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THis Second Part of the Pharmaceutice Ra∣tionalis, is divided into three Sections, whereof the First treats of Medicines that regard the Thorax, the Second of Medicines that regard the Viscera of the Belly; the third of outward Medi∣cines, viz. Phlebotomy, Vesicatories, Issues, Cutaneous Affects, &c.
WE must observe the divers states of this Disease, or the distinctive Marks which belong to it: As First, when it is meerly a Cough: Secondly, when it begins to degenerate in∣to a Phthisick or Consumption: Thirdly, when the Phthisick is consummated, or past recovery.
1. And First, as to a new Cough from what Cause soever it a∣rises, it is never free from suspicion of danger, if it happens in a Body predispos'd to a Phthisick; though in other robust Persons it be not presently to be fear'd: For if at any time it be rais'd from some great evident cause, and being without a Fever, and an indisposition of the whole Body, it proves not very trouble∣some, then it is said to be only a cold taken, and is either wholly neglected, or soon Cur'd without much ado. Again, if it be ac∣companied with a small Feaver, Thirst, and loss of Appetite, there is hope that the Blood being restor'd to its due temper, the Cough will also cease of its own accord; but if drawing in length, and not easily submitting to vulgar Remedies, it produces much Spit∣ting, and that discoloured, it ought no longer to be neglected, but must be dealt withal with a method of Cure, and fit Reme∣dies, and an exact Form of Diet: For then it may be suspected that the Lungs having receiv'd some prejudice in their Conformation do not transmit the Blood entirely, but with a deposition of the Serum, or Lympha, and often the nutritive Juice; and likewise that those humours there deposed do putrify, and consequently that by a reciprocal injury they taint the Blood, whereby it still offends the Lungs the more.
2. But if to a Cough daily growing worse and worse, with much and thick Spitting there be added a Languor, and falling away of the whole Body, a loss of Appetite, difficult breathing, thirst, and a boiling of the Blood; there is great cause to sus∣pect that a Phthisick is at least begun, if not well advanced: Wherefore we must then use all our endeavours both to free the Lungs from the offensive load of matter already gather'd toge∣ther in them, and to fortifie them against the continual Incursion of the same; and at the same time to cleanse the Mass of Blood of its dregs, and to restore it to a good Crasis, whereby it may duly contain its Serosities, and other humours within its own tex∣ture, or convey them to some other place than the Lungs.
3. But if beyond the state ev'n now describ'd of this Disease, the Spittle daily increases, and becomes more discolour'd, and all other things still growing worse and worse, there be join'd to it a total decay of strength, and a Hectick Feaver, with a continu∣al thirst, Night Sweats, a dying Countenance, with a falling a∣way of flesh ev'n to the drought of a Skeleton; then there is no room left for Physick, but only for a sad Prognostick, or at least all hope of Cure being laid aside, we have nothing left to insist on but Anodines, which may help towards an easie death.
Wherefore according to the said three states of this Disease, its method of Cure must be in a threefold manner: viz. First we must prescribe what is to be done for Curing a Cough, whilst be∣ing not entred the limits of a Phthisick, it has only the name of a Cold taken. Secondly, what is proper in a beginning Phthisick. Thirdly, what is to be done when it is consummated and despe∣rate.
1. Men of a tender constitution, or such as are inclin'd to a Consumption from their birth, or have sometimes formerly been us'd to be endanger'd by a Cough, ought immediately as soon as they find it coming to stand on their guard, and betake them∣selves to the Rules of Physick, according to which, to proceed methodically in a way of Cure, the Therapeutick Indications must chiefly be these three. 1. To appease or take away the disorder of the Blood, whence the Fluxions of the Serum proceed. 2. To derive from the Lungs to the Pores of the Skin, or Urinary pas∣sages, and other Emunctories, the dreggy Excrements of the Blood, and all superfluities apt to depart from it. 3. To corro∣borate the Lungs themselves against the reception of the Serum, and other humours; and likewise to fortify them against the in∣vasion of outward Cold, from which they are wont to receive a farther prejudice. We shall speak of each of these a little more at large.
1. The first Indication regards both the Effervescency of the Blood, in that it grows over hot, and boils in its Vessels, by reason of the Effluvia's being restrain'd within it; as also its disso∣lution, in that being loosen'd in its Texture, it lets fall too much the Serum and other Humours from its embraces, to remove both a thin form of Dyet must be ordered, and the person being care∣ful to avoid all injury from outward Cold, a pretty free tran∣spiration must be procur'd, or at least the wonted transpiration must be restor'd: For these ends let the Patient presently be thicker cloath'd, and let him keep himself in Bed, or within his Chamber; at least let him not go forth of Doors: Evenings and Mornings let a gentle Sweat be rais'd by giving him Posset-drink with Rosemary, or Sage boil'd in it: If notwithstanding the Cough grows worse, Bleeding proves often of good effect, so his strength and constitution bear it; after which Hypnoticks generally do well, inasmuch as they retard the motion of the Heart, and con∣sequently the overhasty Course of the Blood. Moreover, they cause it to pass the Vessels of the Lungs gently, and with mode∣ration, without casting off any great quantity of Serosities; and to send forth what is superfluous either by Sweat, or by Urine: For this purpose also Pectoral Decoctions must be given, because they destroy the Acidities of the humours, and hinder, and put a stop to the dissolution of the Blood, and its fusion into Se∣rosities. For the like reason and manner of Operating, Medi∣cines prepar'd of Sulphur are of such egregious use against the Cough.
2. The Second Indication, viz. the derivation of the Serum, and other dreggy Excrements of the Blood from the Lungs, and their Evacuation by other ways, is perform'd by Diaphoretick Medicines, Diureticks, and gentle Purgers; which must go along with other Medicines, or be now and then interchangeably us'd with them. Therefore after Bleeding, we usually give a gentle Purge, and sometimes repeat it. In the Pectoral Decoctions, let the Roots of Chervil, Butchers-broom, Elecampane, and other things moving Sweat and Urine be of the Ingredients: Millepedes, Volatile Salt of Amber, and other fixt Salts, and Powders of Shells, made into Pills with Turpentine, are often given with good ef∣fect.
3. The Third Indication, viz. the fortifying of the Lungs, and its Ductus's against the Fluxions of the humours and the assaults of the Cold, and the suppression of the Catarrh, vulgarly so call'd, is perform'd by Linctus's, Eclegma's, and other particular Reme∣dies, and has chiefly a regard to two things, viz. gently to close the Mouths of the Vessels and Glands that gape into the Trachea with Astringents, lest they cast forth the Serosities too much in∣to
it: And Secondly, To make smooth and glib the sides of the Ductus's of the Trachea, that they be not offended, and thence continually stirr'd up to a troublesome Cough, either by the sharp Serum coming upon them, or by the assault of any outward Cold; and moreover, that those Ductus's being made slippery enough, the Spittle sticking sometimes very fast to the sides of them, may be more easily gotten off and Cough'd up: For the First intent it is, that Conserve of red Roses, Olibanum, Mastick, Lohoch de Pino, Syrup of Jujubes, of dried Roses, of Cup-moss, and other Astringents are so often ingredients in pectoral prescriptions. On the account of the second intent Licorice, with its various pre∣parations is accounted so famous a remedy against any Cough whatsoever. For this end Syrups, Eclegma's, and all other sweet Pectorals seem to be ordered; to which is added Oyl of sweet Al∣monds, either given by it self, or reduc'd into the Form of some Milky pap by long stirring it with some Pectoral Syrup. These are the chief Therapeutick Indications, together with the apt in∣tentions of Curing, which seem to be of most considerable use for a new Cough, whilst it is yet free from the suspicion of a Phthisick, or at least not yet entred its manifest limits: It now remains after this general method briefly given unto you, to set down some Select Forms of Medicines appropriated to each In∣tention: These, though they are manifold, and diversly prepar'd, yet those that are of chiefest note, and most in use are Mixtures, Linctus's, Eclegma's, Tinctures, Balsams, Troches, Tablets, Powders, Pills, Decoctions and distill'd Waters: We shall give you some of the most Elegant Receipts of each.
TAke Syrup of Meconium, and of Jujubes, of each an Ounce and a half, Olibanum powdred a Dram, Water of Earth-worms, or Hysterick Water, or Water of Peony Compound a Dram: Mix them, the Dose is one spoonful going to Bed, and after Mid-night.
Take Water of Snails, and of Earth-worms, of each an Ounce and a half, Liquid Laudanum Tartariz'd two Drams, Syrup of Violets an Ounce: The Dose is one spoonful going to Bed.
Take Water of Snails six Ounces, Syrup of the Juice of ground Ivy three Ounces, Flowers of Sulphur half a Dram: Mix them, the Dose is a spoonful going to Bed, and early in the Morning.
Take of our Syrup of Diasulphur four Ounces, Water of Earth-worms an Ounce: The Dose is one spoonful after the same manner.
TAke Syrup of Jujubes, and Maidenhair, of each an Ounce and a half, Syrup of red Poppies an Ounce: Mix them, let it be taken with a stick of Licorice.
Take Oyl of sweet Almonds fresh drawn, Syrup of Maiden-hair, of each an Ounce and a half, Sugar Candy two Drams: Mix them by bruising them in a Glass Mortar, or shaking them in a Glass Vial till they grow white.
TAke Conserve of red Roses, two Ounces and a half, Lohoch Sanum an Ounce and a half, Species Diatragacanthi frigidi a Dram and a half, Flowers of Sulphur half a Dram, Syrup of Violets, or of red Poppies what suffices: Make a soft Lohoch; the Dose is a Dram and a half in the Evening, and early in the Morning; at other times let it be taken with a stick of Licorice.
Take Powder of the Leaves of Hedge-mustard, or of Rockets an Ounce and a half, Clarified Honey four Ounces: Mix them, make a Lohoch, give it after the same manner; it is proper in a cold Con∣stitution.
TAke Tincture of Sulphur free from any Empyreuma three Drams: The Dose is from six drops to ten at Night, and early in the Morning in a spoonful of Syrup of Violets, or of the Juice of ground Ivy. I know not a more excellent Remedy in any Cough, so there be no Feaver.
Take Tincture of Sulphur of Antimony two Drams: The Dose is twenty drops Evenings and Mornings in a spoonful of Pectoral Syrup.
Take Tincture of Gumm Ammoniacum prepar'd with the Tincture of Salt of Tartar an Ounce: The Dose is from fifteen drops to twenty. Tinctures of Galbanum, of Assa-faetida, of the Gum of Ivy, prepar'd after the same manner, are likewise proper in a cold Constitution.
TAke Opobalsamum two Drams: The Dose is from six Drops to ten, in a spoonful of the Water of Hyssop, or Pennyroyal, or of any other Pectoral Water.
Take Artificial distill'd Balsam, commonly call'd Mother of Balsam two Drams: The Dose is from six Drops to ten, in a spoonful of Sy∣rup of Violets, or of Canary Wine at Night, and in the Morning.
Take Balsam of Sulphur two Drams: The Dose is from five drops to ten after the same manner.
Take Balsam of Peru a Dram: The Dose is from two drops to four, or six, in Conserve of Violets.
TAke Species Diatragacanthi frigidi, half an Ounce, Licorice a Dram, Flowers of Sulphur two Scruples, Flowers of Benzoin a Scruple, Sugar Penids three Ounces, Solution of Tragacanth made in Hyssop water what suffices: Make a Paste, form it into Troches, weighing half a Dram; let one of them be taken pretty often in the Day or Night.
Take Seeds of white Poppies six Drams, Powder of red Poppy Flow∣ers a Dram, Extract of Licorice two Drams, Lac Sulphuris half a Dram, Sugar Penids two Ounces, Mucilage of the Seeds of Quinces what suffices: Make a Paste, and form it into Troches.
Take Species Diaireos, and of Fox Lungs, of each half an Ounce, Sugar Penids two Ounces, Solution of Tragacanth, what suffices: Make a Mass to be form'd into Troches.
Take Powders of Elecampane Roots, Anniseeds and Licorice, of each two Drams, Flowers of Sulphur a Dram, Tablet Sugar an Ounce and a half, Juice of Licorice diluted and strain'd, what suffices: Make a Mass for Troches.
TAke Species Diatragacanthi frigidi three Drams, Powder of red Poppy Flowers, Lac Sulphuris, of each half a Dram, Sugar dis∣solv'd in Poppy water, and boil'd to a consistency for Tablets four Ounces: Make Tablets weighing half a Dram.
Take Species Diaireos, and of Fox Lungs, of each three Drams, Flow∣ers of Sulphur, Elecampane Roots, of each half a Dram, White Benzoin a Dram: Make a fine Powder, and Oyl of Anniseeds a Scruple, Sugar dissolv'd, and boil'd to a consistency for Tablets eight Ounces: Make Tablets weighing half a Dram.
THese, though seldom, yet sometimes are given in a Cough and affects of the Lungs with good success.
Take of the Reddish tops of ground Ivy what suffices, being bruis'd let them be made into a Cake, and presently dry'd in the Sun, then re∣duce it into a fine Powder, and keep it in a Glass; this Plant retains its vertue, with its smell and colour excellently well for a long time, beyond all Conserves and Syrups, and is of wonderful efficacy in a great and obstinate Cough: Give from half a Dram, to a Dram twice a day, with a distill'd water, or Pectoral Decoction.
After the same manner, Powders are prepar'd of other Pectoral Plants, and are given with good success.
Take Cup-moss three Drams, Lac Sulphuris a Dram, Sugar-candy half a Dram: Make a Powder, the Dose is from a Scruple to half a Dram twice a day. This Powder is proper for those that are troubled with a Convulsive or Chin-Cough.
Take Flowers of Sulphur, Olibanum, Ceruse of Antimony, of each two Drams, divide it into twelve parts: Give one Mornings and Evenings in a spoonful of some fit Vehicle.
TAke Aloes Rosat. or rather Pilul. Ruffi, Flowers of Sulphur, of each a Dram and a half, Flowers of Benzoin a Scruple, Juice of Licorice diluted with water of Snails what suffices: Make a Mass, form it into little Pills; let four of them be taken at Night, repeat∣ing the Dose every Night, or every other Night.
Take Powder of Elecampane Roots, Licorice, and Flowers of Sul∣phur, of each a Dram, Flowers of Benzoin half a Dram, Tar what suffices: Make a Mass, and form it into small Pills; the Dose is three or four at Night, and early in the Morning.
Take Millipedes prepar'd two Drams, Powder of the Seeds of Nettles and Burdock-seeds, of each half a Dram, Oyl of Nutmegs drawn by distillation a Scruple, Salt of Amber half a Dram, Juice of Licorice what suffices: Make small Pills, let three of them be taken at Night, and in the Morning.
THese are taken either by themselves, or with Milk added to them: Among those of the first kind, the Pectoral Deco∣ction according to the London Dispensatory, first presents it self; which is to be taken twice a day, from four Ounces to six or eight.
Take Leaves of ground Ivy, Maiden-hair, Harts-Tongue, Colts∣foot, Agrimony, of each a handful, Roots of Chervil, Butchers-broom, of each an Ounce, Seeds of Carthamus and sweet Fennel, of each half an Ounce, boil them in six Pounds of fountain water, till half be consum'd, adding towards the end either of Licorice three Drams, Raisins ston'd two Ounces, and six Jujubes, or of the best Honey three Ounces: Make an Apozeme, Scumming off the Froth, and Clarifying it with the white of an Egg. The Dose is six Ounces warm twice or thrice a day.
Decoctions to be taken with Milk are us'd Mornings and E∣venings instead of a Breakfast and a Supper, according to the manner following.
Take great Daisie Flowers a handful, Snails cleans'd, in number three, Candied Eringo Roots half an Ounce, Barley three Drams, boil them in a Pound and a half of fountain water to a Pound: Take from six Ounces to eight warm, adding as much of Milk, and afterwards let the quantity of this be encreased by degrees.
After the same manner, let Cup-moss, also the Leaves of ground Ivy, St. John's-wort, and of other Pectorals be boild, and taken with Milk.
Decoctions of Woods frequently conduce very much to the Cure of an obstinate Cough, especially being taken constantly for some time instead of Beer, as an ordinary Drink.
Take Roots of Sarzaparilla four Ounces, of China two Ounces, red and white Saunders of each half an Ounce, shavings of Ivory and Hartshorn, of each three Drams: Let them infuse according to Art, and boil in eight Pounds of fountain water to four Pounds, adding to it of Licorice six Drams, Raisins ston'd an Ounce and a half: In a Phlegmatick or cold Constitution, add Raspings of Guaiacum.
EVery Man may make many and different Forms of these, as occasion requires, and according to the Constitution of the Patient they may choose sometimes Milk alone, sometimes Milk with some part of Wine, sometimes Ale, or Brunswick Beer: I shall give you a Specimen of these as follows.
Take Leaves of ground Ivy, Hyssop, Pennyroyal, of each four hand∣fulls, Snails half boil'd in their shells two Pounds, Nutmegs slic'd, in number six. All of them being small shred together, pour to them of new Milk eight Pounds: Distil them in common Organs, the Dose is three Ounces twice or thrice a day by it self, or with some other Me∣dicine: When its taken, let each Dose be sweeten'd with Sugar-Candy, or with Syrup of the Juice of ground Ivy.
In a Constitution that is not hot, especially if there be no fer∣vent heat of the Blood or Praecordia, to six or seven Pounds of Milk add of Canary Wine a Pound or two, and in a Phleg∣matick or Aged Body, instead of Milk, let the Menstruum be Ale or Brunswick Beer.
Moreover, in the Winter when Snails are not easily, or scarce at all to be gotten, the Lungs of a Lamb, or of a Wea∣ther may properly enough supply their place, and sometimes also those of a Calf half boil'd and slic'd very small; and let them be di∣still'd with the foresaid Ingredients, and added to a fit Menstruum in common Organs, or a Rose-still.
In this Classis, where its treated of a Cough not yet arrived to a Phthisick; we may aptly range the Convulsive, or suffoca∣ting Cough of Children, commonly called the Chin-Cough. This Disease chiefly assaults Children and Infants, and at certain times, viz. in the Spring especially and Fall, its usually Epidemical. The Diseased have frequent and very cruel fits of Coughing, in which the Organs of Respiration do not only greatly labour, but likewise being affected with Convulsions, variously interrupt, suspend, or pervert their Actions: But for the most part the Diaphragm be∣ing seiz'd with Convulsions by it self, or by the impuise of other parts, obstinately so continues for a very long space sometimes its Contraction, and sometimes its Dilatation, that Inspiration or Ex∣piration being hindred for a time, the Vital Breath can scarce be drawn at all; so that the Coughers cry out as though they were strangled, and their Countenance turns black through the Stag∣nation of the Blood: If haply those Organs being not so much seiz'd with Convulsions, they can Cough out freely, nevertheless
they are still fore'd to Cough with violence, and so long till theia strength fails them.
Though this Cough seldom kills, or proves very dangerous, yet it is very difficult to be Cur'd, and oftner ceases of it self as the year changes, then it is conquered by Medicines. The reason is, that we must not only in this, as in an ordinary Cough, alter the Blood, and derive its drossy Excrements from the Lungs to the habit of the Body, to be sent forth by transpiration, but we must likewise take care to correct the Nervous Juice, which in this case is vitiated with a Heterogeneous and Elastick matter which causes the Convulsive motions.
As to the Cure of this Disease, the method of Curing us'd in other Coughs seldom proves successful in this; whererore only Empirical Remedies are commonly Administred.
Amongst many Remedies of this kind, the two following are usually preferr'd before all others whatsoever, and are chiefly in use, viz. to give inwardly Cup-moss, and various preparations and compositions of it, and if there be need of and further Cure, the Child is to be put into some sudden fright. And if these things work not the desir'd effect, Ptisans, Syrups, Julapes, or Decoctions and other Pectorals are laid aside, and commonly all other Medicines are thrown by, expecting till the Disease either ends of it self in process of time, or be Cur'd by the succeeding change of the year.
Cup-moss, so commonly us'd amongst us against Coughs of Children, has an Astringent vertue, (as we find by its tast) and contains Particles of a smart nature, which denote a plenty of Volatile Spirits, whence we guess its use to be to fix the Blood, and to moderate the Fluxions of the Serum, and likewise by Vo∣latilising the Nervous Juice, to take away its Convulsive disposi∣tion: Its usually given in the form of a Powder, Decoction, and Syrup according to the following Forms.
Take Cup-moss Powdred a Dram, Sugar-Candy a Scruple: Mix them, divide it into three or four parts, take a Dose Evenings and Mornings, with a fit Vehicle.
Take of the said Moss two Drams, Lae Sulphuris two Scruples, Powder of Anniseeds a Scruple: Divide it into six parts, give them after the same manner.
Take of the said Moss Dram, boil it in a quantity of Milk suf∣ficient for one Dose; let the straining be taken Evening and Morn∣ing: For those with whom Milk does not agree, or to whom it does no good; let a decoction of it be prepar'd in fountain water, or Hyssop water, or any other Pectoral water, and let it be given to two or three Ounces twice a day, sweetning it with Sugar, or some proper Syrup.
Take of this Moss an Ounce, boil it in two Pounds of some Pectoral Water, till half be consum'd: To the straining, add of Sugar-Candy a Pound, and let it evaporate in a gentle Bath heat, to the consistency of a Syrup.
The other remedy commonly in use for the Cough of Children, is to put them into some sudden fright, as by setting them in a Binn when a Mill goes, &c. which sometimes Cures the Disense on a sudden; the reason of which doubtless consists in this, that the Animal Spirits being put to flights, and driven into new di∣stractions, quit their former disorders, and likewise that the Con∣vulsive matter is either dissipated by that perturbation, or driven into other Nerves, where it proves less offensive.
The Empirical Cure of this Disease being thus set forth, toge∣ther with the Remedies vulgarly us'd, and their Aetiologies at least probably explicated: I shall now set down a certain ratio∣nal method of Curing, and haply more efficacious against these sorts of Coughs of Children: Therefore in such a case, I usual∣ly prescribe according to the Forms following, and sometimes successively enough: And First, since we must begin with a Purge;
Take Syrup of Peach Flowers a spoonful, Hysterick water a Scruple: Mix them, let it be taken Cum Regimine.
Or, Take Calamelanos six Grains, Scammony sulphurated, Rosin of Jalup, of each three Grains: Make a Powder, give it in a little pulp of preserv'd Cherries to a Boy of six Years Old; and let the Dose be encreas'd, or lessen'd according to the Age: Let the Purge be repeated in six or seven days.
If the Patient (as it often happens) be prone to Vomit, take Oxy∣mel of Squills six Drams, Salt of Vitriol four Grains: Mix them, give it to a Child six Years Old, and according to this proportion, let a Dose be accommodated to others: I have known this kind of Vomit given every Morning for four or five days successively to have done well.
Blistering Plaisters are much us'd, and let them be apply'd sometimes to the Nape of the Neck, sometimes behind the Ears, sometimes to the Insides of the Arms near the Armpits, and as soon as the Sores in those places begin to heal, let others be rais'd elsewhere.
Instead of Beer, let the following Decoction be his ordinary drink.
Take China Roots and Ounce and a half, all the Saunders of each half an Ounce; shavings of Ivory and Hartshorn, of each three Drams: Let them infuse according to Art, and boil them in six Pounds of fountain water till half be consum'd, adding of Raisins ston'd an Ounce and a half, Licorice three Drams.
Take Spirit of Gum Guaiacum with Sal Armoniack a Dram, Syrup of Cup-moss three Ounces, Hysterick water an Ounce: The Dose is a little spoonful at Night, and Early in the Morning.
Or, Take Tincture of Sulphur two Drams: The Dose is three drops at Night, and early in the Morning in a spoonful of Syrup of Cup∣moss.
To some persons of a hot Constitution, and turning of a deep red, or rather black colour with Coughing, I have sometimes successfully ordered a Vein to be opened, or that two or three Ounces of Blood should be drawn from them by Leeches.
Take live Millepedes cleans'd two Ounces, Powder of Anniseeds a Dram, Nutmegs haif a Dram, double refin'd Sugar an Ounce: Being bruis'd together, pour to them of Hyssop water six Ounces, Magistral Snail water two Ounces: Stir them together a little with a Pestle, and express it storngly; the Dose is two or three spoonfuls twice a day.
Thus far of the Cough and its Cure, whilst it is only an en∣trance to a Consumption; now we must treat of this affect, having pass'd the frontiers of this dangerous Disease, and set down a me∣thod of Cure, and forms of Medicines proper for Curing an Inve∣terate Cough, viz. when either neglected, or not easily yielding to Medicines, it begins to degenerate into a Phthisick, that is to say, when it is come to that pass; that the Blood being loosn'd in its Texture, does not only pour the superfluous Serum, but even the Nutritive, and haply the Nervous Juice, the Lympha, and other its dreggy Excrements on the Lungs, and deposes them within its Ductus's; and withal, that the depravation of the Lungs is by so much augmented, that its Vesiculae being distended, or many of them broken into one, and so a Solution of Continui∣ty, or an Ulcer being caus'd, a greater Mass of Matter for the Consumption is daily heap'd together: Moreover, and that the matter, in regard it is permitted to continue long there, Putrisies, and so still corrupts the Lungs more, and taints the Blood passing through them. In this case the Therapeutick Indieations are chiefly these three, viz. First of all to stop the dissolution or the Blood, which is the Root of all the mischief, and to prevent it from pouring always matter in so great a plenty on the Lungs. Secondly, To evacuate by Expectoration the corruption gather d together within the Lungs, and that sufficiently in some short time. Thirdly, To corroborate and dry the Lungs being dis∣solv'd as to their unity, or become too lax and moist, or other∣wise weak, lest they are daily more corrupted, and receive the Morbifick matter always more and more. Each of these Indica∣tions prompts us various intentions of Curing, and requires divers sorts of Remedies, and many ways of Administration; of which I shall here briefly touch the chief.
Therefore what the first Indication suggests, to wit, to stop the dissolution of the Blood, these three things (as much as may be) must be procur'd, viz. First, that the Mass of Blood may contain within it, and assimilate whatever Nutritive Juice it is supply'd with, and be so proportion'd with it, that it be not faulty either in quantity or quality. Secondly, That the Acidities engendred either in the Blood, or convey'd to it from elsewhere be so de∣stroy'd, that the Blood retaining always its Mixture or Crasis, be not so subject to Fluxions or Fusions. Thirdly, That all dreggy Excrements in the Blood be deriv'd from the Lungs to other E∣munctories, and places of Evacuation.
As to the first of these intentions of Curing, that the Nutritive Juice be proportion'd to the Blood, before all things it must be ordered that Persons troubled with a Cough and Phthisick, abstain as much as may be from Drink, and take liquid things but in a very small quantity, so that the Blood being weak in its Crasis, may be able more easily to subdue the minute Portions of fresh Juice, as long as it is not too much cloy'd with it, and to retain it within its Texture. Again, let that fresh Juice consist of such Particles as are subtle and gentle, that they may be ma∣stered by the Blood, and be assimilated without any eager heat of contest: Wherefore Asses milk, sometimes also Cows Mild, or Goats Milk; also Water-gruel, Cream of Barley, Ptisan, Almond Milks, and other simple sorts of food agree better, and nourish more than Flesh, Eggs, or Gelly-broaths, strong Ale, Wine, or any other kind of richer Fare. Secondly, That the Blood retain∣ing its temperament, be not easily dissolv'd into Serosities offend∣ing the Lungs; as well its own Acidities, as those of the other humours that are mixt with it, and especially of the Nervous and Lymphick humours must be destroy'd: Which intention is excel∣lently perform'd by Medicines prepar'd of Sulphur, which there∣fore in this case (so there be not a Hectick Feaver) are frequently given, and in a large Proportion. Wherefore let the Tincture, Balsam, Syrup, Flowers, and Milk of Sulphur be given twice or thrice a day in a good large Dose; for the same purpose Traumatick or Vulnerary Decoctions, also Decoctions of Pectoral Herbs (com∣monly so call'd) and Roots are to be taken instead of ordinary drink: Moreover, Powder of Crabs Eyes, of Millepedes, and of other things containing an Alkalisate or Volatile Salt, are often given with good success. The Third intention of Curing, refer∣ring to the First Indication, viz. That the dreggy Excrements of the depraved Blood, (in case they much abound) be withdrawn from the Lungs, and Voided by other Emunctories, suggests to us many ways to be put in practise for withdrawing them; For besides Bleeding, Evacuation by Urine, and now and then a gentle
Purge (which have place in all Coughs, even in a beginning Phthisick) we ought also to range here Baths, Breathing in a warm Air to promote perspiration, also frictions of the extream parts, Dropax's, Issues, Vesicatories, shaving the Head, Errhin's, Apophlegmatisms, and all other general or particular ways of E∣vacuating humours or vapours.
The Seeond Indication in a beginning Phthisick, viz. that the corrupted matter depos'd within the Lungs, be every day readily and clearly discharg'd, is perform'd with expectora∣ting Medicines: These are said to operate in a two-fold man∣ner, according as their vertue is conveyed to the Lungs two ways. For some of them taken by the mouth, immediately send their active Particles into the Trachea, which partly by making the passages slippery, and by loosening at the same time the matter there sticking, and partly by irritating the Excretory Fibres into Convulsions, cause an Expectoration: In which number Linctus's and Fumigations are esteem'd the chief. Expectorating Remedies of the other kind, which are justly e∣steem'd the best, exert their Energy by the conveyance of the Blood, for consistion of such Particles which cannot be subdued and assimilated by the Mass of Blood, when they enter it, being immiscible with it, they are presently cast forth again, and pe∣netrate from the Arteries of the Lungs into the Ductus's of the Trachea, where cleaving to the matter, they divide, attenuate, and so exagitate it, that the Fibres being thereby irritated, and successively contracted in Coughing, the Contents of the Trachea, and of its Vesiculae are thrown up into the mouth. Medicines proper for this use besides Sulphur and preparations of it, are Ar∣tificial Balsams distill'd with Oyl of Turpentine, Tinctures and Syrups of Gumm Ammoniacum, Galbanum, Assa-faetida, Garlick, Leeks, and the like strong smelling things; of which also Lo∣hoch's and Eclegma's are prepar'd, and these indeed work both ways, so that partly by slipping down into the Trachea, and part∣ly by entring the Lungs by the Circuit of the Blood, they set up∣on the Morbifick matter both before and behind, and so throw it forth with the greater force.
As to the Third Indication, viz. That the injur'd Conformati∣on, or vitiated constitution of the Lungs may be restor'd or a∣mended; such things must be us'd which resisting putrefaction, mundify, consolidate, dry and corroborate; for which ends also Medicines prepar'd of Sulphur, Balsamicks, and Traumaticks are proper: Hence some Empiricks successfully preseribe not only the fume of Sulphur, but likewise of Arsenick to be drawn through a Pipe or Funnel into the Lungs, Moreover for this reason it is, that the change of Habitation, as from Cities to a Country or
Sulphureous Air, or travelling from one Country into another hotter, proves so notably beneficial.
So far of the method of Cure which seems to be proper for a deeper Cough, or a beginning Phthisick: Now we must set down some Select Forms of Medicines according to each of those Therapeutick Indications, which also according to the way us'd in a gentle Cough, free from a Phthisick, we shall distribute into certain Classes, and those are Mixtures, Linctus's, Lohoch's, Tin∣ctures, Balsams, Troches, Lozenges, Powders, Pills, Decoctions, and distill'd Waters: We shall set before you some Examples of each of these, to which also may be added some of the forms of the Medicines prescrib'd before for a beginning Cough, and not yet arriv'd to a Phthisick.
TAke of our Syrup of Diasulphur three Ounces, Water of Earth∣worms an Ounce, Tincture of Saffron two Drams: Mix them, take a spoonful going to Bed, and early in the Mornign.
Take Syrup of the Juice of Ivy three Ounces, Snail water an Ounce, Flowers of Suslphur a Dram: Mix them by shaking them together, the Dose is a spoonful Evenings and Mornings.
Take Tincture of Sulphur two Drams, Laudanum Tartariz'd a Dram, Syrup of the Juice of Ivy two Ounces, Cinnamon water two Drams: The Dose is a spoonful at Bed time, and if the Person does not sleep, towards Morning.
The Syrup of Diasulphur. TAke Sulphur prepar'd after our manner, half an Ounce, the best Canary Wine two pounds: Make a close digestion in B. M. or in Sand for twenty eight hours: Which being done, take double refin'd Su∣gar two pounds, dissolve it and boil it to a consistency for Tablets in a little Water of Elder Flowers; then pour to this by little and little the Wine ting'd with the Sulphur whilst warm; let it boil a little on the fire, scumming it, and strain it through Woollen. You will have a mest delicate Syrup of a Gold colour, and of great efficacy against the Cough and other affects of the Lungs (so there be no bayling heat of the Praecordia, nor Hectick Feaver) the Dose is a spoonful Evenings and Mornings by it self, or with other Pectorals.
Syrup of Garlick. TAke Cloves of Garlick Pill'd, and out in slices, in number ten or twelve, Anniseeds bruis'd, half an Ounce, Elecampane Roots slic'd three Drams, Licorice two Drams; let them have a close and warm digestion, for two or three days in a pound and a half of spirit of Wine, put the clear and warm straining into a silver-dish; add of double refin'd Sugar a Pound and a half; the Dish being put on hot Coals, let the liquor be set on fire, and whilst it burns stir it; sirain it through Woollen, and keep it for use.
Syrup of Turnips. TAke Turnips slic'd, and double refin'd Sugar, of each half a pound; put them in a glaz d Pot, a lay of Turnips, and a lay of Sugar till it be full: Let the Pot, being cover'd with Paper, be put into an Oven to Bake with Bread; when it is taken out, press forth the Li∣quor, and keep it for use: The Dose is a spoonful Mornings and E∣venings.
Syrup of Snails. TAke fresh Snails with their shells, in number Forty; cleanse them with a Linnen Cloath, then each of them being run through with a Bodkin; let the Apertures of the shells be fill d with Powder of Sugar Candy, and being put in a Linnen Bag, let them be hung up in a Cellar, and let a Glass Vessel be set under them to receive the Syrup which will drop from them: The Dose of this is a spoonful twice or thrice a day in a fit Vehicle, viz. Aqua lactis, or some Pe∣ctoral Decoction.
2.3. Linctus's and Eclegma's. TAke Conserve of red Roses three Ounces, Tincture of our Sulphur two Drams: Mix them by stirring them in a Glass Mortar; the Dose is the quanticy of a Nutmeg at Night, and early in the
Morning: Sometimes to allay a troublesome Cough, you may add to this of Olibanum half a Dram, or a Dram.
Take Conserve of red Roses four Ounces, Flowers of Sulphur four Scruples, fine Oyl of Turpentine a Dram, Species of Fox Lungs three Drans, Syrup of the Juice of ground Ivy what suffices: Make a soft Lohoch to be taken after the same manner, viz. Mornings and Even∣ings; also to be suck'd at other times with a stick of Licorice.
Take Powder of Sugar Candy four Drams, Tincture of Sulphur two Drams: Mix them by stirring them in a Glass Mortar; let it be taken after the same manner.
Instead of the Tincture of Sulphur, you may put other Balsa∣mick Tinctures, as of Balsam of Peru, of Opobalsamum, of the Gum of Ivy, Guaiacum, Amber, with many others, which may be mixt either in Conserve of red Roses, or with Conserve of the Flowers of Colts-foot, or with Sugar Candy.
4.5. Tinctures and Balsams of the same nature and composi∣tion as we have preserib'd before in a beginning Cough, are pro∣per in a Phthisick, only the Dose must be a little larger.
Take of Tar an Ounce, Water of quick Lime thrice Cohobated, two pounds, distil them in Balneo to half: Then let the filtrated Liquor be drawn off in Balneo to the consistency of honey; to which pour Tin∣cture of Salt of Tartar half a pound: Let it digest in a close Glass to extract the Tincture: The Dose is from twenty drops to thirty, with a proper Vehicle. After the like manner a Tincture in gotten out of the black Oyl of Soot, Liquid Amber, Liquid Storax, and many other things.
Take of our Sulphur prepar'd with the addition of Myrrh, Aloes, and Olibanum in a subtriple quantity an Ounce: Let a Tincture be drawn off with Oyl of Turpentine, also with Rectified Spirit of Wine: The Dose of this is from fifteen drops to twenty.
6.7.8. Troches, Tablets, and Powders, because chiefly direct∣ed for the Cough, are in a manner of the same Nature and Com∣position with those before prescrib'd for that affect, when new taken; only that for drying and consolidating the Lungs Sul∣phureous and Traumatick ingredients are requir'd in a greater proportion.
Take Powder of the Leaves of ground Ivy a Dram, Flowers of Sul∣phur two Drams, Sugar Penids a Dram and a half, Juice of Licorice diluted with Hyssop-water, what suffices: Make Troches weighing half a Dram.
Take Powder of Yarrow bruis'd, and dry'd in the hot Sun, half a Dram, Flowers of Sulphur, Olibanum powdred, of each a Dram, Pow∣der of red Roses dry'd, half a Dram, Sugar dissolv'd, and boil'd to a
consistency for Tablets six Drams, Oyl of Anniseeds a Scruple: Make Tablets weighing half a Dram. Take one thrice, or oftner in a day, and especially at night, and early in the morning.
9. Pills. TAke Juice of ground Ivy Clarified in the Sun a pound, Flowers of Colts-foot dry'd, tops of Hyssop, Sage, Penny-royal, of each a handful, Anniseeds, Carraway-seeds, sweet Fennel-seeds bruis'd, of each half an Ounce; distill them in Balneo Mariae to half, then strain it, and distill the straining to the consistency of Pills, adding Juice of Li∣corice half a Dram, Powder of Elecampane Roots, Flowers of Sulphur, of each three Drams, Flowers of Benzoin a Dram, Balsam of Peru, half a Dram, Tincture of Sulphur three Drams, Laudanum Tartariz'd two Drams: Make a Mass, form it into small Pills, and take three or four at night, and early in the Morning.
10. Decoctions, such as we have before prescrib'd for an ob∣stinate Cough, may be also properly taken in a beginning Phthi∣sick. In desperate Cases I have sometimes very successfully pre∣scrib'd the following Decoction to be taken twice or thrice a day, and also instead of ordinary drink.
Take Guaiacum four Ounces, China, Sassafras, of each two Ounces, all the Saunders, of each an Ounce, shavings of Ivory and Hartshorn, of each three Drams: Let them infuse, and boil them in twelve pounds of fountain water to half, adding Licorice an Ounce, Raisins ston'd four Ounces; strain it.
11. Distill'd Waters such as before prescrib'd, are also proper here, to which may be added the Water of Solenander drawn from Hogs Blood with Turpentine; also Balsamick Waters distill'd from Turpentine with Pectoral Ingredients.
Take Leaves of ground Ivy, white Horehound, Hyssop and Penny∣royal, of each three handfuls, Roots of Elecampane and Florentine Orice, of each two Ounces, Turpentine dissolv'd with Oyl of Tartar four Ounces, Hyssop-water four pounds, Malaga-wine two pounds, di∣stil them in Sand; let all the Liquor be mixt, the Oyl being separa∣ted: The Dose is two or three spoonfuls twice a day, with a spoonful of the Syrup of the Juice of Ivy.
12. In the last place, We must here prescribe Forms of Va∣pours and Fumes, the use of which sometimes does more good in a Phthisick, not past recovery than any other Remedies; and
this because they go to the Lungs it self, and so by an immedi∣ate operation, Purge it, dry it, free it from Putrefaction, strength∣en it, and open its Ductus's.
First, Therefore let a moist steam be made after this man∣ner.
Take Leaves of Hyssop, ground Ivy, whit Hore-hound, of each two handfuls, Elecampane Roots two Ounces, Calamus Aromaticus, half an Ounce, Anniseeds, Caraway-seeds, of each an Ounce, being slic'd and bruis d, boil them in a sufficient quantity of fountain water: Let the Vapour of the hot strain'd Liquor be drawn into the Lungs through the hole of a Paper roul'd up Conically, or in the Jhape of a Funnel, use it Mornings and Evenings for a quarter of an hour.
2. A fumigation or dry Vapour is usually made one while more gentle of meer Balsamicks, another while more strong of Sulphu∣reous, and sometimes Arsenical substances.
Take Olibanum, white Amber, Benzoin of each two Drams, Gum Guaiacum, Balsam of Tolu, of each a Dram and a half, Powder of red Roses, red Saunders, of each a Dram: Make a Powder to be strew'd on burning Coals.
Take Gum of Ivy, Frankincense, of each two Drams, Flowers of Sulphur a Dram and a half, Mastick a Dram; with a Solution of Gum Tragacanth, make Trothes.
Take white Amber, Olibanum, of each two Drams, Auripigment prepar'd, half an Ounce, Storax Calamita, Laudanum of each a Dram and a half, with a sufficient quantity of the Solution of Gum Tragacanth: Make Troches for fumigation.
Empiricks ordinarily prescribe the smoak of Auripigment to be taken in a Pipe lighted, like Tobacco, and that sometimes with good success. Moreover its a practise with the vulgar to take bits of Cloth Painted with Auripigment (such as serves for Hang∣ings in Taverns) and shredding them very small to kindle them in a Pipe like Tobacco, and so to draw the smoak into the Con∣sumptive Lungs for a Cure.
Now in the last place it remains for us to speak of the great confirm'd Phthisick which is commonly past Cure, and to advise what is to be done when the Lungs being very much vitiated and affected with one or more filthy Ulcers do not convey the Air and Blood according to their due Course, but defile, or cor∣rupt the Mass of the latter, by Ministring to it continually a stook of Putrified matter, so that a Hectick Feaver, and an Atrophia through want of nourishment seize the Diseas'd with a great de∣cay of all their faculties, and daily impairing their strength, preci∣pitate them to the Grave: The most certain sign generally ac∣knowledged of this Disease growing so desperate, is a very trouble∣some
pain, with an Inflammation in the Throat, for this affect argues a great Putrefaction of the Lungs, whence the corrupted Effluvia's exhaling, stick against the narrow passage of the Throat and there pierce, and vehemently irritate the tender Fibres in that part: In this case its in vain to attempt to Mundify the Lungs, and to cleanse the Ulcer, and dry it; for all hot Medicines de∣signed for those ends, and proper enough in a beginning Phthi∣sick, are not to be endur'd when its confirm'd; because augmen∣ting the Inflammation of the Lungs they increase the Hectick Feaver, the Thirst, Watchings, and other very troublesome Sym∣ptoms, or stir them up a fresh: And indeed in such a state of this Disease, when we only propose to our selves to protract Life by helping towards a well-bearing of the Distemper, and to an easie death, those Remedies are of chiefest use that moderate the fer∣vour of the Blood, allay the heat of the Praecordia, restore the Spirits, and gently cherish them: Hence for Food, Asses Milk, also Water-gruel, Barly-Broaths, Cream of Barley; and for Drink, Pti∣sans, Emulsions, Milk, Water distill'd with Snails and temperate Pectorals are usually of greatest success. Let Syrups and Linctus's which lenify the Inflammation of the Throat and Lungs, and fa∣cilitate expectoration, be often or daily given, but especially gentle Hypnoticks to procure a moderate rest: I shall now give you some of the more Select Forms of each kind.
Take Barly half an Ounce, Candied Eringo Roots six Drams, pa∣rings of Apples a handful, Raisins ston'd two Ounces, Licorice three Drams, boil them in three Pounds of fountain water or two: Make a Ptisan to quench thirst; let it be taken three or four times a day, and if it agrees, let it be used instead of ordinary drink.
Take twenty Caudae Gammorum, Candied Eringo Roots an Ounce, a Crust of White-bread, Raisins ston'd two Ounces, Licorice three Drams; boil them in three pounds of running Water, to two pounds: Strain it, take three or four Ounces thrice a day; after the same man∣ner you may make a Decoction of Snails.
Take Snails half boil'd and slic'd three pounds, Leaves of ground Ivy six handfuls, Nutmegs slic'd, in number six, Pith of White-bread two pounds, Milk from the Cow eight pounds, distil it in an ordinary still. After the same manner you may distil a Water è Caudis Gammorum: The Dose is three or four Ounces thrice a day, sweetning it with Saccharum Perlatum, or Sugar of Roses.
Take Ears of green Wheat what suffices, distil them in a Rose Still: Let the Person drink three or four Ounces thrice a day, sweetning it, with Saccharum Perlatum.
Take Syrup of Meconium three Ounces, Water of green Wheat six Ounces: Mix them, let two or three spoonfuls be taken going to Bed every Night, or every other Night.
Take Conserve of the Flowers of Wild or Garden Mallows three Ounces, Lohoch de Pino two Ounces, Syrup of Jujubes two Ounces: Make a Lohoch, of which let a Dram and a half, or two Drams be often taken.
I shall now give Instances of some Patients which I have had in Cure in the foregoing Distempers: And First, of one troubled with a simple Cough, which begins of it self, and is free from the suspicion of a Phthisick.
Some years since I took care of the Health of a Student, who from his Childhood had been subject to a Cough, and was wont often to undergo severe fits of it, and of long continuance; he seem'd to be of a pretty strong Constitution, only that his lungs, being originally weak, suffer'd much whenever his blood began to run into serosities; in summer, as long as a free perspiration lasted he was sound enough, but spring and fall, when the blood changing its temper, either of its own accord or upon some slight occasion offer'd falls into serous fluxions, he fell lightly into a Cough accompanied with abundance of thick spittle; yet this affect very often vanisht by degrees within six or seven days, without any great adoe with Medicines, assoon as the mass of blood was purg'd by the lungs: But if to the said slight occasion of this Disease other greater Causes were added, as chiefly the stoppage of the Pores, and errours in Diet, sometimes a most violent and obstinate Cough came upon him, not soon, nor easily yielding to Remedies, and threatning nothing less than a Phthi∣sick: Then growing ill indeed, for the first days he had light shi∣verings in his whole Body, and perceiv'd a Catarrh in his La∣rynx: Afterwards he was troubled with a frequent Coughing, ac∣companied with a thin spittle, together with a giddiness, deadness of the senses, and a dropping at the Nose.
In this state his best Remedy, and often try'd with good success was to drink Sack somewhat freely, and as little of any other Li∣quor as might be; for by this means the Acidity and flowing of his Blood being supprest, and a more free perspiration rais'd, he sound himself very much eas'd, and sometimes in a very short space grew well: Moreover going to Bed, and first in the Morn∣ing he us'd to take seven or eight drops of Tincture of Sulphur in a spoonful of Syrup of Violets, or of the Juice of ground Ivy, Or,
Take Conserve of red Roses four Ounces, Spirit of Turpentine two Drams: Mix them, the Dose is the quantity of a Chesnut Evenings and Mornings.
But if these Remedies, together with the Canary Antidote, and a thin Diet do not do, the Disease not being Cur'd by such means, runs then to a great length, and following him sharply for some
Weeks, and sometimes Months, brings the Diseas'd to a mighty leanness, and even to the brink of the Grave: For the Cough growing daily worse and very troublesome, hinders sleep mighti∣ly, and interrupts it, his strength languishes, his appetite is deje∣cted, heat and drought press hard upon him: In the mean time the Spittle is daily increas'd, and cast forth in a vast quantity; so that afterwards not only the Serum and dreggy Excrements of the Blood, but even the nutritive Juice, and the wastings of the solid parts being continually pour'd on the Lungs, turn into cor∣ruption, which is Cough'd forth in abundance; but respiration grows difficult, the Limbs very weak, and the Flesh consumes ve∣ry much.
When our Patient was lately ill in this manner, we prescrib'd the following Method and Remedies, by the continued use of which he at length recovered: In the first place a thin Diet being ordered him, and Ale or Beer wholly forbidden, he took of the following Apozeme about four Ounces twice a day warm, and a little of it at other times cold, to quench his thirst.
Take China Roots two Ounces, Sarzaparilla three Ounces, white and yellow Saunders, of each an Ounce, shavings of Ivory and Hartshorn, of each three Drams: Infuse them according to Art, and let them boil in eight pounds of fountain water to half, adding Raisins of the Sun three Ounces, Licorice three Drams: Strain it, and let it be us'd for ordinary drink.
Take Tincture of Sulphur three Drams: Let him take from seven drops to ten going to rest, and early in the Morning in a spoonful of Syrup of Violets, or of Syrup of the Juice of ground Ivy.
When by a long use of this Medicine he began to loath it, the following Eclegma was ordered in its stead.
Take Conserve of red Roses four Ounces, Spirit of Turpentine two Ounces: Mix them by bruising them together, the Dose is about a Dram at the same hours.
Afterwards instead of this, the following Powder was sometimes taken.
Take Powder of the Leaves of ground Ivy prepar'd in the Summer Sun three Ounces, Sugar Candy half an Ounce: Mix them, the Dose is half a spoonful twice a day, with three Ounces of the following distill'd water.
Take Leaves of ground Ivy six handfuls, Hyssop, white Hore-hound, of each four handfuls, the Lungs of a Lamb half boil'd and slic'd small; pour to them of Posset-drink made with small Ale eight pounds, distil it in common Organs: Let the whole Liquor be mingled, and when it is us'd, sweeten it at pleasure with Sugar Candy, or Syrup of Violets.
To appease the almost continual toyl of Coughing, he swallow∣ed now and then the following Troches, or a little extract of Li∣corice.
Take Species Diatragacanthi frigidi three Drams, Powder of the Seeds of Annise, Caraway, and sweet Fennel, of each half a Dram, Flowers of Sulphur two Scruples, Flowers of Benzoin a Scruple, extract of Licorice diluted with Hyssop water what suffices: Make a Paste, and form it into Troches. Or,
Take Species Diaireos, è Pulmone Vulpis, of each two Drams, Flowers of Sulphur, Roots of Elecampane, of each half a Dram, Oyl of Anniseeds half a Scruple, Sugar dissolv'd in a sufficient quantity of Pennyroyal water, and boil'd to a consistency for Tablets six Ounces: Make Tablets according to art, weighing half a Dram; let him take one as often as he pleases, swallowing it by little and little.
In the midst of this Course, though he had a weak Pulse, and was of a cold temperament, he was let Blood in the Arm: Be∣sides these Remedies, a great benefit accrued to him from the fresh Air, which he took daily either on Horseback, or in a Chariot. For by this, he first began to recover his Appe∣tite, Digestion, and Sleep, which afterwards were followed by degrees with an abatement of the other Symptoms, so that at length he perfectly recover'd: He has us'd a method like to this, and with the like success, as often as till this time he has been troubled with a tedious and stubborn Cough; and now though he be wholly free from that distemper, yet he is forc'd carefully to avoid all occasions by which the Pores are stop'd; or, by which a Fusion or Precipitation of the Blood into Serosities is rais'd, such are chiefly his going by Water on the Thames, and his drink∣ing Acid Liquors, as Cider, French, or Rhenish Wines.
The foregoing Relation gives you a Type, and way of Curing a Cough, caus'd through the fault of the Blood, and not reaching the limits of a Phthisick: Now follows another which Illustrates the nature of the same affect, when it proceeds chiefly from the Nervous Liquor.
A Boy about ten years of Age, subject from his Infancy to be often troubled with a Cough, has undergone of late years some great and tedious fits of that Distemper, that is to say, he is wont at times to fall ill of a hollow and shrill sounding Cough without Spitting, which almost continually toyls him Day and Night, and so tormenting him for many Days, nay and Weeks, it brings him to a very great weakness: Afterwards the Course of the Disease being pass'd over, (which happens not till the store of Morbid matter be consum'd) in a short time he becomes well enough again, and as free as may be from any Distemper of the Thorax, till the Morbifick matter (as it seems) being heap'd to∣gether
again to a fullness, without any evident cause the same af∣fect returns, and acts over its Tragedy again with its wonted se∣verity: About the time it first seizes, the Cough usually troubles him only Mornings and Evenings; afterwards the Distemper grow∣ing worse by degrees, he often Coughs whole Days and Nights al∣most without ceasing, and if at any time Sleep either happening of it self, or being procur'd by Anodines, gives some truce, pre∣sently upon his waking, a more violent fit of Coughing comes up∣on him: After this manner Coughing very frequently and most vehemently without Spitting he continues ill for three Weeks or a Month, till he be brought to a mighty leanness, and an extream weakness; and then the Distemper remits by degrees, so that he Coughs somewhat more seldom, and Sleeps indifferently, shortly afterwards growing very hungry, he soon becomes full of Flesh, and vigorous, and recovers in a short time his former Health. These fits seldom trouble him in the Summer, but in the rest of the year they return sometimes three or four times, and put the Patient in great danger of his Life. The cause of this Distemper is not the same as of a vulgar Cough, in which a Serous humour distilling either slowly, or in a plentiful manner from the Vessels of the Trachaea, or of the Lungs into the Vesiculae or little Pipes of the Trachea induce the Symptoms that attend that affect; for it plainly appears that in this the Ductus's of the Aspera Arteria are wholly free from any Serum or thick humour, because the Cough which is always deep and sonorous, throws forth nothing: Nor does this Cough arise from the Blood forc'd into the Mem∣branes of the Lungs, because in this there is no Feaver, Thirst, nor Pain, as in a Peripneumonia; neither does its Morbifick mat∣ter seem to stick to the Nerves or Muscles ordain'd for breathing, because then besides the Cough, Asthmatick or Convulsive fits, with a sense of choaking would sometimes follow, which do not happen to our Patient.
I guess therefore that a certain Serous and sharp matter, full of a Scorbutick taint, falling from the Head by the conveyance of the Nerves, enters the Nervous Fibres and Membranes of the Lungs, or of the Trachaea, and throughly cleaving to them, in∣creases by degrees to a fulness, and at length growing angry and turgid, through its perpetual irritation creates so troublesome a Cough.
When this affect once seizes, it is wont to hold on its Course for a very long time, in despite of all Remedies: Pectoral Medi∣cines commonly so called, as Syrups, Linctus's, Eclegma's did little or nothing towards the Cure of this Disease, though some∣times I have thought good to use them for making the Lungs slippery, and to moisten them, lest hap'ly they should be endange∣red
to be torn asunder, by the violence of the Cough, and their Vessels to be broken; for sometimes in a violent fit, our Patient used to Cough forth a little Blood, though no thick Spittle.
A gentle Purge in the beginning of this Disease has often done good, as also in its declination. Opening and Diuretick Medi∣cines always work a good effect, of both which he uses what suffices throughout the whole Course of his Distemper, for his or∣dinary drink. Evenings and Mornings he takes some drops of the Tincture of Sulphur, with the Water of Snails lacteated: I was forc'd sometimes to give late at Night a Dose of the mix∣ture of Diacodium, or of Liquid Laudanum: In two of his fits he was Blooded, from which he receiv'd no good.
In the last fit, which beginning about the Autumnal Equinox, pass'd over somewhat more lightly and gently, the following method of Cure was observ'd.
First of all, this Cathartick was given him, and repeated after four days.
Take Calamelanos half a Scruple, Rosin of Jalup four Grains: Mix them, make a Powder, let it be taken in a spoonful of Syrup of Vio∣lets.
Take China Roots slic'd a Dram, Grass Roots three Ounces, Chervil Roots an Ounce, Candied Eringo's six Drams, shavings of Ivory and Hartshorn, of each three Drams, Raisins of the Sun ston'd, three Ounces: Boil it in three pounds of fountain water, to two pounds, strain it, and let it be us'd for ordinary drink.
Take Syrup of Jujubes two Ounces, Diacodium an Ounce, Spirit of Sal Armoniack with Gum Ammoniacum a Dram: Mix them, the Dose is a spoonful going to Bed, and early in the Morning: He was much reliev'd by this Remedy, though he took it only every other, or every third day; and sometimes in its stead, a Dose of the Tincture of Sulphur, with Syrup of Violets was given him.
The Disease declining, he was purg'd twice, and afterwards recovering by degrees, he grew well enough within a fortnight: But finding him subject not only to frequent relapses of Cough∣ing, but that each fit when it came upon him was irresistible, and that its stay notwithstanding any use of Remedies was of long continuance, and threatned nothing less than a Consumpti∣on: I advis'd him that as well for preservation, and in case the affect return'd, as for Curing it, he should Travel to a Region hotter than ours. He took my advice, and about the beginning of November went to Montpellier, where passing half a year, he had only two slight touches of illness: Since being return'd to England, he enjoys, thanks be to God, a perfect Health, quite free from his Cough.
THe Indications for Curing a Spitting Blood, are chiefly these two, viz. First, presently to moderate and stay the Flux of Blood: And then in the Second place to heal the dissolution of Unity, without leaving a Consumptive Putrefaction in the Lungs.
In reference to the First, These two things are chiefly to be procur'd: First, That the Blood do not flow to the part affe∣cted: Secondly, That withal the Aperture of the Vessel be some way clos'd.
1. To keep the Blood from flowing to the part affected, ma∣ny intentions of Curing must be set upon together, viz. We must lessen the quantity of Blood, moderate its fervent boiling, alter its ill temper, retard its motion, or divert it another way: For which ends Blooding, Ligatures and Frictions most commonly do well. Moreover, Julapes, Decoctions, Emulsions, and Juicy expressions of Herbs ought to be given, and likewise moderate Hypnoticks; especially Diacodiats are taken with good success: For these by putting a stay to the motion of the Heart, allay the fervour of the Blood.
2. To close the Aperture of the Vessel, Astringent Remedies, and Agglutinatives are most proper: The chief of these are usu∣ally given in the Form of a Linctus, so that some of its Particles in swallowing, falling on the Aspera Arteria may more immedi∣ately communicate their vertue to the part affected. But the way of this Operation seems to be of no great moment, because the Efficacy of the Medicines reaches chiefly, and in a manner only by the way of the Blood to the Root of the Disease: Where∣fore not only Lohoch's, but likewise Decoctions, Powders and Pills of Traumatick, and Balsamick Ingredients are successfully prescrib'd.
The Second Indication, which is for preservation, having re∣gard to the Cure of the dissolution of Unity, without leaving a∣ny blemish in the Lungs, ought to provide against two sorts of evils, viz. That the Spitting Blood (to which the Persons affe∣cted will be always subject) does not return at times; and that
the Consumption, which threatens all those that Spit Blood, does not follow it: For which ends in order to the prevention of this Disease, we must take an assiduous care of, or use a constant method of Cure to the Blood and Lungs.
1. As to the Blood, its Mass ought always to be kept in a due quantity, a just temper, and a gentle and continued motion: Hence lest it abound too much, or being affected with an evil temperament, grows turgid, or deposes impure dregs in the Brest, we must sometimes use Bleeding, and a gentle Purge; an exact Form of Diet is always necessary. Moreover, drinking of Asses Milk, or of Mineral Waters contribute sometimes egregiously to the purifying and sweetning of the Blood.
Again, Decoctions, Distill'd Waters, Juices of Herbs, which take away the Dyscrasies of the Blood, and derive the Serum and other Impurities from the Lungs, and carry them forth by Sweat or Urine, must be diligently taken: Issues also mightily conduce for this end.
2. Nor must less care be taken of the Lungs themselves, that their whole frame, and especially the place affected, be preserv'd in a due Conformation, and right Tone: Hence all violent moti∣on, by which Unity is farther dissolv'd, or its restauration hin∣dred, is carefully to be avoided. Let the Person live in a clear and brisk Air, though it must not be too sharp and piercing. Let him abstain from gross Food, long Sleeps, large Suppers, and o∣ther errours in Diet, which cause a Repletion, or Obstruction in the Praecordia: Besides this, let Remedies be us'd, which are said to Cure the Lungs, by a peculiar or certain Specifick Ver∣tue.
Having given you the method of Curing Blood Spitting, I shall now set down some Select Forms of Medicines, answering to each of the Therapeutick Indications, and to the various intentions of Curing that belong to them: And we justly give the precedency to those which encountring the most urgent Symptome, pre∣sently stop the flowing forth of Blood, cast out of the Lungs by a Cough, or otherwise: In the First rank of these Medicines, we place those which hinder the Blood from flowing to the part af∣fected, and have a certain Astringency, together with an Agglu∣tinative Vertue, by which the Aperture of the Vessel is clos'd; and after a Glyster and Blooding (unless the weakness of the Pulse, and a deficiency of heat forbid it) they are presently given in the form of a Julape, Decoction, Emulsion, Juicy Expression, Powder, Pills and Lohochs: I shall give you some of the choicest and most efficacious prescripts of each of these, as also of Hypno∣ticks, which nevertheless must not be us'd at random, and indif∣ferently, but every of them methodically and seasonably, accor∣ding
to the various Constitution of the Patient, and Nature of the Disease, as a prudent Physician shall direct.
TAke the Waters of Purslain and red Poppies, of each six Ounces, Dragons Blood finely Powdred half a Dram, Syrup of red Pop∣pies two Ounces, Spirit of Vitriol of Mars, half a Scruple: Mix them, the Dose is three Ounces, repeating it within five or six hours.
Take Plantain water a pound, the Gums Tragacanth and Arabick Powdred, of each half a Dram; mingle them and dissolve them, then add Syrup of dry'd Roses, an Ounce and a half: Make a Julape, the Dose is three or four Ounces every third or fourth hour.
Take the Waters of Oak-buds, red Roses, and Nymphaea, of each four Ounces, Blood-stone very finely Powdred, Bole Armeniack Pow∣dred, of each half a Dram, Syrup of Nymphaea two Ounces: Mingle them, the Dose is three or four Ounces, three or four times a day.
Take of the Dew or insipid Phlegm of Vitriol a pound, Syrup of Myr∣tles two Ounces: Mix them, the Dose is two or three Ounces, often in the day, or in the night.
Take Cypress tops eight handfuls, Willow Leaves or Flowers six handfuls, Roots of the greater Comphrey and Nymphaea, of each half a pound, Balaustia two handfuls, all being slic'd small together, pour to them of fresh Milk eight pounds, distil them in Common Organs: The Dose is three or four Ounces, thrice or oftner in a day.
Take of this distill'd water, and of Plantain water, of each half a pound, the Gums Tragacanth and Arabick, of each two Drams: Dis∣solve them, the Dose is three Ounces every third hour.
The following Mixture is prescrib'd by Frederick Deckers, to be taken a Spoonful at a time, and seems to be a good Medi∣cine.
Take Plantain water two Ounces, Cinnamon two Drams, Confecti∣on of Hyacinth a Dram and a half, distill'd Vinegar half an Ounce, red Coral prepar'd half a Dram, Balaustia, Dragons Blood, of each half a Scruple, Laudanum Opiatum three Grains, Syrup of Myrtles an Ounce: Mingle them.
Take the Waters of Plantain, red Roses and Purslain, of each four Ounces, Blood-stone and Dragons Blood reduc'd into a fine Powder, of each half a Dram, Sugar Candy six Drams: Make a Ju∣lape.
A Solution of common Vitriol, or of Vitriol of Mars made in foun∣tain water, and apply'd to a Wound with a rag, excellently stops all Fluxes of Blood, but it is not proper to be given inwardly.
TAke Leaves of Blood-wort, Perwincle, Mous-ear, Plantain, Wood∣sorrel, both sorts of Daisies of each a handful: Flowers of red Roses half a handful, Barley half an Ounce, Raisins two Ounces, boil them in three pounds of Water, in which red hot Iron has been quench'd, till it comes to two pounds; add to the straining Syrup of St. Johns wort two Ounces, or of Mous-ear: Make an Apozeme, the Dose is four or six Ounces thrice a day.
Take Leaves of St. Johns wort, Roots and Leaves of Tormentil, great Burnet, Meadow-sweet, of each a handful, Seeds of Purslane, Plantain, and Sorrel, of each a Dram, Conserve of red Roses half a pound, fountain water four pounds: Let them boil close in B. M. for twelve hours; to the straining, add Spirit of Vitriol of Mars, half a Scruple, take it after the same manner.
Take Barley water with madder Roots boil'd in it, a pound and a half: Put into it, when grown pretty cold, of red Rose Leaves a handful: Add Spirit of Vitriol a Scruple, let there be a close and warm infusion for three hours: Make a Tincture, to the straining add Syrup of the Juice of St. Johns wort, an Ounce and a half: Take three or four Ounces, thrice or four times in a day.
Take of the Decoction of the Roots of fresh Nettles, a pound and a half, Seeds of white Poppies, and of Henbane, of each two Drams, Melon seeds pill'd six Drams: Make an Emulsion according to Art, sweetned with Sugar Penids: The Dose is three Ounces, three or four times a day.
TAke Juice of Plantain Leaves half a pound: Let two or three Drams be taken thrice a day, with three Ounces of the distill'd Water above written, and sweeten it at pleasure.
Take Leaves of fresh Nettles, Plantain, the lesser Daisy, of each three handfuls; being bruis'd together, pour to them of Purslain water six Drams: Wring it forth hard, take it as the former.
TAke Powder of Blood-stone, of Dragons Blood ground on a Marble with Rose-water, and of Pearl, of each a Dram, Bole Armeniack, Terra Lemnia, of each half a Dram, Troches of Winter Cherries two Drams: Make a Powder, divide it into twelve parts; let one part be taken thrice a day with the distill'd water above written.
Take of the Seeds of Henbane, and white Poppies, of each ten Drams, Terra Sigillata, red Coral, of each five Drams, Sugar of Roses three Ounces: Make a Powder, the Dose is a Dram Morning and Even∣ing. This Composition brought into a soft Consistency with some pro∣per Syrup, is call'd Helidaeus's Electuary, so Famous heretofore in Germany.
The foresaid Powders may also be made into convenient Pills and Tablets, by adding the Solution of Tragacanth, or some fit Sy∣rup.
The spungy Excrescency usually growing to the fruit of the Dog-Rose Tree, made into Powders, and given twice a day to the quantity of half a Dram, is a very good remedy in spitting Blood.
Take Yarrow bruis'd and dry'd in the Summer Sun, what you think good: Make it into a fine Powder, and keep it in a Glass for Ʋse: The Dose is from half a Dram to a Dram, twice a day in a fit Ve∣hicle.
The Powder of Julius Caesar Scaliger, or rather of Serapion is mightily commended: The Dose is four Drams, twice or thrice a day.
TAke Conserve of red Roses, and of the Dog-Rose, of each two Ounces, Powder of the Seeds of the white Poppy, and of Hen∣bane, of each two Drams, Species Diatragacanthi frigidi, a Dram and a half, Blood-stone, Sanguis Draconis prepar'd, of each half a Dram, Syrup of red Poppies what suffices: Make an Electuary, let the quantity of a Chesnut be taken Evenings and Mornings, and at other times suck it with a stick of Licorice.
Take Conserve of the Flowers of great Comphrey, and of Water-Lillies, of each an Ounce and a half, Troches of Winter Cherries, and Dia∣tragacanthum frigidum, of each a Dram and a half, Syrup of Jujubes what suffices; Make a soft Lohoch, of which take often with a stick of Licorice.
Take of the White of an Egg well beaten two Drams, Lucatellus's Balsam half an Ounce, Troches of Winter Cherries two Drams, Syrup of red Poppies what suffices: Make a soft Lohoch, take the quantity of a Chesnut Morning and Evening.
The Second Indication being for preservation, suggests to us those Remedies which keeping the Blood in a just temper, and the Lungs in a due Conformation, provide against a relapse of Spitting Blood, and an ensuing Consumption; such as regard the Blood are either gentle Evacuatives by Seige, Urine, and Sweat, or meer Alteratives. Every one of these are wont to be pre∣scrib'd either in the Form of a Drink, Powder, Electuary or Pills: We shall set down some Select Forms of some of the chief of them.
1. As to Evacuatives, a gentle Purge may sometiems be orde∣red after this manner.
Take of the best Sena three Drams, Cassia bruis'd with the Fistula an Ounce, Tamarinds three Drams, Coriander-seeds a Dram and a half: Boil them in a sufficient quantity of fountain water to fix Ounces, to the straining add Syrup of Cichory with Rhubarb an Ounce, Clari∣fy it with the White of an Egg. Or,
Take Gereons Decoction of Senna four Ounces, Purging Syrup of Apples an Ounce: Mix them, and make a Potion.
For preserving the Blood in a good temper, and that its dreggy Excrements deriv'd from the Lungs, may be continually dis∣charg'd by Sweat and Urine, the following Alteratives, or some of them must be constantly taken; which being also of a heal∣ing Nature, relieve Lungs that are infirm, or dissolv'd in their Unity.
For ordinary Drink, let it be pure Water, especially in a hot Constitution, or water a little ting'd with Claret Wine: Those with whom this Drink does not agree, may use with as good success a Bochet of China and Sarsa, with the shavings of Ivory, Hartshorn, and white Saunders in it, or sinall Beer, or Ale, with the Leaves of Harts Tongue, Oak of Hierusalem, and the like in∣fus'd in it.
Let Pectoral Decoctions, or Hydromels with temperate Trau∣matick Herbs be taken twice or thrice a day, to six or seven Ounces.
Take Roots of fresh Nettles, and Chervil, of each an Ounce, Leaves of Harts Tongue, Speedwel, Mous-ear, Ground Ivy, St. John's-wort, of each a handful: Boil them in three pounds of fountain water to two pounds, adding Raisms stone'd an Ounce and a half, Licorice two Drams; to the straining add Syrupus Byzantinus two Ounces, Clarifie it with the White of an Egg: Make an Apozem to be taken to four or six Ounces twice or thrice a day for a Month.
In a cold or Phlegmatick Constitution, the Licorice and Rai∣sins being omitted with the Syrup, add towards the end two Ounces of the best Clarified Honey; strain it, and keep it for use: The Dose is the same as the former.
Let these things sometimes be taken betwixt whiles with a distill'd water appropriated to the same end; which also may be more frequently taken by some Persons, to whom Apozems are nauseous and loathsome.
Take Cypress Tops, Leaves of ground Ivy, of each six handfuls, Snails half boil'd a pound and a half, All the Saunders bruis'd, of each an Ounce: Being slic'd and bruis'd, pour to them of new Milk eight pounds, distil it with common Organs: The Dose is three or four Ounces with a spoonful of Syrup of the Juice of ground Ivy twice a day.
2. In respect of the Lungs, viz. that the Union of its parts, and the due Conformation of the whole may be preserv'd without any obstruction, or opening of its Vessels, temperate Balsamicks are of chiefest use: For this end Lucatellus Balsam is perscrib'd even by the vulgar to be taken constantly, and for a long time by such as Spit Blood. Chymists and some famous Women cry up above all things a Balsamick Oyl drawn by distillation, which they call Mother of Balsam.
I shall now illustrate this Method of Cure by a Story.
A famed young man falling from a Scorbutick Cachexia into a Palsey, and for the Cure of this Disease, having try'd Remedies not only great, but likewise disproportionate to his Blood and Spirits, viz. Salivation, and the use of hot Baths, happened to be seiz'd with a Spitting of Blood, and its fits (of all I ever knew that were not presently mortal) seem'd the most dread∣ful.
The First appearance of this Blood Spitting was after the ope∣ration of Hews's Powder, by which having for some time un∣dergone a Salivation, though without Curing his Palsey, he was brought to a great weakness: Then being afflicted with a Catarrh, and a very troublesome Cough, he began to cast forth a discoloured Spittle, and sometimes ting'd with Blood, sometimes sprinkled with it. But this Disease being mild at First, soon va∣nish'd by the use of Medicines, and afterwards the Person going into the Country, and breathing a purer Air, grew better, and in a while seeming to be sound enough in his Brest, he went to Bath to Cure his Palsey: Where Bathing every day for six Weeks in the hot waters, he got his Cough again, and soon after fell into a terrible Spitting of Blood, so that in twenty four hours space Counghing up Blood almost continually, and in a large measure, he threw forth a vast qantity.
Going to see him the First time in this Condition, provision being made for the whole, I presently ordered Bleeding for Re∣vulsion, though after its Administration (both then and ever after) his Blood Spitting either return'd a fresh, or was provok'd more by it. Moreover I gave Julapes, Lohoch's, Decoctions, and even Hypnoticks, which doing little or no good: I ordered Li∣gatures about his Arms and Thighs, which first of all gave a check to the Tyranny of this Disease: And as now and then the Evil burst forth again, I perswaded him at length that forbearing the use of Beer, he should drink constantly a Decoction of Sarsa and China with Pectorals: By the almost continued use of this, observing likewise an exact Form of Diet, and abstaining wholly from Wine, hot Aliments, and Salt and Sugar, he had his health well enough for above two years.
But afterwards being very much heated in a Crowd, he fell a∣gain into a terrible Spitting of Blood: A Physician being call'd, he was presently Blooded in his Arm, after which his Blood Spit∣ting became more violent; and when on the Second and Third days after he was Blooded again, the Evil encreas'd upon him each time: At length Ligatures being us'd (as before) and a Pectoral Decoction, and a Lohoch carefully taken, the Disease presently abated, and in a short time wholly ceas'd: Neverthe∣less he continued the use of his Pectoral Decoction, and thin Diet, viz. without any Flesh above six Weeks, and thereby ob∣tained truce from his Enemy for three years: And when after∣wards sometimes after drinking Wine, or too plentiful a Diet, the Blood growing turgid, began to burst forth of the Lungs, presently by the Ligatures, together with the use of the De∣coction and Linctus, and the thin Diet, the force of it was al∣ways allay'd.
Nevertheless he became not so secure, but was forc'd to keep in a manner always watch and ward against that lurking Enemy: For not long since through the Distemper of the Season, he was seiz'd with a very troublesome Catarrh, accompanied with a Cough, and much Spittle which was now and then Bloody, and then the former Medicines did not do: Whereupon of his own head he betook himself to new things; and First of all he took Evenings and Mornings a spoonful of the Syrup of the Juice of ground Ivy, and found thereby great good: but that Syrup, by reason of the Sugar, growing in a short time loathsome to him, he took twice a day in a spoonful of some Liquor to half a Dram, or a Dram of the Powder of that Herb well prepar'd; which Re∣medy being us'd a long time, he became much better as to his Catarrh and Cough, but his Blood Spitting breaking forth now and then, though it were in a small quantity, he chang'd his Me∣dicine
again; and took twice a day a Powder of the Tops, and e∣specially of the hairy Excrescencies of the sweet Bryar Tree: Which Medicine alone, a certain Physician formerly renown'd for the Cure of Spitting Blood, had us'd with great success: Nor did our Patient receive a less prosperous effect from that Reme∣dy: For by it he presently got wholly free from his Cough, Ca∣tarrh, and Blood Spitting, and so continued for a very long time, till at length thinking this Disease of his Brest wholly conquer'd, and therefore to be slighted, he took up arms against the other more ancient, viz. the Palsey. Wherefore whilst neglecting his Spitting Blood, he took daily to overcome that Distemper, a large Dose of hot Medicines, viz. Magistral waters distill'd with Wine, Spirit of Hartshorn, of Sal Armociack, Aromatick Pow∣ders and Confections, and indulg'd himself likewise to a more plentiful Diet, drinking Ale and Wine moderately, the roaring Lion which seem'd before a sleep, rous'd himself again, viz. he had not long continued that Antiparalitick Method, but the Blood Spitting return'd with a very great violence, so that in the space of twenty four hours, he Cough'd forth above three pounds of forthy Blood; and afterwards when a Physician being call'd, he was presently Ordered to be Let Blood, after bleeding the Blood Spitting beginning to be abated (as it was always wont before) was provok'd a fresh: Which nevertheless after the Applicati∣on of the Ligatures, and the diligent taking of the Linctus and Pectoral Decoction, was presently mitigated, and in a short time wholly ceas'd. And when afterwards he had us'd above Three Months the Pectoral Decoction, and an entirely thin Diet, viz. without Flesh, and of meer Herbs, Corn, and Milk Meats, he revocered in a short time his former health, and now lives in that state, triumphing over that cruel Disease.
This Person always found the use of the Pectoral Decoction to do him good: Wherefore though he chang'd now and then his other Medicines, he always retain'd the same Composition of that; and recommended it to many other Persons seiz'd with a Blood Spitting with success.
The Form of the Prescript is thus.
Take all the Saunders, of each six Drams, Infuse them for twelve hours in seven pounds of fountain water, then let it boil till a third part be wasted, after add of the Leaves of Coltsfoot, Maiden hair, Mous-ear, Speedwel, Flowers of St. John's-wort, of each two handfuls, sweet Fennel-seeds six Drams, Licorice slit half an Ounce, Raisins ston'd half a pound, boil them to four pounds; then strain it, and use it for your ordinary drink.
Moreover, when the Blood Spitting was upon him, or was coming, he took thrice, or oftner in a day the quantity of a Nutmeg of the
following Electuary, drinking after it seven spoonfuls of the Ju∣lape.
Take Conserve of red Roses three Ounces, Conserve of Hipps and Com∣phrey, of each an Ounce and a half, Dragons Blood a Dram, Species of Hyacinth two Scruples, red Coral a Dram, with a sufficient quantity of Syrup of red Poppies, Mix them, and make a soft Electuary, take at Night, and early in the Morning a Dram and a half, drinking after it a draught of the following Julape; at other times let him take it with a stick of Licorice.
Take of the Waters of Plantain, and of the Spawn of Forgs, of each six Drams, Syrup of Coral, and of dry'd Roses, of each an Ounce, Dragons Blood two Scruples: Mix them, made a Julape.
THe Peripneumonia is an Inflammation of the Lungs with an Acute Feaver, a Cough, and a difficulty of Breathing; it is caus'd by a rushing of the Blood into the Ductus's of the Lungs, and its being there inflam'd and obstructed.
The Primary Indication in order to the Cure of a Peripneu∣monia is, that the Blood forc'd into the Vessels of the Lungs, and causing there an Obstruction with an Inflammation, be thence discust, and restor'd to its former Circulation, which if it may not be done, the Second Indication will be, that that matter be duly Concocted or Suppurated, and with all expedition voided by Spittle.
1. Whilst the former Indication holds good, the Intentions of Curing will be these following: In the First place, That the excessive current of the Blood to the part affected be cut off, or some way hindred. Secondly, We must endeavour that the mat∣ter stagnating in the Lungs, or extravasated, be suck'd up again by the Veins into the rest of the Mass, and restor'd to its Circu∣lation: Which the better to effect. Thirdly, The Blood must be freed of its clamminess, or viscous nature, whereby its fluidity is hindred. And Fourthly, We must obviate by fit Remedies those Symptoms that are very pressing: viz. the Feaver, Cough, Watch∣ings,
and difficulty of Breathing: But if notwithstanding all this, the other Indication must be pursued, we must add to the Re∣medies before mentioned, such as they commonly call Maturating and Expectorating Medicines.
1. To satisfy the First and Second Intentions together, Blood∣ing is requisite almost in every Peripneumonia, nay sometimes it ought to be often repeated: For the Vessels being emptied of Blood, they do not only withdraw the matter which maintains the Disease, but likewise drink up again what was forc'd into the part affected: Wherefore if the strength holds, and the Pulse be of a sufficient vigour, its good to bleed freely at the very begin∣ning, but otherwise you must do it in a moderate quantity, and repeat it now and then as occasion requires: In this Distemper the Vein should always be open'd with a large Orifice, and the Blood should not only Issue forth in a full stream, but its running should be continued; for otherwise if in the midst of bleeding, whilst the vitiated Blood flows forth, the Orifice be stop'd with the Finger, (as some are wont to do to prevent fainting) when its open'd again, a pretty good Blood will Issue forth next, the vitiated Blood, if any such be remaining, being fallen back, and not presently returning to the Orifice. Besides Bleeding, many other Remedies are here to be us'd, viz. such as repress the turgid motion of the Blood, and empty its Ductus's, whereby the Morbifick matter may be drank up again: Wherefore a very thin Diet is prescrib'd, consisting almost meerly of Barley and Oat-meats. And though Catharticks are wholly forbidden, be∣cause they strongly exagitate the Blood, and force it more violently into the part affected: Nevertheless Glysters ought to be daily Administred which gently ease the Belly, and draw the dreggy Excrements of the Blood downwards. Moreover qualifying Julapes and Apozemes, which allay the fervour of the Blood, and pleasant∣ly lead off its superfluous Serosities, and likewise gently open the passages of the Brest, are taken with good effect.
The Third Intention of Curing which has regard to the take∣ing away of the obstructing clamminess, or viscous nature of the Blood, it perform'd wholly by those Remedies which loosen its over-close Texture, and dissolve the Combinations of its Salts. And truly those Remedies which Reason and Analogy might di∣ctate in this respect, are us'd even at this time after a long expe∣perience: For Powders of Shells, the Tusk of a Boar, the Jaw∣bone or a Pike, and other things endow'd with an Alkalisate Salt; also Sal Prunella are prescrib'd by all Practitioners, both Ancient and modern. I have known Spirit of Sal Armoniack, and of Hartshorn, to have done great good in this Disease: And for the same Reason it is (viz. Because of the good effect of the
Volatile Salt) that an Infusion of Horse-dung, though a vulgar Remedy, has often given great relief.
Fourthly, As to the Symptoms and their Cures, a great many Remedies appropriated to these, are Coincident with the former: For the same Julapes and Apozemes which appease the fervour of the Blood, and also restore the Animal Spirits, are in most common use against the Feaver: To which also in respect of the Cough, and the diffculty of Breathing, temperate Pectorals are joyn'd: The greatest difficulty is, what must be given against want of sleep, it at any time the Person be very much molested by it: For Opiats adding to the prejudice of Respiration, which is under some stress from the beginning of this Disease, may scarce be taken with safety, nay sometimes they become pernici∣ous: Wherefore Laudanum's, and the stronger preparatious of Opium must be utterly avoided in a Peripneumonia; though in the mean time Anodines, and the more gentle Hypnoticks, as especially the Water and Syrup of red Poppies are not only al∣low'd, but accounted Specificks in this Disease, and in the Pleu∣risy: Moreover we may sometimes use Diacodiats so the strength holds, and the Pulse be strong, and in a good temper: For the pain of the Brest, if at any time it proves troublesome, its pro∣per to use sometimes Oyntments, Fomentations, and Cata∣plasms.
The Secondary Therapeutick Indication, whereof the Intenti∣ons are to Concoct, and to discharge by Spittle, the matter sticking in the Lungs, (since it cannot be discust, or drank up again) requires Medicines commonly call'd Maturatives and Ex∣pectoratives; but they must both be temperate, to wit, such as rather appease than exasperate the Thirst and Feaverish heat. We have given you before in the Chapter of the Cough, the kinds of these Medicines, which are properly call'd Pectorals. We shall now set down the choicest Prescripts, and most proper for this affect.
1.2. Medicines Conducing to the First and Second Intention, are prescrib'd according to the Forms following.
TAke Water of Ladies Thistle ten Ounces, of red Poppies three Oun∣ces, Syrup of the same an Ounce, Pearl prepar'd a Dram: Make a Julape, the Dose is six spoonfuls every fourth hour.
Take the Waters of Black-Cherries, Carduus Benedictus, and Baum, of each four Ounces, Powder of a Boars Tusk a Dram, Syrup of Violets ten Drams: Make a Julape, and take it after the same manner.
Take Grass Roots three Ounces, shavings of Ivory and Hartshorn, of each three Drams, Raisins ston'd an Ounce and a half, Licorice two Drams; boil them in three pounds of fountain water to two pounds, to the straining add Syrup of Violets an Ounce, Sal Prunella a Dram: Make an Apozeme, take to three or four Ounces thrice a day.
For the same Intention, viz. that the emptied Vessels may withdraw the matter maintaining the Disease, or may drink up again the Morbifick matter it self, a Purge also is prescrib'd by some: In the Practise of the Ancients, it was a thing in constant use after bleeding, to Order Preparatives and Purgers against this Disease, as well as against most others: And Chymists of late with a greater confidence give Vomits, and cry them up before all other Remedies in a Peripneumonia. Nay further, neglecting bleeding, or forbidding it, they lay the chief stress of their Cure in Antimonial Emeticks, though I know not whether any thing can be imagin'd more pernicious than that their rash proceeding. In rustick and robust Bodies sometimes this Medicine is given without harm, but in tender Constitutions it may be reckon'd little Inferiour to poyson: And as to purging, though it be not proper in the very beginning, but in a manner always does harm, yet the Morbifick matter ceasing to flow to the part, and the effer∣vescence of the Blood being appeas'd, you may empty the Body gently with a Purging Medicine.
Take Gereons Decoction of Sena four Ounces, Syrup of Roses Solu∣lutive and Ounce: Mix them, make a Potion.
Take the best Sena three Drams, whole Cassia, Tamarinds, of each half an Ounce, Coriander-seeds two Drams: Boil them in a suffi∣cient quantity of fountain water, to six Ounces; to the straining add Syrup of Violets an Ounce, Clarifie it with the White of an Egg, and give it.
Let not Purges be given always, nor ever in this Disease with∣out consideration, but Glysters must be given frequently, nay for the most part every day; but let them be only Lenitive and Emollient, so that they gently loosen the Belly without much stirring the Blood and Humours: For this end Milk, or Whey with brown Sugar, or Syrup of Violets often do well. Or,
Take the Leaves of both Mallows, Melilot, and Mercury, of each a handful, Linseed, and sweet Fennel-seeds, of each half an Ounce, sweet Prunes, in number six: Boil them in a sufficient quantity of fountain water to a pound, to which add Syrup of Violets an Ounce, Sugar ten Drams, Sal Prunella a Dram: Make a Glyster.
3. Medicines for the Third Intention, viz. For dissolving the clamminess of the Blood, are usually given in the Form of a Powder, Spirit, Draught, or Bolus according to the Forms fol∣lowing.
TAke Crabs Eyes powdred two Drams, Sal Prunella a Dram and a half, Sugar of Pearl a Dram: Make a Powder, divide it into six parts, take one every sixth hour, with some proper Julape or Apozeme.
Take Powder of a Boars Tusk (or of the Jaw-bone of a Pike) Crabs Eyes, of each a Dram and a half, Flowers of Sal Armoniack, Powder of red Poppy Flowers, of each half a Dram: Mix them for four Doses.
TAke Spirit of Sal Armoniack distill'd with Olibanum three Drams: The Dose is from twelve to fifteen, or twenty Drops thrice a Day.
Take Spirit of Ʋrine, or of Soot three Drams, give it after the same manner.
Take Spirit of sweet Nitre, viz. often Cohobated with Spirit of Wine three Drams: The Dose is from six drops to ten, after the same manner.
Take Spirit of Tartar half an Ounce: The Dose is from fifteen drops to twenty, or twenty five, with a fit Vehicle.
Take of the simple Mixture an Ounce: The Dose is from a Scruple to half a Dram after the same manner.
TAke Carduus water a pound, fresh Horse-dung three Ounces, dis∣solve it warm, and filter it: The Dose is three or four Ounces twice or thrice a day, adding Syrup of Violets, or of red Poppies half an Ounce.
Take Leaves of Dandelion two handfuls, being bruis'd, pour to them Water of Ladies Thistle half a pound, Treacle water half an Ounce: Wring it forth hard, to which add Powder of Crabs Eyes a Dram, take four or six spoonfuls thrice a day.
The Fourth Intention of Curing, having regard to the most urgent Symptoms, suggests to us various preparations of Medi∣cines. 1. In respect of the Feaver, the Julapes and Apozems be∣fore set down are proper. Moreover you must frequently use Sal Prunella. 2. For the Cough and difficulty of Breathing, Lin∣ctus's, Lohochs, and Decoctions, or Pectoral Julapes are given with success.
Take Syrup of Jujubes, of Maiden-hair, of each an Ounce and a half, Syrup of Violets an Ounce, Flowers of Nitre a Scruple: Make a Linctus to be taken now and then with a stick of Licorice.
Take Syrup of Dialthea an Ounce, Diacodium, Syrup of red Poppies, of each half an Ounce, Crabs Eyes finely powdred two Scruples: Make a Linctus to be taken as the other.
Take Syrup of Hyssop, of Licorice, of each an Ounce and a half, Powder of red Poppy Flowers a Scruple, Crabs Eyes a Dram, Lohoch de Pino six Drams: Mix them, make a Lohoch, of which take the quantity of a Nutmeg four times, or oftner in a day.
Take Roots of Grass, Chervil, Marsh-mallows, of each an Ounce, Figgs in number four, Jujubes, Sebestens, of each in number six, Rai∣sins of the Sun an Ounce, Licorice three Drams, Barley half an Ounce, boil them in three pounds of fountain water to two pounds: Strain it, the Dose is three or four Ounces.
Take Raisins ston'd an Ounce and a half, Filberts slic'd in number four, Licorice slic'd three Drams, Hyssop-water a pound and a half: Make a close and warm Infusion according to art for six hours, to the straining add Syrup of Althea an Ounce and a half: Make a Julape, the Dose is three or four spoonfuls often in a day, swallowing it down by little and little.
3. Against want of Sleep, Take of red Poppy water three Ounces, Syrup of the same six Drams, Plague water two Drams: Make a draught to be taken going to Bed.
It the Pulse be strong, and the strength holds, Take Cowslip water three Ounces, Syrup of Meconium half an Ounce: Mix it, and drink it going to Bed.
4. If the pain be pressing about the part affected, Take of the Oyntment of Marsh-mallows two Ounces, Oyl of sweet Almonds an Ounce and a half: Mix them for a Liniment to be apply'd with thin Lawn Paper.
Take Oyntment of Marsh-mallows, and the Pectoral Oyntment, of each an Ounce and a half, Oyl of Linseed fresh drawn a Dram, to which add of the Emplaister of Mucilages what suffices: Make a Plaister for the Region of the Brest, to be apply'd on the part affected.
Fifthly, For the last Intention of Curing, which answering the Secondary Indication prescribes ripening and expectorating Medi∣cines, the Forms following are proper.
Take Linseed Oyl fresh drawn three Ounces, Syrup of Violets two Ounces, Hyssop water half a pound: Mix them in a Glass, take two or three Ounces thrice a day, shaking the Glass first.
Take Olibanum powdred a Dram, put it in an Apple made hollow, and let it Roast in hot Embers: Let it be eaten going to Bed, and let the person do this three or four times.
Take Oyl of sweet Almonds fresh drawn, Syrup of Maiden-hair, of each an Ounce and a half, Sugar Candy two Drams: Bruise them in a Glass Mortar, till they are throughly mixt: Make a Linctus, and take of it often with a stick of Licorice. Take also a spoonful of it thrice a day, in a draught of Posset-drink.
As to the rest, the Remedies prescrib'd in a beginning Phthisick are good also here.
I shall now give you an example or two of Persons affected with a Peripneumonia: Whilst I was writing these things, I was call'd to one very ill of a Peripneumonia: This Person being a∣bout Fifty Years of Age, of a lean Body, and a Bilious tempera∣ment; upon taking Cold fell into a Feaver with a Cough, a pain in his Brest, and a difficulty of Breathing: Having so lain ill four days without any Remedy or Physical Administration; I found him in a high Feaver with a Thirst, and mighty Inflamma∣tion of his Praecordia, and fetching Breath with great Pain and difficulty, his Thorax much labouring, and being troubled with a wheezing in the Wind-pipe, so that he seem'd manifestly in the very Agony of Death: His Pulse, though quick and troubled, yet being strong enough, I presently ordered eight or ten Ounces of Blood to be taken from him: By which finding some ease, after three hours intermission, a Glyster being first Administred, I or∣dered him to Bleed again to twelve Ounces. Moreover, I di∣rected him to take twelve drops of Spirit of Hartshorn every sixth Hour with a proper Julape, and betwixt whiles, a Dose of the following Powder.
Take Powder of Crabs Eyes, and Sal Prunella, of each a Dram and a half, Pearl a Dram, Sugar Candy two Scruples: Make a Powder, divide it into eight parts.
He took also a Draught of a Pectoral Apozeme often at plea∣sure; by the use of these things, all the Symptoms began to a∣bate within three days, and the night following he sweated and
slept a little: The Day after he was Blooded again, and after∣wards the same Medicines being continued, he perfectly recove∣red within four or five days: The Blood taken from him was al∣ways in its surface viscous and ill coloured.
A Gentleman of a Sanguine Complexion, and a strong habit of Body after immoderate drinking of Wine, fell into a Feaver with a dangerous Peripneumonia; so that thirst and heat very much pressing him, and sitting upright always in his Bed, or in his Chair, and almost continually panting, he had very much a∣do to draw in Air enough to support Life: He being not able to lose much Blood at a time, I drew Blood twice or thrice from him one day after another, frequent Glysters were Administred. More∣over Apozemes, Julapes, also Spirit of Sal Armoniack, and Pow∣ders of Shells were given him by turns: Within four or five days the Feaver abated somewhat, and he began to breath better, and to take now and then short sleeps, though he complain'd still of a mighty heaviness upon his Breast, and an intolerable oppression of his Lungs. Wherefore bleeding being no longer safe, I ap∣ply'd large Vesicatories to his Arms and Legs: The Blisters in his Arms dry'd up in a short time; but those on his Legs did not only continue open, but ran mightily after five or six days, and so for near a Month daily discharg'd a vast quantity of a most sharp humour: In the mean time his Lungs grew better by little and little, and at length were wholly freed of their in∣cumberance. Lastly, The Blisters rais'd by the Vesicatories, could very hardly be throughly Cur'd, and not without frequent Purging.
THe Pleurisie is an Inflammation of the Pleura caus'd by a boiling Blood flowing into it through the Vertebral Arte∣ries, and there growing clammy, with a continual and acute Feaver, a pricking pain of the side, a Cough, and a difficulty of breathing.
When a Pleurisie commencing passes into a Peripneumonia; or an Empyema, or inclines to a Phthisick, there is a proper method of Cure particularly set down in each of those Diseases for it: But as to what concerns our present purpose, Three Indications present themselves for a primary and simple Pleurisie, viz. a Cura∣tory, Preservatory and Vital one.
The First Indication takes care that the Inflammation or Ob∣struction of the Blood in the Lungs be remov'd by all possible means as soon as may be: Wherefore in a Pleurisie let a Vein be open'd, and so the strength holds, and the Pulse be strong, let the Person bleed freely; and truly it is much better to take a large quantity of Blood at first, and every time after (as often as there is need to repeat it) than to Bleed often, and to draw a a little at a time; because a great many portions of the Blood grown clammy and degenerated into a viscous nature, are gathe∣red together about the part affected; which unless withdrawn from thence, upon a great emptying of the Vessels by a large emission of Blood, so that the greatest part of them flow forth, the bleeding will be frustrated of its desired affect: Its all one in which Arm the Vein be open'd, though its now common∣ly done on the side affected.
But if by reason of the weakness of the Pulse, and the failing of the Animal faculty, you ought neither to Bleed at First, nor to repeat it though the pain be very urgent; then Cupping-Glas∣ses with a Scarification being apply'd to the place griev'd, may very well supply its place. Moreover to take away the Inflam∣mation of the Pleura, besides an Evacuation of Blood by breath∣ing a Vein freely, or by Scarification, its Serous and other Ex∣crementitious humours must also be set upon, and be gently purg'd forth of its Mass, and from the Bowels by Siege, Urine, and Sweat Strong Purges are justly forbidden, because they
trouble the Blood, and force it farther into the Places affected; and Antimonial Vomits (though approved by some) are neither safe, nor grounded upon reason. Let Glysters be frequently, or rather daily Administred; nay and sometimes gentle Purges may be allow'd so the Feaver be not very great, qualifying Julapes and Decoctions, and things gently moving Sweat or Urine, such as before prescrib'd for the Peripneumonia, are also proper here. Let all hot things of a sharp or smart nature, whether they are Spices, or things containing a Vinous Spirit, be carefully a∣voided.
The Second Indication being for preservation, and directed a∣gainst the clamminess and effervescency of the Blood, prescribes those Medicines, which consisting of a Volatile, or Alkalisate Salt, destroy the Combinations entred into by the Acid, sixt, and other∣wise Morbifick Salts, with other more gross Particles: In which respect the Eyes and Claws of Crabs, the Tusk of a Boar, the Stone of Carps, the Jaw-bone of a Pike, the Bone in the Heart of a Stag, the Pisle of a Deer, Sal Prunella, Salt of Coral, the Vo∣latile Salt of Urine, or of Hartshorn, Powder of Goats Blood, Infusion of Horsedung, Spirit of Hartshorn, of Sal Armoniack, Spirit of Tartar, Mixtura Simplex, Bezoartick Mineral, Antimo∣ny Diaphoretick, Flowers of Sal Armoniack, are very famous Remedies in the Pleurisie.
The Third and Vital Indication, which takes care that the strength and Vital heat be preserv'd in their due Tone and State, during the Course of the Disease, prescribes principally a fit Diet, and likewise Cordial Remedies and Anodines, and things which seasonably afford Relief to other Symptoms, if haply they present: First, in a true Pleurisie you must order a most thin Diet, viz. consisting of meer Oat, and Barley-meats, and for ordinary drink, Ptisan or Posset-drink is more proper than Beer alone, though in a mignty thirst, this also may be allow'd in a moderate quantity. Moreover to quench thirst, Julapes, Apozemes and Emulsions may be taken at set times, to all which let Sal Prunella be added. Secondly, let only temperate Cordials be given, which may gent∣ly refresh the Animal Spirits, and not add to the Accension of the Blood which burns before too fiercely: For these intents the Waters of Ladies Thistle, Carduus Benedictus, Bawm, Borage, Cow∣slips, and Black-Cherries, are usually given with good success, to which the Powders of Pearl and Coral may be added. Thirdly, Anodines must be used both inwardly to procure sleep, if at any time it be very much wanted; as also outwardly to ease the pain of the side: The most usual things of the former kind are the di∣still'd water, Syrup, and Powder of the red Poppy, which are ac∣counted Specificks in the Pleurisie, as well as in the Peripneumo∣nia.
Moreover, when a very acute pain and watchings press ve∣ry much, we may give also Diacodiats: Against Pains, Oynt∣ments, Fomentations, Cataplasms, and sometimes the warm In∣wards of Animals newly kill'd, are proper to be applyed.
I shall now give you Select Forms of Medicines adapted to each of these Indications.
First, Therefore about the beginning of the Disease, to take a∣way the Inflammation, Julapes, Apozemes, Powders, Glysters, and gentle Purges are wont to be prescrib'd.
Take Water of Ladies Thistle eight Ounces, Water of red Poppies four Ounces, Syrup of the same an Ounce, Sal Prunella a Dram: Make a Julape, the Dose is two or three Ounces every third hour.
Take Grass Roots four Ounces, Barley half an Ounce, parings of Apples a handful, Raisins of the Sun an Ounce, Licorice two Ounces; boil them in three pounds of fountain water to two pounds: To the cleer straining add Syrup of Violets an Ounce and a half, Sal Pru∣nella a Dram and a half: Make an Apozeme, the Dose is two or three Ounces often in a day.
Take Sal Prunella two Drams, Flowers of Nitre a Dram, Powder of the Flowers of red Poppies two Scruples, Sugar Candy four Scruples: Make a Powder, the Dose is half a Dram, three or four times a day.
Take of the Decoction of Mallows Roots and all, together with sweet Prunes a pound, Syrup of Violets three Ounces, Sal Prunella a Dram: Make a Glyster.
Take of whole Cassia bruis'd two Ounces, Tamarinds an Ounce, white Rose Flowers a handful, Coriander-seeds two Drams; boil them in a sufficient quantity of fountain water to a pound: To the straining add Syrup of Cichory with Rhubarb two Drams: Clarify it with the White of an Egg, the Dose is five or six Ounces in the Morning, for two or three days one after the other.
Secondly, To dissolve the clamminess or coagulating Viscous∣ness of the Blood, the following things are of use, viz. in the Form of a Drink, Powder, and Spirit.
Take fresh Horsedung four Ounces, Carduus water a pound and a half; make a close and warm Infusion for two hours, then filter the Liquor, to which add Syrup of the Juice of Dandelion, or of Cichory two Ounces, Spirit of Sal Armoniack a Dram, give five or six spoon∣fuls three or four times a day
For this end Water of Horsedung does admirably well.
Take Horsedung four pounds, Leaves of Carduus Benedictus, Ladies Thistle, Scabious, Pimpernel, of each three handfuls; being slic'd and mixt together, pour to them of fresh Milk six pounds, distil them
with common Organs: The Dose is two or three Ounces, either alone, or with other distill'd Waters in the Form of a Julape.
For the same use the Tinctures or Solutions of other Dungs are given by some Physicians, and are highly magnifyed by them. Helmont deservedly commends in the Pleurisie the Dung of an Ox, Panarolus Pidgeons Dung, others the White of Hens Dung: Epipha∣nius Ferdinandus usually gave with good success in the Pleurisy, the Decoction of Tobacco macerated in new Wine. Valeriola used the Decoction of the Flowers of red Poppies, as a try'd and familiar Re∣medy. Sylvius prescribes the following mixture to be taken one spoonful after another, by little Intervals of time.
Take the waters of Stone-Parsly and Hyssop, of each two Ounces, Fennel-water an Ounce, simple Treacle water half an Ounce, Lauda∣num Opiatum four Grains, Sal Armoniack half a Dram Syrup of red Poppies an Ounce: Mix them.
To this composition, Frederick Deckers adds Powder of Crabs Eyes, and Bezoartick Mineral of each a Scruple.
Medicines very efficacious for this use, are wont to be given in the Form of a Powder; for Example,
Take Powder of Crabs Eyes two Drams, Sal Prunella a Dram and a half, red Poppy Flowers half a Dram: Mix them, make a Powder, the Dose is half a Dram, three or four times in a day, with a fit Ve∣hicle.
Instead of Crabs Eyes, you may use the Powder of the Jaw-bone of a Pike, or of a Boars Tusk, or of a Stags or Bulls Pisle, and if these do not succeed, you may try what follows.
Take Antimony Diaphoretick, or its Ceruse, or Bezoartick Mineral two Drams, Volatile Salt of Hartshorn half a Dram, Powder of red Poppy Flowers two Scruples: Make a Powder, the Dose is a Scruple or half a Dram, thrice or oftner in a day.
It is for the same Intention of Curing, that Riverius gives Powder of Chimney Soot, from half a Dram to a Dram, and that others give the Powder of Pigeons or Hens Dung. Nay farther, according to this Analogy by which the Dungs of Animals stor'd with a Vola∣tile Salt give relief in this Disease; its probable that the Dung of a Dog may prove no less successful in Curing the Pleurisie than in the Squinancy; and so much the more likely, because these Disea∣ses often interchange their Types, and the one assumes the like∣ness of the other: Chymical Liquors endow'd with a Volatile Salt, sometimes also work great effects in the Pleurifie.
Take Spirit of Blood two Drams, Red Poppy water three Ounces, Syrup of the same an Ounce: Mix them; give a spoonful of it every other while.
Take Spirit of Sal Armoniack distill'd with Olibanum three Drams, the Dose is from twelve drops to fifteen or twenty, three or four times
a day in a fit Vehicle. After the same manner you may give Spirit of Ʋrine, of Soot, or of Hartshorn.
Take Spirit of Tartar three Drams: The Dose is a Scruple in a fit Vehicle.
Take Mixtura Simplex three Drams: The Dose is from a Scruple to half a Dram.
3. As to the Third Indication, besides a thin Diet, Cordial Re∣medies, and Anodines are prescrib'd: Forms of the former kind may be supply'd by the Julapes and Apozemes prescrib'd for the first Indication, and by the Spirits and Powders for the Second: In∣ward Anodines to be given in Watchings, and in a very Intense pain are prescrib'd according to the Forms following.
Take red Poppy water two Ounces, Syrup of the same six Drams, Spirit of Hartshorn twelve drops: Make a draught to be taken going to Bed.
If we must go higher, Take Carduus water two Ounces, Diacodi∣um from three Drams to half an Ounce, or six Drams, Spirit of Sal Armoniack with Frankincense half a Scruple: Make a draught. Some∣times, though rarely, its necessary to rise to Laudanum's, which being seasonably given, have a mighty good effect, inasmuch as they procure Sleep, and move Sweat and Ʋrine.
Take water of Cowslip Flowers two Ounces, Laudanum Tartariz'd, from sixteen drops to twenty, Spirit of Blood half a Scruple, Syrup of Violets two Drams: Mingle them, make a draught.
Outward Anodines are usually prescrib'd in the Form of an Oyntment, Fomentation, and Cataplasm.
Take Oyntment of Marsh-Mallows two Ounces, Oyl of sweet Almonds an Ounce, Album Graecum two Drams: Mix them by braying them together.
Take of the Emplaister of Mucilages two Ounces and a half; Malax it with Oyl of Linseed, and let it be apply'd upon Lawn Paper.
Take the tops of Both Malbows, Leaves of Mercury and Beets, of each three handfuls: Boil them in a sufficient quantity of fountain water; let the straining be us'd for a Fomentation.
Take the remaining faeces of the Herbs, after the Liquor is wrung forth, and being bruis'd, add to it of Oat-meal six Drams, Linseed, Fenugreek-seeds, of each two Ounces, Oyntment of Marsh-Mallows two Ounces: Make a Cataplasm.
I need not go far for Stories and Instances of persons troubled with the Pleurisie; for I have a notable Example of this Disease now under Cure, viz. a very fine young Woman, subject most frequently, and as it were habitually to that affect, is committed to our care. This Virgin, who is very fair, of a Sanguine Com∣plexion,
but of a weakly Constitution, has been wont for many years past upon every slight occasion, viz. upon taking Cold, or by errours in any of the six nonnatural things, nay sometimes upon the meer change of the Season, or of the Air, to fall into a Feaver, presently accompanied with pains of the Pleura, a Cough, and a difficulty of Breathing, and for the most part horrible Convulsi∣ons following them. She has been taken so very ill formerly of this Distemper, that she has been often forc'd to keep her Cham∣ber six Months or more every year; but of late, though she be not freed from this affliction, yet she is seldomer tormented with it: The last year she was pretty well all the Summer, and well near all the Autumn; about the beginning of Winter she fell sick of that Disease, and now towards the end of it, is fallen ill again. The Pleuritick pain constantly possesses the right side, where the Blood sticking, and being extravasated in its passage about the Intercostal Muscles, the Irritated Fibres commence a most tor∣menting pain, together with a Convulsive motion of Coughing which they reiterate almost perpetually: In the mean time the Lungs being found enough, and open in their passages, readily con∣vey the Blood, as clammy as it is, without any lett or stay, which often is the cause of a Peripneumonia. No Remedies are wont to do good to this person without Bleeding, which is always so particularly necessary, that every time she is ill, we are forc'd even whether we will or no, to repeat it two or three times, nay some∣times oftner: The Blood emitted has constantly a Viscous and whitish Film on its surface. This Disease was always a simple Pleurisie without any Peripneumonia, and for its Cure she con∣stantly us'd the following method with success.
Take Spirit of Sal Armoniack with Gum Ammoniacum three Drams, give from fifteen drops to twenty thrice a day, with the follow∣ing Julape.
Take Carduus water, Black-Cherry water, of each six Ounces, Hyste∣rick water a Dram, Sugar six Drams: Betwixt whiles she took a Dose of Powder with three Ounces of an Apozeme.
Take the Powders of Crabs Eyes, of a Bores Tusk, of Sal Pru∣nella, of each a Dram: Make a Powder, divide it into six parts.
Take Grass Roots three Ounces, Candied Eringo's an Ounce, sha∣vings of Ivory and Hartshorn, of each two Drams, parings of Apples a handful, Raisins of the Sun an Ounce: Boil them in three pounds of fountain water to two pounds; add to the straining, Syrup of Violets an Ounce, Sal Prunella a Dram: Mix them, make an A∣pozeme.
Glisters of Milk with Syrup of Violets were administred some∣times every day, and sometimes every other day; if at any time Opï∣ats, though never so gentle, were given her to allay pain, commonly afterwards an aking and heaviness of the Head, and Convulsive Affects most sorely tormented her.
BY the word Empyema, according to its usual acceptation, is denoted a Collection of Pus, or corrupted matter within the Cavity of the Thorax, by which the Organs of Respiration are opprest: That Pus commonly flowing thither, either from a Pleurisie, or a Peripneumonia (and sometimes haply from a Squi∣nancy) suppurated and broken.
As to the Cure of an Empyema, we must in the First place con∣sider whether the signs of this Disease, as to the reality of its present Being, be certain or doubtful; if certain, there will not be much need of Physick, but only the Body being prepar'd, you may presently proceed to open the side. Therefore if after a Pleurisie or Peripneumonia not rightly Cur'd, or after an inward effusion of Blood occasion'd by a stroak, fall, or wound, there be perceiv'd a floating of Pus, or of corrupted or bloody matter within the Cavity of the Thorax, and this with little or no Spit∣ting, we need no longer think of Maturating or Expectorating Medicines; but the Belly being loosen'd, and the Blood and hu∣mours duly qualified by Julapes, Apozemes, and Anodines, either order a bare Incision; or in tender and timorous persons, First, let a Cautery be apply'd betwixt the sixth and seventh Vertebrae, and after the Eschar being rais'd, let the Incision Knife be entred obliquely towards the hinder and upper parts, and that leisurely, and by little and little, till it penetrate into the Cavity of the Thorax, and then a little silver Pipe being put in, let the matter within contain'd, be let forth some at one time, and some at an∣other, but so that as far as the strength will bear, the evacuation of the whole humour be as quick as may be; for a portion of it being left within, upon frequent admission of air to it, will stinch most horridly within a few days; to prevent which evil, or sudden∣ly
to remove it, let a vulnerary and adstersive Liquor be injected with a Syringe twice or thrice a day. After the Incision is duly perform'd with what else belongs to it, well known to skilful Chirurgions, there will not be much more left for a Physician to do: He must prescribe a proper Diet, frequent Glisters to loosen the Belly (as often as occasion requires) and likewise vulnerary Medicines commonly so call'd, which hinder the dissolution of the Blood, and its running into Serosities prejudicial to the Brest.
But if the Signs of this Disease are not certain, and (as it u∣sually happens when a Peripneumonia, or an Impostume of the Lungs precede it) are wholly doubtful, you must not proceed to an Incision too hastily or inconsiderately: For I have known some Spitting forth a purulent matter, nay a faetid Pus, to whom an Incision of the Thorax has prov'd of no good effect, and not without some prejudice. Therefore till it shall appear by infal∣lible Signs that it is an absolute Empyema you may use for a while expectorating Medicines (such as before prescrib'd for Curing a Peripneumonia) and also things gently moving an Eva∣cuation by Urine and Sweat: But these at length availing nothing and the Empyema still continuing or encreas'd (since it is better, so there be strength, to try a doubtful Remedy than none) you may proceed to the Incision.
As to Forms of Medicines requisite for Curing an Empyema; before the Incision the same Remedies are proper, which are pre∣scrib'd for a Peripneumonia, but the incision being over, the fol∣lowing will be of particular use.
Against Faintings and Swoonings, which happen during that Operation, or after it: Let the following Julape be al∣ways in a readiness to be taken now and then to four or five spoonfuls.
Take the Waters of Bawm, and of Black Cherries, of each six Ounces, Aqua Mirabilis an Ounce, Pearl powdred a Dram, Syrup of Clove Gilly-flowers an Ounce: Mingle them, make a Julape.
Let the following Decoction be taken three or four times a day.
TAke Leaves of Harts Tongue, Speedwel, Agrimony, Colts-foot, Mous-ear, Sanicle, of each a handful, Roots of Madder and Cher∣vil, of each an Ounce, Barley half an Ounce, red Ciches half an Ounce, Raisins of the Sun an Ounce and a half: Boil them in four pounds of fountain water till half be consum'd; when it is taken, let it be sweeten'd at pleasure with Clarified Honey, or with Syrup of Mous-ear. If there be no Feaver, let the following Pills be ta∣ken at Night, and early in the Morning, to a Scruple or half a Dram.
Take Powder of Crabs Eyes two Drams, Flowers of Sulphur a Dram, Sal Prunella half a Dram, Species of Diarrhodon Abbatis a Scruple, Ve∣nice Turpentine wash'd, what suffices: Make a Mass, and form it into Pills: or the Turpentine being omitted let the same Medicine be taken in the Form of a Powder, from half a Dram to two Scruples twice a day.
THe Morbifick matter of this Vomica, or Impostume of the Lungs is always a meer Pus, which nevertheless is there engendred tacitely, and as it were unawares, without a Feaver or Inflammation, and lyes so private, that it scarce presents any signs of it self, but a little Cough, which at first is dry, then turns moist, which continuing some time, the Breath is drawn with some difficulty, the Spirits faint, and the Body wears away by little and little, though in the mean time the Spittle has no Pus or Blood mixt with it: But if the Impostume unexpectedly breaks, it commonly kills the Patient.
If after the Impostume is broken, and the Purulent Spittle be∣ginning to come away with ease, and the strength holding firm,
there be room for any method of Cure: The Primary Indicati∣ons according to the common custom in most Diseases must be these three, viz. Curatory, Preservatory, and Vital. The First, directs that the matter of the Impostume be with speed evacua∣ted by Spitting, and that the sides of it be cleans'd and made sound again as much as possible, The Second provides against a confluence of new matter to the Receptacle, and other neith∣bouring parts of the Lungs, whence a Consumption would be engendred. The Third relieves the faintings of the Spirits, and restores lost strength, and the Nutrition which was frustrated.
In respect of the First Indication, expectorating Medicines (commonly so call'd) and of the hottest and smartest nature, which cleanse and dry most, and especially (since for the most part here is no Feaver) Sulphureous things are proper; which al∣so are prescrib'd according to the Forms following.
Take Tincture of Sulphur three Drams, give from seven drops to twenty going to Bed, and early in the Morning in a spoonful of Syrup of the Juice of ground Ivy: Or,
Take Syrup of our Diasulphur six Ounces, give a spoonful at the same hours.
Take dry'd Leaves of ground Ivy, Germander, Maiden-hair, Colts∣foot, Hyssop, white Hore-hound, Savory, of each a handful, the Roots of Elecampane, Florentine Orris, Chervil, of each an Ounce, Anni∣seeds half an Ounce: Boil them in six pounds of fountain water to three pounds and a half, add towards the end White-wine six Ounces, the best Clarified Honey three Ounces: Let the straining be Clarified and kept for use: The Dose is six Ounces thrice a day warm. Or,
Take Water of quick Lime six pounds: Put it in a large mouth'd Glass with the following Bag.
Take dry'd Leaves of Germander, ground Ivy, white, Hore-hound, of each a handful, Roots of Elecampane and Florentine Orris slic'd, of each an Ounce and a half, Annisecds bruis'd two Ounces, Licorice an Ounce and a half, Raisins ston'd three Ounces: Let them stand cold and close cover'd, pour it out as you use it, still leaving the Bag behind.
Take Lohoch Sanum three Ounces, Species Diaireos two Drams and a half, Flowers of Sulphur a Dram and a half, Oxymel sim∣ple two Ounces: Make a Linctus to be taken with a stick of Li∣corice.
Take Powder of the Leaves of Hedg-musiard, and of ground Ivy, of each half an Ounce, Flowers of Sulphur a Dram and a half Sy∣rup of Diasulphur, or of the Juice of Ivy what suffices: Make a soft L••hech.
Take fine Myrrh, and white, Amber, of each half an Ounce, Sul∣phur vivum, Auripigment, of each two Drams, shells of Fistick Nuts a Dram and a half: Make a Powder for Fumigation; let it be us'd with a Paper Funnel Morning and Evening.
The Second Indication which is for preservation, cutting off the Mortinck matter, and providing against the Consumption which is apt to ensue, undertakes the purifying of the Blood, and the strengthening of the Lungs; for which eads Purges, Vul∣nerary Decoctions, distill'd Waters, and Physick Drinks are proper.
Take Gereon's Decoction of Sena (with Agarick a Dram and a half) three Ounces and a half, Purging Syrup of Apples an Ounce, Aqua Mirabilis two Drams: Make a Potion to be taken once a week with governance.
Let the Form of the vulnerary Decoction be the same, which is pre∣scrib'd for the Empyema after the Incision; or because there is no Feaver, you may give that Decoction of the shops, to four or six Ounces thrice a day.
Take Fir tops six handfuls, fresh Leaves of ground Ivy, Hyssop, Savory, Rocket, Hedge-mustard, Winter Cress, of each four handfuls, Sun-flower Seeds six Ounces, sweet Fennel-seeds two Ounces, Roots of Elecampane, and Florentine Orris, of each three Ounces, being slic'd and bruis'd, pour to them of Brunswick or Spruce Beer eight pounds, distil it with common Organs: Let the Liquor be all mixt, and when its us'd, let it be sweeten'd at pleasure with Syrup of the Juice of ground Ivy: The Dose is three or four Ounces thrice a day.
Take Roots of Sarzaparilla six Ounces, China Roots two Ounces, all the Saunders, of each six Drams, shavings of Ivory and Hartshorn, of each half an Ounce, Mastick-wood an Ounce, being slic'd and bruis'd, let them Infuse according to art, and boil in twelve pounds of foun∣tain water, till half be consum'd, adding of Licorice an Ounce, Rai∣sins of the Sun four Ounces; let the straining be us'd for ordinary drink.
The Third and Vital Indication prescribes Cordial and Anodine Remedies, and a fit Diet: The same Forms of Medicines in a manner that are prescrib'd for an Empyema after Incision, are proper here. Also the same Diet which is ordered in a begin∣ning Consumption, and Asses Milk often does good in this case: Concerning the Cure of this Disease, I have obferv'd that an Issue made in the side has often a very good effect.
A Gentleman of a middle Age, having been always strong and healthy, found himself ill without any manifest cause, and in a short time fell into a languishing condition, losing his appetite, sleeping with difficulty, was thirsty, and had a heat about his Praecordia: He was a long time under the hands of some Phy∣sicians for the Scurvy, and of others as Hectical, and after vari∣ous methods of Cure had been try'd in vain, the Disease at length openly discover'd it self: For whilst one Night being more restless than usual, he toss'd himself very much in his Bed; the Impostume within his Lungs breaking on a sudden, he threw up by Coughing a vast quantity of Pus, which stunk most horribly, so that within four or five hours he had thrown up about two pounds. Moreover the Cough continuing for above two Months afterwards, he daily voided by Spittle of that Purulent, thick, and mighty stinking matter, till his Flesh being consum'd, and his strength wholly spent, he was decay'd, and fallen away to nothing.
After the Impostume was thus broken, we carefully gave him Medicines to cleanse and heal the place where it gather'd, and to mundify the Blood and the Lungs, and free them from the imminent Consumption. Our Tincture and Syrup of Diasulphur, together with Pectoral and Vulnerary Decoctions and Distillations, also Linctus's and Balsamick Pills were taken day after day in a constant method: With these Glisters, also gentle Catharticks and Diureticks were interchangeably given; Vaporations first, then Suf∣fumigations both Sulphureous and Arsenical were also us'd Mornings and Evenings. After these things had been carefully followed a long time without any good; we concluded to open his Thorax, and were soon directed to a place proper for it, for on the left side of his Sternum, betwixt the fifth and sixth Vertebrae a tumour appear'd: Instead of a Cautery, I apply'd thereto a Suppurating Plaister, and within three days the top of that Swelling became red and soft, out of which being open'd the next day after, first issued a thin Ichor, and a little after a yellow and well conco∣cted Pus, and afterwards it continued daily to run in a more plentiful manner, and then the stinking Spittle began to abate, and within a Fortnight wholly ceas'd; the Morbisick matter finding both an easie and more apt passage through that Ori∣fice, which at length was chang'd into an Issue, and a Pea, or a Pill of Wood being daily put into it, there came forth conti∣nually for a year and a half a plentiful Ichor, and in the mean time the Gentleman having wholly got rid of any corruption in his Brest, and recovering his strong and fleshy habit of Body, became sound in all respects, Lastly, That Issue being remoy'd
to the Arm, he has nothing of that Distemper about his Brest, nor minds longer any fence against it.
Shortly after this Cure, I was call'd to a Lady of Quality, who having been troubled with a Cough, and a heat of the Praecordia for many years, on a certain day sensibly perceiv'd somewhat broken in her Lungs whilst she was Coughing, and presently voided by Spittle a great quantity of meer and stinking Pus; after that that Spittle with the Cough, notwithstanding any use of Remedies continuing for a Week, seem'd rather increas'd than diminish'd, I advised that she would permit an Issue to be cut in her side near the place, whence she perceiv'd the Pus to arise, which she readily giving way to, within three days meer Pus, such as she Spit forth by her Cough, began to run from the open Orifice; and afterwards the Morbifick matter find∣ing a sufficient vent by that passage, both the Cough and the Spitting of Pus entirely ceas'd, and within six Weeks the Patient grew perfectly well.
After this I was call'd to a robust man, a great Drinker, who being also affected with an Impostume of the Lungs, did Spit forth a great quantity of mighty stinking Pus: He would not permit any Issue to be made in his side; yet being very free to take all sorts of Medicines, he got free at length of that Disease by a long use of them: The Medicines which chiefly did him good were preparations of Sulphur; wherefore our Syrup and Tincture were given him often every day: To these we gave for Vehicles, sometimes a Pectoral Decoction, sometimes a Pe∣ctoral Hydromel, sometimes Lime water, with the Infusion of Pectoral and Vulnerary Ingredients. Moreover Fumigations, e∣specially of Sulphureous and Arsenical things, gave great Relief.
AN Asthma is a difficult, short, thick, and pursy Breathing, with a great Agitation of the Brest, and for the most part without a Feaver: And its either meerly Pneumonick, proceed∣ing from some stoppage in the Vessels that convey the Air, or meerly Convulsive, arising from some fault in the Organs of mo∣tion, or mixt when both parts are joyntly faulty.
As to its Cure there are two Primary Indications, or rather so many distinct methods of proceeding, viz. the one Curatory, the other Preservatory: The First teaches what is to be done in the Fit, to free the Patient from present danger; the other what out of the Fit, to take away the Cause of the Disease.
1. In the Fit there are two chief Intentions of Curing, viz. First, That care being taken as well of the Air, as of the Lungs, a more free Breathing be procur'd, at least as much as may suf∣fice to support Life: And Secondly, That the Organs of Respi∣ration be reclaim'd and made to cease from the Convulsions they are fallen into, and which are wont to be continued with obstinacy.
As to the former, in the First place let the Patient be set in an upright Posture of Body, in a pretty open place somewhat Airy, and free from Smoak, and the Breath of By-standers; then endeavour that the Lungs being freed of all inward stuffing and oppression, as well as outward compression, may be able to draw and return the Breath deeper: For these ends, lest the weight of the inferiour Viscera press down, and straiten the Praecordia, let the Belly be loosen'd by a Glister, and let the Garments and all other things covering or binding the Thorax be slacken'd. More∣over since in this case the Lungs are usually opprest, either from the Blood growing too turgid within the Pneumonick Vessels, or from the Serum distilling forth of the Arteries and Glands into the Ductus's of the Trachea, the Sallies and Impetuosities of both humours ought to be restrain'd and appeas'd: Hence if the strength will bear it, and the Pulse be strong enough, Bleeding is often proper. Again let those things be carefully given, which
discharge the Serum, and the superfluities of the inflamed Blood by Urine and Sweat: For which end Julapes, Apozems, and Pecto∣rals, commonly so call'd, are of excellent use. Moreover Pow∣ders of shells, preparations of Millepedes, Volatile Spirits and Salts are taken with good effect. In the mean time let there be like∣wise given things that open the Ductus's of the Trachea, and make them slippery, and provoke expectoration; and such also if need be, as stop the Catarrh distilling on them; for which ends Linctus's, Lohoch's, Pectoral Decoctions, and Suffumigations are proper.
As to the other intent of Curing in Fits of the Asthma, viz. That the Organs of Respiration being reclaim'd from the Con∣vulsions they are fallen into, return calmly to their ordinary Fun∣ctions (unless this follows of its own accord, after that the tur∣bulent boiling of the Blood and Serum within the Lungs is ap∣peas'd:) We must use Anti-Convulsive and Anodine Remedies; for Medicines wont to be given in Hysterick passions, are also proper in a Convulsive Asthma.
The Spirit of Hartshorn, of Soot, and especially Spirit of Sal Ar∣moniack distill'd with Gum Ammoniacum; also the Tincture of Gum Ammoniacum, of Sulphur, Castoreum, Assa-foetida, the Syrup of Am∣moniacum, of Sulphur, Oxymel of Squills, and the like; which be∣ing of an ungrateful tast or smell, dissipate the Spirits as it were, and withdraw them from tumultuary Efforts, prove sometimes of notable use: But if the raging Spirits cannot be appeas'd by this means, we must come to Narcoticks, that some of them be∣ing destroyed, the rest may return into order. For Opiats some∣times are mighty beneficial, unless a stopping of the Lungs, and a great oppression of the Praecordia forbid their use: In horrible sits of this Disease, when other Medicines have availed nothing, I have often given Diacodium, nay Laudanum Tartariz'd with good success: Nevertheless these may not be taken without great cau∣tion; for Respiration which is difficult and clogg'd before, being hindred more, and that very much by them, they often put the Patient in danger of Life. Moreover to reclaim the Pnenmonick Spirits from their Convulsions; its good sometimes to put the Spirits to torture in some other part, for when some of them are any where tormented, all the rest for the most part, being in a concern at it, quit their disorderly motions. Wherefore Vesica∣tories, Cupping-glasses, Ligatures, and Painful Frictions give relief: Nay for this reason Vomits taken in the midst of the fit do good. I shall now set down certain Select Forms of Remedies appropri∣ated to each of those ends.
First therefore to restrain the Fluxions of the Blood and Se∣rum, and to discharge their superfluities, deriv'd from the Lungs, by Sweat and Urine; let the following things be pre∣scrib'd.
Take Leaves of ground Ivy eight Ounces, Rue, Penny-royal, and Dragons, of each two Ounces, Sal Prunella a Dram and a half, Srru∣pus Byzantinus, Syrup of red Poppies, of each an Ounce: Mix them, make a Julape; let three or four Ounces be taken thrice or oftner in a day.
Take Grass Roots three Ounces, Roots of Butchers-Broom two Oun∣ces, Candied Elecampane an Ounce and a half, Barley half an Ounce, Raisins of the Sun an Ounce: Boil them in three pounds of fountain water to two pounds, to the straining add of Sal Prunella a Dram and a half, sweeten it if it be needful, with a sufficient quantity of Syrupus Byzantinus, or of Syrup of Violets.
Take Tincture of Sulphur three Drams: The Dose is from six drops to ten at Night, and early in the Morning in a spoonful of the Syrup of the Juice of Ivy, or of Violets.
Take Feculae of Aron and Briony, of each a Dram and a half, Flow∣ers of Sulphur a Dram, Flowers of Benzoin half a Dram, Sugar Can∣dy half an Ounce, Licorice two Drams: Make a Powder to be taken to half a Dram, or two Scruples twice a day, with the foregoing Ju∣lape or Apozeme. Or,
Take of the foresaid Powder two Ounces, Honey or Oxymel what suffices: Make a Linctus, take at Night and early in the Morning, about half a spoonful, at other times take it with a stick of Lico∣rice.
Take Syrup of Hore-hound, and of Garlick, of each an Ounce and a half, Tincture of Saffron, and of Castoreum, of each two Drams: Mix them, take about a small spoonful in the fits.
Take Spirit of Sal Armoniack with Gum Ammoniacum three Drams, the Waters of Snails, and of Earth-worms, of each three Ounces, Sy∣rup of Horehound two Ounces: Mix them, take a spoonful once in four or five hours.
Take Powder of Hedg-mustard, or of ground Ivy gathered in the Summer Sun an Ounce, Oxymel simple what suffices: Make a Linctus.
So much concerning the Medicines and method requisite in a fit of the Asthma. The other Indication which is for preservati∣on, undertaking to remove the Morbifick cause, and the whole Morbid Root has two parts, or distinct Intents of Curing, which for the most part are both set upon together; one of these en∣deavours to amend the Conformation of the Lungs, if it be any way prejudiced or faulty, and the other to take away the Irre∣gularities of the parts for motion, and of the Spirits appointed
for them: Both these Intents will very well be answered, if Pe∣ctoral Remedies commonly so call'd are joyn'd with Anti-Con∣vulsives, and are us'd interchangeably with other Medicines which have regard to the preparation of the whole Body, and to Emer∣gent Symptoms; for which ends the following Method and Forms of Medicines may be us'd.
Take Aloe Rosata a Dram and a half, Flowers of Sulphur a Dram; Salt of Amber half a Dram, Tar what suffices: Make Pills, in number twenty four; take four in the Evening every Night, or every other, or third Night. Or,
Take Gum Ammoniacum, and Bdellium dissolv'd in Vinegar of Squills, of each half an Ounce, Flowers of Sulphur three Drams, Powder of the Leaves of Hedg-mustard, and of Savory, of each half a Dram, with a sufficient quantity of Syrup of Diasidphur, or of Oxy∣mel of Squills: Make a Mass, form it into little Pills, and take three every Evening. Or,
Take Millepedes prepar'd two Drams, Flowers of Benzoin half a Dram, Salt of Amber two Scruples, Extract of Elecampane half a Dram, Castoreum half a Dram, Saffron a Scruple, Venice Turpentine what suf∣fices: Make a Mass, and form it into small Pills; take four every Evening and Morning, unless when you Purge.
If Pills are not grateful, or the foresaid Medicines will not do; then let the following be try'd to free the Lungs from obstru∣ction.
Take Spirit of Gum Ammoniacum, distill'd with Sal Armoniack three Drams, Syrup of the Juice of Ivy three Ounces, Magisterial wa∣ter of Snails, and of Earth-worms, of each an Ounce, Tincture of Saf∣fron two Drams: Mix them, take a spoonful going to Bed, and early in the Morning. Or,
Take Tincture of Gum Ammoniacum three Drams: The Dose is from fifteen Drops to twenty in a spoonful of Oxymel, or Syrup of ground Ivy. Or,
Take Tincture of Sulphur three Drams: The Dose is from seven Drops to twelve or twenty at the same hours, with a fit Ve∣hicle.
After the like manner also other Spirits endow'd with a Vola∣tile Salt, and mixt with Pectoral Syrups, and Cephalick waters may be usefully prescrib'd Morning and Evening.
Instead of a Mixture or Asthmatical Julape of distill'd waters of the shops, the following Magisterial may be prepar'd to be us'd frequently, and upon several occasions.
Take Roots of Elecampane, Florentine Orris, Angelica, Masterwort, of each four Ounces, of Briony a pound, Leaves of white Horehound, Hyssop, Savory, Penny-royal, ground Ivy, of each four handfuls, fresh Juniper and Ivy Berries, of each a pound, Lawrel Berries half a
pound, Seeds of sweet Fennel, Caraway, Annise, Lovage, Dill, of each an Ounce, Cubebs two Ounces, long Pepper, Cloves, Mace, of each an Ounce; all of them being slic'd and bruis'd, pour to them of Brunswick Beer eight pounds; distill them with common Organs: Let the whole Liquor be mixt, and when its used, let it be sweeten'd at pleasure with Sugar, or the Syrup of the Juice of ground Ivy, or with Oxy∣mel.
Moreover, instead of Oxymel, or of any common Pectoral Syrup, let the following Forms of Medicines be prescrib'd which are more appropriated to an Asthma: And in the First place the Syrup of Elecampane, invented by Horatius Augenius, and afterwards re∣commended by Platerus, Sennertus, Riverius, and other famous Practitioners shall be set down here, and ought to be frequently made use of.
Take Roots of Elecampane, and of Polypody of the Oak prepar'd, of each two Ounces, Currans two Ounces, Sebestens in number fifteen; Coltsfoot, Lungwort, Calaminth, Savory, of each a handful, one large Tobacco Leaf, Licorice two Drams, Seeds of Nettles, and of Cotton∣plant, of each a Dram and a half; boil them in Wine and Honey diluted, to a pound and a half, and with the like quantity of Sugar make a Syrup: Let it be taken either by it self in the Form of a Linctus, or a spoon∣ful at a time Mornings and Evenings, or put a spoonful of it to a Dose of the distill'd water or Apozeme.
Take Roots of Florentine Orris, and of Elecampane, of each half an Ounce, Garlick pill'd four Drams, Cloves two Drams, white Benzoin a Dram and a half, Saffron a Scruple, being slic'd and bruis'd, let them digest warm in a pound of rectified spirit of Wine for twenty eight hours: To the straining add of the finest Sugar a pound, put it in a silver Bason on hot Coles, then the liquor being fired, keep stirring it as long as it will burn, and then the flame going out, it will become a Syrup; let it be given after the same manner as the former.
Moreover, in this place we may aptly insert the Decoctions of an old Cock so much commended by famous Physicians, both ancient and modern, for the Cure of the Asthma. These Broaths are of two kinds, viz. with or without Purgers, and we find various and differing sorts of both amongst Practical Authors, though I shall only give you a form or two.
Without Purgers this is a common Form:
Take Roots of Elecampane, and of Florentine Orris, of each half an Ounce, Leaves of Hyssop, and of Horehound dry'd, of each six Drams, Carthamus-seeds an Ounce, Anniseeds and Dillseeds, of each two Drams, Licorice slic'd, and Raisins cleans'd, of each three Drams; let them be prepar'd and sewed up in the Belly of an old Cock, which must be boil'd in fifteen pounds of fountain water till the flesh falls from the Bones, strain it and let it settle: The Dose of the clear Liquor is
six Ounces, with an Ounce of Oxymel simple; or if you would have it purge, in each draught dissolve fresh Cassia and Manna, of each half an Ounce: Let it be taken for many days together, sometimes for a whole Month.
Riverius prescribes a good Form of this sort of Purging Broath.
Take Roots of Elecampane, and of Florentine Orris, of each a Dram and a half, Leaves of Hyssop and Coltsfoot, of each a handful, Li∣corice slic'd, Raisins clean'd, of each two Drams, Figs in number four, Senna cleans'd three Drams, Roots of Polypody of the Oak, Carthamus∣seeds of each half an Ounce, Anniseeds a Dram and a half: Boil them with a third or fourth part of an old Cock according to art, and make a Broath for one Dose to be taken in a Morning; let it be continued for twelve or fifteen days.
I shall now give you a Relation of a Person, who was subject to fits of this Disease, which were meerly Convulsive, and of an∣other, who was subject to fits of the same, which were partly Convulsive, and partly Pneumonick.
A Noble Man of a tall Stature, and full and strong grown, ha∣ving bruis'd is left Side by a fall, found himself injur'd upon it, and afterwards fell into an Asthmatick Distemper, so that now and then, though at no set times, First a pain would seize him about that place, and presently after a great straitness of Breath followed, with a vehement and long continued straining of all the parts of Respiration, so that during the Fit, the Patient seem'd to be in the very Agony of Death: I was first call'd to him after he had lain ill of such an Asthmatick Fit for two days, and was look'd upon as almost past Cure. Nevertheless finding his Lungs to be without hurt, our Prognostick bid us still hope well, and presently other Physicians being joyn'd with me in Consultation, it was prescrib'd as follows.
Take Spirit of Gum Ammoniacum distill'd with Sal Armoniack three Drams: Let him take from fifteen drops to twenty, in a spoon∣ful of the following Julape, drinking after it five spoonfuls; let it be repeated every sixth hour.
Take the waters of Elder Flowers, Cammomil and Penny-royal, of each four Ounces, Snail water two Ounces, Sugar an Ounce, mix them: Between whiles he took a Dose of the following Powder with the same Julape, or Pectoral Decoction.
Take Powder of Crabs Eyes two Drams, Sal Prunella a Dram and a half, Salt of Amber half a Dram, max them: Divide it into eight parts for as many Doses.
Large Vesicatories were apply'd in the inside of his Arms near his Armpits; Glisters were daily administred, and frequent Fricti∣ons: By the use of these things he received a sudden and unexpe∣cted
ease, and within a few days got wholly free of that Fit, and afterwards as often as he perceiv'd a little touch of the said Di∣stemper coming, he presently took a large Dose of that Spirit, with the same Julape thrice or four times a day: By which Re∣medy, being frequently taken sometimes for preservation, and sometimes for Cure, he has now past above two years without any great and terrible fit of his Asthma, which before was habi∣tual, though he has now and then undergone some light touches of it, but easily blown off.
An Honourable old Gentleman (upon taking cold as 'tis judg∣ed) found himself ill; for he complain'd of a pain in the middle of his Brest by his Sternum, which at Night as soon as he was warm in his Bed, growing worse, disturb'd his sleep, and was very troublesome to him for the most part of the Night: Never∣theless without any straintness of Breath, or evident sign of an Asthma: To take away this pain he was both Purg'd and Blood∣ed, Pectorals and Antiscorbuticks were daily given him, Oyntments and Fomentations were apply'd to the place pain'd, yet without any great good or ease: For the change that happen'd after, was rather for the worse; for the pain being a little abated, he was seiz'd with a laborious and troubled Respiration, so that after his first sleep, or as he began to slumber, he was taken with a fit of the Asthma, and being out of Breath, and opprest about the Praecordia, was forc'd to sit upright in his Bed: Moreover this painful Breathing, and Convulsive agitation of the parts for Re∣spiration did not only return every Night, but daily grew more violent, and continued longer upon him: Insomuch that one Night awaking from his first sleep, he was seiz'd with a most vi∣olent fit of the Asthma which lasted for many hours, and brought him as near death as a Man might be and live. No Physician be∣ing present, a Barber then let him Blood, which gave him some relief; in the Morning upon a consultation of Physicians, he was ordered for that day a thin Diet, and a loosning Glister: At Night and the Morning following, he took twelve drops of Spirit of Gum Ammoniacum distill'd with Sal Armoniack in a Vehicle proper in that case, and continued its use afterwards for many days: Vesicato∣ries were apply'd to the insides of his Arms near his Arm-pits: Moreover Julapes and Pectoral Decoctions, Lohoch's, Glisters, nay and sometimes gentle Purges had their truns; Bleeding also was repeated after two days. Whereas before he was wont to drink for his Mornings draught about a pint of Beer with Wormwood and Scru∣vygrass, Instead of this, he took about eight of the Clock, fifteen drops of Elixir Proprietatis tartariz'd in a draught of Coffee prepar'd with a Decoction of Sage: By these Remedies the Asthmatick Fits presently abated of their wonted fierceness; insomuch that the
beginning and end of every Night were quiet enough, though about the middle of it some uneasiness about the Praecordia kept him waking, and made him sit upright in his Bed for an hour or two; at length growing weary of Physick, he took only now and then some of the Medicines above mentioned: But in the mean time, though his Asthmatick Fits troubled him little or not at all by Night as before, yet by reason of his Lungs being very much stuffed, and a Serous humour falling into his Feet he could not walk fast, or go up any steep Ascent without a great diffi∣culty of Breathing, and danger of being choak'd; and at present an Asthma or Phthisick is not so much fear'd as a Dropsie.
IF at any time the affect of the Dropsie or Anasarca, being ge∣neral, has taken possession every where, or in most places of the Flesh, and Cavities of the Viscera: Its no wonder if that filthy Mass of Waters gets possession also of the Breast; but besides this, it sometimes happens that the Region of the Thorax is either o∣riginally or alone overwhelm'd with waters, the other parts in the mean time being every where sound enough, or injur'd only Secondarily.
That Serous humour causing the Dropsie of the Breast, arises there either in the Form of a Vapour, which exhaling from the Praecordia and Sides of the Thorax is readily condens'd into Water, or Secondly, the Serum is there depos'd in its proper Form as it distils into that Cavity from the Mouths of the Vessels, viz. of the Arteries there open'd: Or Thirdly, the Lymphaeducts, or some∣times, though rarely, the Chyle Vessels, somewhere opening themselves, or being broken may produce that affect.
A young Man of a healthy and strong constitution, who had long us'd himself to violent exercises, both by riding and other ways, perceiv'd at length a fulness, or as it were a certain windy rising in his Thorax, insomuch that the left side of his Lungs seem'd to swell, and his Heart to be thrust forth of its place to∣wards the right side; for in that part it was perceiv'd to beat most: After he had continued in this condition some time, he perciv'd on a certain day a Rupture as it were of some Vessel
within the Cavity of his Thorax, and after it for half an hours space, he could not only perceive in that Region a dropping of humour as it were from the top to the bottom of his Brest, but it could also be head by the standers by. Notwithstanding this, finding himself otherwise well dispos'd, he slighted Physick; but afterward upon motion, stooping, or any stirring of his Body, he perceiv'd in his left side a floating of waters inwardly gathered together: Nay, and the motion and sound of it was most mani∣festly perceiv'd of others, both by handling, and by the ear: Hence as it was plain that this Person had a Dropsie of the Breast, so it seemed most probable that this Disease took its rise from this, that the Lymphaeducts appertaining to the left side of the Lungs being first obstructed near their Insertions into the Du∣ctus Chyliferus, had swollen up to a vast bigness, and afterwards being broken, distill'd forth their humour into the Cavity of the Thorax.
This Gentleman not perceiving himself in danger, and having try'd some Medicines without any good effect, was advised upon a consultation of Physicians, to have his Side open'd: Wherefore provision for the whole being made, a Chyrurgion apply'd a Cautery betwixt the sixth and seventh Vertebrae, and the day following he put a Pipe into the Orifice, cut into the Cavity of his Brest, up∣on which presently a thick Liquor, whitish like Chyle, and as it were Milky issued forth: There were only about six Ounces ta∣ken from him the first time, and the day following as much: On the third day somewhat a larger quantity being let forth, he was presently seiz'd with a great fainting, and afterwards being Feaverish, he was ill for a day or two: Wherefore till he recove∣red his due temper and strength, it was thought fit to stop the egress of that matter, and afterwards a small evacuation only of the same being daily made, the Cavity of his Brest was in a man∣ner wholly emptied, though he still carries the Pipe in the Ori∣fice with a Tap, which being drawn forth once in twenty four hours, a little gleeting of humour still issues out: In the mean time being well dispos'd as to his Stomack, Countenance and Strength, he Walks and Rides abroad, and performs other exer∣cises which he had been formerly us'd to with vigour enough: He us'd not much Physick, nor did he need it: After the Incision we prescrib'd him temperate Cordials, viz. Powder of Pearl, Julapes, and sometimes Hypnoticks, and afterwards a vulnerary Decoction to be taken twice every day.
By this Method and Form of Medicines continued for some time the Person seem'd to recover his due temper, strength, and habit of Body, nay and to be sound in his Breast; yet he still car∣ried the Silver Pipe in the Orifice of his Side, out of which an
Ichor continually issued: And when after some Months this being taken forth, that Issue was clos'd up, there was a gathering again of the same humour within the hollow of the Breast, as was per∣ceivable by the sound and floating of it: But afterwards as upon the return of the Disease the same Remedy presented it self, and consequently the opening of the Side was ordered (Nature as it fell out performing the Office of a Chyrurgion) it happened of its own accord, and gave way for the matter which was ready to break forth; and now he is fain to keep that Orifice constant∣ly open as a sink to prevent that gathering of nastiness in his Brest.
As to the Cure of the Dropsie of the Brest, the Primary Indi∣cations, as usually in Curing most other Diseases, are three, viz. Curatory, Preservatory, and Vital.
The First endeavours that the Waters gathered in the Cavity of the Breast be some way or other evacuated. The Second pre∣vents the gathering of new matter. The Third takes care to restore strength, and speedily to remove the Symptoms that in∣jure it.
To satisfy the First Indication, there are only two ways or manners of evacuation, by which that filthy Mass of Waters may be clear'd forth, viz. either that the Vessels of the Breast, and Du∣ctus's of the humours being emptied, drink up again that Lympha when Rarifyed, and then convy it forth, either by the way of the Blood, or of the Breath: or Secondly that the water be all let forth in its proper Species by an Incision of the Side.
The former way, though seldom, yet sometimes to my know∣ledge succeeds: For the Texture of the Lungs being spongy with∣in, and outwardly very Porous, whilst upon every Diastole it is dip'd in the waters lying under it, it sometimes imbibes them being converted into vapour, and so either returns them to the Blood, or exhales them with the Air continually breath'd forth at the Mough; that this effect may more readily happen for Cu∣ring this Disease, Physical Aids are here us'd: Therefore for that intent the passates of the Blood, Air, and humours, ought to be emptied as much as may be, and to be kept open and free: For this end let gentle Purges, Diureticks and Diaphoreticks be methodically given by turns, also Thoracical and Expectorating Remedies must be us'd: Let the Diet be thin and heating, and let such a method be ordered in all things which may promote the exhalation of the Blood, and cause all the superfluous humours to evaporate. I shall set down some Forms of Medicines pro∣per for these purposes.
Take Roots of Chervil, Butchers-broom, Polypody of the Oak, of each an Ounce, Leaves of Agrimony, Maiden-hair, Oak of Hierusa∣lem, ground Ivy, of each a handful, Carthamus-seeds an Ounce, Roots of Florentine Orris half an Ounce: Boil them in four pounds of foun∣tain water till a third part be consum'd, then add to the straining Sena Leaves an Ounce and a half, Agarick two Drams, Mechoacan, Turbith, of each half an Ounce, yellow Saunders a Dram and a half, Roots of the lesser Galingal a Dram: Boil them close cover'd for two hours, then strain it, add of the best Honey two Ounces, and Cla∣rify it with the white of an Egg: Make a Purging Hydromel, the Dose is from six Ounces to eight in the Morning, twice or thrice a Week. Or,
Take Calamelanos a Scruple, Rosin of Jalap half a Scruple, Balsam of Peru what suffices: Make four Pills, let them be taken in the Mor∣ning, repeating the Dose within five or six days.
Take Tincture of Sulphur three Drams, give from seven drops to ten going to Bed, and early in the Morning in a spoonful of the following Mixture, drinking after it three spoonfuls.
Take the waters of Snails, Earth-worms, and Compound Radish wa∣ter, of each four Ounces, water of the Juice of Elder-berries fermented a pound, Syrup of the Juice of ground Ivy two Ounces,: Mix them, make a Julape. Or,
Take Tincture of Gum Ammoniacum, or of Galbanum: Give to twenty drops at Night, and early in the Morning with the same Mixture. Or,
Take Millepedes prepar'd two Drams, Flowers of Sulphur two Scru∣ples, Flowers of Benzoin a Scruple, Powder of wild Carrot, and Bur∣dock-seeds, of each half a Dram, Venice Turpentine what suffices: Make a Mass, form it into little Pills, take four at Night and early in the Morning, drinking after it a little draught of the same Ju∣lape.
At nine a Clock in the Morning, and five in the Afternon drink a draught of the water of Quick-lime Compound, to four Ounces, by it self, or with some other appropriate Medicine.
For ordinary drink take the following Bochete.
Take Roots of Sarsaparilla six Ounces, China two Ounces, the Woods of white and yellow Saunders, of each six Drams, shavings of Ivory and Hartshorn, of each three Drams, Roots of Calamus Aro∣maticus half an Ounce, Raisins ston'd half a pound, Licorice three Drams: Let it infuse according to Art, and boil it in twelve pounds of fountain water to six pounds, strain it.
I was call'd to a young Scholar at Oxford, who had been ill for three Weeks of a pain of his Thorax, and of a great difficulty of Breathing that constantly followed him in the Even∣ing,
which also upon a quick motion of his Body, or his go∣ing up a steep Ascent tormented him above measure; he could not rest long on either side, but was forc'd to lye always on his Back, and with his Head raised: And if he try'd to lye on either side, presently a pain followed the Position of his Body; and if haply he rolled himself from one side to the other, the pain also being presently remov'd, he felt as it were wa∣ters floating from one place to another: So if he let his Bo∣dy hang downwards over the Bedside, he presently felt wa∣ters falling towards his Clavicular Bones. Moreover, if at any time his Body was heated more than ordinary by motion, the heat of a Bed, or of a Fire, presently he felt in his Brest a boiling as it were of waters on the Fire, and at the same time complained of a Giddiness, and of a little fainting of his Spirits. Being well satisfied by a due consideration of these things that he had a Dropsie of the Brest, I prescrib'd the Me∣thod and Medicines following with success.
Take Calamelanos fifteen Grains, Rosin of Jalap half a Scruple, Syrup of Roses solutive what suffices, make three Pills. He took them early in the Morning, and had twelve Stools, which gave him great ease. Then again on the third day he had only four Stools by the same Medicine, though with greater relief to him than before. He took afterwards for many days of a Diuretick and Pectoral Apozeme six Ounces: And Lastly, the same Purge being repeated, he grew perfectly ivell.
AS to the method of Curing this Disease, there are three Pri∣mary Indications, all which (since we are in a manner al∣ways at a loss which of them is the chiefest, and first to be put in Practise) must be prosecuted together: Therefore the Inten∣tions of Curing must be. First, That the obstructions of the Du∣ctus's must be open'd, if haply there are any either in the Porus Biliarius, or Meatus Cysticus, or elsewhere about the Liver, or Vessels that convey the Choler. Secondly, That the Blood be re∣duc'd to its due temper and Crasis, lest it engender Choler in too great a plenty, or render it unapt for separation. Thirdly, That the strength be upheld, and that the Symptoms chiefly prejucicing it be provided against.
1. To satisfy the First Incication, Cathartick evacuations both by Vomit and Seige are greatly conducing, with which the de∣scent of the Choler towards the Intestines is Irritated, and the ob∣structed Vessels being by this means mightily agitated, are freed from their stoppages. Secondly, We must give Medicines that are smart, bitter, and salt, and others endow'd with a certain in∣stigating vertue, which may sharply stir up the motion of the Gall gathered together in the Liver, and there stagnating. In this place also we must range such Medicines as are thought to be good against the Jaundise by a similitude of substance, and as it were by a Signature; viz. as being endow'd with a yellow Juice, though many of these because they move Urine or Sweat, may aptly enough be plac'd in the same rank with the former, viz. a∣mongst evacuative Medicines.
The Second Indication requires altering Medicines altogether, viz. such as may depress the exaltations or wild efforts of the Sul∣phur and fixt Salt, and help to the restitution of the Volatile Salt which was depress'd before: For these purposes Medicines con∣taining an Acid or Volatile Salt, and likewise Chalybeats will do excellently well: Hence Spirit of Salt, of Vitriol, Juice of Limons; also Spirit of Hartshorn, and Sheeps dung, Goose dung, Crocus Mar∣tis, and other preparations of it of divers kinds, are often prescrib'd in the Jaundise with good success.
The Third Incication being for the support of the strength, and for removing Symptoms that prejudice it, suggests to us many and diversifyed manners of Curing; but to avoid tedious∣ness, I shall only set down certain general Rules concerning Diet, and some Cordial and Anodine Remedies peculiarly proper in this case.
The Therapeutick Indications being thus laid before you, it remains for us now to adjust Select Medicines, viz. both simple and compound to each of those Intentions before propos'd, and to explicate the manners and ways of operating of those Remedies which are accounted of most note in this Disesse: First therefore we shall set before you the Forms of Evacuating Medicines appro∣priated to the Jaundise.
EMetick Medicines most commonly are of good effect in a new Jaundise, whilst the tone and strength of the Viscera hold good; forasmuch as they both ease the Ventricle of its offensive load of viscous Phlegm, with which its in a manner always op∣prest in this Disease, and likewise by irritating the Vessels which convey the Choler, and strongly shaking the Ductus's of the Li∣ver, they clear them of their stoppages, and bring the Choler to pass by the ways it formerly was wont.
Take of the Infusion of Crocus Metallorum, from half an Ounce to six Drams, Vinegar of Squills an Ounce, Oxymel simple half an Ounce: Make a Vomit to be taken with governance.
Sometimes it is proper to give the Evening before the following Mixtrue, as a preparation to facilitate the Vomiting.
Take Powder of the Roots of Asarabacca, Faecula of Aron Roots, of each a Scruple, Tartar vitriolated half a Scruple, Oxymel simple an Ounce: Mix them.
Take Sulphur of Antimony seven Grains, Scammony sulphurated eight Grains, Cream of Tartar half a Scruple: Make a Powder, give it in a spoonful of Panada.
Take Nine Leaves of Asarabacca; being slic'd and bruis'd, pour to them of Whitewine three Ounces, press forth the Juice, give it in the Morning with governance.
Take Cambogia prepar'd eight Grains, Tartar vitriolated seven Grains: Make a Powder.
PUrging Medicines have place in this Disease, whether it be new or inveterate, viz. both that the plentiful supply of Ex∣crements, be now and then clear'd from the first passages, and that the Vessels that convey the Choler be stirr'd up to ex∣cretion.
Take Electuary of the Juice of Roses three Drams, Rhubarb a Dram, Salt of Wormwood, Cream of Tartar, of each half a Scruple, Syrup of Rhubarb what suffices: Make a Bolus.
Take Roots of sharp pointed Dock prepar'd an Ounce, tops of Sea Wormwood, and of the lesser Centory, of each two pugils, Roots of Gentian and Turmerick, of each two Drams, yellow Saunders a Dram; boil them in a pound and a half of fountain water to a pound; towards the end, add of the best Sena six Drams, of the best Rhubarb three Drams, Agarick a Dram and a half, Coriander-seeds two Drams, Whitewine two Ounces, let them boil close covered for two hours, then strain it, and let it settle till it be clear: The Dose is from four Ounces to six, with Syrup of Rhubarb an Ounce, water of Earth-worms three Drams: Make a Potion to be taken for three or four days together, or every other day.
TAke Choice Rhubarb two Drams, Agarick Trochiscated half a Dram, Cinnamon half a Scruple, Ginger half a Scruple: Make an Infusion in Whitewine and Succory water, of each three Ounces, being close cover'd and kept warm for three hours: In the strain∣ing dissolve Syrup of Rhubarb an Ounce, water of Earth-worms two Drams.
Take Rhubarb powdred, from half a Dram to a Dram, Salt of Worm∣wood a Scruple: Make a Powder,
Take Pilulae Ruffi a Scruple, Extractum Rudii half a Scruple: Make four Pills, let them be taken in the Morning with governance, repeat∣ing them within four or five days.
In the Third place follow Deopilatives, and these are Diureticks, or Diaphoreticks, of which also some are accounted Specificks for their Similitude of substance; these sorts of Medicines both pro∣mote the separation of the Choler from the Blood, and being se∣parated, force its way through the straitest passages and Pores in the Liver: Moreover at the same time by fusing the Blood, they cause its Serosities and Bilous Excrements to be sent forth in some measure by Sweat and Urine.
Take Elixir Proprietatis an Ounce, give twenty drops in the Morn∣ing, and at five in the Afternoon with a fit Vehicle: After the same manner, the Tincture of Antimony, or of Salt of Tartar are often gi∣ven with success; also Mixtura Simplex in a greater Dose. For Ve∣hicles also for the same Intention of Curing, Apozemes, distill'd waters and Julapes are proper.
Take Roots of the greater Celandine, stinging Nettles, Madder, of each an Ounce, tops of Sea Wormwood, white Horehound dry'd, Agri∣mony, Germander, of each a handful, Worm-seeds two Drams, shavings of Ivory and Hartshorn, of each two Drams, yellow Saunders a Dram and a half, Coriander-seeds two Drams; boil them in three pounds of fountain water to two pounds, add of Whitewine four Ounces, and strain it, add Syrup of Cichory with Rhubarb two Ounces, Water of Earth-worms an Ounce and a half: Make an Apozeme, the Dose is from four Ounces to six twice a day.
Take Leaves of white Horehound dry'd, of the lesser Centory, of each a handful, Roots of Gentian and Turmerick, of each three Drams, Cinnamon a Dram, Saffron half a Dram, being slic'd, let them be put into a Glass with White or Rhenish Wine two pounds: Make a close Infusion, the Dose is three Ounces.
To this place belongs the famous Anti-Icterick of Gesner.
Take Roots of the greater Nettle a pound, Saffron a Scruple: Bruise them well, and extract a Tincture with Whitewine, the Dose is three Ounces in the Morning for four or five days.
Like to the former is that of Fr. Joel. Take Roots of the great∣er Celandine slic'd two handfuls, Juniper Berries a handful, being bruis'd, pour to them of Rhenish Wine a pound, and extract the Juice: The Dose is four Ounces twice a day.
The Juice of white Horehound is mightily commended by Diosco∣rides for the Cure of the Jaundise, and its Syrup by Forestus.
Instead of the Elixir and other Chymical Liquors which are or∣dered to be taken in a very small quantity to avoid nauseousness: You may give more successfully Electuaries, Powders, and Pills to others of a strong Constitution.
Take Conserve of Sea Wormwood, the outward yellow Coats of Oran∣ges and Limons, of each two Ounces, Species Diacurcumae an Ounce and a half, Powder of Ivory, yellow Saunders, the Lignum Aloes, of each half a Dram, Troches of Capers a Dram, Troches of Rhubarb half a Dram, Salt of Wormwood two Drams, with a sufficient quantity of Syrup of Cichory with Rhubarb, make an Electuary; the Dose is the quantity of a Chesnut twice a day, drinking after it of the following Julape three Ounces.
Take Waters of the greater Celandine, Fumitory, Wormwood simple, and of Elder Flowers, of each five Ounces, Magisterial water of Snails, Water of Earth-worms Compound, of each two Ounces, Sugar half an Ounce: Mix them, make a Julape. Or,
Take Roots of the greater Nettle, Angelica, Gentian, of each four Ounces, the greater Celandine entire six handfuls, Wormwood, Tansie, both Southernwoods, of each four handfuls, the outward Coats of twelve Oranges, and of four Limons, Earth-worms prepar'd, Snails, of each a pound, Cloves bruis'd two Ounces, being slic'd and bruis'd, pour to them of Whitewine eight pounds, distil it with common Organs: Let the whole Liquor be mixt. Or,
Take Filings of Steel a pound, fresh Strawberries six pounds, put them in a glazed Pot and stir them together, and let them stand for a day, then add of the Roots of English Rhubarb slic'd a pound, the Rinds of four Oranges, being slic'd, pour to them of Whitewine six pounds, and distil them according to art: Let the whole Liquor be mixt: The Dose of this and the former is three Ounces twice a day after the Electuary, or other Medicine.
Take Powder of the Roots of Turmerick and Rhubarb, of each a Dram and a half, Rinds of Caper Roots, Asarum Roots, of each half a Dram, Extract of Gentian and Centory, of each a Dram and a half, Salt of Wormwood four Scruples, Seeds of Water-cresses half a Dram, of Rocket half a Scruple, Elixir Proprietatis a Dram, Gum Ammoni∣acum dissolv'd in a sufficient quantity of Water of Earth-worms: Make a Mass, Form it into little Pills, the Dose is half a Dram Evenings and Mornings, drinking after it of the distill'd Water three Ounces.
Sylvius highly commends for the Cure of the Jaundise a Decocti∣on of Hemp-seeds in Milk, and a Solution of Soap.
The Second Indication having regard to the altering, or due tempering of the Blood, that it engender Choler only in a mode∣rate quantity, and duly separate it, requires those kinds of Medi∣cines which depress the Sulphur and fixt Salt when too much exalted: For these ends, I know not by what chance or guidance Medicines endow'd with a Volatile Salt, as Earth-worms, Snails, Millepedes, nay Lice, the Dungs of Fourfooted Beasts, and of Fowl, being introduc'd into Practise for Curing the Jaundise, are usually
given not only by Empyricks, but likewise prescrib'd by Physici∣ans of the best account: These sometimes by themselves, but oftner joyn'd with Evacuatives and Deopilatives enter the chief compositions of Anti-ictericks.
Fonseca prescribes Goslings Dung gathered in the Spring time and dry'd, and also the white Dung of Chickens; the Powder of both which is given from half a Dram to a Dram, in a fit Vehicle.
Take Powder of Earth-worms prepar'd, Goose dung, of each three Drams, Ivory, yellow Saunders powdred, of each half a Dram, Saffron a Scruple: Make a Powder, divide it into six parts for so many Mor∣ning Doses, with some Liquor fit for the purpose.
To the Anti-icterick Apozem and Tincture above prescrib'd, Earth-worms; also Goose-dung, and Sheeps-dung, are usefully added.
Take of fresh and live Millepedes, in number from fifty to a hun∣dred, Saffron half a Scruple, Nutmegs a Scruple, being bruis'd toge∣ther, pour to them of Celandine water four Ounces, water of Earth∣worms two Ounces, wring it forth hard, and drink it: After this manner let it be taken first once, afterwards twice a day for a Week.
Its a vulgar and Empirical Remedy with our Country men to take Nine Lice alive in the Morning for five or six days, by which Remedy I have heard that many have been Cur'd when other things did no good; which certainly can give relief no other way but by restoring the Volatile Salt, which was depress'd in the Blood.
On the account of the same way of Curing, the Flowers of Sal Armoniack, the Volatile Salts of Amber, Hartshorn, and Soot, and like∣wise their Spirits are often given with great success in this Disease.
Take Powder of Earth-worms prepar'd two Drams, Species Diacur∣cumae a Dram, Flowers of Sal Armoniack half a Dram, Salt of Am∣ber a Scruple, Extract of Gentian a Dram, Saffron a Scruple, Gum Ammoniacum dissolv'd in water of Earth-worms what suffices: Make a Mass, Form it into small Pills; the Dose is three or four Morn∣ing and Evening, drinking after it of the Julape before written three Ounces.
Take Spirit of Hartshorn ting'd with Saffron three Drams: The Dose is from fifteen drops to twenty, with the distill'd water above mention'd.
In this rank of Medicines with which the Blood distemper'd with the Jaundise is intended to be corrected, Chalybeats also just∣ly claim a place; for these give a considerable relief in the Jaun∣dise, as well as in other Cachectical Distempers, not so much by opening the obstructions of the Viscera, as by depressing the ex∣altations of the Sulphur and fixt Salt, and by volatilizing the Blood.
Therefore to the Decoction, Tincture, or Infusion above writ∣ten, the Filings of Iron, or its Powder prepar'd (its Mineral Tex∣ture being some way loosen'd) or its Vitriolick Salt extracted, may be properly added; for hence it is that our Mineral waters sometimes cure even to a Miracle such as are quite given over in the Jaundise: Though these waters when drank in a very large quantity, passing through all the Vessels, open also all the Du∣ctus's of the Liver, be they never so much shut up.
Therefore also to the Electuaries, Pills and Powders before ex∣prest, preparations of Steel, sometimes of one sort, and some∣times of another, may likewise be added in a fit proportion: Moreover, you may give to the quantity of a spoonful of its Syrup twice a day in three Ounces of the Anti-icterick Apo∣zeme or distill'd water; also the Tincture of Steel to twelve or fifteen drops may be given after the same manner with good ef∣fect.
Lastly, in this rank of altering Medicines, we ought to place those which are said to Cure this Disease, not as inwardly taken, but outwardly apply'd either by the touch, or being put into the Urine of persons troubled with the Jaundise.
As to the First, its a common Remedy with the vulgar to take a Tench, and apply it to the right Hypochondre, or to the Ven∣tricle as some will have it, or according to others, to the Soles of the Feet of the Person that has the Jaundise, whence they expect the Disease to vanish in a short time; though many promise a cer∣tain Cure by this means, yet it did not succeed with me, having sometimes try'd it.
The other Cure of the Jaundise at a distance, is said to be done by I know not what Sympathy, or secret manner of work∣ing.
Take the fresh Ʋrine of the Patient made at one time, ashes of the Ash-tree searced what suffices: Mix them, and make it into a Paste, and form it into three Balls of an equal bigness, and put them in a close place near the Fire, or a Stove; when these Balls grow dry and hard, the Jaundise vanishes: After this manner I have known this Disease successfully Cur'd when it was grown inveterate, and would not yield to other Remedies; this is a familiar practice with the vulgar.
The reason of this Operation is, that when the Lixivial Salt in the ashes is mixt in the Urine, it presently sets free the Volatile Salt, which before was kept under in it, or entangled with other Par∣ticles, and at the same time that this is done in the Icterical U∣rine, it happens by Sympathy that the Volatile Salt also in the Blood of the Patient gets free from the Dominion of the fixt Salt and Sulphur, and consequently the Icterical Dyscrasy of the Blood
vanishes: And thus Phil. Grulingius and Felix Platerus tell us that Making Water on warm Horsedung has Cur'd many Persons troubled with the Jaundise, viz. inasmuch as the fixt Salt of the Urine, and consequently of the Blood of the Patient is altered by the Volatile Salt of the fresh Horsedung, and is reduc'd to its due temperature.
The Third and Vital Indication orders a fit Dyet, and like∣wise prescribes Cordials and Anodines, both which are often wanted.
As to what concerns the First, the Diet in this Disease is wont to be more Physical than in any other whatsoever: For Vegeta∣bles, and their parts, vulgarly call'd Hepatick Remedies, are boil'd in the Broaths of persons troubled with the Jaundise; their Broaths also are usually made of Worms and Snails (being accounted the Antidotes of the Jaundise) instead of other Flesh: Moreover their Ale and other ordinary Drinks are Impregnated with an Infusion of Physical things.
Take Roots of the greater Nettle, and of Strawberries, of each an Ounce and a half, Candied Eringo Roots an Ounce, shavings of Ivory and Hartshorn, of each two Drams, Earth-worms cleans'd, in number twenty, a Crust of White-bread, Mace two Drams; boil all in two pounds of fountain water to a pound: Strain it through Hippocrates Sleeve, add to it Species of Diatrion Santalon half a Dram: Make a Broath, of which take from four Ounces to six twice a Day. For or∣dinary drink fill a little Vessel of four Gallons with Ale, into which af∣ter it has wrought, put the following bag.
Take Tops of Sea Wormwood, and white Horehound dry'd, of each two handfuls, Roots of sharp pointed Dock dry'd six Ounces, Bark of the Ash∣tree, and of the Barbery-tree, of each three Ounces, the outward Rinds of eight Oranges, and of four Limons, being slic'd and bruis'd, let them be prepar'd according to art.
Many Persons in the Jaundise being troubled with a great weak∣ness and frequent faintings, stand in need also of Cordial Reme∣dies.
Take small Aqua Mirabilis eight Ounces, Earth-worms four Oun∣ces, Syrup of Orange Pills two Ounces: Mix them, the Dose is two or three Ounces.
Moreover there are some who in this Disease are found subject now and then to very troublesome pains, chiefly tormenting them by Night, and who are often molested with want of sleep; where∣fore Anodines also must here come in use.
Take Aqua Mirabilis, water of Earth-worms, of each an Ounce, Diacodium six Ounces, Tincture of Saffron half an Ounce: Mix them, the Dose is a spoonful or two late at Night when there is want of sleep.
Take Laudanum tartariz'd two Drams, Aqua Mirabilis two Oun∣ces, Syrup of Clove Gilly-flowers an Ounce: Mix them, the Dose is a spoonful after the same manner.
THe Liver often uses to be faulty, especially in one of these two things, viz. either intercepting the Nutritive Juice ap∣pointed for other parts, it applies it to its proper use, as its gene∣rally seen in Children troubled with the Rickets, and in many o∣thers leading a sloathful and idle Life: Or Secondly, it too easily receives into its most inward Recesses, the filthiness of the de∣praved Blood, and all dreggy Excrements coming in its way, and retaining them does not only grow large, but is obstru∣cted in its Ductus's, whence oftentimes proceeds a Jaundise, or Dropsie, and tumours, and preternatural Concretions of divers kinds.
Therefore we must take care of these two things, viz. lest the Liver by taking to it self too much of the Nutritive Juice, grow to too great a Bulk, and lest by retaining the filthy dregs of the Blood, it be troubled with obstructions, and preternatural tu∣mours.
Both these faults are much more easily prevented than Cur'd: For the former is effected only by taking care that the Blood being well constituted in its Crasis, and enjoying a free Circulati∣on, both distributes the Nutritive Juice to the parts, and especi∣ally the outmost, and driving all its Excrements to all their re∣spective Emunctories deposes them there: And indeed the Hepa∣tick Medicines (vulgarly so call'd, though they regard the other Viscera as well as the Liver) do first and more immediately exert their vertue by purifying the Blood, rather than by correcting the Liver, or other entrals; for entring the Blood, and being im∣miscible with it, they so throughly exagitate it, that they make it discharge all its superfluities by their proper Emissaries; and if any Medicines are found by some specifick virtue, to have respect to one part more than to another, its because their Particles being more ally'd, and consequently associated to the Recrements to be separa∣ted
within that entral, are carried thither together with them: For this reason Rhubarb, Turmerick, the greater Celandine, and many other things ally'd to the Gall, readily pass to its Ductus's, and are wont to do good in the Jaundise: We have before set forth the Ener∣gies and ways of operating of these Medicines: As to other He∣paticks commonly so call'd, we shall briefly set down certain Forms, First of those which are said to prevent or remove the Non-natural accretion of the Liver, and then of those which do the like, in respect of its obstructions, and preternatural tu∣mours.
1. Against the too great accretion, or disproportionate nourish∣ment of the Liver: First, a spare and thin Dyet, short Sleep, and frequent and moderate Exercises are proper. Wherefore if at any time Infants and Children are found obnoxious to this affect, as likewise to the Rickets, we order that they suck thin and serous Milk, that they are daily toss'd in their Nurses Arms, and carried from one place to another with a swift motion, or that they are put in a Chariot, or in a Chair, and swiftly driven to and fro, and that they learn to use their feet as soon as may be, and go a∣bout.
Take the Waters of Snails and Earth-worms, of each three Ounces, Syrup of Cichory with Rhubarb two Ounces, Spirit of Sal Armoniack with Gum Ammoniacum a Scruple: Mix them, take a spoonful at Night, and early in the Morning.
Take Roots of Male Fern, Chervil, Candied Eringo's, of each an Ounce, Leaves of Agrimony, Harts Tongue, Male Speedwel, of each a handful, shavings of Ivory and Hartshorn, of each two Drams, white and yel∣low Saunders, of each a Dram, Raisms ston'd an Ounce and a half, Barly three Drams: Boil them in three pounds of fountain water to two pounds; to the straining add the waters of Snails and Earth∣worms, of each an Ounce and a half, Syrup of Cichory two Ounces: Make an Apozeme, take to two or three Ounces in a day.
Take Powder of white and yellow Saunders, Crabs Eyes, Lignum Aloes, of each half a Dram, Salt of Wormwood a Scruple: Make a Powder, the Dose is from half a Scruple, to a Scruple twice a day.
Take Emplastrum Diasaponis, Ceratum Santalinum, of each what suffices: Make a Plaister to be apply'd to the right Hypo∣chondre.
Take Ʋnguentum Splanchnicum two Ounces, Oyl of Wormwood an Ounce: Mix them, make a Liniment for the Region of the Liver.
The Remedies for most other Diseases of the Liver, are either Simple or Compound: Amongst those of the former kind, are u∣sually reckon'd all Cichories, Sorrels, sharp-pointed Docks, and
in a manner all Vegetables which have a sort of bitterness joyn∣ed with somewhat of a smartness (in which the Deopilative vertue is said to consist) as Wormwood, Germander, Ground-Pine, Fumitory, Tansie, Agrimony, Liver-wort, Lignum Aloes, all the Saunders, Tamarisk-bark, Ash-bark, and the Roots of Capers, with many others which make up the greatest part of Botanicks.
The fixt Salts of Herbs, and the Acid Spirits of Minerals claim a chief place amongst these, because they mightily agitate the Mass of Blood, dissolve its Concretions, clear its stoppages, and make it every where permeable in all its parts.
Its also manifest both by reason and experience, that prepara∣tions of Steel are often proper in Distempers of the Liver, as e∣specially in the Jaundise, and the Dropsy.
In the Antidotaries of the Ancients, we find a great many Physical Compositions which seem to be wholly design'd for the Liver, as the Electuary ê scoria ferri Rhasis, &c. But passing over these, I shall now give you some Forms and Examples of Medi∣cines which are accounted Deopilatives, according to the practice of our times.
TAke Roots of Fern, Chervil, the greater Nettle, Dandelion, of each an Ounce, Leaves of Agrimony, Harts Tongue, Speedwel, Oak of Hierusalem, Liver-wort, of each a handful, white and yellow Saunders, of each three Drams, shavings of Ivory half an Ounce, Red Cicehs an Ounce, Coriander Seeds three Drams, Raisins two Ounces: Boil them in four pounds of fountain water, to two pounds, adding about the end Whitewine four Ounces, strain it through Hippocra∣tes sleeve; to which put Species Diarrhodon Abbatis a Dram, our prepar'd Steel two Drams: To the straining add Syrup of Cichory with Rhubarb two Ounces, waters of Snails and Earth-worms, of each an Ounce: The Dose is six Ounces twice a day, after a Dose of the following Electuary.
Take Conserve of the yellow Coats of Oranges and Limons, of each two Ounces, of Wormwood and Fumitory, of each an Ounce, Simple Powder of Aron Roots, Lignum Aloes, yellow Saunders, and Caper Roots, of each a Dram and a half, Crabs Eyes a Dram, Salt of Worm∣wood two Drams, Syrup of Fumitory what suffices: Make an Electu∣ary, the Dose is the quantity of a Wallnut twice a day, drinking after it a draught of the Apozeme before written, or of the following di∣still'd water.
Take Leaves of Wormwood, Centory, Tansie, both Southernwoods, Branches of Tamerisk, of each four handfuls, green Wallnuts four pounds, green Ashen-keys two pounds, the outward Kinds of ten O∣ranges, and of four Limons, Snails, Earth-worms prepar'd, of each a pound; being all slic'd, pour to them of Whitewine eight pounds, di∣stil it with common Organs: Let all the Liquor be mixt, the Dose is three Ounces, sweeten it with Sugar, or some proper Syrup.
If a Form of Pills be more grateful; the following Ecphra∣ctick Extract (as the Shops call it) seems good.
Take white and clear Tartar, and fresh Filings of Iron, of each four Ounces, let them be bruis'd together into a Powder, then boil it in four pounds of fountain wa•••••• to two pounds, (some use White∣wine) to the straining add tops of Centory, Sea Wormwood, and Car∣duus, of each a handful, Gentian Roots half an Ounce, Species Dia∣curcumae a Dram and a half; let them boil close cover'd for three or four hours, then strain it, and let the straining evaporate by a gentle Bath heat, to a consistency for Pills, adding if you please, Troches of Rhubarb, or Species of Hiera Picra two Drams: The Dose is from a Scruple to half a Dram made into Pills, in the Evening with a fit Vehicle.
For the same intent, viz. to prevent or remove obstructions of the Liver, a Purging Physick Ale to be taken Spring and Fall for many days, is highly extoll'd by some, and diligently us'd by certain Persons every year during their Lives.
Take Roots of sharp pointed Dock prepar'd, and of Polypody of the Oak, of each three Ounces, Madder two Ounces, English Rhubarb two Ounces, Leaves of Sena four Ounces, Epithymum two Ounces, yellow Saunders an Ounce, Seeds of Carthamus and Coriander, of each an Ounce and a half, being slic'd and bruis'd, Make a Bag according to art for four Gallons of Ale, after six days take to twelve Ounces more or less in the Morning, by which you may expect four or five Stools, Sine Regimine.
THe Dropsie call'd Ascites, is a tumour of the Belly, caus'd by a Watery Humour contain'd within its Cavity; which Hu∣mour probably is the Serum of the dissolv'd Blood, distilling forth of the Caeliack and Mesenterick Arteries into the Cavity of the Abdomen, and especially if it happens, that Scirrhous Tu∣mours, Glands, little Swellings, or other praeternatural Concre∣tions are rais'd about the Mesentery, Liver, Spleen, Womb, or other Viscera of the Belly; for the Circulation of the Blood be∣ing stopt in those places, the Serous part of it is forc'd from the rest, and falls into that Cavity, and commonly the Nutritive Juice goes with it, wherefore when this Region swells, the Mem∣bers are usually extenuated.
Nevertheless the Blood is not always dissolv'd in an Ascites, as it is in an Anasarca, but is sometimes too compact in its Crasis, yet so that its forc'd by reason of the Obstructions of the Vis∣cera, to depose within the Abdomen its Salt Serum, which it could not evacuate by the Pores of the Skin, and the Urinary passages.
Its also likely that the Lacteous or Lymphatick Vessels being sometimes broken or opened, fill the Abdomen with a Mass of Wa∣ter or Chyle.
I conceive also that this Inundation of the Belly, may some∣times arise from the Nervous Liquor, distilling gently and insen∣sibly from the Fibres and Membranes: And likewise from vapours condens'd within the Cavity of the Body.
Concerning the Cure of Ascites, we must consider by how many possible ways and manners, waters gathered together with∣in the Abdomen may be evacuated: And we find that the Reme∣dies, which according to the ordinary practice of Physick, are accounted Hydroticks, work that end by Purging, by Evacuati∣on by Urine, by Sweating, and by insensible transpiration, and with some Persons you must proceed this way, and with others that, or the other; and if neither of these seem possible, or suc∣ceed well, you must timely think of an Incision. I shall now consider each of these ways.
First therefore Catharticks seasonably given, often abate the Tumour of an Ascites, and sometimes wholly take it away; for asmuch as their Particles irritating the Ventricle and Intestines, discuss the Contents and Flatus's of those Viscera, and likewise the humours sticking in their Tunicles and Glands, and heap'd together in the Vessels and Ductus's of their neighbouring parts, and force them partly into to Ductus's of the Intestines, and partly send them into the Mass of Blood: But it does not succeed thus, if at any time this Disease proceeds from a Lympha, float∣ing within the Cavity of the Abdomen, or from an Inflation or Tympanitical extention of the Membranes; because Hydragogues carry forth little or nothing of those waters, and if they are strong, exasperate and increase the Flatulent Distemper. Ca∣tharticks accounted Hydragogues, are either Emeticks or Pur∣gers.
1. The Hydragogue Emeticks of chiefest note, are Gum Gutta, Esula or Cataputia, and diversified preparations of them: Also Hercules Bovii, & Pilulae Lunares.
2. The Purgers are Elder, and Dwarf Elder, Sea Bindweed, Hedge Hyssop, Juice of Orris, Elaterium: I shall briefly set down certain Forms and manners of prescribing, compounding, and gi∣ving each of these.
1. Gum Gutta is highly extoll'd for Purging Serous humours; but in regard being given by it self, it mightily disturbs the Sto∣mack, and often weakens it, therefore to repress a little its exces∣sive and violently Emetick force, various ways are contriv'd for preparing it; but its best of all corrected with an Acid Spirit, or with an Alchalisate Salt, or by throughly tempering and com∣pounding it with Aromaticks.
Adrian Mynsicht commends its Magistery, which is made by dissolving it with Spirit of Wine, and then by drawing it off, and preciptiating it with fountain water; also by dissolving it with Spirit of Wine Vitriolated, and Ting'd with Roses and red Saun∣ders, and then by evaporating it, others prepare it with the fume of Sulphur after the manner of Scammony Sulphurated: Others grind it on a Marble, moistning it with Oyl of Cinnamon, or of Cloves, or other Chymical Aromaticks: I use most its Solution, made with the Tincture of Salt of Tartar: The Dos of which is from fifteen Drops to twenty or thirty.
Take Gummi Gutta six Grains, Mercurius Dulcis fifteen Grains, Con∣serve of Violets a Dram and a half: Mix them, make a Bolus.
Take Gummi Gutta twelve Grains, Salt of Wormwood six Grains, Oyl of Mace a Drop, Conserve of Damask Roses a Dram: Make a Bolus. And its wont to be given with Tartar Vitriolated, or Cream of Tartar, and powdre of Rhubarb.
Take Gum Gutta sulphurated or vitriolated fifteen Grains, Croam of Tartar half a Scruple, Extract of Rhubarb a Scruple, Oyl of Cin∣namon two Drops: Make four Pills.
A Woman of late being ill of a dangerous Ascites, and as it seem'd to me in a desperated condition; by taking the following Medicines for six days successively, grew much better, and in a short time after perfectly recovered.
Take Gum Gutta powdred twelve Grains, Oyl of Cinnamon a Drop, Syrup of Buckthorn what suffices: Make a Bolus, let the Dose be encreas'd every day, by rising from twelve Grains to twenty.
Take of our Tincture of Gum Gutta a Scruple, water of Earth-worms an Ounce, Syrup of Rhubarb half an Ounce: Mix them, give it Cum Regimine.
Though there are various kinds of the Spurges, and all of them work violently by Vomit or Siege, by reason of their mighty Irritation of the Viscera, and consequently evacuate Serous hu∣mours in a plentiful manner; yet because of the excessive strength of most of them: The lesser or wild Spurge, is now in a manner only in use: And its most approved preparations are the Powder of the Rinds of its Roots, and its Extract; We also add its Tin∣cture, which is not Inferiour to the rest.
Take the lesser Spurge, with the Roots cleans'd four handfuls, Lig∣num Aloes, Cloves, of each a Dram; being bruis'd, boil them in four pounds of fountain water till half be consum'd' let the straining Cla∣rifie by settling in an oblong Glass, then let the clear Liquor Evaporate by a Bath-heat to the consistency of an Extract; The Dose is a Scruple.
Take of this Extract half an Ounce, pour to it in a Matras six Ounces of the Tincture of Salt of Tartar, digest them in a Sand Bath till the Tincture be Extracted: The Dose is from twenty to thirty Drops, with a fit Vehicle.
Take Powder of the Roots of the lesser Spurge, from seven Grains to ten, Cinnamon half a Scruple, Salt of Tartar eight Grains; bruise them together in a Glass Mortar, give it by it self, or with the Addition of some fit Conserve or Syrup: Make a Bolus or Pills.
3. Praecipitatum Mercurii cum Sole, or Hercules Bovii; For as much as by its Acrimony, it mightily irritates the Fibres of the Stomack, and fuses the Blood by reason of its Mercurial and Sa∣line Particles, it raises a violent Vomiting, and so forces a dis∣charge of the Serous humours, which are violently drawn into the Cavities of the Viscera.
Pilulae Lunares, in like manner by reason of the Vitriolick Par∣ticles of the Silver, being sharpen'd with other Saline Menstruums produce the like effect, viz. by much corrugating the Fibres of
the Viscera, they strongly force the Serous humours into their Ductus's, and causes them to be evacuated.
A Solution of Silver being made in Aqua Stygia, and well purified, is redud'd by a gentle evaporation into clear Crystals; which by them∣selves (or with the addition of Sal Nitre to repress the force of the Lunar Vitriol) are made into Pills with the Crum of Bread: The Dose is sometimes a single Pill, sometimes two or three according as they work, and as the strength will bear, these sorts of Medicines are sometimes given with success in a strong Constitution, and where the Viscera are sound, and of a good habit; but scarce ever have a good effect in ten∣der and Cachectical Bodies, and are seldom taken by such persons with∣out doing them hurt.
Hydragogue Medicines which work meerly or chiefly by Seige, are either mild, as Elder, Dwarfe Elder, Sea Bindweed, and the Juice of English Orris, which are rarely given by themselves, but want to be quicken'd by such as are smarter, and for return they qualify the vehemency of the other; or they are strong, as Hedg-Hyssop, Jalap, and Elaterium.
The Seeds of Elder and Dwarfe Elder, being dry'd and powdred, and taken to a Dram, gently evacuate Serous humours by Seige; a Water and Spirit are distill'd from the Juice of both their Ber∣ries fermented, and Robs and Syrups are made of it; which with many other preparations of those Vegetables are highly extoll'd for all Hydropical Distemper.
Sea Bindweed, and Hedg-Hyssop, are now rarely us'd by them∣selves, but often enter the Compositions of other Hydragogues, and chiefly in Apozemes.
The Juice of English Orris is a good Medicine, and the more to be esteem'd because easie to be had for poor people: Its given from six Drams to an Ounce and a half, or two Ounces, either by it self in a fit Vehicle, or with other proper ingredients. Ja∣lap is a well known and vulgar Medicine against all sorts of Dropsies. Every ordinary Man that has that Disease, presently takes a Pennyworth of the Powder of Jalap, with a little Ginger in Whitewine; and this Medicine taken a pretty many times sel∣dom fails of success.
Elaterium is justly accounted a most powerful Hydragogue, in regard that most powerfully irritating the Fibres of the Viscera, and at the same time fusing the Blood and humours by a sort of corrosive vertue as it were, it forces whatsoever Serosities the Tunicles of the Viscera, Membranes, and Vessels; also those that the Glands and Fleth contain within them, to discharge them∣selves into the Cavities of the Stomack and Intestines: Which Medicine working well, sometimes the swelling of the Belly fall. This indeed is the chief Instrument of the Empyricks Arsenal against
an Ascites, though using it in all cases, they oftner give if to the prejudice of the Patient, than to his advantage: The Dose is from three Grains to ten or fifteen. Its taken either by it self, only with the Addition of Aromatical Correctives, or its given with other Hydragogues in the Form of a Powder, Pills, or of an Electuary: Its Tincture and Essence are Extracted with Spirit of Wine, or with Tiacture of Salt of Tartar.
These are the chief simple Hydragogues, of which being duly prepar'd with the Addition of other things, divers sorts of Com∣pounds are made, some common in Shops, others Magisterially prescrib'd, and are every where in use , and a great many more may be ordered ex tempore on occasion. We shall here set down some few Select Forms of them, and especially such as are taken in the Form of a Potion, Powder, Electuary and pills.
Take Roots of Dwarfe Elder, and English Orris, of each an Ounced and a half, Leaves of Sea Bindweed, and Hedge Hyssop, of each a handful, Roots of Asarabacca and wild Cucumbers, of each two Oun∣ces, Roots of the lesser Galingal six Drams, choice Jalap half an Ounce, Elaterium three Drams, Cubebs two Drams, being slie'd and bruis;d, pour to them of small Spirit of Wine Tartariz'd three pounds; let them digest close luted in a sand Furnace for two days, strain off the clear, which being purified by settling; give from two spoonfuls to three with a fit Vehicle.
Take Elaterium, Sea Bindweed, Ginger, of each a Scruple, Galin∣gal, Cloves, Cinnamon, of each half a Scruple, Salt of Tartar fifteen Grains: Make a Powder for two Doses.
Take Powder of the Roots of the best Jalap a Dram, Giner a Scruple, Cream of Tartar fifteen Granins: Make a Powder, give it in a draught of Whitewine.
Take Rhubarb powdred a Scruple, Elaterium five Grains, Tartar vi∣triolated half a Scruple, Spike three Grains, with Syrup of Buck∣thorn: Make four Pills.
Take Pilulae Aloephanginae half a Dram, Elaterium half a Scruple, Oyl of Cloves three drops: Make four Pills.
Let the Hydropick Pills of Bontius be given from half a Scru∣ple, to half a Dram: They are made after this manner.
Take of the best Aloes two Drams and a half, Gummi Gutta pre∣par'd, a Dram and a half, Diagredium corrected a Dram, Gum. Am∣moniacum dissolv'd a Dram and a half, Tartar vitriolated half a Dram: Make a Mass, and form it into Pills.
Certain Hydragogue Electuaries, are now every wher much in use amongst Practitioners; and especially one given us by tye famous Sylvius, and another by Zwelfer. This that follows likes us well.
Take Rosin of Jalap two Drams, Tartar vitriolated a Dram, Ex∣tract of Rhubarb two Drams, of Esula a Drm and a half, Roots of the lesser Galingal a Dram, bruise them very well: And lastly add Conserve of English Orris Flowers four Ounces; and with a suffi∣cient quantity of Syrup of Peach Rlowers Make an Electuary, the Dose is from half a Dram, to a Dram and a half, or two Drams.
I might here give you many other Purging Hydragogues, but Catharticks do not always Cure the Ascites, nay they often make it worse, and (if you insist too long upon them) render it In∣curable. Therefore now let us enquire whether Diureticks will do good in this case or not.
And truly any Man might easily be induc'd to believe that Me∣dicines provoking Urine, contribute very much towards the E∣vacuation of Waters from any part or Cavity of the Body: In reality its manifest by frequent experiments, that they often Cure the Anasarca, and give relief in it before all other Remedies: Let us see therefore what they can do for draining the Cavity of the Abdomen.
As to this, its manifest in the first place, that there is no im∣mediate passage open from the Ascitical Mass of Waters to the Reins, how near soever they lye to them; but whatsoever wa∣ters are conveyed from that Mass to the Reins, must of necessity be first of all drank up again into the Blood, and be thence dis∣charg'd into that receptacle of the Urine: Now little is it that the small Mouths of the Veins (if haply any of them are open) can receive? And this is that only thing which Diureticks are able to perforem viz. By fusing the Blood, and driving its Serosi∣ties to the Reins in a plentiful manner, to make it draw to it self, being so drein'd, the Waters floating in the Belly. In the mean time there is no less danger lest Diureticks unseasonably given, whilst they fuse the Blood too much, drive the Serum, which is forc'd to part from it, into the watery Mass of the Ascites, more than into the Reins, and so rather to increase than remove that deluge of the Belly. And truly I have frequently observ'd that this sometimes happens; and 'tis for this reason tha the Ancients always mixt Astringents and Corroboratives in their Medicines for the Dropsie, not that such (as is vulgarly said) strengthen the tone of the Liver, but preserve the Crasis or Mixture of the Blood from being wholly dissolv'd by too much fusion. There∣fore in an Ascites which happens chiefly, or in part, by reason that the Serous humour stuffs and mightily swells the Compages of the Viscera and Vessels, and especially the Tunicles, Glands and Fibres themselves, and the spaces betwixt them; even as Cathartieks are proper, so are also Diureticks, and are often taken with success, for as much as by the use of these, the
Mass of Blood is drein'd (the Serum being deriv'd to the Reins in a plentiful manner) and readily receives into it self those waters every where stagnating about the Mouths of the Vessels, and conveys them to the Urinary Common-shore: But on the con∣trary in a true Ascites where the Textures of the Viscera being free from such stuffings with Serum, the filthy Mass of Waters fills the Cavity of the Belly, Diureticks are given either to no purpose, or with prejudice, because they fetch out nothing of the water stagnating in the Belly, and very often by fusing the Blood, drive the waters more violently thither, being apt to di∣stil into it of their own accord.
In an Ascites all Diureticks of every kind are not equally pro∣per, nor ought to be indifferently give; for it is to be observ'd, that Persons troubl'd with this Disease make little Urine, which is also reddish, and resembling as it were a Lixivium; which is a sign that the Crasis of their Blood is so close bound by reason of the fixt Salt and Sulphur being exalted and combin'd together in it; and consequently that its Serum is not duly separted within the Reins, which nevertheless is thrown off in the Involutions of the Obstructed Viscera, and so is depos'd in the Cavity of the Belly. Wherefore in this case we must give only those things to move Urine, which so restore and corredct the Constitution of the Blood, that the Irregularities of the fixt Salt and Sulphur being taken away, the Serous part may be separated within the Reins, and sent forth in a more plentiful manner: For which end not Acid or Lixivial things, but such as are endow'd with a Vo∣latile Salt are proper; for I have often observ'd in such Patients, that when Spirit of Salt, and other Acid distill'd Liquors of Mi∣nerals, and when the Deliqia or Solutions of Salt of Tartar, of Broom, and of other things have rather done hurt than good; the Juice of Plantain, of Brooklimes, and of other Herbs abound∣ing with a Volatile Salt; also the expressions of Millepedes have given relief: For the same reason Sal Nitre throughly purified, or Crystal Mineral has often a mighty good effect. You may find Forms of Medicines proper for this use in our preceding Tract, where we have set down Examples of Diureticks, in which both Volatile and Nitrous Salts are the Basis: Moreover to this place belongs that notable Experiment with which Johan∣nes Anglus says he often Cur'd an Ascites from a hot Caus, which Medicine also the most experienc'd Physician Dr. Theodore Mayern usually prescrib'd in the like Case, and was wont to extol. It is as follows.
Take Juice of Plantain and Liverwort, and fill an earthen Pot with it to the Brim, then stop it very close, and put it in a hot Oven as soon as the Bread is drawn, and make a gentle Fire round the sides
of the Pot to continue the heat of the Oven; after it is boild strain the Liquor, and being sweeten'd with Sugar, let it be drank Morn∣ings and Evenings, and it Cures.
In Imitation of this, I have often prescrib'd with success after the following manner:
Take green Plantain Leaves four handfuls, Liverwort and Brook∣limes, of each two handfuls, being bruis'd together, pour to them of small Compound Raddish water, or of some other Magisterial water half a pound, wring it forth hard: The Dose is three Ounces thrice a day.
Diaphoreticks, though most efficacious in an Anasarca, yet are of little or no use in an Ascites; for being unseasonably given, they often cause a great prejudice to the Patient, without doing him the least good, because by heating the Blood they make the waters floating in the Cavity of the Belly, to grow fervid, and to boil as it were, so that the Spirits and Humours are mightily troubled by the Vapours thence rais'd, and so a disor∣der of all the functions follows, and the Viscera themselves being sodden as it were, are very much injur': Moreover when a Sweat is thus unduly rais'd, the Blood being forc'd to a fusion and precipitation of Serum, discharges more yet into the watery Mass of the Ascites; therefore when some prescribe Fomentations and Liniments to be apply'd to the swollen Paunch, and order Bathing, for the most part it falls out for the worse to the Pati∣ents; for besides Feverishness, a Head-ach, Vertigo, faintings of the Spirits, and other ill Symptoms of the Heart and Brain, most frequently caus'd by such means, the Belly also swells the more by it, because the Blood being agitated and dissolv'd, deposes the Serum there in a larger measure: Nay, and the Mouths of the Vessels are thereby made more loose and open, so that they di∣stil forth waters faster, they being now dispos'd to part from the Mass of Blood. The Remedies which are wont to be Admini∣stred with most success, when we will not proceed to an Incision, are Glisters and Plaisters.
The former draw the Serum out of the Vessels and Glands of the Intestines, and Mesentery, without fusing the whole Mass of Blood (which strong Catharticks will do) which being so em∣ptyed, receive into them some of the extravasted Lympha; For this end the following Glister usually prescrib'd by us in the like case is mighty proper; in regard at the same time it irritates the Fibres of the Intestines, and draws the Serum imbib'd by the Blood, or before contain'd in it, to the Reins.
Take Ʋrine of a sound Man that drinks Wine one pound, Ve∣nice Turpentine dissolv'd with the Yolk of an Egg, an Ounce and a half, Sal Prunella a Dram and a half: Make a Glister, repeat it daily.
Plaisters sometimes do good in an Ascites, but let them be such as strengthen the Viscera by some restringent and comforting vertue, and help to close the Mouths of the Vessels, that they do not dicharge the Serosities in too great a plenty: For this end I usually apply Emplastrum Diasaponis to the swollen Belly with good success. Or,
Take Emplastrum de minio, and Paracelsi, of each what suffices: Make a Plaister to be apply'd to the Belly. If at any time this Di∣sease be complicated with a Tympany, other sorts of Epithems are proper, as we shall decalre hereafter.
The great and most present Remedy for an Ascites, is to make an Inision, and draw forth the water, tho this practice as often Kills the Patient, as Cures the Disease; wherefore there is need of great caution in what Persons, and in what time of the Disease this ought to be attempted: In Cachectical Persons, and such as have been long ill, in whom the Conformation and tem∣perament of the Viscera are generally vitiated, it cannot prove of any good effect to let forth the waters by piercing of the Belly; for presently upon it the Spirits faint, the strength is dis∣solv'd, nay and a fresh inundation of the Morbifick humour soon succeeds it: But those who before having a good constitution of the Viscera, and being sound enough as to all other parts, fall into an Ascites upon some great evident cause, as they need not presently at first attenmpt an Incision, so they ought not to defer it long if it be judg'd requisite. For upon a long delay the Visce∣ra which are immerg'd in the waters, and as it were sodden in them, become incorrigibly vitiated.
Its besides my purpose to describe here the Administration of this Incision, whether it be perform'd the ordinary way, or ac∣cording to the way of Sylvius, with a Perforated Needle. As physicians seldom prescribe this operation, they looking upon it as dangerous, so Quacks and Empiricks never consulting them, attempt it very often inconsierately and uprosperously. For conclusion, I shall here give you a relation of a true and terrible Ascites lately Cur'd without an Incision.
A young Woman tall and slender, an Merchants Wife, giving Suck to her Child, drank both by day and by night to increase her Mild, an immoderate quantity of Ale, sometimes plain, and sometimes made into Posset-drink; after having us'd this ill way of Diet for six Weeks, she feel suddenly into a cruel Ascites, the beginnings of which she never had minded; for her Abdomen
being full of waters floatig within it, swell'd mightily, and its Bulk when she turn'd her self, from one side to the other, fell without the Ilia, and the borders of the rest of her Body; in the mean time the Flesh of all her Members was mightily consum'd, and she seem'd not less Consumptive than Hydropical.
The Child being wean'd, and better Diet ordered, she entred upon Physick, and in the first place took gently Hydragogues both Purging by Siege and Urine, but without any benefit, nay after all Purging she was worse: Afterwards being Committed to our care, and almost in a desperate condition, I proceeded with her after the following method.
Having wholly forbidden her the use of Ale, and all other drinks but what were Physical, I prescrib'd these things.
Take Leaves of Plantain, Brooklimes, Clivers, of each four hand∣fuls, being bruis'd together, pour to them water of Earth-worms, and Radish-water Compound, of each three Ounces, wring ti forth; she took it twice a day, viz. at eight of the Clock in the Morning, and at five in the Afternoon, she continued the use of this Medicine a long time, but altered now and then the Composition, changing sometimes the Herbs, sometimes the Liquor to be poured to them.
Take of the reddest Tincture of Salt of Tartar an Ounce and a half; she took twenty Drops going to Bed, and early in the Morning in two spoonfuls of the following Julape, drinking after it seven spoon∣fuls.
Take of the reddest Tincture of Salt of Tartar an Ounce an da half; she took twenty Drops going to Bed, and early in the Morning in two spoonfuls of the following Julape, drinking after it seven spoon∣fuls.
Take water of the Flowers of Elder, and of Saxifrage, of each six Ounces, the waters of Snails, Earth-worms, and Radish Compound, of each two Ounces.
On her Belly she wore a Plaister made of Empl. de Minio, & Oxycroceo.
The following Glyster was given her first every day, afterward every other or third day.
Take Ʋrine of a sound Man a pound, Turpentine dissolv'd with the Yolk of an Egg an Ounce and a half, Sugar an Ounce, Sal Prunella a Dram: Make a Glister.
By the constant use of these things, in six Weeks time the swel∣ling of her Belly came down, but her flesh daily falling away, a Consumption was fear'd: Wherefore to prevent it, she went in∣to the Country and drank Asses Milk, and by the benefit of this nourishment and of the fresh Air, taking continually the above mention'd Medicines, she recover'd perfectly within three Weeks or a Month, and lives still, and is in good health.
A Tympany may be thus defin'd, or at least describ'd, viz. that it is a fixt and continued tumour of the Abdomen, equal, hard, stiff, yielding a sound upon striking, taking its rise from a sort of Convulsive Inflation of the Membranous Parts and Viscera, by reason of the Animal Spirits being driven into those Fibres in too great a plenty, and there hindred from a Recess, through the fault of the Nervous Juice obstructing it: To which affect a gathering of Winds in the empty places is consequently added for compleating it.
That we may have timely notice of its beginning, we must understand that there are some previous affects which dispose to it, as especially a Hypochondriack, Colick, Hysterick, and some∣times an Asthmatick disposition: And if after frequent returns of Fits in any of these Distempers, a tumour of the Abdomen fol∣lows, though never so small at first, a Tympany is presently to be fear'd.
A Tympany seldom kills of it self, but after it has continued a long time, to make more sure work, it joyns to it self at length an Ascites as a forerunner of death.
In order to the Cure of a Tympany, as in most other Diseases, there are three primary Indications, whereof the first and always the most pressing being Curatory, endeavours to remove the tu∣mour of the Abdomen, by recalling the Animal Spirits from that Convulsive extention, and reducing them to order: The Second being preservatory, keeps those Spirits or others from inordinate excursions into the Nervous Fibres of the Belly, and at the same time corrects the faults of the Nervous Liquor accompanying them, as to its Crasis or Motion: The Third is Vital, and by removing the Symptoms that are most pressing, relives and up∣holds as much as may be all the functions that are opprest or weakned.
The First Indication is always of chiefest moment, the whole stress of the Cure consisting in it, but its very difficult to be per∣form'd: For it does not readily occur to us with what remedies or ways of Administration it ought to be attempted. Bleeding has no place here, but in a manner always is shun'd as hurtful; also Catharticks for as much as they irritate the affected Fibres,
and trouble the Spirits, and drive them more violently into those Fibres, do rather increase than diminish, or Cure the tumour of the Belly: So likewise Diaphoreticks force the Spirits together with the Morbifick Particles deeper into those Fibres, from which they ought to be summon'd forth and withdrawn. The chief means of Cure seems to be plac'd in the use of Diureticks and Glisters; and great things are likewise expected from Topicks, because they are apply'd more immediately, and by contact to the Disease it self, and because we see they excellently dissolve or discuss tumours in other places; but all dissolvents are not pro∣per here, even though in other tumours they are very Medicin∣able: For those that are hot, being accounted discussors, most commonly rather do hurt than good in a Tympany, whether they are us'd as a Fomentation, or Liniment, or apply'd in the Form of a Cataplasme or Plaister: For they both open and di∣late the Ductus's of the Fibres, so that they lye more open to the Inroads of the Spirits; and at the same time rarify the Parti∣cles sticking in them, so that they coming to occupy a greater space, the Inflation and Swelling of the Belly is augmented. Last∣ly as to Alteratives, even of those which do good against other affects of the Genus Nervosum, only some few are proper in a Tympany; for where the Morbifick matter sticking within the strait Ductus's cannot be driven forwards or quite through, Ela∣stick Medicines, by fastning the matter deeper, render the obstru∣ction still greater or more fixt: Wherefore the Spirits of Harts∣horn, Soot, Sal Armoniack, and so Tinctures, Elixirs and other Medicines endowed with a Volatile Salt, or Particles otherwise active, do not only cause a very troublesome heat and drought in persons troubled with a Tympany, but also make the Abdomen swell more, because they trouble the Spirits, and fuse the Blood and Nervous Juice, so that the Particles deposed by each of these are forc'd into the parts affected.
Nowwithstanding Physick can do so little against this Disease we must not cease to move every stone in order to Cure, or give ease to the Patient: Therefore in the First place (because it is the Custom to begin with Evacuatives) though strong Ca∣tharticks always do hurt, and the more gentle are scarce ever able to carry off the Conjunct Cause; yet these latter, for as much as they withdraw somewhat of that which feeds the Di∣sease, and prepare the way for other Medicines to exert their E∣nergies more freely, ought to have their turns in the Practice of Physick, viz. once in six or seven days; and at other times let Glisters (the use of which is much better) he frequently Admi∣nistred: Hydroticks being forbidden, let moderate Diureticks be diligently plyed, to which at the same time let such things be
joyn'd which regard the altering and reducing of the Spirits and Humours, which truly make up the chiefest part of Pharmacy for a Tympany: Moreover in the mean time let not the use of Topicks be neglected. We shall set down certain Select Forms of Medicines appropriated to each of these ends: For a Medicine gently loosening, use the Laxative Wine prescrib'd for a Tym∣pany by the famous Greg. Horstius in the Fourth Book of his Ob∣servations, Chap. 30. or instread of it, let the following be pre∣scrib'd in a shorter Form.
Take Flowers of Peaches, and of Damask Roses, of each two Pugils of Broom, Elder, and the lesser Centory, of each a Pugil, Leaves of Agrimony and Sea Wormwood, of each a handful, of the best Sena an Ounce, Rhubarb six Drams, Carthamus-seeds half an Ounce, of Dwarf-elder two Drams, yellow Saunders three Drams, Galingal Roots two Drams, being slic'd and bruis'd, sew them up in a Silken Bag, and put it in a Glass with two pounds of Whitewine, Saxifrage water a pound, Salt of Tartar a Dram and a half; let them stand for forty eight hours, then let the Patient begin to drink it, taking about four or six Ounces every third or fourth day.
In a hotter constitution let the following Form be given, which I have sometimes try'd with good success.
Take of Purging Mineral waters eight pounds, Salt of Wormwood two Drams, let it evaporate with a gentle Bath-heat to two pounds: To this I use to add of water distill'd from Purgers with Wine four Ounces: The Dose is from four Ounces to six.
Or to that Liquor evaporated to two pounds, add of the Roots of Mechoacan and Turbith, of each half an Ounce, Rhubarb six Drams, yellow Saunders two Drams, Cloves a Dram: Let there be a close and warm digestion for two hours filter it warm through lawn paper, the Dose is three or four Ounces.
Glisters are of frequent use in this Disease, because they loosen the Belly without any great irritation of the Fibres.
Take water of the Infusion of Stone-Horse-dung with Cammomile Flowers a pound, Honey of Herb Mercury two Ounces: After the same manner also let Decoctions or Infusions be prepar'd of Dogs-turd with Carminatives.
Take of the Emollient Decoction a pound, Sal Prunella, or Sal Armoniack, from a Dram to a Dram and a half: Make a Glister.
Take of the Ʋrine of a sound Man a pound, Sal Prunella a Dram, Ve∣nice Turpentine dissov'd with the Yolk of an Egg an Ounce and a half: Make a Glister.
2. Dinreticks, If any other Remedies, premise help in this Di∣sease.
Take live Millepedes cleans'd three Ounces, one Nutmeg slic'd, be∣ing bruis'd together, pour to them of the following Diuretick water a pound, express it strongly: The Dose is from three Ounces to four twice a day.
Take of the green Berries of Juniper and Elder of each six pounds, Firr tops four pounds, green Wallnuts two pounds, Winters Bark four Ounces, the outward Rinds of six Oranges and four Limons, the Seeds of Ameos, Rocket, and Water-cresses, of each an Ounce and a half, Dill-seeds two Ounces, being slic'd and bruis'd, pour to them of Whey made with Whitewine eight pounds, distil it with common Or∣gans: Let all the Liquor be mixt.
Take Crystal Mineral half an Ounce, Volatile Salt of Amber two Drams, Powder of wild Carrot-seeds a Dram, Venice Turpentine what suffices: Take small Pills, take three at Night, and in the Morning, drinking after it of the foresaid water three Ounces.
Take sweet Spirit of Salt half an Ounce, give from eight drops to twelve twice a day with a Draught of the same water, adding Syrup of Violets a spoonfull.
Take Spirit of Salt of Tartar an Ounce; give from a Scruple to half a Dram, twice a day after the same manner: So also Spirit of Nitre, and Tincture of Salt of Tartar may be given.
Take Leaves of Plantain, Chervil, and Clivers, of each four hand∣fuls, being bruis'd together, pour to them of the former distill'd wa∣ter a pound, express it strongly: The Dose is three Ounces twice or thrice a day with some other Medicine.
Take Grass Roots three Ounces, Roots of Butchers-broom two Oun∣ces, Chervil and Candied Eringo's, of each an Ounce, shavings of Hartshorn and Ivory, of each two Drams, burnt Hartshorn two Drams and a half, Burdock-seeds three Drams; boil them in three pounds of fountain water to two pounds: In the warm straining put Leaves of Clivers and Watercresses bruis'd, of each a handful, adding of Rhenish Wine six Ounces; let there be a close and warm Infu∣sion for two hours; then strain it again, and add of the Magisterial water of Earth-worms two Ounces, Syrup of the five Roots an Ounce and a half, make an Apozeme, the Dose is four Ounces twice a day, with some other Medicine.
Whilst these things are taken inwardly, let Topicks also, and outward applications be carefully Administred, not such as are hot and discussing, but such as are endow'd with Particles of a Volatile and Nitrous Salt, which destroy the combinations of the other Salts, and make void the efforts of the Spirits, for which ends we propose the following things: If Fomentations ought to be us'd at all, let them not be apply'd too hot, and let them not be prepar'd of the vulgarly call'd Carminatives, but chiefly of Salts and Minerals. Cabrotius (quoted by Helmont) says, he Cur'd a Person eighty years of Age, whose Belly he somented
twice a day with a Lixivium, in which he boil'd Salt, Allum, and Sulphur, and after apply'd Cow-dung, for a Cataplasm, I use to prescribe as follows.
Take Flowers of Sal Armoniack an Ounce, Crystal Mineral two Ounces, small Spirit of Wine containing much Phlegm in it two pounds: Mix them, and dissolve them in a Glass.
Let a Woolen Cloath dipp'd in this warm, be apply'd on the whole Abdomen, and be chang'd now and then, dipping it afresh: Let it be done twice a day for half an hours space, afterwards let there be apply'd either a Cataplasm of Cow-dung, with the Pow∣der of Dogs-turd, or the Plaister following.
Take Emplastrum Diasaponis, that is, of Minium with Venice Soap what suffices: Let it be thin spread on thin Leather, and apply'd to the whole Belly, renewing it within ten or twelve days.
The Second Indication requires chiefly altering Medicines, viz. such as put a stop to the Fermentations of the humours in the Viscera of the Belly, and to the wild Efforts, and irregular excur∣sions of the Spirits, and which likewise procure the even mix∣tures and due motions of the Chyle and Nervous Juice: For which ends Chalybeats are principally us'd; and truly not only for this Disease, but for many others belonging to the Viscera of the Belly, it's usual to have recourse to Steel Medicines, though in the mean time many Empyricks confidently prescribing them, do not consider after what manner such Medicines work, or what alterations for the better may be expected from them: And in∣deed it very often falls out, that nature her self is destroyed, and not the Disease, when Chalybeats, of which there is a great variety, and of diversified Operations, are given without any distinction or choice, or without respect to the Temperament, Constitution, and state of the Disease in Patients.
We have treated elsewhere ex professo concerning Medicines prepar'd of Iron and Steel, and of their vertues and manners of working; so that it's needless to repeat the same here: As to this Disease, if any of them are proper for it, certainly they are not all: For those in which the Sulphur still remains, and being free, predominates over the other principles after that the texture of the mixt Body is open'd, must be wholly excluded from this number; for by their powerful fermentation, they greatly fer∣ment the Juices of the Viscera, and put the Blood and Spirits in such a Commotion, that the whole Region of the Belly is puft up in a greater Bulk, as though some Spirit rush'd violently into it.
Nor are those more proper here, from which the Sulphureous Particles are wholly driven away with the Saline, as in Crocus Martis prepar'd by a very strong and long Calcination; for as this Medicine is good to stay all fluxions, so it sixes more
any Impactions of Spirits and humours, and renders them more obstinate.
But there remains a Martial Remedy of a middle kind, in which the Sulphur being wholly, or for the greatest part expell'd, the Vitriolick Salt remains, and has for the greatest part the Predo∣minancy, as it has in a Solution of the Filings of Iron, or in its Infusion either simple, or in Mineral waters, in Salt or Vitriol of Mars, in our preparation of Steel, with many others, preparations and compositions of which have been often found by experience to have done great good in some cases; for these destroy the Exotick, and restore the Genuine Ferments of the Viscera; open their Obstructions, fix the Blood, and keep its Texture from much dissolution: Wherefore Chalybeate Medicines, as also some other Alteratives have haply some effect against the Procatarctick and more remote Causes of a Tympany, but do little or no good at all against its Conjunct Cause.
Take of our Steel ground very fine two Drams, of the Distill'd water above written two Pounds, Syrup of the five Roots two Ounces, mix them in a Glass, and let it Clarifie by setling; the Dose is three or four Ounces in the Morning and at five in the Afternoon.
Take Powder of Aron Roots, and of Crabbs Eyes of each three Drams, Chrystal Mineral two Drams, Vitriol of Mars a Dram and a half, Sugar of Rosemary Flowers two Drams: Mix them, the Dose is half a Dram, twice a Day with a fit Vehicle.
Hartman highly extolls the Liquor of the Flowers of the Herb Mullein as a Specifick Remedy in this Disease: Put those Flowers fresh gather'd into an Alembick and press them in hard, then the Ves∣sell being carefully stopt that nothing can breath forth, let it stand in an Oven whilst bread is bak't, and afterwards the Flowers being taken forth press forth the Liquor very hard, and let it be Distill'd in Bal∣neo: The Dose is a Scruple in Decoction of the Seeds and Roots of Fennel. Certainly if this Medicine can do any thing, it ought to be given in a greater Dose.
Johannes Anglicus Commends the Electuary Rosata Novella with Diatrion Santalon and Ants Eggs; which Medicine truly being probable enough seems to promise something: In Imitation of these I shall here propose the following.
Take Conserve of the Flowers of Cichory and Indian Cress of each three Ounces, Powder of Aron Roots, Lignum Aloes, yellow Saunders of each a Dram, Crabbs Eyes a Dram and a half, Salt of Worm∣wood an Ounce, Ants Eggs an Ounce, Liguor of male Mullein half a Dram, with a sufficient quantity of Syrup of Citron Pills make an Electuary, the Dose is two Drams, twice a Day, Drinking after it of the former Distill'd water, or of the following Julape three Ounces.
Take water of the Leaves of Aron, of the Juice of Elderberryes, water of Juniper and of Elder Flowers of each six Ounces Magisteriall waters of Snails and of Earth-worms of each two Ounces, Syrup of the Juice of Elderberryes two Ounces, mix them, make a Julape.
The third Indication being vital Prescribes Remedies chiefly against Faintings of the Spirits, and difficulty of Breathing, and against Watching and Thirst: I shall briefly set down certain Forms of both kinds.
TAke water of Navews, of Marigold and Cammomill Flowers of each three Ounces: Dr. Stevens's water two Ounces, Tincture of Saffron two Drams, Sugar an Ounce. Pearl a Dram; make a Julape, the Dose is four or five Spoonfuls thrice or oftener in a Day in Faintings.
Take Conserve of Marigold Flowers two Ounces, Confection of Alkermes and of Hyacinth of each two Drams, Pearl Powdred an Ounces, of the Juice of Citrons what suffices; make a Confection, take the quantity of a Nutmeg Evening and Morning drinking after it a Draught of the Julape.
TAke Aqua Hysterica six Drams, Syrup de Meconio half an Ounce; mix them, take it late at Night, Or,
Take small Cinnamon water an Ounce, Diacodium three Ounces, Tincture of Saffron two Drams, mix them, take to the quantity of a Spoonfull late at Night if Sleep be wanting. Or,
Take Syrup of Cowslip Flowers three Spoonfulls, Compound Peony water one Spoonfull, Laudanum Tartarizd a Dram, take a Spoonfull late at Night if you cannot Sleep.
Quenchers of Thirst must be frequently given in this most Thir∣sty Disease, but it must be in a very small quantity, that we may allay that most troublesom Symptom without much Drink, which is always pernicious: For which end,
Take Conserve of Wood-Sorrel passed through a Sieve three Ounces, Pulp of Tamarinds two Ounces, Sal Prunella a Dram, Syrup of the Juice of Wood-Sorrel what suffices, make a soft Lohoch of which let him lick often.
AN Anasarca is describ'd after this manner, that it is a white and soft Tumour of the whole outward part of the Body, or of some parts of it, yielding to the Touch, and leaving a Pit up∣pon Compression, proceeding from an Aqueous Homour extra∣vasated and heapt together, both within the Interstices of the Muscles, and within the Pores of the Flesh and Skin, and even of the Glands and Membranes.
That watery Humour proceeds wholly or for the greatest part from the Blood, for being continually produc't within the Mass of Blood through the defect and fault of Sanguification, it is pour'd forth of the Mouths of the Arteries in a greater quantity than that it can be receiv'd and carried back by the Veins and Limphaeducts and be sent forth by the Reins and Pores of the Skin, and other Emissaries of the Serous Latex.
And Anasarca whilst it is simple, is the least dangerous amongst all the species of Dropsies: And a particular Anasarca oc∣cupying only the Inferior Members, so the Belly do not swell withal, is much safer than an Universal one.
In order to a right proceeding towards a Cure, two chief scopes of Curing here present themselves, viz. First we must take Care that the water betwixt the Skin and the Flesh be some way E∣vacuated and Consum'd; and Secondly that a new supply be not continually engendred and heapt together: For which end we must use what means we may both that the Viscera of Concoction being cleans'd from Excrements, and free from Obstructions, prepare always a good Chyle, and supply the Mass of Blood with it in a due quantity, and likewise that the Blood, (its Principles being restor'd to their fermenting Power) may duly ferment and convert into its own Nature the Juice of the Chyle continually sent into it. The Vital Indication seems not necessary in this Disease as in many others, because Faintings of the Spirits, or Watchings, for which Cardiacks, and Hypnoticks are required, seldom happen here: And there is little need of restoring Diets because Fasting and Abstinence do more good, and most com∣monly are the greatest part of the Cure; the reason is that the Vessels being drain'd by Fasting, drink up the waters Stagnating
betwixt the Skin and the Flesh, or elsewhere, and send them forth partly by the Reins, the Pores of the Skin, and other Emissaries, and partly employ them most Advantageously for nourishing the Body, they being yet full of a Nutritive Juice. First, to per∣form the first Indication which is for the Evacuation of the Mor∣bifick matter, all Hydragogue Medicines both Simple and Com∣pound, and likewise the Forms of Medicines set down before in the Chapter of the Ascites ought to be apply'd to use: Moreover not only Catharticks and Diureticks, but likewise Diaphoreticks have often place in the Cure of the Anasarca, though for the most part they are forbidden in other kinds of the Dropsie.
In a simple Anasarca you may Purge Strongly, and it often does much good.
I have given you before Forms of Hydragogue Catharticks of both kinds. viz. of such as exert their force both upwards and downwards, and both of a gentle and strong Operation; from whence you may take them, and apply them to the present Method of Curing.
If you ask how Catharticks work in this Disease, and where∣fore they carry forth waters better and more efficaciously than in other kinds of the Dropsie: I say that in an Anasarca the Morbifick matter (which is a Lympha) resieds partly in the Mass of Blood, and partly in the habit of the Body within the Pores and empty Spaces lying betwixt the Vessells: Wherefore a strong Cathartick being given, it presently Exagitates the Mass of Blood, fuses it, and moves it to an Excretion of any supersluous or he∣terogeneous thing: And at the same time irritates the Mouths of the Arteries which lye open towards the Cavityes of the Intestines, that the water cast out of the Blood may find a way forth ra∣ther by these Emissaries. Hence in the fust place the waters floating within the Mass of Blood are clear'd forth in a plen∣tifull manner, and then the Vessells being drain'd soon drink up the waters betwixt the Flesh and the Skin, and presently send them forth partly by seigh, and partly by Urine or Sweat: There is no fear in the mean time, lest, as in an Ascites, the Morbifick matter being Exagitated, and put in Fusion by the Medicine, be driven from the Blood into the places affected, whence it cannot easily get out again; or lest, as in a Tympany, the Vis∣cera by reason of the Fibres of the Ventricle and Intestines be∣ing too much irritated, are mov'd into Convulsive Extensions; for whilst the Viscera are sound, and in a good state, the Par∣ticles of the Medicament do them no hurt, but being car∣ryed thence into the Blood, do not only fetch waters from it, but by Exagitating its Mass, raise up its Active Particles be∣fore
opprest, and dispose them for recovering their power of Fermentation.
Secondly, I have also set down before the Hydragogues o∣perating by Urine, both simple and compound, and have given you Forms of Medicines prepar'd of both, and the ways of give∣ing them: Wherefore I shall not repeat them here: But be∣cause all Medicines of this kind do not good alike in all affects we must here observe that Lixivials (as I have often found by experience) far exceed the rest of Diureticks in Curing the Ana∣sarca. And now it's a much us'd and common Remedy for a∣ny one who has his Members swell'd, to Purge first, and then to take twice or thrice a Day six or eight Ounces of a Lixi∣vium made of White-wine with the Ashes of Wormwood or of Broom, and to continue its use for some Days: This Medicine as I have observ'd in many, powerfully provok's Urine, nay some∣times in such Abundance that the Patients within the space of twenty four hours making above a Gallon and a half of water, have presently recover'd almost to a miracle.
The reason why Medicines containing a fixt and lixivial Sal expell Urine more in an Anasarca than such as are endow'd with an Acid, or Alchalisate or Volatile Salt, is, that in this Disease the watery Homours which upon failing of the Fermentation of the Blood, and of its sanguifying Vertue, are gathered to∣gether as well within its Mass as in the habit of the Body, up∣on stagnating there some time are turn'd somewhat sharp: Where∣fore the Lixivial Particles of the Medicine entering the Blood presently grow in a heat with the Acids of the waters, which as they exagitate and ferment, they cause a mighty Fermentation in the whole Mass of the Blood and a following excretion.
Take of the Ashes of Broom, or of Wormwood, or of the Prunings of Vines calcin'd to a whiteness and sifted, four Ounces, put them in a Glass-bottle with two Pounds of White-wine; let there be a close and warm Digestion for three or four hours, then strain it, the Dose is from six Ounces to eight twice a Day.
Take white Tartar calcin'd with Nitre, and after melted in a crucible till it look blew, three Ounces, small Spirit of Wine a pound and half, water of Snails and Earth-worms, of each four Ounces, let them digest close luted in a sand-furnace for two Days, the Dose of the clear Liquor is two or three Ounces, with four Ounces of the Decoction of the Roots of Butchers Broom and Burdocks made in Ale.
TAke white Ashes of Broom cleans'd two Pounds, put them in a Bag, with Raspings of Sassafras three Ounces, Roots of the lesser Galingal an Ounce, Juniper berryer and wild Carrot Seeds of each an Ounce and a half, make a Bag for four Gallons of Ase, after seven or eight Days begin to draw it.
Diaphoreticks often do excellently well in a Leucophlegmatia (which begins or concludes an Anasarca) and they usually a∣gree better in this Disease when confirm'd than in other kinds of the Dropsie: And though at the beginning they are not able to move Sweat because the habit of the Body is invested with a deal of waters, however by exagitating the Blood they are a means that the active Particles implanted in it, which were dull'd before, and almost overwhelm'd, are rais'd up again, and dispos'd to a Fermentation, and that all the dreggy Excre∣ments, especially such as are Aqueous, are put in Motion, so that presently breaking forth of their Receptacles in a plentiful man∣ner, they readily pass off by Seige, or Urin, and often in some measure by transpiration: But after that the waters being well clear'd by Purging, the Morbifick matter is so far diminisht that the bulk of the Body and the swelling of the Members begin to abate, the remainder of the Humour is excellently con∣sum'd by moderate Sweats, and by a constant perspiration.
We have given you before a List and Forms of Hydroticks; but as to our present purpose for the Cure of an Anasarca, those things are most proper which are given in somwhat a large Dose; for as to such as are prescrib'd in a small quantity, their active Particles being immerg'd in the waters are over∣whelm'd before they can be diffus'd in the Blood so as to exert their force; wherefore Spirits whether Armoniack, or Vinous, also Tinctures and Elixirs, nay and Powders, seldom come in use against this Disease; because in a small Dose they do little, and if it be made very large, they often offend the bowels by their excess in operation, therefore let those things rather be made choice of which being taken in a full Draught and warm may be able to pass the whole Blood uncorrupted, as chiefly the Decoctions of Woods and Roots, whose Particles agreeing well enough with the Blood, but being not to be mastered by it, pass through its whole Mass, and exert an Elastick force, putting all the Humours in a Commotion.
Take Raspings of Guaiacum six Ounces, Sassafras two Ounces, all
the Saunders of each six Drams, shavings of Ivory and Harts-horn of each three Drams, let them infuse according to Art, and boyl in eight Pounds of fountain water till half be consum'd, addïng Roots of Calamus Aromaticus, the lesser Galingal, Burdocks and Butter∣burr of each an Ounce, Leaves of Woodsage and Germander dryed of each two handfulls, let the straining be kept for use, the Dose is from eight Ounces to ten twice a Day warm; to each Dose may be added Spirit of Sal Armoniack succinated, or of Soot from twenty to twenty five Drops: Or Tincture of Salt of Tartar from half a Dram to a Dram.
So much of Hydragogue Medicines to be taken inwardly, which cause waters to be evacuated either by drawing them inwardly towards the Intestines, or by driving them out to the Reins, or to the Pores of the Skin: Moreover there are certain outward Administrations us'd, by which waters gather'd together within the habit of the Body are put in motion, and so dispos'd either generally to pass off by Sweat, or Urine, or particularly, are presently let forth, a Vent being made in some peculiar places.
In the first rank, we place Frictions, Liniments, Fomentations, Baths both dry and moist: And particular things to evacuate waters are Vesicatories, Escharoticks, and prickings by a Needle, I shall speak of each of these, or at least of the chief of them as far as they regard this Disease.
Frictions prove often of good effect in a Leucophlegmatia and an Anasarca: For as the habit of the Body is not only so charg'd with a Glut of filthy waters there heapt together, that nothing can breath through them, but even the outward parts grow cold upon the Blood's being hindred of an access to them, frequent and strong Frictions give a motion to the stagnating waters, and in some measure dissipate them from thence, and by opening the passages call again the Blood into those parts whence it was banisht, wherefore it is good not only to rubb the swollen Member, but even the whole Body once or twice a Day with a course Cloath, or with a little brush now commonly made for that purpose.
In rubbing, or after it, Liniments and Fomentations are som∣times proper: They are prepar'd either of Salts and other Mi∣nerals dissolv'd, or of hot and discussing Vegetables boil'd with Lees of Wine in water; and being apply'd hot open the Pores, give a farther motion to the accumulated Waters and discuss them, and enlarge the compass of the Blood's circuit, the watery Mass being in some measure dissipated. The Liniments consist of Sulphur and Salts of divers kinds, or of Quick-lime and other Minerals, which being powdred and mixt with the
Mucilaginous extracts of Smart Herbs, are made into an Oint∣ment: To which for their better consistency let a fit quan∣tity of Oyl of Scorpions be added: Nay this Oyl apply'd by it self (so it be right) gives often great relief. I knew a Boy swollen very much with an Universal Anasarca, who was Cur'd by this only Remedy: For his Mother (I know not how ad∣vis'd) anointed his whole Body Mornings and Evenings with Oyl of Scorpions, chafing well the parts with her warm hand: Upon which within three Days he began to make a vast quan∣tity of water, and having continued to make water so for some Days, the swelling vanishing by degrees, he grew well.
Baths are scarce proper for any Dropsie but an Anasarca, nor for this but in the first Disposition to it, or as it goes off: For since by the heat of Baths encompassing the whole Body, the Blood being made very hot and instigated, puts the waters every where in motion which were stagnating before, and drinking them into it self conveys them sundry ways, there is danger lest (as it frequently happens) receiving them from the habit of the Body into its Mass, it presently deposes them in the Praecordia, or the Brain; for there is nothing more usual than that the affects of those parts, viz. an Asthma, or Apoplexy happen to Hydropical persons after bathing: But when the conjunct cause of the Disease (viz. the swelling) is moderate, or not very great, a Bath of water impregnated with Salts and Sulphur, or also a hot-house promoting a gentle Sweat, are often us'd with good effect. Instead of a hot-house it's better that the Patients be plac't in some convenient Cells in a Salt-house near the Furnaces, in which the Mineral water is boil'd into Salt, which often proves of mighty benefit to them.
Vesicatories let forth the waters betwixt the Flesh and the Skin in a plentiful manner, and somtimes too profusely, these are to be apply'd to Hydropical persons with very great caution, for such an Epispastick apply'd to swollen places makes a vent too wide; upon the opening of which the water first breaking forth, often draws after it from the whole Neighbourhood a great Glut of it, whence presently follows a great Conster∣nation of the Spirits: Moreover somtimes the place so drain'd on a sudden, being depriv'd of Heat and Spirits, in a short time becomes mortifyed: Wherefore this Medicine is sel∣dom apply'd to the Leggs or Feet of hydropical persons where the neat is weak, and the swelling very great, but somtimes to the Thighs and Arms with security, when need requires.
Escharoticks are apply'd somwhat more safely to the swollen Places than Vesicatories, because the Flux of waters out of this
Vent is not so violent and in such Abundance presently at first: But beginning moderately it grows after by little and little to a great Current, which nature (after being accustom'd to it by degrees) bears better: Moreover there is less danger of a Gangrene after an Escharotick than after a Vesicatory, because in that Application, the part whose Union is dis∣solv'd is fortify'd by the Eschar against the loss of heat. I knew an illiterate Empyrick who often by an Echarotick suc∣cessfully evacuated the Members of Hydropical peasons, though never so much swollen, after the following manner. viz. First he fomented their Leggs Morning and Evening with a De∣coction of Dwarfe-elder, Wormwood Camomill, and other hot Herbs, the Lees of Wine or Ale being added to them, and be∣twixt the times of fomenting he apply'd a Cataplasm made of the Faeces of that Decoction with Bran: After these things had been us'd three Days he covered both Leggs and Feet with a Plaister of Burgundy-Pitch, leaving only a small hole on each Calf to the bigness of a small Nut, in which places he put an Escharotick of the Ashes of Ashen Bark to the naked Skin: which being remov'd after twelve hours a small Eschar was left, out of whose Pores the Matter first Sweated gently, then daily distill'd forth somwhat more freely, and at length (the Eschar falling off) it flow'd forth in a plentifull Stream as from an open Source, till it was drawn from the whose Legg both above and beneath.
There remains yet another way of drawing forth waters from betwixt the Flesh and the Skin, not inferior to the for∣mer, though less in use, viz. by the pricking of a Needle: Which also much be done very cautiously and by little and little, lest a head-strong and excessive Flux of waters be rais'd by it. Take an ordinary Needle, such as Taylors use, and prick the Skin over with it in the place most swell'd, but let it not en∣ter so far as to draw Blood, and so make six or seven little holes at a time about an inch distant the one from the other: The water will Issue by drops forth of each little hole and so will continually Distill forth till all the swelling be gone from the place prickt: Then the next time, after somtimes twelve, somtimes eighteen, somtimes twenty four hours prick again in some other part either of the same Leg, or of the other, and so continue to make such Vents for the waters once or twice a Day in this Member, or that, one alone, or two, or at the same time in many: For after this manner the Hydro∣pical Corruption may be drayn'd more freely and safely than by any other exteriour operation whatsoever; and if in the mean time its flesh supply be provided against by inward Phy∣sick,
Physick, the Disease will be the more easily Cur'd: Moreover in a desperate Dropsie that Administration serves very well to prolong Life, because the waters being continually emptied forth by those outward Vents, the inward and vital Inunda∣tion is the longer delay'd: A Man of late seventy years of Age, plung'd in a Dropsie over his whole Body has continued in Life and kept his head above the waters for these many Months beyond the expectation of all Men by the means of this only Remedy.
So far of the kinds and forms of Remedies prompted to us by the first, that is, the Curative Indication: As for the Preservative Indication which takes care to restore the Crasis, and fermenting or Sanguifying Vertue of the Blood, it sug∣gests to us those Medicines with being endowed with hot and elastick Particles, raise up the active or deprest Principles of the Mass of Blood, or repair them being wasted; for which ends the vulgarly call'd Altering Remedies are wont to be pre∣scrib'd in the Form of an Electuary, Powder, Pills, Distill'd waters, Julapes, Apozemes, and Dyets, to which also Spirits, Tinctures, Elixirs are somtimes added for the greater Effica∣cy: I shall give you an example or two of each of these.
1. Take Conserves of Sea-Wormood, Scurvy-grass, and the yellow Coats of Oranges of each two Ounces, Winters-Bark two Drams, Species Diacurcumae a Dram and a half, Steel prepared with Sulphur three Drams, Salt of Wormwood two Drams, Syrup of Citron Pills what suffices, make an Electuary: The Dose is two Drams in the Morning and at five in the Afternoon, drinking after it a Draught of Julape, or of the Distill'd water to three or four Ounces.
Chalybeats very often do great good in this Disease, as in the Green-sickness: Insomuch that the whole, or at the least the chief scope of Curing Falls frequently on this Remedy: But we must note that these kinds of Medicines do not all equally a∣gree in these cases: For those that are chiefly in use, viz. Salt of Steel, or Vitriol of Mars, and others prepar'd with Acids, and wholly depriv'd of Sulphur, do no good at all, be∣cause they do not promote the Fermentation of the Blood, but on the contrary rather fix it when too Exorbitant, or Elastick: But for an Anasarca, and any other oedematous Cachexia in the habit of the Body, let those Chalybeats be given, in which the Sulphury Particles are left, and are Praedominant, as especially in the Filings of Iron, and in its Scales reduc't into a fine Powder, and in-Steel melted with Sulphur and Powdred; these Powders being taken are presently dissolv'd by the Acid Salts within our Body, upon which the Sulphureous Metallick Particles
being set free and convey'd into the Blood, ferment its whole Mass, raise up the Symbolous Particles there, before lying dor∣mant, and being joyn'd with them give a vigour to the Blood, and renew its fermenting or sanguifying power before deprest: Wherefore we find after a little use of these Chalybeats the pal∣lid colour in the Green-sickness goes off, and turns to a Florid Aspect.
2. Take compound Powder of Aron Roots, and Winters-bark of each three Drams, Roots of the lesser Galingal, Cubebs of each a Dram and a half, Steel prepar'd with Sulphur half an Ounce, Sugar of Rosemary Flowers six Drams, make a Powder, divide it into twenty parts, the Dose is one part every Morning, and at five in the Afternoon with a Draught of the Sudorifick Decoction pre∣scrib'd before.
3. Take of the Gummous extract remaining after the Distillation of the Elixir Vitae of Quercetan half an Ounce, powder of Earth∣worms prepar'd two Drams, Roots of the lesser Galingal, Winters∣bark of each a Dram and a half, Salt of Wormwood two Drams, Iron Rust two Drams and a half, Balsam of Peru a Dram, Tincture of Salt of Tartar two Drams, Balsamum Capivii what suffices, make a Mass, form it into little Pills, the Dose is half a Dram at Night and early in the Morning, Drinking after it of the Julape or distill'd water following three Ounces.
4. Take Elder Flower water, and the Fermented Juice of its Berryes of each a Pound, Magisteriall water of Earth-worms, Rad∣dish water compound, Aqua Mirabilis of each two Ounces, Syrup of the Juice of Elderberryes two Ounces, mix them make a Julape.
5. Take Leaves of Garden Scurvygrass, Rochet, Pepperwort of each six handfulls, Roots of Calamus Armaticus, the lesser Galingal, Zedoary, Florentine Orris, Elder, Aron, of each six Ounces, Winters∣barke, Jamaica Pepper of each three Ounces, Juniper Berryes four Ounces, Cloves, Ginger, Nutmeggs of each an Ounce. Being slic'd and bruis'd pour to them of old Rhenish-wine eight Pounds; distill it in common Organs, let the whole Liquor be mixt.
6. 7. An Antihydropick Decoction is Prescrib'd before amongst Diaphoreticks: A Dyet-drink to be taken instead of Beer may be made according to the Form following.
Take Raspings of Guaiacum and Sassafras of each four Ounces, Roots of Florentine Orris, Calamus Aromaticus, the lesser Galingal, Ele∣campane, of each an Ounce and a half, Juniper and Lawrell berryes of each two Ounces, Seeds of Anise, Caraway, sweet Fennell, Cori∣ander, Dill, of each an Ounce, long Pepper, Cubebs of each an Ounce and a half, Cloves, Nutmeggs, Ginger of each half an Ounce, Ja∣mainca Pepper two Ounces, dry'd Leaves of Salvia Acuta, Wood-sage
Calamint, Agrimony of each a handful, Licorice four Ounces, being slic'd and bruis'd. Let them boyl in four Gallons of fountain water to half; when the straining is cold, let it be put up in Glass-bottles for use: I have known many persons almost given over in an Ana∣sarce who by the constant use of this Drink have perfectly recover'd. Of many examples of persons Cur'd of Dropsies I shall now give you one.
A certain Robust Man, of a middle Age, after having gotten an Epidemical Quartan Ague, and being ill manag'd at first, had lain under it above a year, and in the mean time had us'd an ill Dyet, fell into an Anasarca, which afterward upon his indulging himself to Drink very freely for quenching his Thirst, (which was exceeding great) grew in a short time to a vast height; so that all his Members from the Head to the Foot, and his Belly likewise being swollen, he was not able to turn himself from ont side to the other in his Bed without the assistance of Servants.
As I first visited him, and despairing of Cure, I plainly told him that unless he would abstain from Drink, he must die in a short time; upon which he promis'd, so I could save his Life, that he would Drink no more in a Weeks time, and was as good as his word, for though very Thirsty he scarce took any Liquid thing into him but Physick for six or seven Days: And during that time by carefully taking Hydragogue Catharticks and Diureticks, and all other things Prescirb'd, he grew much better; and afterwards a Method as above Prescrib'd being som∣time followed, he was restor'd to his perfect Health, and now lives a sound Man after five years past.
There remains certain other affects of the Viscera of the Belly, of the Remedies of which according to a due Method I should have treated here; but I have already perform'd this Task for the greatest part elsewhere; for we have deliver'd most of the Medicines that concern the Reins amongst Diureticks, and those that concern the Stomach and Intestines among the number of Emeticks and Purgers: As for what respect the Spleen and the Womb we have fully set them forth in our Hypochondriack and Histerick Pathology: As for what regards the Genital parts and their Diseases, and Cure, we have thought fit to reserve it for another time and place: It concerns us next after having treated hitherto of inward Pharmacy; to discourse somwhat of outward Medicines, which we shall do in the next Section beginning with the great Remedy 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.
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.
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.
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.
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.
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.
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.