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.

SECT. 3. Of Outward Medicines.

CHAP. I. Of Phlebotomy.

TO Discourse Methodically of this great Remedy, we must first consider how many ways and for what causes and ends an Emission of Blood happens either of its own accord, or is indicated by Physick. Then Secondly we shall acquaint you with the good and ill effects, or with the Advantages and Prejudices of this Evacuation, and shall give you likewise cer∣tain rules and cautions to be observ'd in the due Administration of Phlebotomy.

As to the first, Spontaneous Eruptions of Blood being ma∣nifold and of divers kinds, are usually reduc't to these two heads, or orders, viz. either they are Critical, nature endeavour∣ing somthing good and for the Advantage of Health; or Sympto∣matical, which happen for the most part when she is put by of her Government, and all things are in Confusion: The E∣ruptions of Blood of the first kind are again distinguisht, that either they come without a Fever, and are either Periodical, which often happen at set times as the Menses of Women, and in some the Flux of the Haemorrhoides, and in others yearly Bleed∣ings at the Nose, or otherwise customary; which commonly hap∣pen upon the great changes of the year, or of the Air: Or they are erring and uncertain, as when the Blood breaks forth for our good from those places, and from many others, som∣times in this part of the Body, somtimes in that. Moreover Excretions of Blood somtimes happen in a Fever, and often determine it: In all these cases the Blood breaks forth, because growing Turgid within its Vessels, and being very much rari∣fled, it requires a larger space.

Now the Blood grows thus Turgid on two accounts viz. both as its Liquor is Inflammable, and as it is Fermentative.

1. As to the First, that the Blood may have a due Accension

for the preservation of Life, and the due performance of its Fun∣ctions, its Innate Sulphureous Particles must be proportion'd to the Nitrous Particles coming to it from the Air: There∣fore as often as the Blood growing very hot, and being highly rarified, is much open'd and loosen'd in its Texture, so that the Sulphur being at freedom is kindled more than ordinary, a quick and toylsome Breathing follows to draw the Nitre also in a fuller measure than usually: Now if the abounding Sulphur can∣not spend it self after this manner by burning briskly, nor the vital flame be thus regulated, presently the next course for less∣ning the fuel of the Sulphur is that some part of the rari∣fied Blood breaks violently forth: Hence not only in Fevers, but after Drinking Wine, Bathing, being in the Sun, and other Ac∣cidents upon which the Blood grows very Turgid, either Eru∣ptions of Blood happen of their own accord, or it's often ne∣cessary to supply the defect of such Spontancous Evacuation by opening a Vein.

Secondly, the Blood also as it is a Fermentative Liquor is apt to break forth of its Vessels, for if at any time some Hetero∣geneous thing, which will not mix with it, comes into its Latex, it strongly Ferments as Wine in a Hogs-head, and boyls in its Vessels to expell that disagreeing substance, which seeing it can neither conquer, nor send forth by Sweat, Urine, or other ways, the Blood it self throws off some portion of its own substance, as a Vehicle to carry forth that matter with it: hence divers E∣ruptions of Blood variously happen both in Fevers and with∣out them; which are all rais'd by nature for some good intent, though it often happens otherwise through various Accidents and Circumstances; but for the most part there is a failing in Spontaneous Haemorrhagies critically intended; either First, be∣cause the Blood in boyling knows no measure in flowing forth; or Secondly because the mouths of the Vessels being once open'd do not presently close, or cannot presently be shut; or Thirdly be∣cause nature endeavouring an Excretion of Blood, does it by places which are most open, though often improper, as when it hap∣pens by the Lungs, Reins, Intestines, and other Viscera, which therefore from being critical becomes Symptomatical, and often Malignant.

Nor only these ways, but likewise for many other Failures or Impediments of nature, Symptomaticall Haemorrhagies hap∣pen, in all which either the Blood it self, or the Vessels con∣taining, or both of them together, are alwarys chiefly in the fault.

First, the Blood besides the ways above mention'd is apt to extravasate when its Latex being some way corrupted, is not able to retain its due mixture, but being apt to coagulate or

putrifie, runs Into parts, whereof some break forth into Wheals or Pushes, or shew themselves in Spots, others plainly make Bloody Eruptions where they can first find a Vent; as it's ge∣nerally seen in the Plague, Small-pox, Meazles, and in Malig∣nant Fevers, and in some measure in Scorbutick Affects. Second∣ly, The Vessels conveying the Blood are many ways the cause of its Symptomatical Eruption, as first if some of them are in any place obstructed, as often as the Blood is put in a Ra∣pid Motion, it's forc't to burst forth either there, or near the place, and somtimes also in parts far distant from it; hence upon a suppression of the Menses, or Haemorrhoides, a Bleed∣ing at the Nose often follows. Secondly, the little Mouths of the Vessels have somtimes al ill Conformation, for that the fleshy Fibres with which they are guarded are grown Lax, or resolv'd, so that when the ends of the Arteries gape too much, the Mouths of the Veins close; by reason of this affect Scor∣buticall and Cachectical persons are very subject to Eruptions of Blood. Thirdly, It oftens happens that the Vessells having this ill Conformation are likewise affected with Convulsions, so that the Muscular Fibres of the Vessels being disorderly contracted, cause sudden and violent Sallyes of the Blood, som∣times upwards and somtimes downwards, and consequently E∣ruptions: For I have observ'd in some, when the Current of the Blood has been slender enough, with a low and weak Pulse, that the Convulsions of the Vessells beginning in some place, and carried forward as a Wind running here and there in the Body, have driven the Blood vehemently, though never so low of it self, and forc't it into violent Eruptions: And in these cases when opening a Vein, and Medicines cooling and qualifying the Blood have done no good, we have found the greatest re∣lief from Narcotick's, Anticonvulsives, and Ligatures.

To speak now of Bleeding by Art, we generally observe that Physick in some cases imitates nature, in others exceeds it, and often regulates it, and reduces it when it acts amiss; though there are some cases in which nature far exceeds the efficacy of Art in Excretions of Blood. I shall speak brief∣ly of each of these.

First therefore in whatever affects Spontaneous Eruptions of Blood use to do good, if at any time these fail, Physick the Handmaid of nature aptly suplys its place by Phlebotomy, there∣fore if haply the Blood by reason of its Sulphur, being too much at liberty and exalted, is kindled too much, upon opening a Vein the superfluity of that Inflammable fuel will issue forth: So likewise immoderate Turgescencies of the Blood by Reason of some unsubduable substance gotten into it, are allay'd by

this means: Wherefore Bleeding is presently ordered both a∣gainst continual Fevers which proceed from the former cause, and against such as intermit whose fits are from the latter: And so, as often as an accustomed Evacuation at set times which is stopt, or a humour struck back from the outward parts, or a sudden stoppage of the Pores, or if a Surfeit, Drinking of Wine, and other Accidents of this nature, by crowding the Blood with Heterogeneous Particles, cause a Turgescency in it, Phle∣botomy is usually a most present Remedy.

Secondly, Physick does not only imitate nature in letting forth of Blood, but often exceeds it; nay and frequently aids it, and reduces it when it labours, and acts amiss. For if at any time the Blood taking a Head, rushes in a Body to one part, and there either presently breaks forth in a disorderly manner, or being gather'd together in a large quantity causes an Inflammation, a Vein being open'd in some remote part stops that Praeternatural Salley of the Blood, and often puts an end to the Eruption, or Inflammation: Wherefore in the Plurisie, Sqinancy, Perpneumonia, in Spitting, or Vomiting Blood, when na∣ture either yields it self overcome, or bing sturck as it were wiht a Rage seems to lay violent hands on it self, Chirurgery withdrawing the Blood to some other place, and letting it forth, restores all things, when almost in a loft Condition.

Moreover Physick often moderates or reduces nature when too profuse, or extravagant in the Effusion of Blood, for in Truth all immoderate Eruptions of Blood must be stay'd ra∣ther than promoted: Again in regard in the Plague, Small-Pox, and Meazles broken forth, and in Malignant Fevers a Sponta∣neous Eruption of Blood always foreboads ill: Therefore in those affects Stiptick Medicines restraining the Eruption of Blood are more proper than breathing a Vein.

Nevertheless there are some cases of an Effusion of Blood by nature, which Physick can no way imitate, nor supply by Phle∣botomy if haply they fail: In Fevers about the Crisis of the Dis∣ease, viz. after the Digestion of the matter, that is, its pre∣paration for Separation, a Spontaneous Eruption of Blood, in regard it comes in a due nick of time, is far better than any Bleeding by Art, the due season for which is unknown: And so a flowing of the Menses and Haemorrhoides hapening by the Instinct of nature is much more Advantageous than if Blood be caus'd to flow thence by Art.

There is this notable difference betwixt Blceding by opening a Vein, and a Spontaneous Eruption of Blood, that in this the Blood flows in a manner wholly out of the Arteries, and in the o∣ther Evacuation it's drawn only out of the Veins.

So far of Phlebotomy compar'd with a Spontaneous Eruption of Blood: I shall now shew its use and effects both good and evil in the Practice of Physick: Therefore in the first place let us shew in general what sort of alteration this Evacuation causes in the Mass of Blood, and then to what Diseases either of the whole Body, or of particular parts it most immediately has respect to.

Concerning the first it's obvious that the Blood after Breath∣ing a Vein is altered both as to its quantity, and as to its Temper and Crafis, and as to its Motion.

The first and most common Indication for Breathing a Vein is that by this Administration the Mass of the Blood be lessen'd: Hence even the vulgar growing to an overful habit of Body cause themselves to be let Blood to remove that Plethorick Dis∣position, but though the evils of that affect are remov'd or prevented by nothing better, yet the necessity or this Evacuation ought to be avoided as much as may be: Because the Blood is rendred by it more Sulphureous and less Salt, and consequent∣ly it disposes Men to a Feverish habit, and to grow Fat: More∣over the great Remedy, Bleeding, if made common on every slight occasion, will become of no effect in grand Distempers when it is needed: To which we may add that according to the observation of the vulgar, the more familiarly any one uses Bleed∣ing, the oftner he will want it: For the Blood being let forth to avoid an overgreat fullness, the rest of the Mass soon rises again to a Plenitude, though it's worse in its Crasis, For by this means being much berest of its Balsamick Salt which preserves it from Putrefaction: Instead of it, it's more fill'd with a Fatning and Inflammable Sulphur.

2. Phlebotomy amends the Mixture and Temperament of the Blood in sundry respects: First if any Heterogeneous thing be gotten into its Mass, which can neither be mastered, nor easily separated, and sent forth, upon opening a Vein the Blood flow∣ing forth carries with it often a great Portion of that matter: So again the Blood declining from its Temperament is often re∣stor'd by Phlebotomy; for when its Mass upon the exaltation of the Sulphur, or fixt Salt, of both of them together, is de∣generated into a sharp, Salt, or Salino-Sulpureous nature; a Por∣tion of the Blood being drawn out, presently it ferments anew, and often there is such a change made of all those kinds of Particles, that thence forwards the Spirits with the Volatile Salt begin to rise again, and recover their Dominion, keeping he Sulphur, and fixt Salt under, as they ought to be: Hence Bleed∣ing gives often great relief not only in Fevers, but likewise in the Scurvy, Jaundise, and even in a beginning Phthisick: For the Blood

after the Vessells are emptyed, as the Stomack when discharg'd, Concocts and Assimilates all Humours that come into it better, and more easily separates any Heterogeneous thing and sends it a∣way.

But if the mixture of the Blood begins to be much dissolv'd, or wholly to sink, as in the Plague, and Malignant Fevers, we must utterly abstain from Bleeding; for upon taking away of Blood the provision of the Spirits (whose only business it is to pre∣serve the Mass of Blood from Putrefaction and Corruption) is diminisht: So that all things presently tend to a pernicious Dissolu∣tion. Moreover if the Discracy of the Blood be such that the more noble Principles, viz. the Spirits, Volatile Salt, and Sulphur being deprest or spent, the watery and earthy Particles, have the Praedo∣minancy, the Blood must by no means be let forth, but be preserv'd as the Treasure of Life: Hence in a Dropsie, Cachexia, Consump∣tion and other affects, where the active Principles are mightily de∣prest, you had as good cut a Mans Throat as open a Vein.

In the foresaid cases where the Crasis of the Blood is con∣sider'd, it's easy to determine whether Bleeding be proper, or not, but in certain other cases, as especially in a Putrid con∣tinual Fever, when Life and Death depend on this point, there is need of great Deliberation. Now in this difficult case we must consider the State of the Blood, the tendency of the Morbi∣fick Matter, and the strength of nature: First as to the former, if in a Putrid Fever the Blood boyling very much canses a mighty heat, with Thirst, Watchings, and a parching heat of the Jaws, and no free Sweat, or Eruption of Pushes appears, or is ex∣pected in any short time, Bleeding is so plainly indicated, that it were a crime to omit it: But on the coutrary if in a weak Body, a slow and remiss, but continual Fever arises with a weak Pulse, forbear taking away any Blood, and let it be cleans'd by Transpiration, Urine, and Blistering. In a middle State of the Blood, let Bleeding, being of it self indifferent, be determined by other things. Therefore in the second place we must con∣sider the Tendency of the Morbifick matter, or its Propension, which matter if it lies dull in the Mass of Blood and unapt to separate, and so (as it frequently falls out) a Translation of it to the head instead of a Crisis hapning, it threatens the Brain, and the Genus Nervosum, Bleeding ought to be seasonably Ad∣ministred for the prevention of these evils: But if that mat∣ter mov'd with a sudden Impetus, and either rushing inwards to the Viscera of the Belly causes a violent Vomiting, or Flux, or driven outwards brings forth the Small-pox, Meazles or o∣ther Pushes; every such Impetus of nature, of good ought not to be disturb'd, if evil must not be rendred worse by Phle∣botomy:

For to let Blood in these cases is not only danger∣ous, but very often also Extreamly Ignominious. Thirdly, con∣cerning Bleeding in a doubtful case, we must consider the strength of the Patient; for in a sound Constitution, a Vigorous Age, the beginning of a Disease, and whilst the Functions both Vi∣tal and Animal are in a vivid or indifferent State, we may with confidence order Bleeding unless somthing indicates the contrary; but when it is otherwise as to those conditions we must not inconsiderately proceed to that Evacuation.

Thirdly, the disorderly Motions of the Blood, viz. when being struck, as it were with a Rage, it either rushes violently, or conveys offensive matter somtimes into one part, somtimes in∣to another, it is excellently moderated, or reduc'd by Phle∣botomy; wherefore for violent Head-aches, all Convulsive, or Sleepy Fits, for Catarrhs, Inflammations of the Eyes, and for the Cough, Asthma, Fits of the Gout, and of the Stone in the Kid∣neys, or for Phlegmons, Erisipela's and for many other af∣fects caus'd by the Fluxions of the Blood or Serum, Bleed∣ing is commonly prescrib'd, and that with good success, for upon draining the Vessells, the Blood getting a more free pas∣sage is Circulated calmly and undisturb'd: Moreover whatsoever of this, or of the Serum is extravasated, is drunk up again and brought into its due course.

Having thus shewn you the effects both good and evil which happen to the Blood in its different State upon Breathing a Vein, we must now enquire to what chief Diseases either of the whole Body, or of some particular part that kind of Remedy had a most immediate regard to it: And first as to general affects it's well known that Bleeding is indicated by a hot and dry Distemper, and forbidden by a cold and moist. In every Fever it's usually propos'd, never in the Dropsie: Next if we consider particular Diseases, there is no region or part of the Body but some time may require it: The Headaking, the Brain opprest with Blood, or Serum (whence a world of evils spring) the Inflammation of the Eyes, Face, Mouth and Throat, all Diseases of the Brest, and Praecordia (to each of which the disorder of the Blood gives a Rise or affords Fuel; also obstructions, or inflam'd affects of the Liver, Spleen, and other Viscera, so likewise both the overgreat fulness and athletick habit of the whole Body, and the Tumours, and Painful, or Convulsive Passions of each particular Member seem to accuse the Blood as the Au∣thor of all the evil, and require its Emission as it were by way of satistisfaction.

If at any time in these and may other affects Bleeding be manifestly indicated, before we set upon it we must consider

of these four things, viz. in what place, after what manner and by what instrument, at what time, and in what quantity the Blood ought to be let forth.

1. As to the First, though according to the Laws of the Circulation of the Blood there be little difference from what Vessel it be drawn, so it be large enough; yet because besides a general Evacuation of Blood somtimes a partial Derivation pro∣perly so call'd (as when the Blood is to be drawn from some par∣ticular place where it is gatered together) and likewise a Re∣vulsion, when it is to be withdrawn into this or that part, are intended, therefore in the Body of Man various limited pre∣cincts, as it were, are assign'd, out of which Blood may be let according to occasion, and for most necessary uses, somtimes out of this, somtimes out of that, or the other.

If therefore at any time a general Evacuation of Blood be indicated the common or middle Vein of the Arm is best to be open'd for this being of a good largeness easily admits the Lancet, and the Blood flows equally from the whole Body to its wide Orisice, upon the free Emission of which not only the Plethorick Disposition is taken away, but the greater Vessells being every where emptyed by this means, the Bloood stagnat∣ing in any place is restor'd agin to Motion, and if extrava∣sated is drank up agin into the Veins: Wherefore in great affects, where the Blood gathered together in the Brain or a∣bout the Praecordia threatens a sudden Destruction, the best way, not only of a general Evacuation, but likewise for a Re∣vulsion is to let forth the Blood in a full current by opening a Vein in the Arm with a large Incision.

But if without any great Plethora the Blood be to be E∣vacuated from the whole Body, and to be withdrawn from the Superiour Region of the Body to the Inferiour, as in suppressions of the Menses, or Haemorrhoids, it's more propper to draw Blood from the Foot, or from the Haemorhoid Veins by Leeches: And if after an Evacuation of Blood from the whole, it must also be deriv'd from some particular place where it is gathered to∣gether, let it be taken near the place affected; Hence in Ce∣phalick Diseases we open the Vein of the Forehead, Temples, or Thorat: To Cure Tumors and Pains hapning in the Joynts, we either open a Vein beneath or near them, or draw froth the Blood by applying Cupping-glasses, or Leeches there: And so in affects of the Thorax and of the Belly either Cupping-glasses are apply'd to the Region Distempered, or Leeches to the Vessells of the Fundament.

As to what is said that some Vessels have a peculiar respect

to some of the Viscera in particular, as the outward Vein of the Arm to the Head, the inward to the Liver, &c. All this is a meer vnlgar errour, grounded on no reason or Anatomi∣cal observation: Therefore assoon as it is agreed on for opening a Vein, and of the place, make choice of some large Vessel, and very fair to the sight that it may be more easily open'd, and let it not have any Artery, Nerve, and Tendon near it, that it may be Lanced more securely. Wherefore the middle Vein of the Arm is most commonly made choice of, though the Exte∣riour call'd the Cephalick be more safe, being less crowded with other Vessels.

The Jugular Vein, so generally open'd in Beasts is most safe∣ly and easily lanc't, and is as proper as any other what so∣ever for a general Evacuation of Blood from the whole Body, besides its excellent Derivation from the Head.

If you open the Vein above or near the Ancle you must take a mighty care lest you hurt the Tendon, which sometimes hap∣pens through the unskillfulness or rashness or Chirurgeons, to the great prejudice of the Patient: Moreover you must take care of opening a Vein near its Anastomosis with an Artery: For if this be done the Blood springs forth violently all of a Scarlet colour, and its stream is not easily stopt, nor the Ori∣fice of the Vessel soon clos'd.

As to the ways or Instruments with which Blood is drawn forth, it's done either by opening a Vein with a Lancet, or by Suction with Leeches, or by Cupping-glasses after Scarification.

It's known by sad experience that in Lancing a Vein some∣times an Artery is prickt, whence either Death, or a cutting off of the Member sometimes follows; the reason is that an Artery ought incessantly to vibrate and beat in like manner as the Heart it self, its Fibres iterating the perpetual charges of Sy∣stole's and Diastole's, wherefore a hole made in its Ductus be∣comes as it were incurable by reason of the continual Motion of the Vessel, and the Efflux of Blood: It is far otherwise in a Vein whose Aperture presently closes again of its own accord; there being little stress of contraction lay'd on its Tunicles, and indeed only so that its Fibres being a little dilated on occa∣sion, the Blood flowing back, may be gently driven forwards: If at any time a Physician of Patient are fearful of opening a Vein, an Extraction of Blood by Leeches, or Cupping-glasses with Scarification will aptly enough supply its defect, and of∣ten with the like Advantage; nay these Administrations for re∣moving the Conjunct cause of a Disease, where there is need rather of a Partial Derivation, or Evacuation than a general one, are often preferr'd to Phlebotomy.

The due season for letting Blood is often of so great mo∣ment, that whereas this Evacuation does good at one time, at another it proves mighty prejudicial: There are various re∣spects of times to be considered concerning Bleeding, but chief∣ly these four, viz. the time of the Disease, Age, Year, and Day, the First of these chiefly concerns the Cure of the Patient, and the rest his Preservation.

First, therefore if we ought to let Blood in any Disease, the fittest time for it will be about the beginning of it, or in its en∣crease, but not at all, or very cautiously in its height, or De∣clination: For in the former whilst nature endeavouring a Cri∣sis is extreamly busied, so that the Spirits labour mightily, and the Blood ferments very much that its last effort ought not to be disturb'd, and when a Disease is upon remitting, either nature being conqueress, does not stand in need of that Aid, or belng conquered will not bear such Evacuation.

Secondly, if at any time we deliberate of Bleeding for pre∣vention, Infants, Children, and aged Persons are exempted from it by the general Practice of all Nations: This Evacuation al∣so heretofore was forbidden to Women with Cnild, but now it's very ordinarily prescrib'd: Men of a strong Constitution, and of a middle Age herr Bleeding well encugh, and want it very often, but ought not to admit it the first and second time with∣out great occasion, for once begun, and then repeated, it soon passes into an Inevitable custom: Hence those who use to Bleed Spring and Fall cannot afterwards omit this Evacuation with∣out danger: But those for whom it is good or necessary to be let Blood once or twice a Year, the most seasonable times for it will be about the beginning of the Spring and Autumn, when the Blood being apt to Ferment anew, is in danger of changing its Crasts. Bleeding in season prevents the exaltation of the Sulphur and Salts, and consequently keeps the Blood from any Feverish, Scorbutick, or otherwise vitious Distemper: And like∣wise from susing it self and pouring its Serous and other dreg∣gy Excrements on the Brain, Lungs, or Viscera of the Belly. About the Solstices when our Bodies are very cold, or hot, the Blood, ••as also the Juices of all Vegetables being in a fixt State, and unapt for any Turgid Motion, ought not to be let forth unless some urgent cause requires it.

3. Whereas some religiously or rather ridiculously observe in Bleeding the Position of the Heavens and the Aspects of the Moon and Stars, it's altogether Frivolous.

4. As to the time of the Day, in Acute Diseaes when im∣mediate Bleeding is indicated, a Physician being call'd, after the Body is prepar'd, may order that operation at any hour

of the Day or Night. But if there be room for delay, then it's more proper to Bleed rather in a Morning when the Sto∣mack is fasting and the Vessels are emptyed by the Night Per∣spiration, so that the current of the Blood is then in a very great Calm and free from Serous Excrements: Nay though ne∣cessicy presses, let it be delay'd a little till the fresh Juice of things taken into the Body be past into the Blood; for the Vessels being emptyed will draw hastily into them the Chymus not only crude, but often disagreeing with, or disproportionate to the Blood; whence not only its Motion is disturb'd, but also the Vital flame is sometimes in danger of being overwhelm'd: I have known some who upon Bleeding shortly after large Drink∣ing, or pouring in of Vinous Liquors, have fell into dreadful swounding Fits, which continued a very long time, till the Vi∣tal Spirit half overwhelm'd happen'd at length to recover.

5. As to the quantity of Blood to be taken, besrdes the ma∣nifest errour of those who are sparing, or profuse of it in the greatest extreams, there is likewise an errour of no small mo∣ment committed within the moderate Limits, whilst in some cases the Blood is taken too sparingly, and in others in a greater quantity than is fitting: In a burning Fever, the Pleu∣risie, Peripueumonia, Squinancy, Frenzy, Apoplexy, and other great Diseases rising from the Turgescency or Inflammatory In∣cursion of the Blood, a spare Bleeding always does more hurt than good: For besides that it does not remove the Antece∣dent cause of the Disease, viz. the Plethora, it moreover encrea∣ses its Conjunct causes, viz. the Inflammation, or Irruption of the Blood: For it's a constant observation that after a spare Emis∣sion of Blood, its whole Mass presently boyls in a high mea∣sure, and makes new Sallyes into the part affected: The rea∣son of which is, that in a great Plethora many Portions both of the Blood and Serum being driven into strait and by recep∣tacles, are forc't to reside there, which upon the Vessels being a little emptied rush back hastily into the Mass of Blood, and trouble it mightily, driving it here and there in a violent manner.

As a spare Bleeding in some cases is not only useless but hurt∣ful, so in others a too large Effusion of Blood is seldom with∣out danger, and sometimes proves mighty prejudicial to Health: For if at any time there be a failing of strength, or the Body labours under a great Cachexia, we must be spare of Bleeding, and it is either forbidden, or being indicated by reason of some accident it must be allow'd but in a small quantity: Wherefore in Men of a tender, weak, or cold Constitution, and in Consump∣tive Persons, and such as are affected with a long or Malig∣nant Fever, also in those that the Hydropical, or very Cacochy∣mical,

we must not lightly open a Vein, at least being open'd we must not let forth much Blood.

The quntity of Blood to be drawn being agreed upon, the next care must be, that a large Orifices being made, it flows forth equally mixt in as short a space as may be: For other∣wise if it issue, forth at a slender Orifices either by Drops, or in a small stream, the Mass of Blood fermenting will separate into parts, and what is most Subtle and Spirituous will spring forth, the thicker, and more dreggy Portion remaining behind: Hence it is to be observ'd, that if at any time the Blood be∣ing let out of a large Orifice with a full stream be stopt a little by putting the Finger on it, and in a short while af∣ter be let run again, the Blood issuing forth the Second time will be much purer and brighter than the former, because in the interval of its running, the more subtle Particles having got free of the thicker and gatered themselves together in a Body prepar'd themselves for flying forth.

CHAP. II. Instructions and Prescripts for stopping an Eruption of Blood.

There being various and manifold kinds of Haemorrhagies or Eruptions of Blood, Physick is not needful to all of them: If a great Effusion of Blood happens through a Wound, &c. Chi∣rurgery undertakes to stop it: Moreover an Eruption of Blood, if it be Critical, ought not to be disturb'd by any Medicine but to be left wholly to the governance of nature (so she be free and enjoys her power) nay in Symptomatick Bleeding, so long as it is but small, or not very prejudicial Physick is not re∣quired: But then chiefly and in a manner only it is needsul, if at any time the Flux of Blood be either immoderate, or breaks forth in improper places.

Bloody Eruptions of the latter kind require help chiefly if haply the Blood be cast forth upwards by coughing, or vomit∣ing, or be voided downwards by the Fundament, or the Uri∣nary passages, for in these cases though the quantity of Blood voided be not commonly much fear'd, yet because a danger∣ous

or pernicious Ulcer often follows the Solution of Unity so made in the Lungs, or in the Stomack, or Intestines, or in a Vein; therefore we must diligently take care of those Haemorrhagies from their very first appearance, and therefore such Bloody Ex∣cretions are ranged amongst the Diseases of those parts, and we have already delivered elsewhere the Theories and Cures of Blood∣spitting, and the Bloody Flux, so that there is no need for us to repeat them here, no more than that of Pissing Blood which belongs to the Pathology of Nephritick affects, wherefore I shall pass to those Passions, in which there being an immode∣rete Fffulx of Blood, there is a particular necessity for Medicines to stop it.

The chiefest kinds of those sorts of affects are these three, viz. an Eruption of Blood from the Nostrils, and of the Men∣ses, and immoderate Fluxes of the Haemorrhoides. The Cure of this latter belongs rather to Chirurgery than Physick, and we have thought fitting to refer the consideration of the other to the Pathology of the Womb: An Effusion of Blood by the Nostrills is the most general kind of those sorts of Passions, and what I shall here deliver for the Cure of this Eruprion of Blood may be apply'd to all other Haemorrhagies whatsoever.

Therefore concerning the Cure of an excessive Bleeding at the Nose there are three primary Indications, viz. Curatory, Vi∣tal, and Preservatory: The two former have regard to the im∣mediate sptopping of the Symptom as often as it presses; and the la∣ter undertakes to remove the cause of the Disease that the returns of the Eruption of Blood may abate of their violence, or wholly cease: Again this Eruption of Blood must be manag'd one way if without a Fever, and somewhat after a different manner if joyn'd with it.

If at any time therefore without a Fever much Blood flows from the Nostrils, presently as there will be need of Remedies to stop the Blood, there will be three chief intents of Curing, all of them to be put in Practice together, viz. the Turgescency of the Blood must be so allay'd that it be not prone to make disorderly Sallyes: We must farther take care that its Fluxion being withdrawn from the Nostrils, be diverted eisewhere, and that the gaping Mouths of the Vessels within the Nostrils be clos'd: For which ends a great many Remedies both External and In∣terna, and of divers kinds are wont to be administred, we shall speak of the former in order and briefly.

First, therefore let the Patient keep himself quiet with his Head in an upright posture, then let the Joynts of his Arms and Thighs, many of them together, but not all of them be bound with strait Ligatures, which must now and then be loosn'd

and remov'd to other parts; for upon their being bound all at once, and so continued a long time, I have known that terrible Swound∣ings have happen'd, by reason of the Bloods being detain'd in the outward parts, and kept too much from the Heart: Though otherwise this Remedy being prudently administred gives often relief. For since by this means the Blood which passes into the Members by the Arteries, is hindred from its quick return by the Veins, its violent taking to the head is stay'd: More∣over by the painful Ligatures of the Joynts the Muscular Fi∣bres of the Carotide Arteries from whose Branches the Blood issues at the Nostrils are freed from the Convulsion which they often fall into.

2. To withdraw the course of the Blood from the Nostrils, sometimes it's proper to open a Vein in the Arm, or Foot, for the more Blood is carried by the Arteries to the place where a Vein is open'd, the less will flow to the Nostrils: Yet this Administration does not always prove so successful but its con∣trary effect sometimes happens; as we have observ'd before, where we treat of Spitting Blood: The reason whereof is that the Vessels being suddenly, and not sufficinetly emptryed, draw in∣to them again the disagreeing Homours before ejected, and stag∣nating within the Pores, by which the Blood is presently stirr'd up again to a greater Turgescency for Eruption.

3. Cold things apply'd to the Forehead and Temples, also to the Nape of the Neck where the Vertebral Arteries ascend, constringe the Vessels, and somewhat repress or repel the Flux of Blood: But it is ill done of some who advise topical coo∣lers to be apply'd to the Jugular Veins, for this retarding the course of the Blood in its return, causes it to flow more plen∣tifully out at the Nostrils: Moreover as to the usual way of ap∣plying a Linnen-cloath or a Spunge dipt in Vinegar to the Share and Genitals, it gives relief only, as a Ligature of the Members, viz. in as much as it hinders the return of the Blood of the Veins. A sudden and unexpected Sprinkling of cold water on the Face by striking a Terrour often stops an Eruption of Blood.

4. Cupping-glasses applyed to the Hypochondres, Flanks, in∣ward parts of the Thighs, and to the Soles of the Feet, have been accounted both by Ancient and Modern Physicians a fa∣mous Remedy for withdrawing an Eruption of Blood from the Nostrils.

5. Frictions of the extream parts are commended in this af∣fect by some Practitioners, which nevertheless we judge not so very good, nay scarce safe: For though they cause a greater confluence of Blood to the Hands and Feet, yet they so ac∣celerate

its return, that it endangers a more violent Sally of it to the Nostrils.

6. Zacutus Lusitanus among Revulsory Remedies proposes an actual Cautery to be apply'd to the Soles of both Feet, and Cra∣to the bending of the little Finger of the same side, which last you may do well to try in regard it is done easily: Though I do not advise so of the other Remedy, unless the Cure by it were more certain, which might recompence the Pain, and Lameness that will ensue.

7. A Swounding by what means soever caus'd, stops present∣ly for the most part an Eruption of Blood, be it never so refractory: Wherefore when persons seiz'd with an Eruption of Blood and grown weak by it are pull'd out of Bed, or if Blood be taken from them though in a small quantity by opening a Vein, they apprehending a danger in it, or if their Members are long bound, or they are suddenly put in a fright with some feigned Rumour, and upon any other occasion fall into a Swound, or a Fainting Fit, the Eruption of Blood from the Nostrills presently ceases: The reason whereof it evident enough, because as soon as the Motion of the Heart fails both the Blood and Spirits presently rush thither, so that all out∣ward Effusion is incontinently stopt and that which before was immoderate does not begin afresh.

8. In the last place we must take a view of those Remedies for repressing an Eruption of Blood from the Nostrils which are said to work after an Occult manner, and by Sympathy, and An∣tipathy: Of which kind chiefly are the Sympathetical Powder, made of Roman Vitriol Calcin'd to whiteness by the Sun in the Summer: Also a piece of the Wood of a Maiden or young Ash, cut about the moment that the Sun enters Taurus: The efficacy of which Remedy is attested by many credible witnesses to have been prov'd in stopping Eruptions of Blood in wounded Souldiers during the late Civil Wars. So a dry'd Toad sewed up in a Silk Bag and worn on the Pit of the Sto∣mack is said to stop any Flux of Blood, and to prevent its return.

There are many other famous Medicines for stopping Blood, whose operation is wont to be referr'd to Occult causes, and to some secret Vertue: As Neck-laces of the Blood-stone worn about the Neck, also Ʋsnea, or the moss of a Mans Skull car∣ried in the hand: Epithems of the Leaves of Netles stampe and apply'd to the Soles of the Feet, and the Palms of the Hands; which Empirical Administrations being to be try'd without trou∣ble or charge, we have no reason to reject them, especially since in a dangerous case we ought to leave nothing unattempted,

and in regard that those applications may do good sometimes in this respect, that they fortify the imagination of the Pa∣tient.

Whilst these outward Administrations are us'd for repelling or withdrawing the Flux of Blood from the Nostrils, let Topicks also be put into the Nostrils to close the Gaping Mouths of the Vessels, for which use Injections of Liquid things, Pledgets, Powders to be blown in, and Fumes are wont to be prescrib'd, which failing of effect we must come at last to Escharoticks.

9. Amongst Liquids, a Solution of Vitriol made in fountain water, is accounted not only the chief, but as good as all the rest: Some boast of this as of a great secret, and an infalli∣ble stopper of Blood: Indeed the same apply'd to a fresh Wound, for as much as by corrugating the extremities of the cut Ves∣sels it closes them, it keeps back the Flux of Blood and power∣fully stops it: But in regard in an Eruption of Blood from the Nostrils (where the Blood is convey'd to the gaping Mouths of the Arteries and ought to be receiv'd by the Veins, this application closes these as well, or rather than those, it does here little, or no good at all, as I have often known it try'd. This Medicine is prepar'd of green Vitriol, viz. the Hungarian, or of that of our own Country, also of the Factitious Vitriol of Mars dissolv'd in a sufficient quantity of fountain water. I know some commend a Solution of Roman Vitriol, which they are wont to use not only by injecting it, but by applying it Sym∣pathetically to a Bloody Linnen-cloath: I have also known a Water prepar'd of an Infusion of white Vitriol with Bole and Camphire us'd successfully to Wounds, and often to other E∣ruptions of Blood.

But in regard a water injected into the Nostril does not stick enough to the Mouths of the Vessels, but is washt away by the Bloods breaking forth before it can exert its Vertue; there∣fore it is better either that a Stiptick Powder be blown into it, or that a Pledget dipt in the water of Vitriol be thrust in∣to the Nostril to the upper part of it, either by it self, or strew'd to the Nostril to the upper part of it, either by it self, or strew'd with an Astringent Powder. Many Stiptick Powders and of divers kinds are wont to be prescrib'd for this purpose: I com∣monly use either Crocus Martis Calcin'd to the highest reduess, or the Powder of Vitriol Camphorated, or a Vitriolick Soot scrap't from the bottom of an old Brass Kettle, the Powder of which I have often try'd with success in this case. In obstinate Hae∣morrhagies and not yielding to other Remedies, let a Pledget having on its top a Caustick Colcother be thrust up into the No∣strils as far as it will go, that the little Mouths of the Vessels be∣ing burnt, and covered with an Eschar, all Eruption of Blood

may be presently stopt. There are many other Errhines famous amongst Practitioners for stopping Blood, as Hogs-dung thrust up into the Nostrils, which is thought meerly by the Nastiness of its Odour to repel the Blood ready to burst forth: Also the Fume of the Blood dropping on a red-hot Iron and return'd up into the Nostrils, the Powder of which also when burnt is blown up into them. Ʋsnea or the growing Moss on a Mans Scull which has not been inter'd is highly commended by some for this effect.

So much of outward Remedies for stopping Bleeding, whose Vertue ought likewise to be promoted by inward things season∣ably given and cooperating.

Therefore a thin Dyet being prescrib'd, and the Patient or∣dered to keep himself in an erect posture, or not much leaning back, whilst the foresaid Administrations are orderly apply'd, let Medicines appropriated to the same end be prescrib'd also to be inwardly taken: Remedies of this kind have two chief scopes, viz. First to cause the Blood being kept within its Vessels to be quietly Circulated, its Effervescence, whether happning through its Accension or Fermentation, being supprest. Secondly, to retard by fit Remora's, the violent Motion of the Heart, driving round the Blood too rapidly.

1. The first intention requires those kinds of Medicines which suppress the too great Accension of the Blood, and appease its undue Fermentation; for which uses I am wont to prescribe the following.

Take the waters of Plantain, red Poppies, Purslain, and of the Spawn of Froggs of each four Ounce, Syrup of Water-lillies two Ounces, Sal Prunella a Dram; mix them, make a Julape, the Dose is three Ounces thrice or four times a Day.

Take Barley-water two Pounds, red Rose-leaves a handful, Spirit of Vitriol as much as will give it a grateful Acidity, or about half a Dram, make a warm Infusion for extracting the Tincture, add Syrup of the Juice of St. John's Wort two Ounces; the Dose is three or four Ounces to take at pleasure often in the Day time, or by Night.

Take Leaves of stinging Nettles, and of Plantain of each three handfuls, being bruis'd pour to them of Plantain water four Ounces, express it strongly, and take it.

2. For the Second intention, viz. to retard the over-violent beat of the Heart, Hypnoticks and Opiats are proper.

Take red Poppy-water three Ounces, Syrup of Diacodium half an Ounce: Mix them, make a Draught to be taken going to Bed. (Or)

Take Conserve of red Roses an Ounce and a half, Powder of the

Seeds of Henbane and of white Poppies, of each two Drams, Syrup of Poppies what suffices. Maek an Opiate. The Dose is the quan∣tity of a Nutmeg every six or eight hours (Or)

Take Laudanum Cydoniated a Dram, the Dose is fifteen Drops twice a Day in a proper Vehicle.

So much of an immoderate Eruption of Blood, and its Cure, whilst it happens without a Fever, but when it happens in a Fever, and must be stay'd because of too much loss of Blood, it is either Critical, growing to be immoderate by reason of some Accident, to which the Method and Medicines even now prescrib'd may be accommodated, though with some caution and a due respect to the State of the Fever: Or it is meerly Symp∣tomatical, which hapning in a Malignant, or Spotted-fever, the Small-pox, Meazles, or Plague, it scarcely either can or ought to be repell'd or stopt by the foresaid Remedies: For letting Blood is not proper; repelling Topicks, also cooling Julapes or Decoctions, or Narcoticks have no place: The chief intention of Curing will be to change the Eruption of Blood into a Sweat, for upon raising a gentle Sweat, the Flux of Blood, if it be not extreamly dangerous, ceases of its own accord.

Take water of Meadow-sweet and Tormentil of each four Ounces: Of the cold Cordial of Saxonius two Ounces. Treacle-water an Ounce and a half. Bezoartick Vinegar three Drams, Syrup of Coral an Counce and a half, Confection of Hyacinth two Drams, make a Ju∣lape; the Dose is six spoonfuls every third hour.

Take Powder of Toads prepar'd half a Dram, Camphire two Grains; let it be taken with the foresaid Julape every sixth hour. (Or)

Take Pulvis Pannonici Rubri from half a Dram to two Scruples give it after the same manner.

Take Confection of Hyacinth three Drams, Pulvis Pannonici Rubri a Dram, Syrup of Coral what suffices; make a Confection, the Dose is the quantity of a Nutmeg every other hour.

Take Roots of Bistort and Tormentil of each an Ounce, Leaves of Meadow-sweet, Burnet, Wood-sorrel of each a handful, burnt Harts-horn two Drams, Shavings of Ivory and Harts-horn of each two Drams, boyl them in three Pounds of Fountain water to two Pounds, add towards the end Conserve of red Roses three Ounces, sirain it, the Dose is three Ounces often in a Day.

So far of the first Indication which is Curatory together with the scopes of Curing and the forms of Medicines destinated for an Eruption of Blood from the Nostrils, hapning either with, or without a Fever. The second Indication which is Vital prescribes only a thin Dyet, temperate Cordials, and a fit or∣dering of the Patient: The provision for the two For former is so small and easy, that it seems not necessary to set down a form

and rules particularly for them: Concerning the latter the chief question is whether we ought to keep those that are seiz'd with an Eruption of Blood either in Bed, or out of it: It's an un∣question'd thing that those that are weak, and subject to fall often into Swounding Fits, ought not to be stir'd from Bed, unless haply it, be to try a Cure (as we have intimated before: As to others that are not so weak, we say thus, those whose Blood has not an easy Transpiration by reason of the Consti∣pation of the Pores, and upon its being put in a stronger Mo∣tion by the heat of the Bed is dispos'd to greater Turgescen∣cies, and to Eruptions, it will be good for them not only to stay out of Bed, while Bleeding, but likewise sometimes to be cool'd by outward Applications in the whole habit of the Body, or at leastwise in most of its Members: Wherefore Fabritius Hildanus relates how he presently Cur'd one of a violent Bleed∣ing at Nose, after many ordinary Remedies try'd in vain, by putting him into a Vessel of cold water: with the like suc∣cess also Riverius having ordered another affected in like man∣ner to be taken forth of his Bed, and laid on a Woolen Rugg in the Floor, fomented his whole Body with Linnen-cloaths wetted in an Oxicrate: Yet this method is not generally proper for all Persons, and at all times: But on the contrary those whose Blood being of a free Transpirable disposition, and en∣joying open Pores, readily evaporates, and is wont upon any moderate ambient heat to be resolv'd into Sweat, and conse∣quently to become more calm, it's good for such to continue in Bed, not only whilst Bleeding, but as long as that Eruption is in danger of returning in a short time after: For this rea∣son it is that many Persons subject to violent Eruptions of Blood live free from that Distemper during the Summer, whilst they have a free Transpiration, but when the cold of the Winter presses them, their Pores being stopt, they undergo more fre∣quent and dreadful Fits of it.

3. The third Indication being for Preservation, which re∣garding the removal of the cause of the Distemper, either hin∣ders the Eruptions of Blood, or renders them less frequent or less considerable, suggests to us these two chief intents of Curing: viz. First, that the Blood being restor'd to its due Temperament and Mixture, be quietly circulated within its Ves∣sels without Turgescencies and Eruptions; And Secondly, that the Blood Vessels be kept in their due State as to their Con∣formations of their little Months, and the Tones of their Mus∣cular Fibres, so that those Vessels neither cause those disorderly Sallyes of the Blood to the Head, or give way to its Eruption from the Nostrils: For both these ends, in the first placelet the

Redundancy of the Blood, and its great foulness be provided a∣gainst by a seasonable Administration of Phlebotomy and Purga∣tion; and then forprocuring and preserving its right Temperament let the following Alteratives be given in fit seasons for Physick.

Take Conserve of red Roses, and of the wild Rose, of each three Ounces, Powder of all the Saunders, of each half a Dram, of Co∣ral prepar'd a Dram, of the reddest Crocus of Mars two Drams, Sal Prunella four Scruples. With a sufficient quantity of Syrup of Coral, make an Electuary, take early in the Morning, and going to Bed the quentity of a Chesnut either by it self; or Drinking af∣ter it of the following distill'd water three Ounces.

Take of the tops of Cypress and Tamarisk of each eight handfuls, tops of St. John's-wort and of Horse-tayl of each four handfuls, all the Saunders bruis'd, of each an Ounce, Pith of White-bread two Pounds, being slic't very small pour to them of New-milk eight Pounds, distill it with common Organs: Sweeten each Dose as you take it with a sufficient quantity of the Syrup of the Juice of Plan∣tain.

Take Leaves of Plantain, Brooklimes, and stinging Nettles of each four handfuls, being bruis'd pour to them of the foregoing water half a Pound, small Cinnamon water two Ounces, express it strong∣ly; the Dose is three or four Ounces in the Morning at nine of the clock, and at five in the Afternoon.

Let Medicines of this kind be taken Spring and Fall for twenty or thirty Days, giving sometimes a gentle Purge between whiles: But in the Summer let Mineral Chalybeat waters be Drunk for a Month, than which there is not a more excellent Remedy in this case. I shall now give you an example of one Cured of an Eruption of Blood, whose case was somewhat particular.

I was lately sent to for advice for a Gentleman living far off who had been troubled a good while with frequent and vio∣lent Eruptions of Blood, sometimes from the Nostrils, some∣times from the Heamorrhoids; this person had been often let Blood by the advice of his friends, but found no good there∣by, nay most commonly after opening a Vein falling into cold Sweats, and Swounding Fits, and still as liable to Eruptions of Blood, he was wont to be much worse: To this Person (not having seen him) I prescrib'd Julapes, and cooling Decoctions, and Anodyns, also Juicy expressions of Herbs, and other things to cool the Blood, but these things also (as though all yet were far from the makr) had nothing a better success; at length being call'd into the country to see him, I found the affect with which he was seiz'd to be meerly or chiefly Convulsive, for the Blood breaking forth daily, his Pulse was weak, his Extream parts cold, and all the Vessels were fallen, as though too much

emptied: Moreover the Patient was troubled with a continual Giddiness, and a Trembling of the Heart, and was taken now and then with Swounding Fits, or with the apprehension of it: Truly it was so far from it that the Blood should break forth of the Vessels by reason of any Redundancy or Turgescency, that ra∣ther on the contrary its Current was so extreamly low and small, that it seem'd scarce able to maintain the Stream of Circulation: But the thing was, that often in a Day he sensibly pervceiv'd somewhat on a sudden to pass privately sometimes up, and sometimes down his Body like a wind, and for the most part an Eruption of Blood from the Nostrils or Haemorrhoids followed the Tendency of that Motion. So that it was easy hence to conclude, that the moving Fibres of the Blood Vessels, by which they are contracted, being seiz'd with Convulsions, drew suddenly every way in a disorderly manner the Stream of the Blood, as small and low as it was, and forc't it now and then to an Eruption: Which also was the easier done, because the Lax and Gaping Mouths of the Vessels permitted the Blood dri∣ven to them to flow forth without any due stay: A Method of Cure ordered pursuant to this Aetiology confirm'd it by its good success: For Bleeding, and the use of Blood-stopping Me∣dicines being thenceforwards omitted, I prescrib'd the use of the following Powder whereof he took a Dose every sixth hour with a proper Julape.

Take Powder of the Roots of Male Peony, red Coral, and Pearl of each a Dram, Ivory, Crabbs Eyes, Blood-stone, of each half a Dram, Sal Prunella a Dram, make a Powder, the Dose is half a Dram.

Take black Cherry water eight Ounces, Balm water and small Cinna∣mon water, of each two Ounces. Treacle water an Ounce, Syrup of Coral an Ounce and a half.

I farther ordered that Ligatures should be us'd in due course to certain places, and now and then to others as occasion re∣quir'd, both to stop, and to intercept the Convulsions of the Vessels: And by these Remedies and ways of Administrations he soon grew well without any Relapse.

CHAP. III. Of Vesicatories.

HAving treated of the Emission, and stopping of the Blood, according to occasion, there ramain certain other Humours, to wit the Nervous and Nutritious Homours, and likewise the Serous and other Excrementitious ones which are wont to a∣bound within the Brain, Nerves, and within the Nervous and Fleshy Fibres, and even in the Pores of the Skin, and of the Solid parts, which being often deparved or letted in their Mo∣tion, require an Emission, being otherwise apt to prove greatly prejudicial, and often to cause dangerous Distempers: Where∣fore for a seasonable prevention of affects arising, or which are apt to arise from such cause, Physick has found out certain other Emissaries to derive immediately, or meidately the fore∣said Homours from the parts and places where they prove offensive: And those Emissaries are either coutinual, viz. Issues of various kinds, which as everlasting Soures continually dis∣charge that Ichor or Excrementitious Humidity; or they are Temporary, when upon occasion the Scarf Skin being remov'd in some part of the Body, the extremities of the Vessels in the Skin are laid naked, and withal so irritated, that they dis∣charge in a great abundance Serous Homours of a verious Ori∣gine and Nature, and continue so too Evacuate them for some time, sometimes longer, and sometimes a shorter while. Now such a manner of drawing forth Serous Homours from the Ex∣teriour Surface of the Body, or of some certain part of it is wont to be effected by Medicines call'd by the Ancients Phae∣nigms, or Synapisms, by the Modern Vesicatories; of which (be∣cause their knowledge prepares the way to the Doctrine of Issues) we shall in the first place treat here, and shall parti∣cularly insist on the explication of, these three things, viz. first it shall be shewn of what substances, and after what manner ordered, Vesicatories are prepar'd. Secondly, they being of va∣rious kinds, we shall declare what are the ways and manners of working in each, or at least in the chief of them: And Thirdly, we shall enquire for the Cure of what sort of affects they ought to be us'd, and to what places apply'd.

1. As to the first, the most simple Blisterers are either Fire,

or Solid Bodies, or Liquors endued with Fiery Particles, which nevertheless are seldom put to this use by reason of the Terrour they give, and the Imminent danger lest being roughly apply'd they do not so much Blister the Scarf-skin, as burn both this and the Skin, and other parts: What therefore is more safe and less to be dreaded, let Epithems made of Concrets which have smart Particles, or (as is said) Potentially Fiery, be ap∣ply'd to the places to be Blistered; which being either more mild were call'd by the Ancients Phaenigms, because the Scarf∣skin being remov'd they made the part red: Or in respect of the matter they were call'd Synapisms, and were wont to be prepar'd of Mustard, Pigeons-dung, Squills bruis'd, Garlick, Milk of the Fig-tree, and the like; or they were more strong and for the most part consisted of Euphorbium, Cantharides, Flam∣mula Jovis, Batrachion, water Plantain, with many other things, which being endow'd with a certain Burning or Corrosive qua∣lity are outwardly apply'd for the said use, but inwardly taken are Poysonous and often Mortal.

The Compositions and Forms of Blisterers are manifold and of sundry sorts: Though one, or two, and the more simple the better, may suffice here, and in most cases it's all one which you use: According to our wont we shall here set down some of the more select, and most useful prescripts of these sorts of Medicines: And to say little here os Dropax's, Synapisms, and Phaenigms, which are now in a manner out of use: Almost all Vesicatories at this time made use of, have Cantharides for their Basis.

Take Powder of Cantharides from half a Dram to a Dram, Pow∣der of Ameos-seed a Scruple: Stale Leaven wrought with Vinegar what suffices; make a Mass for a Playster, spread part of it on Leather, and apply it to the part for twelve hours. This works infallibly and strongly enough; but because it is not compact, and sticking, but is apt to slide from the place where it is put, or to crumble, therefore for a more convenient application the following does very well, and is now every where in use amongst most per∣sons.

Take Cantharides three Drams, Euphorbium half a Dram, Pow∣der of Ameos-seeds a Dram, Melilot Playster what suffices; let them be incorporated with a warm hand, using as much of the Powder as the Mass of Playster will receive. Let a sufficient-quantity of this be spread on Leather, and be apply'd for twelve or sixpeén hours,

Some use to incorporate as much of the said Powder with Burgundy-pitch as it will receive, and to spread it on Leather, and then to cover the edges of this Playster with another

Mass of Playster, made of Powder of red Saunders incorpo∣rated with Burgundy-pitch, so administring a Dropax and Vesicatory together: Moreover by applying continually the said Playster to the place rubified and ulcerated after the Scarf-skin is Blistered and remov'd, and by wiping it clean only once or twice a Day, and presently applying it again, they make the little Ulcers, rais'd by Blistering, to run as long as they please, nay sometimes above a Month, and to discharge a great plenty of Ichor, or Excrementitious Humidities,

Others sew up Cantharides bruis'd and sprinkled with Vine∣gar in a little Bag of very fine Silk, and apply them to the place to be Blistered,

Some Empiricks instead of Cantharides lay on the place to be Blistered a Mass of the Leaves of Batrachion, or Flammula∣jovis bruis'd, by which the Scarf-skin being Blistered, or ra∣ther eaten away, the Skin it self, as if toucht with an actual Fire, is often mightily inflam'd, and deeply ulcerated; whence not only a great discharge of Ichor, but sometimes an Inflam∣mation of the whole Member, and a Feverish Disposition en∣sue, wherefore those things must not be us'd without con∣sidertation.

2. If we enquire into the manner and way how these and other Vesicatories operate, First we must shew after what manner actual Fire, and things endued with Particles proceeding from Fire, cause a Blistering; and then by an easy Analogy we shall come to know the force and manner of working of those sorts of Medicines which are said to contain a Potential Fire: Therefore concerning the former we observe that Fiery Par∣ticles, not apply'd too roughly, Penetrating the Scarf-skin without Solution of Continuity, enter the Skin it self, where the extremities of the Blood Vessels, Nerves, and Nervous Fi∣bres, are terminated; and there altering these from their Po∣sition, wrest them sundry ways, and pervert the Conformation of the whole Texture of the Skin: So that from all the Ves∣sels being mightily irritated, a Watery Humour fill'd with Fiery Particles, and therefore rejected both from the Blood, and from the Nervous Juice, is voided in a great abundance: That Lym∣pha, because it cannot pass through the Scarf-skin, separates it from the Skin and raises it into a Blister.

Hence it will be easy to understand after what manner Ve∣sicatories perform their operation: viz. Cantharides (and so all other things of the same vertue) being outwardly apply'd, and coming to be made warm by the Effluviz's of the part they lie on, and so stirr'd up to exert their force, emit from them a great plenty of Smart and Fiery Particles as it were, which

penetrating the Scarf-skin without breaking it, strongly fix themselves in the Skin: Where sirst they act on the Spirits and then by their means on the Humours and Solid parts: Those Particles very much irritate the Spirits and make them cause painful Convulsions of the Fibres, and they fuse the Humours and make them separtate into parts, so that the Watery part being mightily fill'd with those Smart, and as it were Ve∣nemous Particles, is thrown off on every side by the rest of the Latex: And the extremities of the Vessels and Fibres be∣ing either in the mean time Eaten away by Burning, or open'd and emulg'd as it were by Twitching, that Ichor is voided in a plentiful measure from their little Mouths carrying with it the offensive Particles. Which Ichor afterwards separates the Impervious Scarf-skin from the Skin, and raises it into a little Blister. And after this is broken and remov'd, is plentifully voided for some time from the Ulcerated Skin.

But this is not only so done, because the Serous La∣tex inbibing the Smart Particles of the Medicine, and con∣veying them forth, does not always carry them back all the same way that they came in; but sometimes being imbued with those Particles it regurgitates into the Mass of Blood, and afterwards being circulated with it, and voided with its offensive Load by other Emunctories, it offends in its passage or as it goes forth certain weak, or tender Ductus's. Hence many after the use of great or many Vesicatores having their Urinary passages there∣by affected with an Acrimony or Erosion, get a Strangurie which in some is most sharpe and intolerable: Again in o∣thers troubled with the Stone that application sometimes cau∣ses Bloody Urine: Hence also it may be suspected, that tender Lungs, or such as are inclin'd to a Consumption, may be much endangered by the outward application of this Medicine: Which nevertheless I have not hitherto known happen to any; but rather on the contrary I can testifie by frequent trials that it rather proves to their advantage than to their prejucice: For the smart Particles of the Catharides, upon long application being sometimes plentifully imbib'd by the Blood, infect its whole Serum; which Latex nevertheless so aculeated, as long as it is mixt with the Balsamick Blood, offends no part; but being separated from it by the Reins, it sometimes hurts them, and often not only twitches the Neck of the Bladder with its Acrimony, but sometimes Corroding it fetches thence a Mucus, and little Schims, and even Blood it self: But in the Mass of Blood, those same sharpe Salino Volatile Particles often do great good; be∣cause they destroy the fixt and acid Salts in it, and likewise open the too close Texture of the Blood, and so cause its Serous

and other Morbifick Particles before fast bound in it, to be separated from it, and to be readily sent forth by Urine and Sweat; hence in Fevers, Vesicatories long apply'd cause a large Evacuation by Urine and a free Sweat: Moreover the same open the Obstructed passages, and stir up the Portions of the Blood and Serum stagnating in any place, or extravased, and restore them to Circulation: Wherefore they are wont to do good not only in Distempers of the Serum, but also of the Blood, nay in the Pleurisie, Peripneumonia, and in any other Fevers whatsoever.

Hitherto having shewn after what manner Vesicatories work, first on the Spirits, and then on the Humours and Solid parts; I must next set down their effects both good and evil; also the manner of using them: That they work first on the Spirits it is plain from hence, that they exert no power on the Dead: And its an ill Omen in very weak persons when Vesicatories do not work, because it's a sign that the Animal Spirits are mightily dejected, or lessen'd in their store.

Therefore to explain well the Energy, or Vertue of this Medi∣cine, we must consider what Humours it evacuates, or alters immediately or mediately: And then in what Diseases, and in Bodies how dispos'd it does good or hurt.

As to the first, the Humours immediately let forth by a Vesicatory partly issue from the Pores and Glands of the Skin, and partly from the Mouths of the little Arteries, and partly from the extremities of the Nervous Fibres; haply some little of the Juice fresh receiv'd may be cast back again from the little Mouths of the Veins, though much of it cannot: The Humours mediately voided by a Vesicatory are those which the foresaid parts being emptied receive from elswhere, and convey forth.

1. The Scarf-skin being remov'd by a Vesicatory from the Skin a Serous Humour is drawn from the Glands and Pores, and this not only from the place Blistered, but those Pores being pervious to others, a Portion of Serum coming from other Pores sometimes succeeds in the Cells of the first drain'd, and thence also distill forth, wherefore in an Anasarca the little Ulcers rais'd by a Vesicatory empty waters on every side in great plenty, and derive them from all the Neighbouring parts, nay some∣times from those that are very remote.

2. The Mouths of the Arteries do not only Spew forth the Portion of Serum brought to them according to common course, but the Serous Latex being imbued with the irritative force of the Medicince in the whole Mass of Blood is thereby separ∣ated from the Blood in a more plentiful manner, and carried

forth by the said Mouths of the Arteries, and with it other Excrements, and sometime the Morbid matter it self in a large measure: Hence in Malignant Fevers, nay and in some Putrid Fevers of a difficult Crisis, when the Refuse and Cor∣ruptions of the Blood unapt for separation threaten the Prae∣cordia, or Brain-vesicatories deriving it forth continually and by degrees, often give great relief: To which may be added that the same also (as we have hinted before) alter and restore the Blood degenerated or deprav'd as to its Salts, and likewise by opening or rarifying its Texture, dispose it to a Eucrasy: Where∣fore this kind of Remedy often agrees excellently well, not only in a Feverish State of the Blood, but likewise when it is otherwise vitiated, or Cacochinical.

3. Reason and Experience convince us that Vesicatories draw from the extremeties of the Nerves, and Nervous Fibres the Latex contain'd within their Ductus's, and free it from Stag∣nation, and that they exagitate the Heterogeneous Particles mixt with the Latex, and deriving them from the Brain convey them forth, whence they are found of excellent use in Con∣vulsive affects.

From these things we may gather for the Cure of what Dis∣eases this kind of Remedy is chiefly conducing; for in order to an Evacuation from the Pores and Glands of the Skin as often as a Serous, sharpe or otherwise offensive Humour is gathered together in or near them, and being excluded from Cir∣culating with the Blood obstinately sticks there, certainly there is no readier, or easier way of clearing the same forth than by applying a Vesicatory on or beneath the place affected; wherefore it is not only indicated in an Anasarca, and all Cu∣taneous foulnesses and breaking forth; but a Vesicatory is like∣wise requir'd in Pains either of the Gout, or Scurvy any where sixt in the outward habit of the Body, or in some Member.

Secondly, Vesicatories are always us'd in Malignant Fevers in respect of the Blood, both to Purge it by degrees from all Heterogeneous and Morbifick matter, and to alter it from its two Acid, or Salt, or otherwise vitiated Disposition into a due Temperament: Nay they are of most excellent use in all Pu∣trid Fevers threatning ill, and of a difficult Determination: Therefore also in the Scurvy, Leucophlegmatia, the Longing Disease of Maids, and in any other Cacochimia that kind of Remedy does often great good: Again, Vesicatories are generally apply'd with good success not only for correcting the Blood it self, but likewise as often as being deprav'd it pours its Corruptions on the other parts, and so gives a beginning to Diseases, and cause Fits of them in the Head, Thorax, Belly, or Members.

Wherefore in Head-aches, Vertigo's, and Sleepy affects this is a known and vulgar Remedy; and so in a Catharrh, and any Defluxion either into the Eyes, Nose, Palate, or Lungs, every ordinary Man Prescribs Cantharides for a Revulsory without ad∣vising with a Physitian. I must own that my self having been often seiz'd with a violent Cough accompanied with much and thick Spittle (to which I am Originally inclin'd) have not found more good from any Medicine than from Vesicatories; there∣fore I am wont when that Distemper presses, first to apply Blister∣ing-plaisters on the Vertebrae of the Neck, then those little Ulcers being heal'd, I apply them behind the Ears, and after∣wards if need requires on the Shoulder-blades; for so the Se∣rous Filth breaking forth in abundance from the dissolv'd Tex∣ture of the Blood, is deriv'd from the Lungs, nay and the mix∣ture of the Blood sooner recovers its Crasis, its irregular Salts being by this means destroyed.

3. In respect of the Humour to be evacuated or deriv'd from the Genus Nervosum and the Brain it self, Epispasticks as they are of most common use in Sleepy, Convulsive, and Pain-causing affects, so they often prove mighty beneficial: Was ever any one seiz'd with a Lethargy, Apoplexy, or Falling∣sickness, but presently his Freinds or Attendants, though never so ignorant, flead his Skin with Cantharides? In strange Con∣vulsive Motions, usually ascrib'd to no less than Witchcraft, I have apply'd Vesicatories with great success to many parts of the Body together, and by renewing them now and then in fresh places, I have continued them above a Month: Again fixt and cruelly tormenting Pains in the Membranous parts are seldom Cur'd without this AdminiAstration: For sometimes Hu∣mours and Morbifick Particles, which being throughly radi∣cated, yield not at all to Catharticks, or Medicines working by Sweat, or Urine, seem to be utterly rooted out by Vesica∣tories, laying hands, as it were, on the Disease.

Yet this Remedy though very general, does not work so rea∣dily and successfully in some Diseases and Constitutions; where∣fore we must not use it inconsiderately, or indifferently to all persons; for those that have the Stone, and are subject to fre∣quent and great Fits of the Strangury scarce ever undergoe its application without prejudice. Wherefore in persons so affected we must not use Vesicatories but in Malignant Fevers, or in Acute Diseases of the Head to prevent a greater Mischeif.

As to the various Temperaments and Constitutions of Men, in respect of which Vesicatories agree or dissagree, more or less: Concerning these things this threefold notable difference pre∣sents it self, fiirst some in a manner always bear the use of

this Medicine well, and the little Sores made in the Skin by it distill forth the Excrementitious Humidities plentifully e∣nough without any Disury or great Inflammation of the place Blistered, and then heal of their own accord: Which effect happens only in a Blood of a good Temperament, where the Salt and Sulphur being in a moderate quantity and in a due state, there is a good plenty of Serum; whose Latex re∣ceding readily and in a copious manner from the rest of the Blood takes with it the smart Particles of the Medicine im∣bib'd, and partly distills them forth by the place Blistered, and partly conveys them out by the Urinary passages without of∣fending them: On this account also those good effects before mention'd are puoduc't in the Mass of Blood.

But Secondly, this Medicine does neither agree, nor work well with others, for it makes the place on which it is apply'd mighty red, or rather excoriats it with a violent Pain, and a great In∣flamation: And yet the little Sores there made, though they torment the Patient a good while, cast forth but a very little Ichor, or scarce any at all: Moreover in those to whom Blister∣ing always proves so torturing, a cruel Stangury for the most part succeeds it: This troublesome and withal unprofitable use of Vesicatories happens very frequently to Men of a hot and cholerick Temperament, whose Blood contains Salt, and Sul∣phur, in a great plenty, and but a little Serum, which is wholly tainted with the others: Wherefore when its Latex which ought to carry off the smart Particles of the Medicine, does not part readily, nor in a plentiful manner from the rest of the Blood (to wàsh them away presently) those Particles still sticking in the Skin, Taint and Poyson, as it were, the Blood in its pas∣sage, and being thereby hindred in its Circulation, they cause it to gather together and stagnate within the extremities of the Vessels, whereby they are inflam'd: Moreover the Serous Latex at length separated by the Reins, being but in a small quantity and sharpe of it self, and made more sharpe by the Particles of the Medicine, irritate the Neck of the Bladder, and often corrode it with its Acrimony.

There remains a Third, though more rare case, of persons Blist∣ered, in whom the little Sores rais'd in the Skin presently pour forth the Serous Humour in such abundance, that there is streight way need of repelling Medicines, and such as close the Mouths of the Vessels; otherwise upon the too great Efflux of waters a Dissolution of the strength, and a failing of the Spirits are endanger'd to ensue: I have known this to have happen'd so constantly in some, that they were forc't for the time to come to abstain from the use of Cantharides, how great soever the

need were of them: The reason of which seems to be that the Blood being endowed with an Over-salt and sharpe Serum had its Texture too easy to be dissolv'd: Besides this great Efflux of Serum rais'd upon the first application of a Vesica∣tory, it hapning sometimes late in Malignant Fevers, and in others of an ill or no Cirsis, and continuing for some time, wholly drains the Morbifick matter, and often frees the Patient from the very Jaws of Death: In such a case after that the little Sores have voided little, or an indifferent quantity of I∣chor the first Days, at length nature attempting a Crisis this way, a vast quantity of Serous-filth flows from the same; and so continues to flow forth for many Days, nay sometimes Weeks, till the Patient lookt upon before as given over, recovers his perfect Health: As it is not easy to heal the little Sores so flowing in abundance, so it is not safe to do it before the whole Seminal Root of the Disease be spent: Not long since a famous Dr. of Physick of London recovering with much a∣doe of a Malignant Fever, had in many parts of his Body places Blistered, daily distilling forth a plenty of Ichor, after some time (they being troublesome and tedious to him) he apply'd strong Repercussives to them all, and so presently stopt all Issue of Matter: Those Sources had been scarce stopt two Days, but falling into a Relapse of his Disease, on a sudden he was seiz'd with a Languor of the Spirits, and frequent Fainting Fits, with a cold Sweat, and a low and weak Pulse; and not being able to be reliev'd by any Remedies, however cordial they were, he died within three Days: The cause of which seems to be that the Malignant matter suddenly struck back into the Nervs of the Heart; whose action being thereby hindred, the Vital Function soon fail'd.

CHAP. IV. Of Issues.

VEsicatories differ from Issues in this, that these are ordered for longer continuance. Moreover the former for the most part being requisite in Acute Diseases and others, whose Mor∣bid matter requires a speedy removal, regard chiefly the taking away of the Conjunct cause of the Disease, and therefore are made of a good breadth, but superficial withal, that such run∣ning Sores being large may evacuate much Matter, and then be easily Cur'd: But on the contrary Issurs being chielfy in∣dicated for Preservation, are design'd for removing, or over∣coming the Procatarctick cause of the Distemper: Wherefore they consist of a narrower, but deeper Orifice, made through the whole thickness of the Skin, so that letting forth the Mor∣bifick matter still in less quantity, they derive it farther, and continue longer to empty it forth.

Concerning Issurs there are these three chief heads of enquirie viz. First what Humours chiefly those Emissaries evacuate, and whence they derive them. Secondly, in what Diseases and Constitutions they agree better, or worse; And Thirdly, in what places, after what Form, and with what Instruments they ought to be made.

1. As to the former, Issues in like manner as Vesicatories Purge forth all Humours within the Skin, though lying in a less compass, or such as are convey'd through it both from the Sangui-ferous and Nervous Vessels; nor do they only like Ve∣sicatories irritate and draw from the outward Superficies of the Skin, but perforating the whole Skin, convey forth what∣soever flows from the sides of the Orifice through the broken Vessels, and whatever comes from elsewhere under the hole: Wherefore not only the Humours gather'd together within the Pores and Glands of the Skin, or convey'd thither by the Ar∣teries and Nerves flow to Issues, but moreover the Serous Ex∣crements under the Skin, which are wont to be convey'd, or to pass from place to place through the Interstices of the Muscles and Membranes, tend to them from all parts, and there find their way forth. Again, an Issue made in a fit place antici∣pates Mothisick Humours, which are wont to be convey'd to

parts that are weak, and long afflicted, and so frees sometimes this part, sometimes that, from their Incursion: Hence the Gouty, or Nephritick, or Colick, nay sometimes the Paralitick, or Scorbutick matter is intercepted by Issues in its passages from its Sources to the Weakned places or Receptacles; and so the usual Fits of the Disease being evaded, is convey'd forth: And this Emissary even as Trenches cut for draining Fenny moi∣stures, empties forth by defrees Humours sticking in any part or region of the Body, and there doing hurt, and so it pre∣vents or cures a Morbid Disposition.

2. From these various ways of giving relief, with which Is∣sues are wont to do good in general its easily gathered for what affects chiefly they are required; for though there be in a man∣ner no Disease, in which this Remedy either does hurt, or proves useless, yet it seems more necessary in some cases than in others; it's prescrib'd even by the vulgar for almost every Distemper of the Head, both outward and inward: Every ordinary person advises an Issue above all things for the Convulsions of Infants and Children, for the Inflammation of their Eyes, their Swellings of the Kings-evil, and so for Head-aches, Sleepy, Vertigious, or Convulsive affects of Adult or Aged persons: Nor is this Re∣medy less extol'd against Diseases of the Brest; is there any one subject to a Cough, Bloody or Consumptive-spitting, or to an Orthopnaea, who has not an Issue made him? In like manner also Issues are commended for affects of the Belly, there is scarce any Hypochondriacal person, or Hysterical Woman, and no Gouty or Cahecttical person but have their Skin pierc't in more places than a Lamprey. It would be a tedious thing to re∣count here particulary all the Distempers for which Issues are good.

3. Nevertheless this Remedy, however good and useful of it self, does not agree with all persons, nor therefore must it be indifferently prescrib'd to all: For there are two sorts of Men, who thongh they happen to be sick, may be excus'd from Is∣sues; because this Emissary evacuates too much in some, and in others little, or less thanit ought, and in the mean time is mighty painful and intolerable.

An Issue sometimes does not agree well because it evacuates or spends too much the Humour, or Spirits: For I have ob∣serv'd in some that an Issue made in any part of the Body voids forth an Ichor in quantity immoderate, and in quantity vitious; for out of it at frequent times, if not continually, a Watery, thin, and faetid Latex, often making the Pea, and coverings black, flows in a great abundance, so that from its too great Efflux the Strength and Fiesh are consum'd.

An Issue sometimes vioding forth no very great quantity of Ichor spends the Spirits and Strength more than it ought, which is known by the effect, and sometimes not till afterward; to wit, because some upon keeping one or more Issues open, grow weak and lean, and upon their being stopt, become presently more Vigorous, and of a full habit: Moreover it's a common observation that many upon having an Issue made near the Head, have been soon after seiz'd with some defect and weak∣ness in their Sight, so that they were forc't presently to close it up, which seems to happen for this reason, because where the stock of Spirits is but small, and their consistency very thin, little spendings of them, or of the Juice out of which they are engendered, in case they are continual, are with difficulty endur'd.

Moreover in an other, and that a different respect, Issues, as also Vesicatories are forbidden to some, or are prescrib'd to them with great caution; because voiding little or scarce any thing at all, they mightily torment the place in which they are made: For those who being of a Cholerick, or otherwise hot Tem∣perament, have their Mass of Blood thicker, and of a closer Texture than it ought by reason of its being but little diluted with Serum, in these persons a Solution of continuity being made, and kept in being by an Issue, the Blood (not deposing Serum enough to keep it self free) sticks it self in the pas∣sage, adn so being extravased causes a mighty painful Infsam∣mation; and in the mean time such an Issue voiding such a very small quantity of Ichor proves as useless as trouble∣some.

As to the places where Issues are to be made, they are to be chosen according to the ends of Curing, or the intentions requir'd from them; which are chiefly these three, viz. First, a general Evacuation of Humours from the whole Body. Second∣ly, an Evacuation, and at the same time a Revulsion from some particulare Member. Thirdly, an Evacuation and at the same time a Derivation from some particular Member. In respect of the former it's proper to have an Issue cut in the left Arm; The Second intention requires it to be made far from the part affected, and the Third near it.

For these ends, viz. sometimes this, sometimes that, or the other Issues are wont to be made, and that either by Incision, or a Cautery, or Perforation, in every Region of the Body, viz. in the Head, Brest, and Abdomen, and in the Arms and Leggs, nay in most parts of each, and in their Orifices Peas or Wooden Peas, Pellets, or Pledgets are put, and there con∣tinued for keeping them open. By running through the Parts

and Members of the Body, we shall observe the chiefest places, and kinds of Issues.

Some order an Issue to be burnt by a Cautery in the Co∣ronal Suture, and recommend it for withdrawing the Humours and evacuating them from the Brain and its Envelopings: Though some make a common Practice of this, yet I have found it not to have succeeded well in many; so that I have ordered many Issues so made on the Crown of the Head to be clos'd up, And this not without being taught by reason and experience: For the Blood conveys much Filthy Matter towards the place where it uses to discharge its Excrements, and deposes it in the whole Neighbourhood, and especially in the part affected (as being weaker and more apt to receive them) whence it often happens that the Disease is rather in∣creas't than Cur'd: For the same reason, viz. to derive Hu∣mours from the inward part of the Head outwards, others make Issues in the Bregma on the Sagittal Suture, and others in the hinder part of the Head about the beginning of the Lambdoides: But the same exception lies against these as against the for∣mer. Certainly an Issue made in the Arm much better an∣ticipates the Morbifick matter which is wont to be depos'd about the inner parts of the Head, if made in the Legg it revulses it, and made a little beneath the Head it derives it thence. Hence for great affects of the Brain, and its Me∣ninges, in Infants and Children, we cut an Issue on the Nape of the Neck: To Adult or Aged Persons we apply a Cau∣tery on both sides the Spine betwixt the Shoulder-blades: And there we often make two Issues capable of containing many Peas with great success. As to Issues cut or burnt behind the Ears, or a Setaceum past through its carneous Lobe; I have observ'd these things to have been seldom advantageous, but often troublesome; because a Solution of continuity made in these places neither discharges much Ichor, nor lasTs long, for the Orifice though fill'd with a Pea, or Pill, will be covered with a thin Skin growing over it in despite of all we can do.

Issues in the Back do excellently well, not only in Diseases of the Head by evacuating and deriving the Morbifick matter, but likewise in the Gout, Stone, and all Colicks, by anticipaing the Matter that feeds the Disease, and intercepting it as it passes to its lurking holes, which is plainly made appear by Expe∣riments and Observations made in persons reliev'd by them.

Issues betwixt the Shoulder-blades are good for Diseases of the Brest; also in the Arm, or Legg to evacuate or anticipate Humours flowing towards the Lungs, and to withdraw the

same there depos'd; That an Issue in the Thorax cut betwixt the Ribbs sometimes derives immediately the Consumptive mat∣ter from the Lungs, we have shewn elsewhere.

The Region of the Abdomen seems unfit to have an Issue in any part of it: Nevertheless the Practice of some, though it be rare, is much cried up, which order that a large Issue ca∣pable of containing many Peas, be burnt on the Region of the Spleen for all hypochondriacal affects; I have known this done in some without any great good, certainly not enough to re∣compence the trouble of such a Remedy.

Some time since by an Issue in the Groin Isuccessfully Cur'd a mighty weakness and ache in the Loins, not yielding to any other Remedies, and in another person an inveterate Sciatica: For the Glandulous Emunctories seated in that place, imbibe a great store of Excrements of the Blood and Nervous Liquor, which if forthwith discharg'd from them, and that in a con∣tinued manner, it will conduce much to the freeing of the Neighbouring parts from any Morbifick Seminal Root.

The ••••ugh being a large Member seems fit enough for bear∣ing many and large Issues to evacuate Humours plentifully from the whole Body, yet it does not happen so in many, partly because having a Figure too much declining like an inverted Cone, there is no convenient place for binding to keep in the Pea; and partly because a Solution of continuity made amongst the meetings of many Tendons, proves frequently Inflaming and Painful; so that it has been found necessary sometimes when an Issue has been made there to cause it presently to be closed up again to free the Person from Pain, and the trou∣ble of Lameness: Though in some it does better, because an Inflammation does not always happen to the place perfor∣ated, and a Ligature apply'd to it, continues stedfast to those that use to Garter above the Knee.

Moreover we must not only make choice of a fit part of the Body for an Issue, but likewise of a fit place in the Mem∣ber where it is made, which particularly requires the Judg∣ment of a Physician, or skilful Chirurgion: For we must be very careful that a Cautery or Incision be not admitted over, or too near the Tendons or greater Vessels: Nor must an Issue be made in the very Body of a Muscle, but in the Space or Interstice betwixt the Muscles; where the hole must pass the whole Skin and so much farther till the little Membrane of the Muscle underneath be penetrated, wherefore this operation is not to be committedindiscreetly to Quacks and others ig∣norant of Anatomy; for upon an ill performance herein there ensues not only a Frustration of all good, but often great pre∣judices

thence arise, nay sometimes eve•• to the hazard of Life.

It's needless for me here to describe the way of preparing and compounding a Cautery, or the figure and uses of the In∣cision Instrument for making Issues, for these are commonly known, yet it will not be amiss to discourse somewhat here after what manner we must deal with the Symptoms which happen to those Emissaries after they are made, and hinder or pervert their Energies.

There being many and sundry sorts of affects hapening to Issues, a Cure is not requir'd for them all, but only for those of greatest moment: Therefore in the first place it is needed whenever an Inflammation happens to the part or place where it is. Secondly, if the Orifice voids more or less Ichor than it ought. Thirdly, if the Sore be apt to dry up of its own accord, and now and then to be covered with a little Skin, or to grow rank with a Spungy Flesh growing up in its Cir∣cumference. As to the lesser defaults, as when the Sore bleeds often, or if changing its place it gets by little and little into a worse, with many others in which it's wont to pre∣varicate, it will not be worth while to mind them here.

1. An Inflammation sometimes happens to an Issue, and that sometimes so great that it threatens a Spacelus or Mortifica∣tion of the part, nay and sometimes brings it: Now such an affect comes either upon the fresh making of the Orifice, or happens afterward by reason of the Blood and Humours being upon some occasion put in a Commotion, and rushing in a throng to that place.

When an Issue is first made, presently by reason of the So∣lution of continuity, and consequently the Blood's being some∣what letted in its Circulation in that part, some Inflammation and Soreness happen to all persons: But in some who have a very hot Blood, and little diluted with Serum, this proves much more violent, there hapening sometimes a Mortification of the part inducing a Spacelus: Or Secondly, the Blood there stagnating is chang'd into a Pus to be evacuated by an Abscess: Or Thirdly, which more frequently happens, and ought to be always procur'd in our case, the Blood causing an Inflamma∣tion is return'd again into the Vessels, and restord to its Cir∣culation by other Ductus's into which it is forc'd.

But that it be convey'd back these two things are necessarily re∣quir'd, viz. First, that it be much diluted with Serum there plentifully abounding, or rather protruded into the part; And then Se∣condly, that the emptied Vessels behind the Tumour Drink up

again the Blood diluted by the Serum, and driven back: For the Blood driven toward the Tumour, when it can go no far∣ther forward, yet at least that upon lessening its Bulk it may go back, discharges Serum plentifully from it self, and drives it into the places obstructed; which entring into the stagnating Blood, dilutes it, and getting into tis place drives it into the Ductus's of the Vessels; and that Serum in the mean time passing forward exhales through the Pores, and so the Blood which was extravasated being diluted, and sent back by the Serum, and the Serum it self evaporated, the Tumour with the Inflammation vanish by degrees: But in case (as it often happens in hot Temperaments) the Blood extravased and driven into the Pores be not diluted with a plentiful access of Serum, it will not only stick there with obstinacy, but will cause a violently Inflamed Tumour with a Fever, and sometimes other dreadful Symptoms. Not long since a great Divine whose Blood was thick and hot, having an Issue made in the inside of his Legg, though the Skin only was cut, an Inflammation shortly fol∣lowed, which grew so violent within a few Days that it could scarce be hindred from turning to a Gangreen by the use of any Remedies whatsoever. Wherefore when the Blood extra∣vasated through a Solution of Unity, and wanting an access of Serum for diluting it, and carrying it back, tends to a vio∣lent Inflammation, Fomentations, and Cataplasms of Emollient things outwardly apply'd often do much good, because the moist and mild Parricles parting from them, enter the stag∣nating Blood, and dilute it, and so giving it a gentle motion cause it to return more readily into its Vessels; so that those moist applications outwardly us'd supply the defect of the in∣ward Serum requir'd for diluting the Blood: Nevertheless that the Blood so diluted, and put in motion be restor'd to Cir∣culation, it's farther necessary that the Vessels which are to re∣ceive it be fufficiently emptied, for which end besides a slen∣der Diet, Bleeding and Purging are often of necessary use; and indeed it is usual to Purge and often to Bleed Cacochy∣mical, and Plethorical persons a little before, or after an Issue is made. Nor are these Remedies only proper to prevent or remove an Inflammation in case of a fresh Issue, but are like∣wise good whenever that affect happens to an Issue of a long standing: For if at any time the Blood being very impure, and withal Feverishly boiling enters upon an Excretory Tur∣gescency, it often falls out that it deposes its Excrements and Filthy Dreggs about the Issue, being hardly to be Purg'd else∣where, and that it being there hindred from its Circulation upon their being heapt together, is extravasated, and so causes

a violent Inflammation: Such an affect lately hapening in an Ancient Nobleman, and at first neglected, soon turn'd to a Gan∣green, from which nevertheless by the help of proper Medicines carefully administred both inwardly and outwardly, he escapt not without great danger of his Life.

2. If at any time an Issue discharges too much Ichor, which for the most part is thin, and of a very ill Smell, and some∣times discoloured, so that such vast Spendings of Humour, and withal it's intolerable Stench requires a Cure: In such case there are two chief Therapeutick intentions, viz. First, to strengthen the mixture of the Blood that its Texture be not too prone to a Dissolution, and Fusion of Serum: And Secondly, to pre∣serve the place Ulcerated by the Issue, and to keep it free from any Coruptive Ferment, so that no Noysome Filth there lodg'd may defile the Blood as it passes through in circulating, whereby being infected it may presently run into parts, and be forc't to depose the Serum there in such abundance.

The former scope of Curing orders scarce any thing but now and then a moderate Purge, and a good Diet, viz. that the person keep himself from all Surfeits, and irregularity as to the quantity, quality, and seasons of taking his Food; and parti∣cularly from thin Wines, Cider, and other Acid Liquors, with which the Blood is wont to be fus'd, and driven to flowings of Serum: For Persons so affected most surely pay for any er∣rour or irregularity committed in Diet, a Pain presently being rais'd about the Issue.

For the due Preservation of the Tone of the place where the Issue is made, and for keeping it free from Putrefaction, you must take a particular care that for avoiding all Nastiness, both the Solids to be put into the Orifice, and the Coverings, be they either Plaisters, Ivy Leaves, or Oyl-cloaths be chang'd twice a Day: For in some each of these soon gets an ill savour, and presently causes the Ulcer of the Issue to stink: In case this tends to Putrefaction, presently instead of a Pea, or Wooden∣pill, let a Pill of Virgin-wax incorporated with red Saunders and Verdigrease be put into it; and likewise let a Fomentation of the Decoction of St. John's Wort, Yarrow, Centory, &c. be apply'd Morning and Evening.

3. Sometimes it happens that an Issue even as a dryed Foun∣tain, discharges no Humour: The reason whereof usually is either because the hole being not deep enough does not pe∣netrate the whole Skin, which is easily Cur'd by making it deeper; or the Sore though large and deep enough, yet still continues dry because the Serum does not readily nor freely separate from the Mass of Blood, this having too close a Tex∣ture

and then the only Remedy is to wear within the Ori∣fice, Solids more irritating, and working more strongly on the Mouths of the Vessels: For which purpose Pills are made of the Wood of Ivy, of Box, or of the Roots of Gentian, or of Hermodacts, and are often us'd with good success.

4. It often falls out that the Orifice of an Issue being too small, and distilling forth little Ichor is covered over with a thin Skin with the Pea included in it, and that with the hole it is heal'd up: For which default there is scarce a proper Re∣medy to be apply'd; wherefore (rather than still to fret the Skin to no purpose) it's better to let such an Issue close up, or to transfer it to some other place.

5. The Sore of an Issue inclining to heal, and being hin∣dred from it, has very often about its edges, and sometimes in its Cavity a Spongy Flesh growing up; the reason whereof is that the Nutritive Juice convey'd to the ends of the Arteries, and Nervous Fibres, and not presently washt away by the Se∣rous ichor, sticks there, and beginning to be assimilated extend, both those Vessels to fill the Cavity with Flesh; and the Blood in the mean while brought thither Forms within that Mass little Sprouts of Veins for its return; nevertheless that Flesh, as yet rough and shapeless, being kept from the greatest part of the Orifice, grows up above its Brim, and when it is risen so high that it can be no longer veiled and covered with the Skin, it continues still Naked and Spongeous: This Excrescency is easily enough Cur'd by sprinkling on it Escharotick Powders, of burnt Allom, Colcothar, or Mercury Praecipitate; for these sorts of Medicines with their Acrimonious and Stiptick force eat away the Flesh thus Luxuriant, repel the Nutritive Juice, and shut close the Mouths of the Vessels. When that superfluous Flesh grows continually and increases about the edges of an Issue, it's a sign that the Nutritive Juice abounds more there than the Excrementitious Humour, and consequently that in persons so affected that Emissary is not so very beneficial, wherefore under the pretext of this reason many are mightily averse from that Remedy (which certainly is inoffensive in most, though it be not equally advantageous in all.)

There is now an unperswadable opinion which has taken foot∣ing amongst many here in England (I know not if it be so in other Countries) that an Issue or Issues dipose to Barrenness; wherefore to all married Women, and desirous of Children, this sort of Remedy, though otherwise never so conducing to their Health, is Religiously forbidden; though no reason is yet given for this strick Prohibition; only stories are told of certain Women having Issues who are Barren; when it is as easy to

shew more Barren Women without Issues, and many fertile with them: And truly I use to retort this as a chief Argu∣ment against that opinion, there being no need of any other.

CHAP. V. Instructions and Prescripts for Curing Cutaneous affects.

IN the First place the Cuticle or Scarf-Skin being void of Life and Sence has scare any Diseases belonging to it: This sometimes being too compact hinders Transpiration; sometimes also by reason of some Accidents it becomes too gross and callous in some places: But of it self being absolutely insensi∣ble, it is not Distempered, though it be the cause that some affects, to be past off haply by Transpiration, stick about the Superficies of the Skin; because the Recrements and Filthy Dreggs of the Blood and Humours being driven outward and having pasT the whole Skin, when by reason of the close Tex∣ture of the Scarf-skin they are not able wholly to breath a∣way, fixing on the outward part of the Skin, they produce various discolourations and foul affects thereof: Of which sort chiefly are those we call Summer Spots, also Scorbutical and Malignant Spots, and likewise Spots and any other Stains whatever bedecking the Skin, or Scarf-skin with any Marks or Specks without any tumour or unevenness.

As to the affects of the Skin it self in general, in regard they are various and of sundry sorts, they are wont to be di∣stinguisht in a various respect, and first of all that they are either with or without a Tumour: We took notice of these latter even now.

Cutaneous affects with a Tumour are either universal, dis∣perst through the whole Body, or particular, rais'd in these or other Members at random, and as it were by chance.

The former either happen in a Fever, as chiefly the Small∣pox, Meazles, and other Malignant Pushes, to which also may be added the Flitting breaking forth of Children which soon vanish; or they come without a Fever, as especially the Itch, the running Scab, and Leaprous affects.

Particular outward Tumours hapning sometimes in one part, and sometimes in another, for the most part are not only be∣longing to the Skin, but also to the parts under it, viz. some∣times to the Flesh, Membranes, or Glands, and consequently are of a various Nature and a differing Form? It would be too long to treat of all these here particularly, therefore at pre∣sent I shall briefly speak meerly of Cutaneous affects such as before mention'd.

First, as to Summer Spots it's a sign that they proceed from Choller and other yellow Recrements of the Blood, be∣cause they ave: most familiar to those that are yellow Hair'd; again they happen to the Fairest Complexions, and in parts most expos'd to the Sun and Air, because their Skin being of a subtle Texture transmits the Humour rarified by the heat of the Sun, so far till it be stopt by a thick Scarf-skin, near the places where it should break forth: This affect as to the State of Health does not foreshow or threaten any ill: These Spots differ little or nothing from those they call Lenticular Spots.

There are other large Spots about the breadth of the Palm of the Hand which defile the Skin in many places, but espe∣cially about the Brest and Back with Stains sometimes of a dun colour, sometimes wan, or blackish. These being wont to rise and go away at certain times, and as I have observ'd in many, in certain parts, are commonly call'd Liver-marks, though not properly, for these Stains happen on this account, that the Filthy Dreggs and Refuse of the Blood, when not sufficiently receiv'd by the Vessels of separation, are carried to the Skin together with the Serum, with which they are di∣luted, and there being thrown off by the Blood, and left by the Serous Latex which evaporates, they stick fast to the out∣ward Pores and little Orifices, as a Mossy down does to the narrow passages of a River.

Those Spots appear chiefly in the Summer, and most upon the Back and Brest, viz. at that time, and in those places that Men are most apt to Sweat in; that is to say, that Serous Latex which has carried those Filthy Dreggs from the Mass of Blood to the narrow Pores of the Skin, leaves them there, as being unmeet to pass forth by Evaporation. This affect has no e∣vil joyned with it, nor is it the Symptom of any present Dis∣ease, nor does it portend any shortly to ensue, and in regard for the most part coming in places out of sight it cau∣ses no deformity, or trouble, there seems little or no need of its Cure: But because an opinion is spread amongst the vulgar, that the Liver is much in danger by reason of those Spots, and that it necessarily requires help, therefore to fatisfy some im∣portunately

desiring Physick, besides outward Consmeticks we are wont to prescribe inward Hepatick Remedies; the use of which though not very necessary, yet because thereby the Blood is purified, and the Obstructions of the Bowels are open'd, they are not altogether in vain. The inward Medicines useful for this purpose are set down before amongst Hepatick Remedies: The very same outward Remedies, or Topicks are proper in this, as in all other kinds of Spots, of which we shall give you some choice Forms.

Having treated elsewhere professedly concerning Spots of the Plague and Scurvy, I need not repeat them here; especially be∣cause the Method for these is quite dissering from that of the other: For in one kind of Spots in a manner only outward Medicines are wont to be administred without any that regard the Heart or the Viscera of the Belly, and in the other only inward things are given without applying any thing to the Skin.

Therefore as to the Summer Spots, Lentiginous Spots, and the vulgarly call'd Liver Spots, the Art of Beautifying pro∣perly takes care of them, and for removing these Blemishes from the Skin, only Cosmetick Remedies are prescrib'd without any Me∣thod of Cure; there is an infinite store of these amongst cu∣rious Ladys, and others that are nice in keeping the Skin fair; but all of them having regard only to two intentions of Cu∣ring may be reduc't to these two heads: viz. either by open∣ing the Pores of the Skin, and Scarf-skin, and sometimes by excoriating this, they endeavour to draw the Humour out∣ward, and wholly to evaporate it; or on the contrary they are administred, and that with no less success to strike back the Impure Matter which makes the Spots, and to drive it inward: I shall here set down some ordinary Forms of Topicks of both kinds, which have been rationally invented, and often us'd suceessfully enough; since I may not without offence to great Persons unvail the more secret Mysteries of the Cos∣metick Art, and prostitute them to the vulgar.

First, therefore to cleanse the Skin, and to draw the Matter of the Spots outward.

Take of a small Lixivium of Salt of Tartar four Ounces, Oyl of bitter Almonds made by expression what suffices, let it be mixt in such a proportion that the whole Liquour presently turn white, and so let it stand: Let the parts affected be anointed and gently rubb'd Mornings and Evenings with this mixture.

Take fresh Roots of Aron, Briony, and Solomons-seale, of each an Ounce, Powder of Fenugreek Seeds a Dram, Camphire half a Dram, being bruis'd together pour to them Oyl of Tartar per Deliquium

three Ounces, express it, let it bapply'd with a Ragg dipt in it twice a Day.

Take Sulphur-vive powdred an Ounce, black Soap two Ounces, bind it in a Ragg, let it hang in a Pound of Vinegar for nine Days, then apply it to use, washing and rubbing the places affected with it twice a Day.

Secondly, for the other intention, viz. for discussing the Spots from the Skin, and repelling the matter, and driving it inwards. Lac Virginis was a famous Medicine amongst the Ancients, and is still commended and us'd by many. The preparation of this is well known, viz. a Solution of Litharge made in distill'd Vine∣gar, by the affusion of Oyl of Tartar per Deliquium is precipitated into a Liquour as white as Milk: With which let the Face and Hands be washt and gently rubb'd twice a Day: A Medicine like this, or the same, at leastwise of the same Vertue is prepar'd of a Solution of Minium or Ceruse made in the same Menstruum, and preclpitated with water of Allom, or Sal Gemm. (Or)

Take Camphire slic'd two Drams, bruise it in a Glass-mortar pouring on it by little and little the Juice of one Limon, then add to it of White-wine a Pound, strain it and let the Camphire remaining behind be tyed in a Ragg, and hung in a Glass.

Take Verdigrease four Ounces, pour to it of White-wine two Pounds, being put into a Gourd-glass, let it be distill'd in Sand, let the Phlegm first coming off be kept for use, wherewith let the Face be anointed twice a Day. For this purpose also the Dew or Phlegm of Vitriol distill'd by it self does excellently well; some are content with the water of Bean-flowers, or the simple distill'd water of Fumitory, or with the water which Bleeds from the Sprout of a Vine, cut in the Sprin: But the more curious Women and Pretenders to the mosi exquisite knowledge in the Cos∣metick Art are scarce satisfied with any Remedies for the Skin but Mercurial: Wherefore the following water is highly recom∣mended and sold by Empiricks at a great rate for all Blemishes of the Face.

Take Mercury sublimate an Ounce, being reduc't to a Powder let it be put in a Tin-vessel with three Pounds of fountain water, let it stand for twentyfour hours stirring it now and then with a Wood∣den Spatula till the whole Liquor grows black, which nevertheless be∣ing filtred through Cap-paper becomes clear; a Ragg or Fea∣ther being dipt into this, let the Face be gently done over with it once in a Day or two.

This Medicine is of great efficacy against all foulness of the Skin, for it clears the Humours sticking in the little Pores and Orifices, though never so strait, and dissolves the obstinate and inveterate Combinations of the Salts and Sulphurs, and as to

any ill Conformation of the Pores, it restores the whole Skin, and makes it freely perspirable. Wherefore it is not only good for cleansing the Stains or Blemishes of the Face, but like∣wise for removing Pushes, and the redness of it, and Erysi∣pelous affects: Moreover it sometimes happens that many parts of the Face, but especially the Nose and Forehead are thick beset with blackish Specks as though burnt by Gunpowder; which nevertheless proceeds from hence, that the Sudatory Pores are fill'd sometimes with a black thick Humour, sometimes with little Worms having black head, (which little insects being squeez'd forth of the Pores, and laid in the Sun are easi∣ly perceiv'd to live and to move themselves) and in such an affect of the Skin, no Washes or Ointments but Mercurial are wont to do good: Nevertheless a too severe Sting often goes a long with this Honey: For the Particles of the Quick∣silver, together with the Salts (with which they are minute∣ly divided and quickn'd) being apply'd to the Face, discuss thence the offensive and defiling Matter from the Pores, and drive it away, and being struck inward they follow it, and soon insinuate themselves with ease into the Blood and Nervous Liquour (whose Crasis they injure) and through their means very frequently pass their Venom, often not to be rooted out afterward into the Brain, and sometimes into the Praecordia, and other parts: Hence it's frequently observ'd that Men or Women using long and much a Mercurial Ointment, become subject to the Vertigo, and Convulsive, or Paralytick affects, and that their Teeth turn black, and sometimes grow loose.

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.

CHAP. VII. Instructions and Prescripts for the Cure of the running Scab, or the Leaprosie of the Greeks.

AFter the Scab with the Itch, it follows that we treat of another affect somewhat allyed to it in its breaking forth in Pushes, which is commonly call'd the running Scab, by some a Tetter or Ringworm, or Morphew, by others the Leaprosie of the Greeks; but the Names of this affect being variously confounded, and the Nature of it haply being differing in several Countries, I shall describe it as it is now understood by us.

The running Scab begins and affects persons after this man∣ner, viz. First little red Wheals or Pushes, sometimes single, sometimes many of them joyn'd together, arise in many parts of the Body, but especially in the Arms or Leggs; and grow at length in heaps or clusters; the Surface of each Scab when grown in clusters appears rough, and somewhat whitish and scaly, so that upon scratching, Scales fall away, and a thin I∣chor often issues forth, though its soon dryed again, and hardens into another crusty Scale.

These clusters of Pushes at first are but small and few, as in the Arm or Legg, or some other particular Member, hap∣ly three or four appear to the bigness of a peny or two pence: Afterwards if the Disease be suffer'd to increase, they break forth in many places, and grow to a crowns breadth, and at length if not stopt, cover not only particular Members, but the whole Body with a whitish Leaprosie, which rais'd to this degree was judg'd for the most part incurable by the Ancients.

These breakings forth in some are only temporary, as com∣ing in the Winter, and going away in the Summer, in others on the contrary they come in the Summer, and vanish in the Winter: In many others this Distemper is continual, having no time of remission or mean.

The running Scab differs from the Itch, that in this the Pushes are generally single, and separated from each other, though but by small spaces, but in the other they rise in clusters: Again the Itch is extreamly infectious, but the running Scab is not so.

This Disease is also distinguisht from the Leaprosie, that this

is likewise as infectious as the Itch, and its breakings out are much more violent and terrible than in the running Scab, wi viz. being crusty and scaly, and diffus'd in a continued manner through∣out the whole Body.

Hence it appears that the material cause of the running Scab is not a meer Cutaneous Humour depraved and degene∣rated from its Crasis by reason of some Corruptive Effluvia's receiv'd from without, or upon other occasions; because the infection is not easily communicated to others, as in the Itch, nor presently disperst through the whole Body; but the Pushes first breaking forth about the beginning of the Disease seem to proceed from hence, that some Acido-saline Concretions happen in the Mass of Blood (like Tartar in Wine) which seeing they can neither be subdued, nor again dissolv'd are driven to the Skin, as to the sides of the Vessel.

This Disease takes its rise for the most part on two chief oc∣casions, viz. First, from an ill Diet, as from frequent eating of Salt Meats, Pork, Shell-fish, or others, or Secondly, from the corrupted Seminaries of other Diseases left in the Body, as especially of the Scurvy, and French-pox ill or not Cur'd.

For First, those sorts of Food either because they are rank, or otherwise disproportion'd, convey Particles to our Blood, that cannot enter a due mixture with it, or are not easily mastered by it: To which Heterogeneuos Particles gather'd together in great abundance by long continuance of such Diet, Saline Particles of all kinds readily associate themselves, and so make Tartarous Concretions, which are driven to the Skin, and are the Seminaries of the running Scab, or Leaprous affects.

Secondly, the Miasms of the Scurvy and French-pox lest left in the Body, and at long run rais'd to the highest degree in Combinations of Exorbitant Salts and Sulphurs, engender a most plentiful Seminary of this Disease: For the corrupted Taints of the Blood, after that upon long continuance they are become wholly Heterogeneous and unsubdueable, gather to themselves at length the Saline Particles, with which growing together in that Tartarous Concretion, and driven to the Skin, they produce Eruptions of the running Scab.

Concerning the Crue of the running Scab there are two pri∣mary Indications, viz. the Preservatory which regards the cause of the Disease, and the Curatory which has regard to the Symp∣tom, viz. the breaking forth of Pushes: The Vital has sel∣dom place in this case, unless grown altogether desperate, where there is a deficiency of Sleep and Strength: The Me∣thod of Cure ought always to begin with the Preservatory Indication, which removes the causes of the Disease by inward

Remedies, for otherwise outward things are scarce ever ad∣ministred to any purpose (as in the Itch) but the roots of the Disease being cut off within the Blood, the Cutaneous Pushes soon dye away: Though for removing them we must proceed one way when the running Scab begins of it self, and some∣what a differing way when it comes after an inveterate Scurvy, or the French-pox, ill or not Cur'd: We shall consider each of these cases severally and distinctly by themselves.

When therefore this Disease is simple, and primary, and fresh coming, let the evident and external cuases be remov'd, let the ill Diet and the Unwholesomeness of the Air be cor∣rected; therefore let persons who have been long and too much us'd to feed on Salt Meats, Pork, or Fish betake themselves to a Diet of good Juice, and easy of Concoction. Moreover if they live by the Sea side, or in Marshy places, let them re∣move to a more dry and clear Air; and withal let them be as careful of their Drink, avoiding thick and dreggy Beer, and thin and acid Wines which are too much fill'd with Tar∣tar: Finally let them take care that their Drink or Food be not prepar'd of Mineral waters apt to petrify.

2. In respect of the Conjunct and Procatarctick cause, viz. a Saturation of the Blod with Saline Particles of a differ∣ing Disposition and Nature, there are two chief intents of Curing; to wit, that the Blood and Humours be forthwith cleans'd of their impurities: and that the Acido-saline Discra∣sies, of the Blood and Nervous Liquour be altered for the better to keep them from engendring a Tartarous matter: For which ends both evacuating Remedies of divers kinds, and altertives are wont to be prescrib'd: Nevertheless because not all but in a manner only great Remedies are here proper, there∣fore those that are chiefly in use, and found to do most good, are Catharticks, Bleeding, Whey, Mineral waters coming from Iron, Juicy expressions of Herbs, Decoctions of Woods, Cha∣lybeat Medicines and Salivation: We shall set down certain Forms of each of these, and the manners of ussing them.

In the Frist place therefore, a general Purge and Bleeding (as in the Cure of the Itch) being premitted, let the follow∣ing Cathartick Infusion or Tincture be prescrib'd, whose Dose is from six Ounces to eight, to be repeated whithin six or seven Days.

Take Roots of sharp pointed Dock dryed, of Polypody of the Oak of each half an Ounce, Sena ten Drams, Epithymum six Drams, Rhubaru, Mechoacan, of each half an Ounce yellow Saunders two Drams, Celtick Spike half a Dram, Salt of Tartar a Dram and a half, put them in a Glass with three Pounds of White-wine, and

a Pound of Elder-flower water; let them stand close covered in a cold place for three Days, then use it, pouring forth daily a suf∣ficient quantity of the clear Liquour,

Secondly, to sweeten the Blood, and cleanse ti from its Salts, drink every Morning to two or three Pounds of Whey by it self, or with Fumitory, preparations of Cichory, and with sharp pointed Dock infus'd in it, and let this Drink be continued for twenty or thirty Days if it agrees with the Stomack, and withal in the Evening and early in the Morning let a Dose or the following Electuary be taken.

Take Conserve of the Roots of sharp pointed Dock six Ounces, Crabbs Eyes, Coral prepard of each two Drams, Ivory a Dram, Powder of Lignum Aloes, yellow Saunders of each a Dram and a half, Sal Prunella two Drams, Vitriol of Mars a Dram and a half, Syrup of the Juice of Wood-sorrel what suffices, make an Electurary, the Dose if two Drams.

Thirdly, for the same reason as Whey, also Mineral waters coming from Iron are prescrib'd against this Disease, and often do great good: For when all other Medicines have prov'd of no effect, I have sometimes Cur'd a great and almost Lea∣prous running Scab with this alone: Moreover to add to their efficacy we may fitly joyn the use of Sal Prunella, or of Vi∣triol of Mars, or of the Electuary before written.

Fourthly, in some persons having much Serun, and a Watery Constitution, where drinking of Whey, or Mineral waters is not proper, it is good for them to take constantly a De∣coction of Woods at Physical hours, and likewise for their or∣dinary Drink.

Take Raspings of Willow-wood half a Pound, Roots of Sarsaparilla eight Ounces, white Saunders, Wood of the Mastick-tree, of each two Ounces, Shavings of Ivory and Harts-horn of each six Drams, Sha∣vings of Tin, crude Antimony of each four Ounces, both tyed in a Rag; Licorice an Ounce, let them infuse according to Art, and boil in sixteen Pounds of fountain water of half, keep the straining for use.

Fisthly, Chalybeat Medicines, because generally accounted of among the more excellent Remedies, are seldom omitted in this Disease, though they as seldom prove successful: For a gret many preparatious of Iron in which the Sulphurous Par∣ticles predo minate for as much as they ferment the Blood, and put it upon Excretory Effervescencies, encrease rather than di∣minish the Eruptions of the running Scab: Nevertheless Vi∣triolick Salts, Syrups, Tinctures, and Infusions in regard they fix the Blood, and somewhat restrain the Exorbitant excesses of the Salts, answer aptly enough to the intention of Curing

now propos'd, but being too weak cnnot master so Herculean a Disease.

Wherefore Sixthly, these, and a great many other Remedies doing no good, many reommend Salivation as the stoutest Cham∣pion, and only fit to contend with so potent an Enemy: Yet the event does not always answer this mighty expectation, for I must own to have try'd this Remedy my self in four persons afflicted with a greivous running Scab, not yielding to other Medicines, but without any benefit; some of these were put in a very high Salivation by a Mercury Unction, others by Pills of the Solar Praecipitate, which Salivation they lay under for about twenty Days, after which time all the Scaly breakings forth, and clusters of Pushes vanisht: Nevertheless for per∣fecting the Cure a Diet Drinkd ordered of the Decoction of Sarza with frequent Sweating under a Cradle, and deu Puring betwixt while was continued for a Month: Yet this course be∣ing ended when no footsteps of the running Scab seem'd to be left behind, within the second Month a new stock of the same Disease biginning to spring forth, grew up in a short time to its wonted Maturity: Moreover when one of these persons would repeat this Medicine, and another after two returns of the Di2ease would try it a third time, both of them at length despair'd of Cure after they had underwent so much Misery: Whence it appears that the French-pox though Malignant in the highest Nature, and causing most Filthy and Virulent Ul∣cers consuming the Flesh and Bones, may much more easily and ceratinly be Cur'd than the running Scab.

The reason of ti is, that the cause of the Pox consists in a Malignant and altogether Heterogeneous Miasin defiling, and as ti were Poysoning the Blood and Nervous Liquor for some time, though not wholly subverting their Crasis, or utterly de∣praving them for the future: Wherefore that Cure is perform'd by Salivation, or a Sweating Diet, extirpating all that Venom, the Genuine Disposition of the Blood and Humours then re∣maining: But in a deep sort of running Scab the Elementary and Originally composong Particles of the Blood are corrupted, so that unless the Crasis and due Disposition of these be re∣stor'd, all sorts of Evacuations, and Purgings of the Malignant and Venemous matter, though never so fll and eradicative will effect little or nothing: Wherefore it is not without ground that many famous Physitians formerly have judg'd this Dis∣ease when coufirm'd, and drawing near to a Leaprosie to be hardly or never Cur'd.

2. No better event attends this Disease when if succeeds an inveterate Scurvy: Haply the intentions of Curing are some∣what

more certainly pitcht upon when this effect is suppos'd to be the basis or root of that: viz. the Terapeutick intention being thence taken, we insist chiefly on Antiscorbutick Reme∣dies; but yet the more smart and hotter things of this kind, as Scurvy-grass, Cresses, Horse-raddish, Pepperwort and other things irritating the Blood too much, in regard they more dissolve its Crasis, and drive the Tartarous Concretions more plenti∣fully to the Skin, are always found rather prejudicial than ad∣vantageous: And for this reason the use of hot Baths or Bathing in hot waters, which in regard it evacuates the Humours of the whole Body by a most plentiful Sweat, and cleanses the Pores of the Skin, and mightily purges them, amy seem to be very available in this Disease, most commonly is so far from doing good, that the Eruptions are wont thence to be mighti∣ly encreast, and exasperated: For I have known many persons not very much over-gone with the running Scab, who going to our Bath to bathe themselves in the hot waters have re∣turn'd thence perfectly Leaprous: Wherefore when this affect is a Symptom arising from the Scurvy, all Smart, and Elastick things being avoided, let only the more temperate, and such as are endow'd with a Nitrous, Vitriolick, or Volatile Salt be administred: We shall give you some kinds and froms of each of these sorts. In the First p;ace things chiefly excelling in a Nitrous Sal are Chrystal Mineral, the Juices or Decoctions of certain Herbs, and some Purging Mineral waters.

Take Chrystal Mineral, or Nitre purified to the highest degree an Ounce, Flowers of Sal Armoniack a Dram, bruise them together in a Glass Mortar, give to a Dram thrice or four times in the space of twenty four hours.

Take Leaves of the great House-leek two handfuls, being bruis'd boil them in two Pounds and a half of fresh Milk till it turn to Whey and Curd, being strain'd let the clear Liquour be taken to a Pound twice a Day.

Take Leaves of Dandelyon six handfuls, being bruis'd put them in a Glaz'd Earthen Pot with a cover, which put in an Oven after the Bread is draum, and let it stand for six or eight hours, then the Mass being put in a strainer let the clear Liquour run out, the Dose of which is from four Ounces to six thrice or oftner in a Day.

Cucumbers being endow'd with a Nitrous quality are found by experience to be good against this Disease, wherefore let store of them be often eaten, as a Sallet. Moreover let three or four of them being cut into slices be infus'd and close stopt in three Pounds of fountain water all Night; to the clear Liquour pour'd off, add of Sal Prunella two or three Drams; the Dose is half a Pound thrice or oftener in a Day; for the same pur∣pose

also Decoctions of the Leaves together with the Fruit made in fountain water are proper.

Some Mineral Purging waters, as especially those of North∣hal, being resolv'd by Evaporation mainifestly shew the Nitrous Salt wherewith they are imbued: And I have sometimes found by expericence that dayly drinking about two quarts of them for many Days Cures a small running Scab.

2. But as I have hinted before, Mineral waters endow'd with a Vitriolick Salt, as those of the Spaw, and ours of Tunbridge and Astrope far exceed those Nitrous waters, nay and all other Medicines, and are of greater efficacy in the Cure of the run∣ning Scab.

To those who have not the conveniency of using these waters, I ordinarily give with good success against this Disease com∣mon waters impregnated with our Steel, and so most exactly resembling those Mineral waters. It happens that Tin and An∣timony by reason of their Mineral Salts, or at leastwise by rea∣son of the Mercurial Particles in them are extol'd by many for curing the running Scab, and are wont to be prescrib'd with other Medicines. Let Shavings of Tin, and Powder of An∣timony be infus'd in Beer for ordinary Drink; they enter also the Decoctions of Sarza with Woods which are ordered against this affect.

The use of the Viper, and preparations of it, sufficiently re∣commend the excellent Vertue of Volatile Salt for the Cure of the deep sort of running Scab, nay of the Leaprosie it self: For it being manifest by frequent observations that Remedies prepar'd of Vipers do good in the running Scab, and Lea∣porfie, certainly the reason of the help it affords ought to be ascrib'd to the Volatile Salt, with a great plenty of which this Animal is endowed: For the Particles of this destroy the fixt and acid Salts predominating in the Blood of the Diseas'd, and dissolve their Combinations; Nevertheless the Salt, Spirit, and Oyl of Vipers Chymically extracted, by reason of their Empy∣reumatick, and mighty Elastick Particles, which they draw from the Fire, are not proper in this Disease; so neither the Spirit, or Volatile Salt of Harts-born, Soot, or Blood, and other such like Armoniacks, because by exagitating the Blood and Hu∣mours above measure, they cause their Crasis to be more dis∣solv'd, and their Corruptions to be driven forth more plenti∣fully to the Skin: Wherefore the more simple preparations of Vipers, as Broaths of their Flesh boil'd in water, Drinks impreg∣nated with Infusions, or Incoctions of the same, and Powders made of the same dryed and beaten are rpescrib'd with more success against this Disease: Moreover not only the Flesh of

Vipers, but of other kinds of Oviaprous Snakes being boil'd and eaten for ordinary Food, give often great relief.

The running Scab, or scaly breakings forth of Pushes, and growing in figures like clusterings is so frequent and familiar a Symptom of an inveterate French-pox, that the first thing we do is to ask persons affected with the former Distemper, whether they do not conveive that there amy be something of the Malignity of the other bying hid withim them; and if it be found to be so, presently all Specificks against the former and Antiscorbuticks being laid aside, we forthwith betake our selves to Decoctions of Woods, and those doing little or no good, to Mercurial Medicines, And truly by this Method I have soon and easily Cur'd many persons accounted to have a run∣ning Scab, and Leaprosie, who had been long under Cure, and miserably tormented with Remedies appropriated to these Diseases: And we refer this kind of running Scab to the Pa∣thology of the French-pox, whereof it is an Appendix.

The Second Indication which is Curatoyr, having regard to the Disease it sefl, and its primary Symptom, viz. the scaly break∣ings forth, and the clusters of Pushes, prescribes Topical Reme∣dies to be apply'd to the Skin outwardly for removing these effects: For which purpose Baths and Liniments are pecu∣liarly proper; though they seldom, or never Cure of themselves, unless the Procatarctick ause, viz. the Tartarous Disposition of the Blood be first clear'd.

There is a mighty store of these Topicks to be found as well among Physical Authours, as among Empiricks and Quacks: Though among them all, Baths or Liniments made of Tar far exceed all the rest of the Remedies of both kinds: So that in truth we should make use of these alone were it not for their ill smell: wherefore I shall give you certain Forms of Com∣positions with Tar and without it:

Therefore for Baths it's a common thing to use water kept some time in Vessels in which Tar has ben before, and so im∣pregnated by Infusion. (Or)

Take two Pounds of Tar, and incorporate it into a prety thick Mass with white and sifted Ashes, which boil in a sufficient quan∣tity of fountain water, adding Leaves of ground Ivy, Fumitory, white Horehound, Roots of sharp pointed Dock, and of Elecampane, of each four handfuls: Make a Bath to be us'd with governance; or let such a Decoction be prepar'd without Tar for persons troubled with the running Scab, and loathing the smell of Tar.

Sulphurous Baths, both Natural and Artificial, are found by frequent experience not to agree, nay and the former commonly to do hurt: Moreover all Bathing whatsoever ought to be us'd with

great caution; for in regard this Administration exagitates and heats the Blood, it endangers to dissolve its Crasis more (as is said before) and to disperse its corrupted Taints in a more plentiful manner to the Skin.

2. Liniments, whose use is more safe, and proper, are of three kinds, or degrees, viz. gentle, mean, and strong: I shall give you an example or two of each of these.

1. First, therefore in a small running Scab, where the breakings forth and clusters of Pushes are few and very small, fasting Spittle is recommended: Also the Liquour distilling from green Wood in the Fire: So likewise a meer rubbing with the Root of sharp pointed Dock bruis'd, and macerated in Vinegar. (Or)

Take Oyl of Tartar per Deliquium, Oyl of Nuts, or of bitter Almonds by expression, of each equal parts, make a Liniment to be apply'd to the places affected twice a Day.

2. Liniments of the Second kind have Tar for an Ingredient which is esteem'd as good as all the rest.

Take Ʋnguentum Rosatum six Ounces, Tar two Ounces, being melted together let them let mixt. (Or)

Take a good fat piece of Weathers Mutton, stick it with bits of the Roots of sharp pointed Sock, spit it, and roast it: And baste it with Tar, letting it drop leasurely on it, keep the Dripping as a most excellent Ointment for the running Scab.

3. The strongest Ointments against this affect are Mercurial, which consist either of running Mercury, or Praecipitate; let the Forms and Cmposition of the foriner be the same as is prescrib'd before against the Itch. As to the other,

Take white Praecipitate three Drams, Ʋnguentum Rosatum three Ounces: Mix them, to anoint the parts chiefly affected: The use of these in this Disease ought to be very much suspected: For if haply a Salivation be rais'd, a mighty glut of Matter stick∣ing in the pores of the Skin will be put in motion, which if the whole, rushing too much together towards the Ductus Sali∣vales, gathers in a body about the parts of the Throat, it will endanger Suffocation.

Some years since a Virgin of a noble Family, whose Tem∣perament was hot, as having originally a sharp and salt Blood, after having liv'd a very long time, almost from her Cradle somewhat toucht with a running Scab, about the time of her coming to ripeness of years began to be troubled with it in a more grievous manner: For clusters of scaly Pushes did not only every where overrun her Arms, and Thighs, and other parts of the Body out of sight, but likewise made her Hands and Face so loathsome, that she was asham'd to go abroad and converse with others of her quality: An infinite number of

the lesser sort of Remedies were given her without any suc∣cess: By the use of hot Baths she seem'd to grow better at first, but in the end she became worse after them. The waters of Astrope wells which have perfectly Cur'd some persons of a running Scab, did her little or no good; wherefore seeing all ordinary Methods would not do, I propos'd that she should try Salivation, as being a more powerful Remedy than all the rest, and (as it's said) the last: The Patient and her Parents readily consenting to this advice, presently her Body being duly prepar'd by Purging and Bleeding, I gave her (after our wonted manner) Pills of the Solar Praeciptitae for two Days, and after the Intermission of one, the Medicine being repeated the third time she began to Salivate very well and freely, it con∣tinuing upon her for a Month without any ill Symptom: Never∣theless to keep it in its due Tenour, I took care that a Mer∣curial Ointment was now and then apply'd to the Joynts of the Limbs, sometimes to these, and sometimes to others: Be∣fore this course was ended all the breakngs forth were va∣nisht; Notwithstanding which to perfect the Cure, and with∣ao to extirpate the Mercury, she spent another Month in Purg∣ing, Sweating under a Cradle, and in a Diet Drink of a De∣coction of Sarsa, China, &c. at which time seeming to be per∣fectly Cur'd, she continued so for about forty Days: But from thence forwards, though she observ'd an exact Form of Diet, the same Disease began to spring forth afresh, and encreasing by degrees, rise at length to an overgrown state as before: I, being in some confusion at this event, perswaded her to hope an alteration for the better after the flowing of her Menses, which, having not yet happen'd, was expected in a short time: Nevertheless after long expectation, that Excretion at length hapning, and thenceforward continuing its constant course, brought no Cure or relief to that Disease, but rather made it worse: Wherefore she had recourse again to Physick, and tryed sundry sorts of Remedies, almost of all kinds: Which prove∣ing all of no effect, her Friends earnestly desir'd that she should enter again the course of Salivation, hoping that that Method which Cur'd her at first for a short time, being us'd again, would Cure her at least for a longer, or haply restore her to her perfect Health: Therefore according to their desire the same course of Salivation and Sweating being repeated for the two Months space, and thereby the Pushes and Scaly breakings forth being every where vanisht, the noble Virgin seem'd then again to have recovered her Health: But within six Weeks after the course was finisht, the Pushes, and their heaps, or clusters appear again, and daily increasing by degrees in number and

bulk, at length rendred the Body all over in a more loathsome condition than before.

I knew another, a robust Man of an Athletick habit of Body, who after he had been troubled with a running Scab many years, the Disease at length growing worse, and being risen to an overgrown state, had his whole Body covered over with a white, and as it were Leaprous Scurf: So that every Night the Scales falling off in a great pleaty within the Bed like Bran, might be gathered up in heaps: This person, in order to his Cure, first tryed ordinary Remedies almost of all kinds, but without any good: And then having undergone a gentle Salivation of Mercury, he found himself nothing better; afterward that Method being repeated, after a long and high Flux, he seem'd restor'd to his Health: But within three Months the same Disease springing forth afresh, rise in a short time to its Ancient Enormous state: Nay and haveing undergone this irksome kind of Cure a third time, that affect seeming for a while to be driven away, return'd again, and thenceforward in despite of this, and any other Method whatsoever, exercis'd its Tyranny during the Life of the Patient: I need not say any thing of the Leaprosie, which being only a more intense degree of the former Disease, seems scarce to admit of any Cure.