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.

An Account of an Epidemick Fever, reigning An. 1661. which chiefly infested the Brain and the Genus Nervosum.

AFter the Vernal Equinox An. 1661. a certain Anomalous and unusual Fever, seiz'd some Persons here and there, which nevertheless within a Month became so Epidemical, that in many places it began to be call'd the New Disease: Reigning chiefly among Children and young People, it was wont to afflict them with a long, and as it were, Chronical Sickness: Nay and sometimes though rarely it infested Persons stricken in years, and aged, but it kill'd them sooner, and more certainly: The affect first seizing any Person, so tacitely stole upon him, that the begin∣nings of the Sickness were scarce perceiv'd: For arising with∣out any immoderate heat or great thirst, it presently caus'd a great weakness in the whole Body, with a languor of the Spirits, and a deadness of the Animal Functions: The Stomack loathed all Food, and found it self opprest by what was taken into it, and nevertheless it was not inclin'd to Vomit. The Diseas'd be∣ing indispos'd to all motion, sought only to lye on a Bed, and do nothing: Within a short time, and sometimes from the first invasion of the Disease, they complain'd of a great Giddiness, a ringing in the Ears, and often of a turbulent motion and great perturbation in the Brain: Which sort of Symptoms were usually accounted a Pathognomick sign as it were of the sudden approach of this Disease; in case it happen'd that these were wanting, or remiss in some Persons, instead of the Head being affected after that manner, the Disease fixt it self deeper in the Brest, and rais'd a Cough, as we shall presently acquaint you: Now whilst upon the Brain and Nervous Appendix, their being affected after this manner, the Animal Spirits presently from the beginning of the Sickness wax't dull, a slow and hectick Fever as it were, was kindled in the whole Body: Nevertheless the effervescence of the Blood, which was scarce continual, but hapning at ran∣dom, and uncertain, was more intense in some, and more remiss in others according to the Crasis of the Blood it self: And con∣sequently the Thirst, roughness of the Tongue, and other Symp∣toms, which depend on the Feverish Distemper, troubled them more or less. Sweating did not happen of its own accord, nor could it readily or with ease be rais'd by Art: Nay farther, nei∣ther this kind of Evacuation or any other ever hapning as it

were by way of Crisis, put an end to this Disease on a sudden: But continuing for many Weeks and sometimes Months, it brought the Diseas'd into a mighty Atrophia, and often cast them into an incurable Consumption.

About the time of the Diseases increase, which in most Per∣sons happen'd within eight days, if the affect (as it often was wont) seiz'd chiefly on the Brain, and Systema Nervosum, severe Symptoms, viz. a plain Frensy, or deep Stupor, or a total insensi∣bility commonly infested their Oeconomy: For I have frequent∣ly observ'd in many Children, and often in Women, after seven or eight days of their being seiz'd, that they have wholly lost both Sense and Speech, so that they have lain for some time, nay sometimes for a whole Months space, without knowing Per∣sons present, and their Excrements passing from them after an insensible manner: And if the use of their judgment and reason in some measure held, yet they were troubled with a frequent Delirium, and always talk't light-headed in their sleep. But in Men, and others of a hot Constitution, upon the Morbifick Mat∣ter's being convey'd to the Head, instead of a Crisis, a Fury or dangerous and often deadly Frensy ensued: But if neither a Stu∣por nor violent Distraction seiz'd them, a Scotomia, Convulsive motions, with Contractions of the Members, and Twitchings of the Tendons greatly molested them: Almost in all the Dis∣eas'd, the Belly for the most part was loose, and voided plenti∣fully sometimes yellow, sometimes thin and serous Excrements, which stank mightily. It was seldom that any were seiz'd with a Vomiting: The Urine in the whole course of the Disease (un∣less when the Morbifick Matter taking plentifully to the Brain, threatn'd a Frensy) was of a deep red colour, so that some by reason of its deepness, judg'd this Fever to be absolutely Scorbu∣tical: Which nevertheless appear'd to be otherwise, because An∣tiscorbutick Remedies, (whereof a great many, and almost of all kinds were tryed) had little or no effect: It was very much to be admired, how soon after the seizure of this Disease, the Flesh of the Sick fell away, so that they were brought to the dryness of a Skeleton, when in the mean time there was no exceeding great heat to consume the Solid parts by little and little, nor any violent Evacuation greatly to waste them.

Besides these evils infesting the Region of the Head, an affect no less dangerous often seiz'd on the Brest: For in some a very troublesome Cough, with much and thick Spittle was rais'd: This in some Persons happen'd about the declining of the Disease, viz. when the Confines of the Brain obtain'd a calm, the Clouds, as it were, being discharg'd thence on the Brest, a mighty Catarrh presently fell on the Lungs. But in some, especially who suf∣fered

little from the Disease in the Head, presently from the beginning of the Fever, a violent Cough, and a Spitting of fil∣thy Matter, accompanied with a Consumptive Disposition, as it were, seiz'd them, and precipitated them, suddenly and una∣wares into a Consumption; from which nevertheless, by a sea∣sonable use of Remedies, they often unexpectedly recover'd: I observ'd in some, after a long failure of the sensitive faculty, and an oppression of the Brain from the Morbifick Matter, that at length Tumours ensued in the Glands about the Neck, from which, assoon as ripen'd and broken, a thin and stinking Ichor flowed for a long time, and gave ease: I have seen also Watery Wheals sais'd in other parts of the Body, which have past into bollow Ulcers with difficulty to be Cur'd: Sometimes small Spots; and as it were Flea-bites appear'd here and there: Though I have not heard that broad and livid Spots ever were to be seen in Persons sick of this Disease: However notwithstanding this Fever had not any very Malignant breakings forth, yet it was not free from Contagion: For in the same Family it seiz'd almost all the Children and younger People one after the other; and often Persons stricken in years, who attending the sick, famili∣arly us'd about their Beds and Bed-cloaths, were infected with the same Disease: Yet I must say there was not so great a sus∣picion of infection, that for that reason the Friends of the Sick, should be wholly forbidden to visit them, or converse with them.

Though all along the course of this Disease (unless when the Brain was greatly assail'd) it appern'd only mild, and past with∣out any dreadful Symptom, nevertheless its Cure was always dif∣ficult, and was not perform'd but after a long time: For the Diseas'd seldom recover'd within three or four Weeks, nay for the most part scarce within so many Months: But if this Dis∣ease fell on Men of a decayed Age or Strength, especially on such as were before subject to Cephalick Diseases, as the Lethargy: Apoplexy or Convulsions, it often kill'd them in a shorter space. Or if there were any hope of recovery, it could be carryed on very slowly, (scarce any Remedies affording a sensible relief) so that the Diseas'd were no sooner gotten without the Sphere of this Fever, but they found themselves within the Confines of a Consumption.

If the formal reason and causes of the foresaid sickness be en∣quir'd into, it plainly here appears that the Liquour which lies in the Brain and Genus Nervosum, for the most part, together with the Blood, was in fault, and was the immediate cause of the Symptoms that seem'd chiefly pressing, viz. in as much as the Latex, presently from the first invasion of the Disease was be∣come

more impoverisht than its wont, and effaete, as it were, and therefore a Languor and Enervation, with a Spontaneous Lassitude, and a Disability to motion, together with a sudden Consumption of the Body, happen'd to the Diseas'd: Though still the default of this Latex necessarily depends on the Dyscrasy of the Blood, and of the ill Constiution of the Brain [but here, as in other places, I refer you to Dr. Willis himself, for a fall Aetro∣logy of Symptoms.]

I have often observ'd in this Fever, after Oat Broath, a De∣coction of Barley, and other thin Dyet, that no less Ebullition of the Blood has been rais'd, than by a full Meat Broath: For indeed on one side as well as the other, the Nutritive Juice sent from the Chyle into the Blood, in regard it was not imploy'd in the work of Nutrition, troubled the Blood, as some Hetero∣geneous thing that would not duely mix with it: And by rea∣son of the Particles of this superfluous Juice, sent off in a plenti∣ful manner with the Serum, the Urine was very thick and red, and mightily fill'd with Contents: And for this reason the Belly for the most part was loose, in as much as the Blood being full of a Nutritious Juice, suck't a less Portion of Chyle from the Lowels, and discharg'd again into the Intestines a part of that which was brought into it; moreover the Feverish Distemper stuck for so long time in the Blood, because till upon the Resti∣tution of the Animal Governance, Nutrition was rightly per∣form'd, that superfluous Matter was heap't together in the Mass of Blood. I shall now give an instance or two of Persons af∣fected with this Disease.

A Robust and Florid young Man, about the beginning of the Spring, An. 1661. falling sick without any evident cause, soon became weak, and as it were enervated, with a loss of Appetite, and a languishing of the Spirits: Cathartick Remedies, Antipy∣reticks, Digestives, nay and Antiscorbuticks, and others of ei∣vers kinds, being given him, according to the prescripts of fa∣mous Physicians, did not the least good: But the Diseas'd still continuing in a languishing condition, lay by it for six weeks, with a slow Fever of uncertain returns, a quick and weak Pulse, and a deep red Urine. Moreover being mightily pined away, he complain'd of a ringing in his Fars, and an Undulation of sound, as it were, in his head: Though he was affected with a great Stupor, yet his Sleeps were very much troubled and inter∣rupted with a talking Light-headed. After forty days, the Fever not yet declining, it was thought good to draw about four or five Ounces of Blood from the Vessels of the Fundament by Leeches. Hereupon presently the Fever began to be very much exasper∣ated, for the heat became more intense, with a Thirst, Watch∣ings,

and an almost continual tossing of the Body, the Tongue also growing dry and rough; shortly after a troublesome Cough, with much and discolour'd Spittle ensued: There were careful∣ly given him Almond and Barley Drinks, with temperate things against the Cough boil'd in them, Water of Milk distill'd with Snails and Herbs appropriated to the Thorax, Powder of Shells, Niter prepar'd, and likewise Cordial Opiats; which nevertheless scarce giving any relief, the Diseas'd still became weaker: And when after this manner, having been sick above two Months, the Feverish Distemper, and the Cough also daily growing worse, he seem'd to be at Death's Door, at length a Sweat hapening of its own accord, which sometimes came upon him every night, sometimes every other night, he grew better by degrees there∣by, and using afterwards the foresaid Medicines, he became per∣fectly well within six weeks.

Whilst this Person lay ill, I went to see another about Twelve years of Age, affected after the like manner; but this, when I was first call'd, having lain ill above a Month, was reduc't to a Skeleton: Moreover he was affected with a Giddiness, a ring∣ing in the Dars, and a Deafness, and likewise with a violent Cough th•• accompanied with a yellow, and as it were Consump∣tive Spittle: His Pulse was quick and weak, his Urine red and thick, his Appetite very much dejected, his Spirits so faint, and his Strength so fall'n, that he could not keep himself from his Bed: To this Person I gave often in a day Milk distill'd with Snails and temperate Herbs: Moreover instead of ordinary drink, I ordered him daily to take an opening Decoction, such as is us'd in the Rickets: By the help of which Remedies he seem'd to be restor'd to his health within a Months space.

This Fever in a certain Noble Mans Family, prov'd very fatal amongst his Children, who had been originally subject to Ce∣phalick affects. About the Vernal Equinox, a Boy of about Eleven years of Age, began to fall sick. In the first place with∣out an intense heat or drought, a loss of Appetite, and failing of Strength came upon him. Moreover an almost continual Ver∣tigo molested him, with a frequent inclination to Fainting, so that he often thought himself ready to fall in a Swoon: To this Per∣son, by the advice of some Nurse that attended him, Glysters were daily given: And afterward when from the foulness of his Tongue and Mouth, the manifest signs of a Fever appear'd, that Empirick gave him a Vomit of the Infusion of Crocus Metallorum. And the seventh day giving him a Cordial Powder, and cover∣ing him over with Cloaths, she made him Sweat: His Skin no sooner began to be moist, but presently speaking Light-headed,

he complain'd that his Cap was fall'n into water, soon after be∣coming Speechless he dyed, (whilst I was sent for) within four hours.

Shortly after, the same Disease seiz'd his Sister who was younger; whose sickness nevertheless, because it was accompa∣nied with a frequent Coughing and Spitting, was first thought to be only a cold taken: But within a few days, that Cough became manifestly Convulsive; for in Coughing the Diaphragm being rais'd upward, and so held for some time, by a repeated Systole, a mighty Shrill noise, as though she were suffocated came from her: Afterward this little Girl growing more manifestly Feverish, and complaining of a thirst and heat, past the nights without sleep, with a mighty tossing in her Bed, and after a while speaking Light-headed, she complain'd as her Brother had done before, that her Cloaths were fall'n into the water; and as all things grew worse, she began to be troubled with Convul∣sive motions, first in the Limbs, shortly after in the Face, and then in the whole Body: The Fits returning frequently, viz. twice or thrice within an hour, very sorely pursued her, so that this poor Wretch dyed within the space of twenty four hours after the greater Convulsive affects had seiz'd her, the 〈◊〉〈◊〉 of the Animal Spirits being wholly subverted. Whilst the Convul∣sive Fits prest upon her, the Pulse was very much disordered, and often intermitted, and she was affected with a frequent Vomiting.

Because this Fever seizes some Persons predispos'd for it almost yearly, and haply hereafter may at some time become Epidemi∣cal, by reason of the ill Constitution of the year, I think it may not be amiss to delineate some method in order to its Cure.