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. X. Instructions and Prescripts for the curing of Me∣lancholy.

AS the Frensie arises from the burning of the animal Spirits, or from the inflammation of their Substance; so other affects of raving proceed from their Substance being altered after other manners, and its being changed from its genuine disposition, viz. spirituo-saline, into an acetous or sharp nature, resembling aqua stygia, or into a flatness or deadness; which therefore are either Melancholly, or a Mania or Madness, or a Morosis or fatuity: of which we shall now speak ion order, and in the first place of Melancholy.

Melancholy is commonly defined, a Raving without a Fever or Fury, joyn'd with fear and sadness; whence it follows to be a complicated affect of the Brain and Heart; for, that melancholick Persons rave, it proceeds from the fault of the Brain, and the disorder of the animal Spirits residing in it; but that they are sad and timorous, this is attri∣buted to the Passion of the Heart.

There are various and sundry kinds of the Imagination'sbeing de∣praved in Melancholly, concerning which we may observe in general, that the affected either rave concerning all things, or at leaswise concerning most, so that they pass a right judgment in a manner con∣cerning no subject; or they imagine amiss only in one or two parti∣cular cases, but of most others form notions not altogether absurd. First, we shall enquire concerning this affect, as it is more Universal, how the Imagination is prevaricated concerning most things, to wit, for what Causes, and with what difference of Symptoms this is wont to be done, afterward we shall speak of the particular raving.

Tho the delirous affect of universal Melancholy contains manifold symptoms, yet they consist chiefly in these three things; first, that the affected are almost continually occupied in thinking, so that their Fancy is scarce ever idle, and at rest. Secondly, in thinking they com∣prehend fewer things in their mind than they were wont before, so that they often roul in their mind the same Object day and night, being nothing follicitous of other things, which sometimes are of far greater moment. Thirdly, the Ideas of Objects or Conceptions appear often deform'd, and like frightful Apparitions as it were, and they are al∣wayes represented in a greater Species, so that every small thing seems to them great and most difficult, and by reason of this hor∣rid and unusual appearance, the Image once conceived is not easily, nor soon let go.

The Indisposition of the animal Spirits in this affect is wont com∣monly to be described after this manner, to wit, that whereas they ought to be transparent, subtle and light, in Melancholy they become obscure, opake and darkish, so that they represent the Images of things covered as it were with a Shadow or obscurity. But I conceive the state of the animal Spirits in raving is most aptly explicated according to the Analogy they bear with certain chymical Spirits, as it will ap∣pear from what follows.

1. Liquours chymically distilled are of divers kinds, according as the active Elements are combin'd in them after various manners; the most excellent of these, by the consent of all, is said to be, in which the Spirit united to the Sal••••olatizes it, and is again acuated, and re∣cieves somewhat of a firmness from it: of this nature are conceived to be the great Elixir and the Liquour Alkahest: and in truth, in some sort are the Spirits of Blood, of Harts-horn, of Soot, and the like, they being very subtle, volatile and penetrating, and yet not inflamable, or apt to be soon dissipated. And indeed the animal Spirits enjoying a sound and meet disposition, seem in some sort to be as the spirituous Liquour filled with a volatile Salt, which is distilled from the Blood: unless it be that to this a mighty Acrimony and Empyeuma are caus'd by the Fire, of which the Liquour which is in the Brain and Nerves is wholly free.

2. Other Chymical Liquours are too sulphureous and burning, as Spirit of Wine and of Turpentine, which consisting of Spirit and Sulphur combin'd together, are easily inflamed and readily separate from others, and take this way and that, as they find a Passage: of which kind of nature the animal Spirits in some sort participate in the Phrensy.

3. Some Liquours or Spirits are produc'd by Chymistry, in which the fixt salt being raised to a flowing has the Dominion: of which kind are those which are distilled from Vinegar, ponderous Woods, and certain Minerals by a gentle Fire; whose particles are very movable and restless, but of a shorter activity, so that the effluvia do not flow far from them, and if they are distilled in Baleno, nothing but an in∣sipid Phlegm is raised into the Alembick: And indeed we conjecture that the animal Spirits have such a kind of acetous Nature with the do∣minion of the fluid Salt in melancholy Affects, as we shall by and by shew more at large.

4. Some Liquours spagyrically drawn are sometimes extreamly sharp, in which the wild Particles of a fluid Salt, and of an arsenical Sulphur combin'd together are exalted, as are the Stygian Waters distilled from Nitre, Vitriol, Antimony, Arsenick, Verdigrease, and the like; all which are of a wild, very penetrative and invincible Nature, so that their diffuse themselves to a great wideness: and these kinds of Liquours aptly enough resemble the Disposition of the animal Spirits acquir'd in a Mania, as we shall declare beneath.

But at present, that we may deliver the formal nature and Causes of Melancholy, we may opine, that the Liquour distilled from the Blood into the Brain (which filling and irrigating all the Pores and Passages of the Brain, and its nervous appendix is both the Vehicle and Vincu∣lum of the animal Spirits) has degenerated from its mild, benign, and subtle Nature, into an acetous and corrosive Disposition, such as that of the Liquours drawn from Vinegar, Box and Vitriol, and that the animal Spirits, which dispersing their Rayes from the Meditullium of the Brain, both into its globous Substance, and into the Systema Ner∣vosum, produce all the Functions of Sense and Motion both inward and outward, are disposed in like manner as the Effluvia passing from those acetous Chymical Liquours. Concerning which we may observe these three things, viz. First, that they are in perpetual Motion, secondly, that they do not flow far; thirdly, that they are not only carryed by open Passages, but make new prosities in neighbouring Bodies, and insinuate themselves into them. From the Analogy of these Conditi∣ons concerning the animal Spirits it happens, that melancholy Per∣sons are always thoughtful, that they comprehend only a few things, that they form their Notions concerning them amiss. [you may find this fuller explained in Dr. Willis at large.]

So much of the primary melancholy Affect, viz. a Delirium raised through the faults of the Spirits residing in the Brain: whose beginnings tho cheifly, and often in a manner only proceed from the acetous Disposition of the Spirits; yet afterward the conformation of the Brain it self is frequently taken in as a part of the cause. viz. In as much as the Recrements of the melancholy Blood, continually sent into it, ren∣ders its substance more gross and opake, and the primary Tracts or Paths of the animal Spirits being almost defac'd, new oblique and de∣vious Tracts are made, so that tho there be a supply of the better sort of Spirits, they cannot easily irradiate the Brain, or presently recover their former Passages.

Melancholy is not only an affect of the Brain, and Spirits residing in it, but likewise of the Praecordia, and of the Blood there kindled, and thence sent forth into the whole Body: and as it produces in the for∣mer a Delirium, so here a Fear and Sadness: but after what manner let us now see.

In Sadness, in the first place the flamy or vital part of the Soul is straitned as to its circuit, and is restrained within a less space; and then consequently the animalor lucid part of the Soul contracts its Sphere, and has less vigour: but in Fear both are suddenly represt, and made to stagger as it were, and to contain themselves within very small spaces: in both affects the Blood does not circulate and burn live∣ly and with a full flame, but being apt to be heapt together and to stagnate about the Precordia, it causes there an oppression, or fainting; and in the mean while the Head and Members being destitute of its plentiful efflux, languish.

Now that those Passions become habitual in melancholy Persons, the cause is partly in the Blood, and partly in the animal Action of the Heart: for the Blood, by reason of saline Particles exalted, becomes less inflamable: whence it is neither sufficiently kindled in the Lungs, nor does it burn within the Ductus's of the Heart and Vessels with a flame sufficiently clear and plentiful, but such as is apt to be represt, and almost blown out by any puff of Wind: hence in regard the vital Flame is so slender and languishing, that it staggers and trembles at all Motion, it is no wonder if a melancholy Person, the Soul as it were subfiding and being half overwhelmed, is always sad and tlmorous. By reason of this saline discrasie of the Blood, melancholy Persons are seldom troubled with a Fever, but being seised with it, they are more dangerously ill by reason of the irregular burning of the Blood.

Nor does it happen less through the fault of the Heart, that melan∣choly Persons by reason of the course of the Blood being retarded, or often drawn back, become sad and timorous: for since that Muscle is not actuated but by the influence of weak and irregular Spirits, it is not able to perform its Contractions with Strength and Constancy enough, whereby the Blood may be driven forward throughout the whole Body

without stop, or flying back. Therefore the Blood and animal Spirits mutually affect each other with a reciprocal injury, and bring dam∣mage on each other: the melancholy blood, that is, consisting of sa∣line Particles exalted, together with such as are sulphureous, engenders animal Spirits of an acetous nature, as we have shewn: and these Spi∣rits performing the vital Function amiss, cause such a dyscrasy of the Blood to be encreas'd.

So far of Melancholy in genera, viz. of its Essence, conjunct Causes, and chief Symptoms: before we proceed to the kinds and differences of this Disease, we ought to explicate from what causes both procatar∣ctick, and evident, it is wont to arise and be fomented: and first, whence both parts of the Soul. viz. both animal and vital acquire their mor∣bid Dispositions.

Of these we have shewn the former to be acetous, resembling Spirit of Vitriol, or of Vinegar, and the other to be Salino-Sulphureous, or Atrabilarious; moreover, and that as they both soment each other, so that they first engender each other: for sometimes melancholy begin∣ning from the animal Spirits being troubled and put in a certain confusi∣on, and persisting some time, brings a melancholy habit to the Blood; sometimes also the Blood, contracting first that discrasy, perverts the Na∣ture of the Spirits.

That Melancholy oftentimes begins from the animal oeconomy, its easi∣ly seen in excessive Love, extream Sadness, pannick Terrours, Envy, Cares, and immoderate Studies, for on these occasions the animal Spi∣rits being driven out of the wonted Paths of their Expansions, and persisting in their errour through the assiduity of their Passion, at length fall into devious Tracts, which afterward keeping to, they are with difficulty reduced into the ancient and right again. Moreover, since thereupon the Motion and Vigour of the Heart are diminish'd, there∣fore the Blood falls from its due Crasis and Pneumatosis, and thereby being rendred more fixt and salino-sulphureous, furnishes only animal spirits degenerated to a sourness; and so the Blood being depraved a posteriori, gives a Fuel to the melancholy disposition begun by the Spirits.

Nor does it happen less frequently that the seeds of melancholy first laid in the Blood, give at length that taint to the Spirits: for this reason some hereditarily become obnoxious to that Disease. Moreover, a disorderly dyet, the intermission of an exercise long us'd, solemn Evacuations, as of the Menses or Hemmorhoids, also of the Seed, or serous Ichor suddenly supprest, and many other occasions, easily defile the Blood, and render it melancholick, whose evil Disposition will af∣terward of necessity be communicated to the Spirits.

As to what a great many Physicians think, that melancholy rises from a melancholick Humour engendred somewhere primarily and per se and assign particular Places for its Generation; viz: the Brain, Spleen,

Womb, and the whole Habit of the Body, we do not easily grant all this: for besides that no secret Stores of such a humour, lying any where, appear, unless haply in the Spleen, it is indeed the Blood it self which first conceives per se the melancholick Distemper, or any other, and afterward deposes recrements of that Nature in proper Emunctories or Receptacles: nor would the yellow Choler be stor'd up in the Gall-Bladder, or the black, so call'd, in the Spleen, unless the mass of Blood first engendred those Humours. If at any time these, or other recre∣mentitious humours, some where depos'd, be receiv'd by the mass of Blood, they produce its effervescence, but not presently, or easily its distemperature.

1. As to that therefore, that the origine of Melancholy is sometimes as∣crib'd to the Head, and the distemperature of the Brain is accus'd by some as too hot, and by others as cold: I think we ought rather to say that the affect sometimes first begins from the Brain, and from the Soul residing in it.

2. As for the Origine of this affect being sometimes drawn from the Womb, it must not be thought that the melancholy Humour is there first engendred, but that the occasion of melancholy proceeds thence: ei∣ther because by reason of the Menses supprest, the whole Blood being defil'd and become degenerate, afterwards falls into a melancholy dis∣crasy, or for that by reason of the Stimuli of Venery restrain'd with a great reluctation of the corporeal Soul, the animal Spirits being long contained and kept in, at length become fixt and melancholick.

3. That melancholy is sometimes either primarily raised, or very much fomented by the Spleen being ill affected, and thereupon by a peculiar word called Hypocondriacal, it is both the common and our own Opinion; but the Blood being first in the fault, engendring in it self filthy melancholy Dregs at the beginning, deposes them in the Spleen, which afterward receiving again, being exalted into the nature of an evil ferment, it is vitiated more in its Crasis by their defilement.

4. As to that that besides, another species of melancholy, distinct from the Hypocondriacal and the former, is said to be engendred to∣gether in the whole Body, it is nothing else than that the whole mass of Blood becoming degenerate from its right Nature, by reason of errours in the six non-natural things, and on many other occasions, ac∣quires a melancholick Discrasy (that is, where the Spirit being depress'd the sulphureous Particles together with the saline, and some also that are terrene are exalted) this melancholy disposition of the Blood be∣ing very much allyed to that sulphureo-saline Habit, which we have shewn to be often prevalent in a certain kind of Scurvy.

The Prognostick of Melancholy, tho, as to Life or Death, it be for the most part safe, yet, in reference to the event, it is very uncertain: for some recover soon, others are not cur'd but after a long time, and others not at all.

This affect, rais'd on a sudden from some solemn evident cause, as from a vehement passion, is much safer than invading by degrees after a long Procatarixs: for if the evident cause be presently re∣mov'd, that often ceases of its own accord, or is cur'd with little ado; but in this, in regard both the mass of Blood, and the whole troop of Animal Spirits have fallen from their due crasis, and often the conformation of the Brain, as to the tracts of the Spirits, is altered, a Cure does not happen but with great difficulty, and not but after a long time.

Melancholy long protracted often passes into a Fatuity, and some∣times also into a Mania, or Madness: Moreover, sometimes it brings Convulsive affects, or a Palsey, or Apoplexy, nay, sometimes a vio∣lent Death.

There is little or no hope of a Cure, if the affected, being very stubborn and refractory, refuse all Medicines, and any method of management: Moreover, scarce any thing better may be expected from those, who being sick of Diseases in a manner only imaginary, take any Remedies, nad often require many, and of divers kinds, to be given them.

The Cure of Melancholy, as it is always difficult, and long, so it is wont to be very intricate and perplex'd; seeing that in respect of the causes of every kind, evident, procatarctick and conjunct; also by rea∣son of the symptoms daily energing, it ought to be diversly taken in hand, and often to be varied: Nor must we only change the Reme∣dies and method of Cure, but variously intermix with them ad∣vices, deceptions, flatteries, entreaties, and punishments.

But in the first place let the evident cause of the Disease, if any no∣table one has preceded, be search'd out; and if it may be, let it either be presently remov'd, or let the removal of it be some way coun∣rais'd, either be appeas'd, or be subdued by others that are opposite. Wherefore in an excessive passion of Love, Indignation and Hatred come in as a relief; to Sadness, let baits of Pleasures, Musick, the desire of vain Glory, be oppos'd, or also a pannick terrour: In like manner you may proceed with other Passions, either for curbing, or cluding them.

The Therapeutick Method, fitted to the Cure of Melancholy, suggests many other Indications: Whereof the chief, and to which the rest may be best reduc'd, are those three so vulgarly known, viz. the Curatory, which regards immediately the disease, and its Conjunct cause; the Preservatory, which regards the procatarctick and evi∣dent causes; and the Vital, which is occupied in preserving the strength.

As to the first Indication, the Physical Intentions will be, so far to raise, volatize and corroborate the Animal Spirits, being become fixt,

or dejected also, and apt to act overthwartly, or go astray, that af∣terward being more freely expanded, they may irradiate the whole Brain with a full and stedfast beam of Light, for the acts of the Imagi∣nation, Judgment, and the other chief Faculties; and may so vigo∣rously actuate the Praecordia, and make them vibrate so strongly, that the Blood being plentifully kindled may thence spring forward with∣out stop or restagnation throughout the whole Body.

Therefore, for the cure of the Spirits, let it be chiefly procur'd, that the Soul be withdrawn from the troublesome and forc'd Passion, viz. from excessive Love, Jealousie, Sadness, Commiseration, Hatred, Fear, and the like, and be compos'd to a Cheerfulness and delight: let a merry or jocose Discourse, Singing, Musick, Painting, Dancing, Hunting, Fishing, and other pleasant Exercises be brought in ure: those to whom Delights, or Sports are not pleasing (for these are always ungrate∣ful to some melancholy Persons) may be put upon some light Employs; mathematical or chymical Studies, sometimes also travelling does great good; moreover it is often profitable to change the Places of their Habitation in their native Soyl. Those, who must always stay at home, should be advised to look after their houshold Affairs, and govern their Families; to cultivate and order their Houses, Gardens, Orchards and Fields: for a Mind, employed in necessary Cares and Offices, more readily deposes vain or mad Thoughts, and at length quits them: Let melancholy Persons be seldom left alone, for if at any time they. are permitted to follow and dwell long on their Phantasms, and aereal Speculations, the Soul subsides within, and leaving the Body, and undergoing a certain Metamorphosis, indues a new species, and often contrary to the state of Man; wherefore the affected ought to be con∣tinually disturbed by the discourses of their Friends and Acquaintance, to wit, that they animal Spirits being call'd outward from their bye wayes, be brought again into their former and usual Tracts. But if the diseased, being seduc'd by fantastical Illusions, imagine and firmly belived certain prodigious things of themselves; the Mind is to be withdrawn from those things by artificial Inventions, of which man∣ner of Cures there are many Cases and Examples to be found in Books, and a prudent Physician may invent the like as occasion requires.

Tho a melancholy new contracted is sometimes cur'd by a meer or∣dering and management of the Mind and the animal Spirits, yet in a lopng continued to inveterate melancholy, where the Spirits have con∣tracted an acetous Disposition, and the Blood an atrabilarious dyscrasy, and that the Conformation of the Brain, as to its Pores and Passages is injured, and other indications, called preservatory, are required for removing the procatarctick Causes of the Disease. Concerning this thing, the Physical intentions must be in the first place to reduce the Blood to a better and genuine, to wit, a spirituo-saline Crasis; and then to give a vigour to the Brain, and, its Pores being opened, to render it

clear and diaphanous, and withall to strengthen the animal Spirits, and to stir them up to a vigorous Emanation: for which ends I propose the following Method, which nevertheless ought to be varied according to the various Constitutions of the diseased.

Blood-letting has place in a manner in every melancholy, and some∣times it is often to be repeated, for the adust and effaete Blood being withdrawn at times, a new and more sprituous Blood springs up in its place. Concerning the Quantity, Place, and Wayes of administring this Remedy, Authors are of various Opinions; but the Motion and Affects of the Blood being duely weighed, it may suffice first to draw an indifferent quantity of it from the Arm, and afterward, if need be, a less, either from thence, or from the Vessels of the Fundament by Leeches: how the opening of the Slavatella Vein should give so nota∣ble a releif, as is said, I confess is unknown to me: if melancholy Per∣sons are strongly perswaded that blooding there will cure them before any where else, haply it may do them good: a frequent opening of the Hemorrhoid Vessels afterward to endeavour that eva∣cuation, which spontaneously hapning (as Hippocrates tells us) often cures this disease.

Purging ought to be used from the beginning, and to be repeated by intervals, in regard it withdraws the fewel of the disease from the first Passages, and removes the impediments of other Remedies: as to what some judge, that for the speedy eradicating of the Disease, we must chiefly use Hellebore, or the Spurges, and quote Hippocrates their Author, those things, if the success be look'd upon, are not found so generally to agree; but that they often very much injure the Diseased: for strong purgers do not take away the cause of the Disease, to wit, the dyscrasy of the Blood, but rather encrease it: moreover, they far∣ther weaken and prostrate the animal Spirits before dejected. Helle∣bore is so frequently prescribed by Hippocrates, because scarce any other Catharticks were then known, at least wise they were not in common use; but now it is far better to draw gently from the receptacles of the Humours by such as are mild and without roughness, and to cleanse the Viscera and first Passages without troubling much the Blood and Spirits.

Vomitories (as in most Cephalick Diseases, free from a Fever) are wont to give relief after a peculiar manner in any sorts of Distractions; the reason of this partly consists herein, that the viscous load of the Ventricle, which (as we have shewn elsewhere) greatly oppresses the mind, being cleans'd forth, the Spirits thereupon being more free, expand themselves more vigorously and cheerfully. Moreover, in as much as vomiting compresses and evacuates the neighbouring Re∣ceptacles of the Humours, to wit, the Gall-bladder, the Ductus of the Pancreas, and the Glands of the Mesentery, it keeps their Contents from being conveyed to the Head.

Vomits.

Take Oxymel of Squills an ounce and a half, wine of Squils an ounce, Syrup of Tobacco two drams, mix them, make a Vomitory: if it works not at all, or slowly, let a Vomit be rais'd by a free drinking of Posset-drink having the leaves of Carduus boyl'd in it.

Take of the decoction of the middle bark of Elder four ounces, Salt of Vitriol from one scruple to two scruples, Oxymel simple three drams, mix them: let it be taken after the same manner.

To strong and well set People, give the Infusion of Crocus Metallo∣rum, or Mercurius vitae; also the Emetick Tartar of Mynsicht, or Sulphur of Antimony.

Take roots of Polypody of the Oak half an ounce, Epithymum three drams, Senna half an ounce, Tamarinds six drams, Coriander-seeds, three drams, yellow Saunders two drams, let them boyl in fourteen ounces of Fountain∣water to ten ounces: adding Agarick two drams, Rhubarb a dram and a half; to the clarified straining add of the purging Syrup of Apples two ounces, let six ounces be taken, repeating it within three or four dayes.

Take choice Senna three drams, Epithymum, Rhubarb, of each a dram and a half, yellow Saunders half a dram, Corinader-seeds two scruples, Salt of Wormwood half a dram, Celtick Spike a scruple, let there be a close Infusion for a Night in White-wine and water of Apples, of each four ounces; to five ounces of the clear straining add Syrup of Epithymum six drams, Aqua mirabilis two drams, mix them, make a potion. In Bodyes hard to be wrought on, let there be added to these, fibres of black Hellebore macera∣ted in Vinegar, a dram or two.

Those who like better Pills, Powders, Bolus's or Syrups, may use the following.

Take Quercitan's Pills of Tartar, or Crato's Pills of Amber, half a dram, Rosin of Jalap, or Scamony, six or eight grains, Tartar vitrio∣late half a scruple, Ammoniacum dissolved in Aqua mirabilis what suffices, make pills, let four be taken going to bed, and unless they work first, one the next morning.

Take Calomelanos, extract of black Hellebore of each a scruple, Resin of Jalap six grains, Ammoniacum dissolved what suffices, make four Pills, let them be taken with governance.

The Powder call'd Haly, is greatly commended by Valescus de Ta∣renta, Pereda, and others. And indeed in rustick or robust Bodies, this seems a pretty fit Cathartick. Take Epithymum half an ounce, Agarick, Lapis Lazuli of each three drams, Scammony a dram, Cloves in number thirty, make a Powder, the dese is from half a dram to a dram.

Take Pulvis Diacennae, Diaturbith with Rhubarb, of each half a dram, make a powder, let it be taken in a draught of posset-drink, or in a single decoction of Epithymum, to four or five scruples.

Take choice Senna two ounces, roots of Polipody of the Oak two ounces, Epithymum an ounce and a half, yellow Saunders half an ounce, Tama∣rinds an ounce, Coriander-seeds six drams, let them boyl in four pounds of Barnet-water, to an half, strain it, and let it evaporate by a bath heat to the consistency of a Syrup, adding towards the end pure Manna, double re∣fin'd Sugar, of each four ounces, make a Syrup: the dose is stwo or three spoonfuls, in three ounces of a convenient distill'd water, or in any other Liuqor. Or,

Take of the same Liquor evaporated to the consistency of Honey, six oun∣ces, fresh Cassia four ounces, pulp of Corinths two ounces, Cream of Tartar, Salt of Wormwood, of each a dram and a half, pulvis Diasennae two drams, yellow Saunders powdred three drams, mix them, make an Electuary, the dose is from three drams to half an ounce.

Catharticks must not be used without intermission, nro too fre∣quently, but let it suffice to give them within six or seven dayes, and at other times, let the belly, if it be bound, be loosened by Clysters: as to what regards other Medicines which do not evacuate, tho the An∣cients plac'd the least, we put the greatnest stress of the Cure in them; for they (with whom also many Moderns accord) concluded, that there was nothing more to be done for curing Melancholy, than to purge forth the atrabilarious Humour: Wherefore making purging the thing of chiefest moment, they ordered the rest of Pharmacy, called by them preparatory, only for the sake of this; directing thus their intentions, that as soon as the Humour was brought to a fit consistency by altering Medicines, and the wayes made open enough for its excretion, then to carry it forth by Catharticks: which kind of hypothesis seems not to agree with Reason or Physical Experience, to wit, in as much as me∣lancholy Persons, after a frequent purging, how methodically soever ordered, receive rather an injury than a relief. Therefore we, placing the cause of this Disease in the dyscrasies of the Blood and Spirits, and in the weakness or ill conformation of the Brain or Viscera, put alte∣ratives, and corroboratives in the first rank of Medicines, and some∣times interlace Catharticks only for the sake of these. Purging therefore being prescribed for the due removal of Impediments, and at due intervals of time, as to the rest you may proceed after this man∣ner.

Take Conserve of Clove-gilliflowers and Borage flowers, of each two ounces and a half, myrobalan rinds condited six drams, Coral prepar'd, Pearl, of each a dram and a half; Ivory, Crabs-eyes, of each a dram, Confection of Hyacinth two drams, Syrup of Coral, or red poppyes, what suffices, make an Electuary, let two drams be taken, morning and evening, drinking after it three ounces of the following Julep, or distill'd water.

Take water of Cowslip-flowers and of Black-cherries, of each six ounces, of Bawm four ounces, Dr. Stevens's Water two ounces, Sugar six drams, mix them, make a Julep.

Take leaves of Bawm, Borage, Bugloss, Fumitory, Water-cresses, Brook∣limes, of each four handfuls, Clove-gilliflowers, flowers of Marigolds, Bo∣rage, Cowslips, of each three handfuls, the outward coats of six Oranges' and four Lemmons, being all sliced and bruis'd, pour to them of Whey made with Cyder, eight pounds, distill them with common Organs, let the whole Liquor be mixt.

Take powder of Pearl, Ivory, Coral prepar'd, of each two drams, Spe∣cies loetificantis, Diarrhod. Abbatis of each a dram, Oyl of Citron-pills half a scruple, double refin'd Sugar dissolv'd, and boyl'd to a consistency for Ta∣blets in a sufficient quantity of Bawm-water, six ounces, make Tablets according to art, weighing a dram, let two or three be taken in the mor∣ning and at five of the clock in the afternoon, drinking after it a draught of the distilled water, or of Tea. Or,

Take Roots of Chervil, Polypody of the Oak of each an ounce and a half, leaves of Hearts-tongue, Spleenwort, Ceterach, Germander, of each a handful, Tamarisk half a handful, bark of the same half, an ounce, Rai∣sins ston'd two ounces, one Apple sliced, being sliced and bruis'd let them boyl in four pounds of Fountain-water to a consumption of the third part, towards the end add leaves of Water-cresses a handful, strain it and cla∣rifie it, let six ounces be taken twice or thrice a day, let it be sweetned with Syrup of Fumitory.

Iron-Spaw-waters are wont to contribute egregiously to the Cure of Melancholy Persons; viz. in as much as being plentifully drank, they wash away the salino-sulphureous tincture of the Blood, and destroy its evil ferments. Moreover, they cleanse the filth of the Viscera, open obstructions, and which is of mighty benefit, by their astriction they both strengthen the weak or over-lax Viscera, and close the mouths of the Vessels gaping into the Brain, that a passage may not lye open into it for the extraneous matter, together with the nervous Juyce: and in this respect, to wit, by corroborating the Viscera, and closing the passages into the Brain, Vitriolick Preparations of Iron are wont to be given with good effect in Melancholy, and also in the Vertigo.

Take our Steel prepared three ounces, infuse it in two pounds of the water above prescribed, let three or four ounces be taken twice a day by it self, or with some other solid Medicine.

Take filings of Steel an ounce, put them in a Glass with two ounces of the Juice of Oranges, let it stand for a day, shaking it now and then, then pour to it water of Apples, and White-wine of each a pound, or of small, and mild Cider two pounds, let three ounces be taken twice a day after the same manner.

Take Vitriol of Mars, Cream of Tartar, Crabs Eyes, of each a dram, mix them, make a powder, divide it into nine parts, le tone part be taken every Morning in a draught of an appropiate distill'd Water, or a Decoction, or appropriate Julep.

Take Syrup of Steel four ounces, let a spoonful be taken twice a day in a fit vehicle.

Take extract of Steel, from our Steel prepared with an appropriate De∣coction three ounces, powder of Ivory, yellow Saunders, Lignum Aloes of each half a dram, Salt of Tartar two Scruples, Ammoniacum dissolved in Water of Earth-worms what suffizes, make a mass, let it be made into little Pills, let three or four be taken every Evening, drinking after it three oun∣ces of Water of Apples or of Cowslip-flowers.

Whey, if it agrees with the Stomack, being drank plentifully for many dayes, is often used with good effect, for the like reason as Spaw-waters. viz. by washing away the salt and sulphureous Particles of the atrobilarious Blood: Whey with Epithymum infused, or boyled in it, is egregiously com∣mended by some.

Let Broaths be prepared of the Decoction of a Chicken, with the Roots of Polypody, Chervil, Fennel, Butchers-broom, and the Leaves of Ceterach, Hartstongue, Scolopendrium, &c. let a draught be taken in the Morning and at five of the Clock in the Afternoon, in which dissolve Vitriol of Mars from six grains to ten, Salt of Wormwood, Cream of Tartar of each a scru∣ple.

Juices and Expressions of Herbs sometimes contribute egregiously to the taking away of the Dyscrasy of the Blood. Take Leaves of Borrage, Water∣cresses of each six handfuls, two Apples mash'd, the pulpe of two Oranges, double refined Sugar an ounce, all being bruised together pour to them of ex∣cellent Cyder a pound and a half, make a strong expression, let it be kept in a Glass, the dose is four ounces twice or thrice a day.

In the Summer, a Bath of sweet Water, inasmuch as it cleanses the filth sticking in the Skin, and promotes insensible transpiration, does great good to some.

Because Melancholy persons Sleep with difficulty, and after long or frequent watchings are worse, therefore let Anodynes, and sometimes gentle Hypnoticks be prescrib'd to be taken late at night, when there is need. For this purpose, a decoction of Cowslip-flowers or of the leaves of Lettices, or the distill'd water of the red Poppey, or Syrup of the same: Moreover, Emulsions of the seeds of the white Poppey, Syrupus de Me∣conio, and other things that are mild, and soothing the Spirits, are proper.

There being an infinite number of Melancholick persons, as well as of Fools, I shall illustrate our hypothesis only with two exam∣ples; in one of which the Disease began from the sensitive part of the Soul, or from the Animal Spirits, and in the other from its Vital part, to wit, from the Blood.

Some time since a renowned man, about forty years of age, of a florid countenance, chearful, and quick at all business, being af∣flicted in mind, and very much dejected by reason of some misfor∣tunes, became thenceforward very sad and melancholy, with a dead

and fallen aspect: When first I went to see him, he complain'd of much trouble and distraction of his thoughts, which were so great, that his Fancy being occupied day and night without intermission, he liv'd wholly without sleep: and nevertheless this Person minded not at all the concerns of the Publick, nor of his own Family, nor was he greatly sollicitous concerning the welfare of his Soul, or the health of his Body, but rather was con∣tinually perplext about petty things, and almost of no moment: he was so fearful of all things, that he fancied some harm, or Death would presently happen to him upon any little accident. In fine, he always liv'd so sad, as tho he endeavour'd to exceed Heraclitus in mourning. Moreover, he was troubled with so great a straitness and constriction of his Heart, that it seem'd to him as tho the whole Praecordia were most closely strain'd together as a first contracted, and he thought that he always carried a vast and very oppressive burthen there, which forc'd him always to go forward, and stooping towards the Earth. Whilst he was discoursing with his friends, that con∣striction and oppression of the Praecordia was wont somewhat to re∣mit; but then upon any unusual object striking him with a terrour, it returned with more violence: Nor was he only troubled with a certain constriction in the Precordia, but in the whole Body besides, and a certain weight, as it were, seemed to lye on the Region of his Loyns, also on his Shoulders and Arms.

As to the Cure of this Person, after various Medicines us'd with∣out any great success, at length I perswaded him, because it was Sum∣mer, to drink our artificial Spaw-waters for six weeks: Therefore in the first place, in four pounds of Fountain-water, I infus'd for a night, of our Steel prepar'd half a dram, and afterward as much in eight pounds of Water. The Diseased every morning drank the clear Li∣quor, and within four or five hours discharged the greater part of it by Urine. He took moreover going to Bed, and early in the morn∣ing, a dose of an appropriate Electuary, such as above-described, with a Cephalick Julep: Within two months he was m uch better, and af∣terward came to himself by degrees.

Whilst I was writing these things, a young man of Quality, lately returned from travelling beyond the Seas, and being become sickly, committed himself to our care: This Person, being formerly of a san∣guine and chearful temperament, of a gay behaviour, also of an acute wit and a clear disposition, as he travelled through Foreign Coun∣tries, and being in a certain Summer in Spain, he felt in himself a great alteration from the intense heats of that place: For first, he became obnoxious to frequent effervescencies of the Blood, with sudden flush∣ings of heat in the palms of his Hands and the soles of his Feet, and to prickings often wont to arise in his whole Body, and presently to go away again. Afterward, finding himself worse as to his Appetite

and Sleep, and likewise growing dull and somewhat sad, he began to affect less, and sometimes to shun any business or delights, nay, and conversation with his friends. At length this indisposition daily grow∣ing worse, without any manifest cause, or real trouble of mind, he became Melancholick, so that always being thoughtful, fearful, and sad, he took delight in nothing: For Studies, Exercises, Travelling, Conversation with learned men, and all other things which before he delighted in, were then wont to be a trouble or terrour to him: Being affected after this manner for two years, he was so much changed from himself, as tho he were another man: In order to a Cure he consulted the most skilful Physicians of Spain, France, Hol∣land, and of late in England, and tryed various methods of Curing, tho scarce with any benefit. To wit, that melancholy Discrasy of the Blood, first contracted by the distemper of the Air, continuing still, caused Spirits of an acetous nature, as it were, to be supplied to the Animal oeconomy. In the first place I thought good to commend to this Person the following Remedies.

Take Gerion's decoction of Senna (with Tamarinds half an ounce) four ounces, Purging Syrup of Apples an ounce, Aqua mirabilis two drams, mix them, let him take it with governance, repeating it within nine days: afer Purging let Bood be drawn with Leeches, to three ounces.

Take of our Syrup of Steel six ounces, let a Spoonfull be taken in the morning, and atfive of the Clock, in three ounces of the following Liquor, walking upon it for an hour or two.

Take leaves of Baum, Borrage, Buglosse, Burnet, Meadow-sweet, Harts-tongue, Water-cresses, of each four handfuls, roots of Borrage half a pound, Clove-gilliflowers, Marygold flowers of each three handfuls, the outward rinds of eight Oranges and four Lemmons, Mace half an ounce, being sliced and bruis'd pour to them of Whey made with Cyder eight pounds, distill it with common Organs.

Take Conserve of Clove-gilliflowers, the flowers of Betony and Borrage of each one ounce and half, Pearl powdred two drams, red Coral prepared a dram and a half, Species of the Confection of Hyacinth two drams, Sy∣rup of Coral, and red Poppyes of each what suffizes, make an opiat, let the quantity of a Chesnut be taken every Evening, drinking after it two or three ounces of the water of Cowslip flowers.

After sixteen or twenty dayes, the method of alteratives being changed, instead of these let him take the following. Take powder of Ivory, Pearl, red Coral prepared of each two drams, Roots of male Peony a dram and a half: Lignum Aloes half a dram, Orange Tablets four ounces, a so∣lution of Tragacanth made in Baum-water what suffises, make Tablets weighing half a dram, let four be eaten in the Morning, and at five of the Clock drinking after it a draught of Tea.

Take of the same Powder without Tablets half an ounce, Flowers of Sal Armoniack, Salt of Coral of each a dram, with Chios Turpentine six

drams, make amass, let half a dram be taken Morning and Evening, drink∣ing after it three ounces of the distilled Water.

Let him feed only on Food of a good Juice, and of an easie Con∣coction, let him drink small Ale, with the Leaves of Harts-tongue in∣fused in it, he may sip a little now and then of Wine with Water in it, or of Cyder. Let him lead his Life continually occupied sometimes in easie Employs, sometimes in moderate Exercises, or Recreations of various kinds.

So far of universal Melancholy, in which the diseased are in a man∣ner indifferently affected by any Object, so that in every place, by any Accidents and Circumstances they are continually perplext with a multitude of Thoughts, with a Raving, Fear and Sadness.

A Melancholy is said to be Special, when the diseased have regard to some particular thing, or to some certain kind of things: of which they in a manner alwayes think, and by reason of all the Powers of the Soul being continually spent in this one thing, they live always pensive and sad: Moreover, they have absurd and incongruous Notions, not only concerning that Object, but also concerning many other Accidents and Subjects. In this affect the corporeal soul being altered from its proper Species, assumes a certain new one, and being not conforma∣ble to the rational Soul, or to the Body, or to it self, it undergoes a certain Metamorphosis.

There are two kinds of occasions, from which a particular Melan∣choly chiefly and most frequently arises; viz. first, if at any time some severe pressure of an Evil present or at hand (whether it be true or imaginary) lyes upon the Soul: or secondly, if the privation of a good before obtained, or the despair of that which is desired happen: In these opposite Cases the corporeal Soul either being allur'd outwardly omits all domestick care of it self, or of the Body, or of the rational Soul: or being inwardly compress'd, it leaves or perverts the offices both of the Reason and of the Vital and Animal Function. It were a thing of an immense Labour to enumerate the various Cases and wayes of affecting in both kinds; among the mighty store of them, those which being of greatest moment seem chiefly to require a physical help, are a furious Love, Jealousie, Superstition, despair of eternal Salvation, the imaginary Metamorphosis of the Body, or of its Parts, or the fantastical Goods or Evils of Fortune; we shall speak briefly of each of these.

It is a vulgar and most common observation, that if any one once being taken with the Aspect and Conversation of a Woman, begins inwardly to be love-sick for her, and to desire her earnestly, and for his most devoted affection gets nothing but denials and Contempt, unless he be upheld by a very strong Reason, or being seized by other affections, be turned another way, as it were, there is great danger lest he fall into a Love-melancholy; with which Passion if he happen to be

affected, presently he seems transformed from himself into a living Statue, as it were, he thinks or speaks of nothing but his Mistris; he seeks to put himself upon any of the greatest dangers of Life and Fortune for her sake; mean while he does not only neglect the care of Domestick or Publick Concerns, and even of his own Salvation, but, being frustrated of his Desire, often layes violent hands on him∣self; or if he be content to live and survive, pining away both in Body and Mind, he almost deposes man; for the use of right Reason being lost, omitting Meat, Drink, and Sleep, and the other necessary offices of Life, he yields up himself wholly to sighing and sobbing, and to a mournful habit and gesture of Body.

If we enquire into the reason of this affect, we easily find, that the Corporeal Soul of Man being obnxious to violent Passions, when it is wholly carried forth into an Object most dear to it, viz. a Woman belov'd, and is not able to get and embrace her, it is de∣lighted, or contents it self with nought besides, also paying no obe∣dience to the Rational Soul, it wholly grows deaf, and does not hear its Dictates; and crowding the Imagination only with Tragical No∣tions, it dulls the edge of the Understanding. Moreover, in as much as the Praecordia (a plentiful afflux of Spirits be ing denied to them) fail as to their Motions, the Blood heap'd together in the Sinus's of the Heart, and apt to stagnate, causes there a great heaviness and oppression, and consequently Sighs and Groans; mean while the Face and outward Members, by reason of the afflux of Blood and Spirits withdrawn from them, grow pale and languish: hence it is commonly said of Desperate Lovers, that their Heart is broken; to wit, in as much as this Muscle being not vigorously enough actuated with the Animal Spirit, vibrates slowly and weakly, and does no lon∣ger send forth the Blood with vigour into all the Parts.

Such disorder of the animal Function as an excessive Love brings concerning the Acquisition of its Object, the like in a manner is brought by Jealousy concerning the keeping of the same when gotten: so that always (viz. both in the Fruition and in the Desire)

Res est solliciti plena Timoris Amor.

That Soul, if it be not secure of its most dear prey, presently grow∣ing troubled, casts a Cloud and Darkness on its own sereness: and afterward, being infected with a bilous Tincture, every Object seems to it ting'd of a yellow colour: for as a ferment of the Stomack grown sharp perverts all things taken into it into its own Nature, so the affect of jealousy once risen, turns all Accidents and Circumstances to a food for its own venom: and since in this affect the sensitive Soul being bent awry as it were, does not become conformable to its Body, therefore the oeconomy of the Animal, Vital, and vegetative Functions, being de∣praved, the jealous Man raves and pines away.

Superstition and despair of eternal Salvation are wont to imprint al∣most the like affects of Melancholy on the sensitive Soul, the Blood, and the Body, as Love and Jealousie, but somewhat after a differing way of affecting; for in those the Object whose acquisition or loss is in danger, is wholly immaterial, and its affect being first conceiv'd by the Rational Soul, is imprinted on the other Corporeal Soul; in the prosecution of which, if this readily obeys, then no disturbance of the mind of Man arises; but if the Corporeal Soul shewing a reluctancy, (as it often falls out) the Rational still presses with advice and threats, presently that growing troubled, stirs the Blood and Spirits in a disor∣derly manner, opposes the Corporeal goods and delights to the Spi∣ritual, presented by the Understanding, and endeavours to draw the man to its side. And as thus there is a continual bickering be∣tween the two souls, and sometimes the Will is superiour, sometimes the Sensitive appetite prevails; at length a Court of Conscience is set up by the Mind, where every act is narrowly examined; By reason of these frequent variances of the Souls, the Animnal Spirits, as be∣ing too much, and almost continually exercis'd, being often com∣manded, and as it were distracted, now this way and now that way, at length fall somewhat from their vigour and good disposition, and at last being become fixt and melancholick, in as much as they are with-held from their wonted Expansion, they form bye and unusual Tracts in the Brain, and so bring a Delirium with a mighty Fear and Sadness; in those kinds of affects the corporeal Soul being violently drawn away as it were, both separates from the Body, and being mo∣dified according to the character of the Idaea imprinted, is wont to assume a new Species either Angelical or Diabolical; mean while the Understanding, for as much as the Imagination suggests to it only dis∣orderly and monstrous Notions, is wholly perverted from the use of right Reason.

After a like manner of affecting as this, it happens that some melan∣choly Persons undergo imaginary Metamorphoses either as to their For∣tunes or their Bodies. viz. Whilst one imagines himself, and acts a Prince, another a Beggar: another believes himself to have a Body of Glass, and another thinks himself a Dog or a Wolfe, or some other Monster; for after that the corporeal Soul being affected with a long continued melancholy, the Mind being blinded, is wholly fallen both from it self and the Body, she affects a new species or Condition, and, as much as in her lyes, really assumes it.