them, then divide the whole into six or eight parts, of which take one part twice a day in some convenient Vehicle.

In this case, Purging Mineral Waters which have much Nitre in them, also Waters that come from an Iron Mineral, and like∣wise our Artificial Chalybeate Waters prove of notable effect.

When at any time the Stomach perverts the most part of what comes into it, into a bilous and bitterish Mass of filthy cor∣ruption (as it often uses to do) and for that reason is prone to frequent Vomitings, then both acid and bitter things are pro∣per.

Take Elixir Proprietatis an Ounce, the Dose is a Scruple twice a day in some fit Vehicle.

Take Rhubarb Powdred twenty five Grains, Salt of Wormwood a Scruple, Cinnamon-water half an Ounce, Juice of Limmons an Ounce, let it be taken alone, or with some other Liquor.

Take Powder of Aron Compound an Ounce and a half, white Chri∣stals of Tartar three Drams, Vitriol of Steel a Dram, Sugar half an Ounce, make a Powder: the Dose is half a Dram, or two Scruples eve∣ry Morning, drinking after it a draught of the Tincture of Roman Wormwood, or some Coffee.

Take Powder of Crabs Eyes half an Ounce, Chalybeat Tartar two Drams, Sugar-Candy a Dram, make a Powder: the Dose is half a Dram, with a fit Vehicle twice a day.

Oftentimes the cause of a frequent and habitual Vomiting, is not so much the matter irritating the Ventricle, as the extream debility of its Nervous Fibres, which are neither able to Concoct what is taken into the Stomach, nor to endure the weight or burthen of it, but are presently irritated by any thing lying up∣on them, and stir up the Carnous Fibres to Excretory Convul∣sions.

There are two principal causes of this sort of Affect, viz. ei∣ther the debility of the Stomach arising from the Fibres them∣selves, is gotten by disorder in eating and drinking, so that those Fibres, for as much as they are beyond measure extended or o∣ver-heated, and as it were scorch'd, are not capable of admitting or containing a sufficient plenty of Animal Spirits: Or Secondly, These Fibres though they may be well enough dispos'd of them∣selves, yet for that the Nerves are in some other place obstruct∣ed, they are destitute of a due Afflux of Spirits, whence becom∣ing languid and flaxid, they cannot bear what is taken in, but pre∣sently finding themselves over-charged, throw all forth by Vo∣miting.

In the former Affect, those Remedies are indicated, which by their Styptick force cause the too much distended and tenuated Fibres to corrugate and contract themselves into a shorter space; also such as by their most grateful refreshment enliven their lan∣guishing Spirits, and allure others more plenteously to them.

Take Mynsicht's Elixir of Vitriol an Ounce, give from ten Grains to fifteen twice or thrice a day in a spoonful of the following distill'd Water, drinking seven or eight spoonfuls of the same after it.

Take Cypress Tops six handfuls, Clary Leaves four handfuls, the out∣ward Coats of twelve Oranges, Cinnamon, Mace, of each an Ounce, the Roots of Cyperus and the lesser Galingal of each half an Ounce, be∣ing slic'd and bruis'd, let them be put into eight pounds of Brunswich Beer, and distill'd in an ordinary Still.

Take Tincture of the Balsam of Tolu, extracted with the Tincture of Salt of Tartar an Ounce: the Dose is twenty Grains with the same Vehicle: the Tincture of Wormwood prepar'd with the same Menstruum may also be try'd.

Take Powder of the Leaves of Wormwood and Myrtle dri'd in the Sun in the Summer time, of each two Drams, Cinnamon, Flowers of red Roses of each a Dram, Cubebs, Roots of the lesser Galingal of each half a Dram, red Coral prepar'd a Dram; make of all a subtle Pow∣der, then with six Ounces of double refin'd Sugar dissolv'd in Cinna∣mon-water, and boil'd up to a consistency, make it up in little Cakes, weighing half a Dram, let one or two of these be eaten often in a day, as the person pleases.

Take Conserve of red Roses vitriolated four Ounces, Myrobalans con∣dited six Drams, Ginger condited in the Indies half an Ounce, Species of Hyacinth two Drams, the reddest Crocus Martis one Dram, Syrup of Corals what will suffice, make of all an Electuary, the Dose is a Dram twice a day, drinking after it a little draught of the distill'd water.

In the debility or resolution of the Ventricle, by reason of the Nerves being somewhere else abstructed, Paralytick Remedies joyn'd with Stomachicks must chiefly be insisted on.

Take Elixir Proprietatis Tartariz'd an Ounce, the Dose is a Scruple twice a day, with the water above prescrib'd. The Tinctures of Salt of Tartar, of Coral, of Antimony may be us'd after the same manner. In this case also the sweet spirit of Salt, tht spirit of Sal Armoniack, or its Flowers are of great effect: Moreover Vomits, Purges, and even Diaphoreticks are often successively administred, I have known this Distemter sometimes happily Cur'd by Bathing in our hot Baths at Bathe.