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

CHAP. III. Instructions and Prescripts for Curing Convulsive Dis∣eases in Adult Persons, hapning by reason of the Origine of the Nerves being chiefly affected.

THough Convulsive affects which happen to Adult Persons, being denoted by other Names, are also vulgarly accounted to have another Origine, and are wont to be refer'd to those they call Hysterical, Hypochondriacal, or Colick passions, or to the Scurvy; nevertheless if the thing be a little more attentively considered, it will easily appear, that certain Convulsive Symptoms frequently happen both to Men and Women, which properly and duly claim the name of a Convulsion: Now these may be va∣riously distinguisht according to the Manifold seat of the Mor∣bifick cause, but especially into these three kinds, viz. into cer∣tain Convulsions caus'd by reason of the Origine of the Nerves being chiefly affected, and into others which are caus'd by rea∣son of the extremities of the Nerves being stopt with a Morbi∣fick Matter; and lastly into others whose Morbifick Matter de∣scending from the Head, gets possession of the whole, or the greatest part of the Ductus's of some peculiar Nerves, or of them altogether. We shall treat of each of these kinds of Con∣vulsions one after the other.

Therefore first of all as to Convulsions hapning by reason of the Origine of the Nerves being affected, we must note first that the Morbifick Matter besetting the Origines of the Nerves, sometimes passes chiefly into the foremost Pairs of Nerves, viz. which attend the Muscles of the Eyes and Face; and thence Con∣tractions and tremblings sometimes of the Nose, Cheeks or Lips, sometimes of the Eyes or Mouth ensue. Secondly, sometimes the Par Vagum and Intercostal chiefly imbibe the Heterogeneous Particles, and then Inflations or Contractions of the Abdomen and Hypochondres, and also a Palpitation and Trembling of the Heart, a difficult and interrupted Breathing, an intermitting Pulse, and other Symptoms of the middle or lower Region of the Belly chiefly molest us. Thirdly, but sometimes the Morbifick Cause lying behind, chiefly affects the Spinal Marrow; and there∣fore the outward Members and Limbs are rendred obnoxious to Twitchings and Contractions.

Moreover as we may conjecture from various Types of the Con\vulsive affect, it seems that the Convulsive Matter going to these or those Nerves, or to many of them together, either lodges it self in a manner only about their Origines, so that upon frequent Explosions of the Spirits there, an almost continual and very troublesome Vertigo arises; and so Tremblings, and a short Faint∣ing, and danger of Swounding are perceiv'd about the Praecordia, and often Twitchings and gentle Contractions in the Bowels or Muscles: Or Secondly, the explosive Particles convey'd to the Origine of the Nerves, enter deeper into their Processes, and often falling down into the Plexus's of the Nerves, belonging to the Prae∣cordia, or Viscera of the Belly; or also to the outward Members, make there other seats, as it were of Convulsive affects, so that as often as the Spirits are forc't to Explosions about the Origine of the Nerves, presently Fits, as it were Hysterick, Asthmatick, or otherwise Convulsive arise in the Belly, Thorax, or outward Members. I shall now give you some instances of Persons in whom the Morbifick Matter besetting the Origine of the Nerves, and not yet fall'n deeper into their Processes, caus'd frequent Vertigo's, and only gentle Convulsions of the Viscera and Praecordia.

1. A Lady of great Quality, about Thirty years of Age, of a tender Constitution, and of a thin habit of Body, was wont to be sorely afflicted every Winter with a Catarrh distilling on her Trachaea and Lungs, with a Cough, Hoarsness, and great Spit∣ing, but the last year, through a diligent care and caution us'd, she escaped that evil: But after the Winter solstice, upon taking cold, she was seis'd with a violent Head-ach, a ringing in the Ears, a Vertigo, with a mighty Distillation of Rheum at the Eyes and Nose, whence it easily appear'd that the filthy Mass of Serum which was wont before to distil on the Brest, was then wholly depos'd within the Head and Brain: The effect whereof more∣over was, that as often as she began to sleep, she was very much troubled with a sort of Hysterick Fits, to which she had never before been obnoxious: For if at any time beginning to sleep, she clos'd her Eyes, presently it caus'd a rising of a heavy thing in her Belly, a Suffocation in her Throat, and Tremblings and Twitchings about the Praecordia: Which affects nevertheless, when she was perfectly awak't, presently ceas't, so that the Dis∣eas'd was forc't to abstain in a manner wholly from sleep for many days and nights together.

Being call'd to this Lady after she was become very weak up∣on many days Sickness, I was forc't to use only gentle Medi∣cines: Therefore I ordered four Ounces of Blood to be taken from her Foot, and a Clyster of Milk with Sugar to be daily

given her, after which she was wont to have three or four Stools: Moreover every eighth hour I gave her a Dose of Spirit of Harts∣horn in a Spoonful of the following Julape.

Take Water of Penny-royal, Wallnuts, black Cherries of each three Ounces, Hysterick Water two Ounces, Syrup of Clovegilly-flowers an Ounce and a half, Castoreum tyed in a Nodulus, and hung in the Glass half a Dram, Pearl powdred a Scruple, mix them.

I applyed with good effect Vesicatories behind the Ears, and Ca∣taplasms of Leaves of Rue, and Aron, with Bryony Roots, Sea Salt, and black Soap to the Soles of the Feet.

Sometimes in the Evening I gave half an Ounce of Diacodium in a little Draught of the Julape before ordered, which was fol∣lowed by a moderate sleep without being attended according to wont with Convulsions: Which kind of effect I have often ex∣perienced in such a case after Opiats given: For quenching Thirst I gave a Ptisan with Diuretick Ingredients boil'd in it: By the use of these things she was very much reliev'd within a short time: But that which fell out much for her good was, that an Abscess in the left Ear, breaking of its own accord, first dis∣charg'd a yellow Gore, and afterward for many days a vast quan∣tity of thin Ichor: After which Evacuation the Convulsions of the Bowels and Praecordia wholly ceasing, the Disease was per∣fectly determin'd.

I have known many Persons both Men and Women Diseas'd after this manner, who being ill of a Head-ach, an oppression of the hinder part of the Head, or a Vertigo, perceiv'd in their sleep presently Convulsive motions in the Praecordia or Bowels, or in both of them together: Which happens from the Salley of the tumultuary Spirits reflected from the Brain into the Ori∣gines of the Nerves: And as an Opiate gave the Patient before mention'd a quiet sleep without the wonted Sequel of Convul∣sions, so I have often successfully Cur'd terrible Convulsive Fits, both Asthmatical, and as it were Hysterical, by giving Opiats.

1. A Woman sixty seven years of Age having still a florid Coun∣tenance, and being of a gross habit of Body, and who first had liv'd long subject to a Swelling of the Face, and great Fits of the Head-ach, upon the Weathers growing very cold in the Winter, fell into a very grievous Vertigo, with a Trembling of the Heart, a Fainting of the Spirits, and a frequent striving to Vomit: Be∣ing put to Bed if she open'd her Eyes, or was turn'd from one side on the other, she was presently seiz'd with a mighty Scoto∣mia, a danger of Swooning, and moreover with a cruel Vomit∣ing. As I was to see her I did not doubt but the cause of the Disease was the Convulsive Matter convey'd from the outward

Region of the Head to the inmost Recesses of the Brain, by the ill Breath, or Heterogeneous Combination of which the Animal Spirits being struck, they rais'd the Vertiginous affects as they made their disorderly sallyes towards the Brain, and when they tumultuarily rusht into the Roots of the Nerves, they caus'd the Scotomia, the disorders of the Praecordia, and the striving to Vomit: The Cure of this was perform'd within a few days by the application of large Vesicatories to the Nucha, and behind the Ears; the dayly injection of Clysters, and by a frequent use of Spirit of Harts-horn, and a Cephalick Julape.

Dr. Willis gives Instances of Persons in whom some portion of the Morbifick Matter which besets the Origine of the Nerves, descending from the Head, often enters deeper into the Ductus's of the Nerves, and so about their middle and extream Processes and Plexus's makes a fomes of an explosive matter, as it were of Gun-powder: But for brevity sake I omit them.

It is observ'd that when a Convulsive Fit begins within the Brain, at the Origine of the Nerves, presently the remotest Spi∣rits residing in the extremities of the Nerves (as many as are pre∣dispos'd for that Symptom) fall upon Explosions, and so con∣vey upwards, the Convulsive affect there more strongly be∣gun; which happens for this reason, that when some whole Se∣ries of Spirits is disturb'd, those which are in the extream parts, are first destitute of their Original Influx, wherefore those, before others begin to grow in a tumult, and to be irregularly dispos'd, as when a Nerve of the Arm or Thigh is constring'd by lying on it, so that it is hindred of its wonted influence of the Spirits, a stupor with a sense of pricking is first perceiv'd in the Fingers or Toes of the hands or Feet; whence it creeps upwards by de∣grees towards the places affected: And hence it is we find that if whilst the outmost Spirits are exploded, a strong Ligature, or Compression intercepts the succession of others into the same space, or their progress towards the parts, the Convulsion is usu∣ally hindred from ascending upward: Wherefore (as Physical Histories testify) when a stupor beginning at the top of a Finger or Toe of a hand or Foot, creeps to the upper parts with a sense of Formication, or like a cold wind; and at length taking to the Brain, causes terrible Convulsions: If presently at the first seizure the Arm or Leg be strongly bound about, the Convulsion being not able to pass that place, is hindred from getting to the Head: Nay and its an usual thing for Hysterick Women, assoon as a Swelling of their Belly, or an ascent of a heavy lump is first perceiv'd in their Abdomen, to bind about hard the Trunk of their Body with Swathes, and so commonly the Praecordia, and

the Region of the Head are kept from being affected with the Convulsive Fit.

It's likewise observable that if Blood be let forth of a Vein in the midst of a Covulsive or Apoplectical Fit, it presently seems to be congeal'd, so that being receiv'd in a Bason, it does not keep an even and plain Surface like Liquids, but accumulating it self drop upon drop, it rises in a heap like Tallow melted and distill'd into a cold Vessel: Yet as to what some conclude hence, viz. that Convulsions depend wholly on the thickness, obstructed mo∣tion, and stagnation of the Blood, we must not allow of it: For Blood drawn from Persons that are subject to Convulsions a little before the Fit, is diluted with Serum, and fluid enough: Wherefore we may opine that that Congelation is caus'd by the Fit it self: To wit, because in Convulsive motions, from the ex∣cessive Contractions of the Muscles and Viscera, the Blood passing bet wixt them, its Spirit and Serum exhaling, is a little solv'd in its mixture, and therefore is somewhat coagulated, just as when Milk by reason of its too great agitation and Separation of parts one from another, hardens into butlter, wherefore this kind of Coagu∣lation of the Blood seems rather to be the effect of Convulsions than their cause.

The Therapeutick Method.

AS to the Cure of these kinds of Convulsive affects, which in Men or Women proceed from a Morbifick cause, besetting the Origines of the Nerves: The first Indication will be to with∣draw the fuel of the Disease, viz. to hinder the Blood from dis∣charging on the Head, the Heterogeneous Particles, either engen∣dred in it self, or receiv'd from elsewhere from the Bowels. For this purpose an Evacuation, ordered both by Purging and Bleed∣ing, unless somewhat indicates the contrary, is wont to be ad∣ministred with good success.

Vomiting very often gives relief, wherefore let Vomits of the Infusion of Crocus Metallorum, or of Salt of Vitriol, or of Wine of Squills, be given in the first place. Then in a few days let Blood be drawn, either by opening a Vein in the Arm, or by Leeches applyed to the haemorrhoid Veins; then afterwards let a gentle Purge be ordered either of Pills, or of a Purging Apo∣zeme, and let it be repeated in due and convenient time.

Take Crato's Pills of Amber, or Bontius's Pills of Tartar two Drams, Rosm of Jalap sixteen Grains, Castoreum a Scruple, Oyl of Rosemary or of Amber half a Scruple, Gum Ammoniacum dissolo'd in a

sufficient quantity of Hysterick-water, make sixteen Pills, let four be taken every sixth or seventh day.

Take Roots of Polypody of the Oak, sharp pointed Dock prepar'd, and of Chervil, of each six Drams, of Male Peony three Drams, Leaves of Betony, Germander, Ground-pine, Vervain, Male Fluellin, of each a handful, Seeds of Carthamus and Burr-dock, of each three Drams, let them boil in four Pounds of Fountain-water to half, add of White∣wine a Pound, let it be strain'd into a Matrass, to which put Leaves of choice Sena an Ounce, Rhubarb six Drams, Gummous Turbith half an Ounce, Epithimum, yellow Saunders of each two Drams, Salt of Worm-wood, and of Scurvy-grass, of each a Dram, the outward yel∣low Coats of Oranges two Drams, let them digest close luted in a Sand heat for twelve hours, let the straining be kept for use: Let it be sweetned (if need be) with a sufficient quantity of Syrupus Augustanus, or with Syrup of Cichory with Rhubarb; the Dose is six Ounces once or twice in a week.

Each day in which Purging is omitted, let Remedies be given for strengthning the Brain, and for garding the Animal Spirits from incurring Heterogeneous Combinations, or from entring upon Explosions: Of which nevertheless let a certain choice be made according to the Temperament, Habit of Body, and Con∣stitution of the Diseas'd: For to such as have a thin habit of Body, and a hot Blood, Medicines must be given which are not hot, and which do not stir the Blood too much: On the contrary to phlegmatick and gross Bodies, whose Urine is thin and watery, and whose Blood circulates but dully, let hot Remedies be or∣dered, and such as are apt notably to ferment the Humours: In the former case you may prescribe after this manner.

Take Conserve of the Flowers of Betony, Tamarisk, and Male Peony of each two Ounces, Species Diamargariti Frigidi, a Dram and a half, Powder of the Roots of Peony, and of the Seeds of the same of each a Dram, red Coral prepar'd two Drams, Vitriol of Mars two Scruples, Salt of Worm-wood two Drams, with a sufficient quan∣tity of Juice of Oranges, make an Electuary: Let it be taked twice or thrice a day, drinking after it a little draught of the Julape be∣neath prescrib'd.

Take of red Coral ground with the Juice of Oranges on a Marble, or in a Glass-mortar, and dryed half an Ounce, Powder of Mistletow of the Oak, and of the Roots of Male Peony, of each two Drams, Sugar of Pearl three Drams, make a Powder; the Dose is from a Scruple to half a Dram, twice or thrice a day.

Take Species Diamargariti Frigidi two Drams, Salt of Worm-wood, three Drams, Aron Roots powdred a Dram, mix them, make a Powder, let it be divided into twenty parts, and let a Dose be taken in the Morning, and at four of the Clock.

Take Powder of the Roots of Butter Bur an Ounce, the Dose is from half a Dram to a Dram twice a day.

Take Leaves of the Bur-dock, and of Aron, of each six handfuls, being slic't and mixt together, let them be distil'd: The Dose is from two Drams to three twice or thrice a day after a Dose of the Electuary or Powder.

Take of this distill'd Water two Pounds, of our Steel prepar'd two Drams, mix them in a Glass, let them be taken after the same manner.

Take Water of Wallnuts simple, and of black Cherries, of each half a Pound, of Snails four Ounces, Syrup of Flowers of the Male Peony two Ounces; the Dose is from an Ounce and a half to two Ounces after the same manner.

Take Shavings of Ivory, and Harts-horn, of each three Drams, Roots of Chervil, Bur-dock, Valerian, of each half an Ounce; Leaves of Betony, Ground-pine, Scolopendrium, tops of Tamarisk, of each a handful: Barks of Tamarisk and of Bitter-sweet of each half an Ounce, let them boil in four Pounds of Fountain-water to the consumption of a third part, add of White-wine eight Ounces, strain it into a Flaggon, to which put Leaves of Brook-limes, and of Cuckow-flower, of each a handful, make a warm and close Infusion for four hours, let the straining be kept in Glasses close stopt: The Dose is six Ounces twice a day, after a Dose of a solid Medicine. Sometimes in such an Apozeme let two Drams of our Steel be infus'd, and taken after the same manner.

In the Summer time the use of Mineral Waters is proper, for want of them let our Artificial Waters be given in their stead.

But if for the reasons above cited hot Medicines are indicated, we may proceed after the following method.

Take Conserve of Rosemary-flowers, and of the yellow Coats of Oranges and Limons, of each two Ounces, Wallnuts, and Miroba∣lans condited, of each in number two, Lignum Aloes, yellow Saunders, Roots of Serpentaria, Contrayerva, Angelica and Aron, of each a Dram, Vitriol of Mars (or prepar'd Steel) four Scruples, Salt of Worm-wood and of Scurvy-grass of each a Dram, with a sufficient quantity of Preserve of Wallnuts, make an Electuary. Let the quan∣tity of a Nutmeg be taken twice a day, drinking after it a Dose of an appropriated Liquour.

Take Roots of Male Peony, Angelica, red Coral prepar'd, of each two Drams, Sugar dissolv'd in water of Snails boil'd to a consistency for Tablets six Ounces. Oyl of Amber highly rectified half a Dram, make Tablets according to Art, each weighing about half a Dram, let one or two be taken twice or thrice a day, drinking after it a Dose of an appro∣priated Liquour.

Take Roots of Virginia Serpentary, Contrayerva, Valerian of each two Drams, red Coral prepar'd, Pearls, of each a Dram, Winters-bark, Roots of bastard Ditany of each a Dram, Vitriol of Mars, Salt of Worm-wood, of

each a Dram and a half. Extract of Centory two Drams, Ammoniacum dissolv'd in Hysterick-water what suffices, make a Mass for Pills. Let four Pills be taken in the Morning and at four in the Afternoon.

Take Spirit of Harts-horn, or of Soot, or of Mans Blood, or of Sal Armoniack what suffices, take from ten to twelve Drops Morning and Evening in a Spoonful of the Julape, drinking after it a little draught of the same.

Take Leaves of Betony, Vervain, Sage, Cuckow-flowers, Aron, Bur-dock, of each two handfuls, green Wallnuts in number twenty, the Coats of six Oranges and four Limons, Cardamoms, Cubebs, of each an OUnce; being slic't and bruis'd, pour to them Whey made with Cider or White-wine six Pounds, let it distil according to Art: The Dose is two or three OUnces twice a day after a Dose of a solid Medicine: To two Pounds of this add of our Steel two Drams.

Take Water of Earth-worms, and of Snails, of each six Ounces; of Wallnuts simple four Ounces, Raddish-water compound two Ounces, double refin'd Sugar two Ounces, make a Julape: The Dose is four or six Spoonfuls twice a day after a Dose of a solid Medicine.

Take Millepedes cleans'd a Pound, Cloves slic't half an Ounce, pour on them of White-wine two Pounds, let them distil in a Gourd-glass; the Dose is from an Ounce to an Ounce and a half twice a day.

We may prescribe for poor People Remedies more easie to be had after this manner.

Take Conserve of the Leaves of Rue made with an equal part of Sugar six Ounces. Let the quantity of a Nutmeg be taken twice a day, drinking after it a Decoction of the Seeds and Roots of Bur-dock made in Whey, prepar'd of White-wine.

Or let a Conserve be made of the Leaves of the Tree of Life, with an equal part of Sugar; the Dose is from half a Dram to a Dram twice a day.

Take Powder of Millepedes prepar'd three Drams, Ameos-seeds a Dram, make a Powder, divide it into ten parts, let a Dose be taken twice a day. Or twelve Millepedes being bruis'd with White-wine pour'd on them, let the Juice be exprest, make a draught, let it be taken twice a day.

In the mean while that these Remedies are taken inwardly, it is proper sometimes to raise Blisters by applying Vesicatories on the Nucha, or behind the Ears; for so the Serous and sharp Humours are very much deriv'd from the Head: Moreover Sneezing-powders, and Apophlegmatisms often give great relief. The drawing of Blood from the Haemorrhoid Veins, or from the Foot ought to be sometimes repeated: And during the Fit, Plaisters or Cataplasms are applyed to the Soles of the Feet with good effect: It is good also to apply Epispasticks about the Legs and Thighs.