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. VI. Instructions and Prescripts for the Cure of the Psora, or the Scab with the Itch.

AFter the more simple affects of the Skin which hapning without any Tumour or Sore, soil it only with Filthy Spots, I shall now speak in order of the greater affects dis∣solving continuity: And in the First place of the Psora or Scab which molests the Skin in most places of the Body with small Pushes, or breakings forth, being sometimes dry and often scal∣ly without much Itching, as in persons of a Cholerick or Melan∣cholick Constitution, sometimes moist and dispos'd for Ulcer∣ation with a mighty troublesome Itching, as in Persons of a moist Temperament, with a foul Blood: And this affect is most peculiarly a Disease of that part, seeing that it often has its beginning in the Skin it self by outward Contagion, and is frequently Cur'd by certain Remedies apply'd only to the Skin; at leastwise the reason of both holds good so far that it's sel∣dom perfectly gotten, or Cur'd by other means.

This Scab, or Itch is commonly describ'd to be a breaking forth of Pushes here, and there through out the whole Body, proceeding from a sharpe and salt Humour gather'd together within the Pores of the Skin; and by reason of its mighty Itch, causing a necessity of scratching to discuss it thence.

I conceive the Morbifick matter of the Itch to be the Lym∣phick Humour constantly residing in the Glands of the Skin, but degenerated from its Genuine, viz. Salino-volatile Disposition, into an Acid, or otherwise vitiated Temper.

That Lymphick Humour is wont to be depraved these three ways, and consequently falls into a Coagulative and Vitious habit with the Serum newly supply'd from the Blood: viz. First, the Blood it self being very impure, and withal dissolv'd leaves a great store of its corrupted and Filthy Dreggs in the Glands of the Skin, which becoming there a Leaven more Corruptive, strongly ferment, and are coagulated with other adventitious or transient Juices, and so bring forth not only Scabby affects, but Leaprosies of divers kinds; hence frequent and continual feeding on Shell-fish and others, and on Salt Meats, and such as have been dry'd in the Smoak or Sun: Also improper Drinks,

and Venemous Medicines taken into the Body cause breakings out all over the Skin, and those often very dreadful.

Secondly, the Humour gathered together within the Glands of the Skin sometime putrifying by meer Stagnation does not only breed Scabs, but also frequently Lice. Wherefore not only Per∣sons long Imprison'd, but likewise such as leading a Sedentary Life use themselves withal to Stench and Nastiness, are still subject to the said affects.

Thirdly, if haply those causes are wanting, that the Glan∣dulous Humour of the Skin be neither desil'd through the fault of the Blood, nor its own Stagnation, yet a Virulent infection from without disposes it as readily to produce those Diseases, as it's daily manifested to us, the Effluvia flowing from the Pushes of a Scabby Skin, being of no less efficacy than Barm or Yest, whereof if a very small Portion be put into new Ale un∣fermented, it presently ferments the whole Mass, be it never so great, and changes it into the nature of the Liquour whence it was taken.

Therefore the Itch as to its Origine, either is taken by Con∣tagion, or by reason of an ill Dyet, its Incentive and Fuel is communicated from the Chyle and Mass of Blood being viti∣ated, or through nastiness and want of Perspiration it's gene∣rated in the Skin it self: To which we may add that Infants sometimes get this evil Hereditarily contracted from their Parents.

Though this Disease be never Mortal, or very dangerous of it self, but always easy of Cure, yet it has often an ill issue, because being long continued it mightily vitiates the Blood, and the Nervous Liquour; and if Cur'd on a sudden, the Mat∣ter whioh is driven from the Pores being inwardly receiv'd, brings a pernicious Taint on the Praecordia and Brain, or on other Noble parts.

The greatest danger from the Itch threatens Children, and Cachectical Persons, because in both these the Taint of the Cutaneous Humour is more easily sent into the Noble parts, which after the outward Contagion of the Itch is taken away, remaining within, cannot be throughly overcome but by a great deal of Physick (which neither of them can well bear) wherefore such persons ought to be preserv'd with all care and diligence from the Itch, as from the Plague it self.

Concerning the Cure of the Itch there are two primary In∣dications, and both of them twofold: viz. the First being Cu∣ratory has regard to these two things, that the Glandulous Hu∣mour (its Corruptive ferment being wholly extinguisht) be restor'd to its due Crasis. And then Secondly, that the Pores

and Passages of the Skin it self being freed from those Con∣cretions of Ichor recover their Ancient Conformation or free Perspirability.

The Second Indication being Preservatory, provides against these two things, viz. First, that the Impurities and Corruptive Miasms of the Itch, which are driven from the Skin when the ferment is Purg'd, do not regurgitate into the Blood, and Ner∣vous Liquour, and cause not only Discrasies in them, but like∣wise (as it often falls out) bring great damage to the Brain and Praecordia. Secondly, it must be endeavour'd that the in∣fectious Taint of the Humours and Noble parts, contracted from the Scabby Matter, be eradicated at the same time that the Nasty Distemper of the Skin is Cur'd.

All these intentions of Curing ought to be complicated, or at leastwise to be interchangeably prosecuted by Remedies both inward and outward us'd together, to the end that the Mor∣bifick matter being chased from its private Receptacles, may not any where retire and lie hid in any lurking places, but being persued by Medicines in all parts both within and with∣out, may be wholly remov'd; therefore Purges ought always to begin and end this Method of Cure, whatsoever Helmont says to the contrary, and I dare affirm that this Disease is scarce ever Cur'd easily, and never with safety without that Medicine. Moreover open a Vein one of the First things you do, un∣less somewhat indicates the contrary; besides these let altera∣tives have their turns, such as purify the Blood, and strenthen the Viscera, and fortify them against the Ineursions of the Scab∣by Matter: And in the mean time let Liniments, or Baths, or Topical Remedies of other kinds, and appropriated to the Skin be apply'd, for without them, not only Catharticks and Bleeding, but even Diaphoreticks, Diureticks, nay any kind of Medicines whatsoever evacuating or altering the Blood and Humours prove of no effect: We shall set down some select Forms of the Medicines of each kind before mention'd: And First, for due Purging give a Purging Medicine, or a Vomit the first thing you do: Also after Bleeding (if it be necessary) let the person use a Purging Apozeme, or Ale for seven or eight Days.

Take the Electuary Diacarthamum three Drams, Species of Dia∣turbith with Rhubarb a Dram, Cream of Tartar, Salt of Worm∣wood of each half a Scruple, Purging Syrup of Apples what suffices, make a Bolus to be taken with Governance. (Or)

Take Sulphur of Antimony seven Grains, Scammony Sulphurated eight Grains, Cream of Tartar half a Scruple, make a Powder.

Take Roots of Polypody of the Oak, and of sharpe pointed Dock prepar'd of each an Ounce, Leaves of Sena ten Drams; Turbith,

Agarick, Epithimum of each an Ounce, Carthamus Seeds half an Ounce, yellow Saunders two Drams, Seeds of Annise, and Caraway of each two Drams, being slic'd and bruis'd digest them close lu∣ted and warm in four Pounds of White-wine for twentyfour hours, pour off the clear Liquor without expression, the Dose is six Ounces by it self, or with a spoonful of Syrup of Epithimum. (Or)

Take the foresaid Ingredients and boyl them in six Pounds of fountain water, to half, then add of White-wine a Pound, and strain it presently; make an Apozeme, give it after the same man∣ner. (Or)

Take Roots of Polypody of the Oak, and of sharpe pointed Dock of each three Ounces, the best Sena four Ounces, Epithimum, Tur∣bith, Mechoacan of each two Ounces, yellow Saunders an Ounce, Co∣riander Seeds six Drams, let them be prepar'd according to Art, make a Bagg for four Gallons of Ale, after five or six Days drink it, and take to twelve Ounces more or less every Morning for eight or ten Days.

For ordinary Drink let a little Vessel of four Gallons be full'd with small Ale, into which put the following Bag.

Take tops of Tamarisk, Fumitory dryed of each four handfuls, Roots of sharpe pointed Dock dry'd six Ounces, Rinds of Bitter∣sweet two Ounces, being slic't and bruis'd mix them; or let a Bouchet of the Decoction of Sarsaparilla, Saunders, with the Shavings of Ivory, Harts-horn, Licorice, &c. be taken.

As to altering Remedies besides the Physick Ale for ordinary Drink there seems not need of many others, only that a good Dyet be observ'd by avoiding Salt and Peppered Meats, Shell∣fish and others which have been laid in Brine: Also let them forbear Wine, strong Waters, strong Beer, and all Liquors apt to trouble the Blood too much, and to ferment it: In an ob∣stinate Scab, seizing a Cacochymical Body it's proper to give the following Electuary with the distill'd water twice a Day.

Take Conserve of Fumitory, of the Roots of sharpe pointed Dock of each three Ounces, Troches of Rhubarb, Species Diatrion Santa∣lon of each a Dram and a half, Salt of Wormwood a Dram, Vitriol of Mars four Scruples, with a sufficient quantity of Syrup of Cichory with Rhubarb, make an Electuary, the Dose is from a Dram to two Drams twice a Day, drinking after it of the following distill'd Water three Ounces.

Take Firr Tops seven handfuls, Leaves of Fumitory, Agrimony, Female Fluellin, Liver-wort, Brook-limes, of each four handfuls, Roots of sharpe pointed Dock two Pounds, Rinds of Elder two handfuls, the outward Rinds of six Oranges, being slic'd and bruis'd, pour to them Whey made with midling Ale eight Pounds, distil it in com∣mon Organs, let the whole Liquor be mixt.

Ointments to be anointed on the Skin are prescrib'd most frequently, and that very effectually for Curing the Itch: Though those that are us'd to many other Tumours and Sores do no good here: But Sulphur and preparations of it, seem to have a certain Specifick Vertue in this Disease, so that they are in∣gredients in almost all Ointments for the Itch, and are the ba∣sis of the whole Composition. This is a very common receipt with the vulgar.

Take of the Powder, or Flowers of Sulphur half an Ounce, Butter without Salt four Ounces, Ginger powdred half a Dram, make a Liniment.

Somewhat a neater prescript, though not much more Effi∣cacious, is after this manner.

Take Ʋngentum Rosatum four Ounces, Sulphur-vive powdred half an Ounce, Oyl of Tartar per Deliquium what suffices, make a Li∣niment, to which add Oyl of Rhodium a Scruple, to give it a scent.

When you will strengthen or raise the Energy of the Sul∣phur by the addition of other things.

Take of the Ointment of Elecampane without Mercury four Ounces, Power of Sulphur half an Ounce, Oyl of Tartar per Deliquium what suffices: For the same purpose an Ointment is made of the Roots of sharp pointed Dock boyl'd in Butter, or Oyl with White∣wine till the Wine be consum'd; and with Sulphur and Oyl of Tartar. Moreover those Ointments are sometimes us'd by them∣selves, by curious persons abhorring the ill odour of the Sul∣phur.

The Third kind of Liniment against the Itch is made of Mercury needing no assistance from Sulphur, or Vegetables; nay this being more than enough efficacious of it self, is not wont to be apply'd to the whole Body, but only to the Joints of the Arms and Leggs, or being put in a Girdle is to be worn about the Loins, for so it seldom fails of Curing the Itch: Nevertheless there is danger lest this Practice (as it often happens) causes ill and pernicious Symptoms: Frequently af∣ter the Mercury Ointment a Salivation, sometimes also a Sco∣tomia, or Sleepy, or Convnlsive affects ensue: Moreover some∣times the Poyson of the Medicine produces within the Praecordia, or Viscera, horrible affects of the Asthma, Leipothymia, or Bloody∣flux.

The vulgar Form of a Mercural Ointment for the Itch, and very much in use, is this.

Take Quick-silver reduc't into minute parts with an Acid, and (as they call it) Killd, an Ounce and a half. Fresh Haggs ••ard six Ounces, incorporate them well by stirring them a long 〈◊〉〈◊〉 in a Stone or Glass Mortar.

Nor only in the Form of a Liniment, but many other ways the foresaid Medicines may be us'd: For the Fume of Cin∣naber (which is prepar'd of Mercury with Sulphur,) cast on the Coals, and taken in at the Mouth, or breathing against the Superficies of the Body, Cures the Itch: The Mercurial Cos∣metick water before written made about half weaker, and ap∣ply'd to the Skin with a little Cloath in the Sorest places, kills the Itch: Yet the use of these is not so very safe as to be generally administred to all persons.

Of Sulphur and Vegetables either separately, or conjunctly, boil'd in water Baths are prepar'd, which Cure this Distemper, not by washing off only the Filth of the Skin as common Baths, but likewise by destroying its ferment: Besides these there is yet another easier, and much more neat way of Cu∣ring the Itch, viz. by boiling a Shift in fountain water with Powder of Brimstone, and after it is dryed in the Sun, or be∣fore the Fire to wear it four or five Days next the Skin: For so that Disease is wont to be Cur'd without Bathing, or the Nastiness, or ill Odour of an Ointment.

Poor people usually Cure themselves of this Distemper only by taking the Powder of Brimstone in Milk inwardly, and by anointing themselves with the said Powder mixt with But∣ter outwardly: Sulphur seems to be so Specifick an Antidote against the Itch by reason of its Balsamick Vertue which de∣stroys the Acidities, and all Exotick and Corruptive Sharpnesses of the Blood and Humours, and restores to each Latex a Be∣nign, that is, a Mild, and as it were Oyly Nature.

As to Mercury, it's no wonder if medicines made of it, per∣fectly Cure any places of the Skin infested with the Itch where∣ever they are apply'd: For by the application hereof break∣ings forth, and all Virulent Ulcers, viz. any that are Venereal and Scorbutical are wholly conquered: Moreover it seems not strange that this Medicine apply'd to some particular place should Cure an inveterate Itch in case it raises a Salivation; but sometimes it Cures without any such thing, as when a person wears a Girdle of it; to this we say that the Particles of the Mercury pass then into the Venous Blood, and after being diffus'd through its whole Mass, are driven outward from all parts, and depos'd in the Skin where they kill the Itch, and when it happens that these Mercurial Particles are all a∣gain evaporated through the Skin, after the Cure is performed, then no Salivation, or other inconvenience ensues.