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. I. Instructions and Prescripts for the Cure of the Head-ach.

SInce all Pain is an Action violated, or an irksom Sensation de∣pending on the contraction or corrugation of the Nervous Fibres, the subject of the Head-ach must be the parts of the Head that are most nervous, that is, the Nerves themselves, also the Fibres and Membranes, whereof it has many, plac'd both upon and under the Scull; and those parts which are affected with pain are chiefly the two Meminges and their various Processes, the Tunicles of the Nerves, the Pericranium, and other Periostia; the Muscles, the Panniculus carnosus, and lastly, the Skin it self: As to the Brain and Cerebellum, and their medullary appendixes, we con∣clude that these Bodies, in regard they want sensible Fibres, apt to be corrugated and distended, continue free from pain; and so the same is also to be said of the Scull.

Now whenever a pain is rais'd any where about the nervous parts of the Head, its formal cause consists in this, that the animal Spirits being sever'd from each other, and put to flight, cause the Bodies that contain them to be withal convuls'd and corrigated, and so raise that troublesome sensation: And that which so distracts the Spirits, that a troublesome sensation thence arises, is somewhat disproportio∣nate, rushing against the Spirits themselves, or the Bodies that contain them, which entring the Pores or Interstices of the Fibres, severs them from each other, and withal forces the Spirits there residing to Irregularities.

As to the Prognostick of this Disease; in case the morbid disposi∣tion be inveterate, so that Fits for many years have often return'd of their own accord, and likewise upon any slight occasion, we predict that the diseas'd, though not much in danger of life, will not easily be cur'd: Moreover, that the Cure will be yet more difficult, if hy∣pochondriacal, or hysterick affects often troubling them, are wont at frequent times to raise the Head-ach, or if the corrupted taint of an inveterate Venereal distemper be radicated in the Part affected.

And if the Head-ach be not only inveterate, but almost continual, that we may justly suspect it to arise from a phlegmonous or schirrous Tumour, an Erysipela, Abscesses, or Worms, there remains but small or no hope of Cure.

A Head-ach, whether continual or periodical, if it be violent, and has a Vertigo, Vomiting, and other affects, either convulsive or sleepy joyn'd with it, gives suspicion of great danger; forasmuch as it frequently passes into a mortal Apoplexy, and often into an Epilepsy, Palsey, Blindness, Deasness, and other Diseases, either very severe or incurable.

The Therapeutick method of the Head-ach comprehends many Indications, and those of various kinds, according to the manifold species, causes, and differences of this Disease, which it will not be easie to digest, and place all here in an exact order.

An accidental, or occasional Head-ach, viz. such as is wont to arise from an evident cause alone, without any Procatarxis, or pre∣vious disposition, as when it happens upon drinking Wine, Surfeit∣ing, being in the Sun, or through a vehement exercise, also in fits of Feavers, this for the most part ceases of its own accord, upon the removal of the evident cause, and its consequences; or at leastwise is taken away by bleeding, rest, and sweating.

In every habitual Head-ach, whether continual or intermittent, two chief scopes of curing occurr; to which all the other Therapeu∣tick intentions ought to level, and with which provision is made against each cause of the morbid origine.

1. viz. In the first place, for the cutting off all the fewel of the Disease, we must endeavour, both that the matter flowing, or often∣times

apt to flow to the affected or ill dispos'd places of the Head, be either stopt, or withdrawn thence to some other place: and likewise that the Convulsions rais'd in other places, and thence wont to be propagated to the Head be prevented.

2. Then Secondly, in order to the eradicating of the Disease it self, or (if it may be) of its conjunct Cause, we must endeavour, that the places of the Head predispos'd for Aches (whether only weak, or injur'd in their conformation) being fortified against the frequent incursions of the offensive matter, recover their ancient state and vigour; which In∣dication, though it be seldom ever perform'd on a sudden, or through∣ly, yet sometimes by a long and diligent care, the morbid root, how fix'd and radicated soever it be, it consum'd.

As to the first scope of Curing, which we must first and chiefly have respect to, we say that the matter, or Humours, that are wont to be heap'd together about the parts of the Head predispos'd for a Head-ach, and to raise the fits of the Disease, are the Blood, or its Serum, or the nutritive or nervous juice. Moreover, with all these, vapours and effluvia, also excrements, sometimes bilous, sometimes melancholick, sometimes acid, salt, sulphureous, and others of va∣rious kinds being receiv'd into the Blood from the Viscera, sometimes these, sometimes others, are convey'd along with it to the Head; against the salleys and incursions of all which, let Physical defensa∣tives be ordered.

1. And first, if the Procatarxis, or disposition for pains being plac'd about the Membranes of the Head, the Blood, as being hot, and apt for turgescencies, rushes now and then all of a sudden into the Membranes of the Head, and upon its not easily passing them, stretches the Vessels above measure, and severs from each other the nervous Fibres, and so raises fits of this disease: (a sign of which are a sanguine temperament, heat, and a suffusion of redness in the Head about the Face, also a high and vibrating Pulse, with Veins stroutting with Blood; we must presently endeavour both that the Blood being rendred more calm, be not so readily put upon turgescencies; and also that when stirr'd and boyling, it be not carried with a greater salley to the Head than to other Parts, nor be not forc'd there to stag∣nate, by reason of the Sinus's of the Meninges being too much fill'd: Wherefore, if the fit continues long, let the Person be blooded in the Arm, or in the Jugular Vein; out of the Fits it is sometimes proper to draw Blood from the Vessels of the Fundament by Leeches; to wit, that by this means the Blood haply boyling, may be drawn down∣ward towards that place, whither it often tends of its own accord: Let Oxyrhodinums, or other Epithems be applied to the Head; more∣over, let Juleps, Emulsions or Decoctions, which allay the fervour or fury of the Blood be taken: Let the Belly be cooled and kept so∣luble by the use of Clysters: Morever, for prevention, Whey or

the use of Spaw-waters is convenient; also drinking of Water, a thin and cooling dyet do good: You must order a forbearance of Wine, Spices, Bathing, Venery, any violent motion of the Body or Mind, and all hot things: Moreover, for fixing the Blood, and preventing its effervescencies, let distilled Waters, expressions of Heerbs, or Decoctions, Electuaries, Powders, and especially Crystal Mineral be frequently us'd: It will not be needful to subjoyn here a method, or particular forms of Medicines, because in this case almost every Person that is ill, being taught by frequent experience from things that do him good or hurt, is wont to be his own Physician.

2. It is seldom that the Blood is in the fault alone, or only by it self: Other Humours oftner, being carried to the Head by the con∣veyance of the Blood, and there depos'd, cause the Evil: If at any time therefore a filthy glut of Serum breaking forth in abundance from the Blood, causes frequent Head-achs (the signs whereof are Catarrhs at the same time infesting the other parts, viz. the No∣strils, Mouth, or Trachaea) then abstinence and rest being com∣manded, and the Belly being emptied by a Clyster, let the fluxion of the Serum be permitted to appease it self, and the matter dis∣charg'd on the Membranes of the Head to evaporate: Which if they do not follow of their own accord, and in a short time, in a hot constitution Bleeding often is proper; viz. inasmuch as the Vessels being emptied of Blood, suck in again the extravasated Serum: But in cold Persons Vesicatories applied to the Neck, or behind the Ears, are of excellent use: Then after that the Belly is emptied by a Clyster, let the fluxion be appeas'd by the use of an Anodyne, or gentle Opiat: and that being appeas'd, it is proper to give a gentle Ca∣thartick, and then Medicines that operate by Urine, or Sweat, or together by both, and so gently evacuate the superfluous Serosities.

Medicines fit for these ends are every where to be found in Books, which nevertheless may not be us'd rashly and indifferently by Em∣piricks, but they ought to be chosen, compounded, or altered, nay, and sometimes to be prepared Extempore, as occasion requires, according to the judgement and discretion of a prudent Physician, respect being always had to the Constitution, Temperament, Idiocrasis, and other accidents and circumstances of the Patient. Wherefore, in regard it would be superfluous to heap together here a great many Receipts, I have rather thought fit to rpopose here only a form or two of the Medicines of each kind, viz. of such as regard the chief Intents.

Take Pills of Amber half a dram, Rosin of Jalap four grains, Bal∣sam of Peru what suffices, make four Pills; let three be taken going to Bed, and the next morning, if the former do not work enough.

Or, Take Scammony sulphurated half a Scruple, Ceruse of Antimony fifteen grains, Cream of Tartar eight grains, make a Powder, let it be taken in a spoonful of Panada early in the morning.

Take Sulphur of Antimony four grains, Rosin of Jalap five grains, Cream of Tartar six grains, let them be bruis'd together, and with a sufficient quantity of Conserve of Violets make a Bolus to be taken early in the morn∣ing with Governance.

Take roots of Butchers-broom, the great Bur-dock, Chervill, Avens, of each an ounce; preserv'd Eringo's an ounce and a half, Florentine Orris three drachms, the lesser Galingal a drachm and a half, Bur-dock-seeds three drachms, dryed leaves of Betony, Sage, Vervain, Fluellin, of each half a handful, Raisins ston'd two ounces, boyl them in four pounds of Fountain Water, will a third part of it be consum'd; then add of White∣wine half a pound, strain it, let it be sweeten'd (if need be) with Syrup of the five roots two ounces, let six ounces be taken warm twice or thrice a day a good while after meat.

For such as have a Cold and Flegmatick constitution, let a Decocti∣on be prepar'd of the Wood Guiacum, Sassafras, Sarzapar: With the addition of the foresaid Ingredients make an Apozeme, where∣of let six or eight ounces be taken twice or thrice a day warm.

For Poor People, and often to the Rich, I use to prescribe, with good Success, a Decoction of the dryed Leaves sometimes of Sage, some∣times of Betony, Vervain, or of Rosemary, made in fountain Water, and then impregnated with the Tincture of the Powder of Coffee-berries, to be taken twice a day warm to six or eight Ounces.

3. But, if with the abounding Serum, Particles also saline, acid, bilous, or otherwise infesting, are violently carried into the Mem∣brances of the Head, either wholly from the Mass of Blood, or by the Mediation of this, as receiv'd from the Viscera, and there being fix'd, cause more acute and lasting Pains; then it will be proper some∣times to repeat a spare Bleeding, and also a gentle Purging: to ap∣ply Anodyne, and mitigating Epithemes to the Places affected, and al∣so often to give gentle Hypnoticks by frequent changes, Apozemes al∣so, and Juices, and Expressions of Herbs, that allay the Fervour of the Choler, and gently carry it off by Seige and Urine, are of excel∣lent use: but in the mean time, let smart or strong Medicines, whe∣ther they operate by Seige, Urine, or Sweat, in regard they too much fuse, and exagitate the Blood and Humours, be carefully avoided. I have often observ'd in Persons troubled with an acute and obstinate Pain of the Head, that the Serum swimming on the Blood, when let forth, have been ting'd with a Yellowness, or with bilous excrements incocated in it: and that also in this Case a spare and frequent Bleed∣ing, and afterward a free drinking of Whey and Spaw-Waters, have given a notable Relief, and beyond other Remedies.

4. Moreover, if the Parts of the Head suster through the Fault of some one of the Viscera, as of the Stomach, Liver, Spleen, Womb, or any other, (by reason of the Transmission of the ill Ferment) then in the Cure of the Disease, let such Remedies as regard the Viscera be

administred together with Cephalicks: hence, to certain Persons trou∣bled with the Head-ach, whose Stomach also is in a Fault, Elixir Pro∣prietatis, Mynsichts Elixir of Vitrol, Tinctura sacra, Vitriolum martis, the compound powder of Aron Roots, and other things vulgarly account∣ed for Stomachals, often do good; to others whose Heads participate of the evils of the Spleen, Chalybeats often give help: Some Women sometime find ease of their Head-ach by hysterick Remedies; in like manner, when the Faults of other Parts contribute to the Head-ach, let the coindicated things taken from those Parts, be joyned with the first things indicated.

5. Sometimes the nutritive Juice is the Cause of a periodical Head-ach; viz. in as much as being mix'd with the Blood, and not duely assimilated, it causes a Turgescency in it by reason of its disagreeing Particles; so that the Blood boyling to the Head, throws off its Re∣fuse in its Meninges, or certain Parts of them predispos'd for it; and so irritates the Fibres to painful Convulsions. For this Reason, I have known many to have been obnoxious to a daily Head-ach after the Measles, Small-Pox, and other Fevers or Sicknesses, with which the Mass of Blood is wont to be vitiated; viz. so many Hours after Meals, sometimes sooner, sometimes later, first a flushing of Blood in the Face, then a Plentiude and Pain in the Head infested them: more∣over, after drinking of Wine, or eating of turgid Food, they were more severely punish'd. The Access of the Distemper is wont to hap∣pen sooner or later after they have eat or drunk according as the Chyle begins to grow turgid either a little after its first entrance into the Blood, or after it has stay'd some while in it.

This affect is free from Danger, and for the most part is easily enough cur'd. After a Provision being made for the whole, a gentle Purge, and sometimes blooding being ordered, Remedies which re∣store the Crasis of the Blood, such as are chiefly antiscorbuticks, and Chalybeats, prove mighty beneficial.

Take Conserve of Fumitory, Tansey, Wood Sorrel, of each two Ounces, compound Powder of Aron Roots three Drams, Ivoy, Crabs Eyes, Coral prepar'd, of each a Dram and a half, powder of yellow Saunders, Lig∣num Aloes of each half a Dram, Vitriol of Mars a Dram, salt of Worm∣wood a Dram and a half, syrup of the five Roots what suffices, make an Electuary: let the Quantity of a Chesnut be taken in the Morning, and at five a Clock in the Afternoon, drinking after it three ounces of the following Liquor.

Take Water of the Leaves of Aron, Vervain, and of the Flowers of El∣der of each six Ounces, magistral Water of Snails, and Earth-worms of each two Ounces, Sugar on Ounce, mix them.

Various Medicines, wont to be us'd against the scorbutick Diseases of the Blood, may be rang'd here, and giv'n with good Success; for Head-aches, which are so familiar in the Scurvy, oftentimes proceed from

the Fault of the Blood perverting the nutritive Humour, and dischar∣ging its Recrements in the Membranes of the Head: wherefore, the Remedies mention'd by me elsewhere against that affect, claim a place also here.

6. There remains yet another Humour, to wit, the nervous Li∣quor, which being carried into the Fibres of the Meninges and other parts of the Head, sometimes becomes disproportionate to the Fibres by its own disagreeing nature, as it is sharp or otherwise degene∣rate, sometimes twitches the containing Parts and irritates them into Convulsions or painful Distentions, as it strongly ferments with some other humour, viz. the nutritious or serous Humour flowing thi∣ther.

The nervous Humour, where it is thus morbifick, either being vi∣tiated in its whole Mass, brings a very great Injury on the Brain pre∣dispos'd for it, or being faultless of it self, is perverted within the Fibres affected, and so becomes morbifick secondarily; the Cure of which then depends on the Restitution of the containing Parts; viz. If the Weaknesses of the Fibres, or their injur'd Conformations be amended, the Humour irrigating them, will presently be free from Fault, With what Remedies the Defaults of the Parts predis∣posed for Head-achs are remov'd, we shall presently acquaint you.

Mean while, if the nervous Humour, being degenerate in its whole Mass, causes a great Offence to the Head predispos'd for Pain, let those kinds of Medicines, and that method be us'd, with which be∣ing reduc'd to its due Crasis, and gently passing through those Fibres, it may irritate them little, or not at all: for which end, neither strong Purging, nor large or frequent Blooding are proper, in regard they exagitate the Blood and Humours, and impair the Strength, and consequently give a greater Acrimony and Rage to the nervous Hu∣mour which was faulty before. But gentle Loosners, and a spare Bleeding, will now and then be of use; whereby the Viscera may be cleans'd, and the Mass of Blood be somewhat purg'd, and a way be prepar'd for other Medicines which will succeed the better after∣wards.

Now the Medicines that render the nervous Liquor more friendly and benign to the Membranes of the Head, which are wont to be offended by it, are those which are vulgarly call'd Cephalicks, viz. whose Particles, being active enough, and withall fine and subtle, pass the Blood without any Turgescency or Tumult; and then insi∣nuating themselves into the nervous Liquor, gently actuate it, and cause the Ductus's of the Nerves so to open themselves, that there∣by the animal Spirits more freely irradiate all Bodies both sensible and motive, and inspire them without Swoonings, Convulsions, or anomalous Distentions.

These kinds of Remedies, tho not always efficacious, nevertheless often remove some Head-achs that are not very inveterate, and in others, tho never so obstinate, they frequently do good: moreover, those things that are prescribed against Pains of the Head, are also given against Affects of the Brain and Genus Nervosum, and on the contrary, the things that are prescrib'd in these are also given with good Success against those; viz. the Vertue of them being display'd within the Brain, does good against the Apoplexy, Palsie, Lethargy, and other Diseases allied to them, also within are moving Fibres against Cramps and Convulsive Motions; and likewise exert∣ing their Forces within the sensible Fibres, they often relieve Pains.

Great stores of these Medicines are vulgarly set forth in Physical Books, but so, that their Plenty has brought either a Poorness or Con∣fusion to the method of healing; those things which would do most good, often lying hid, or being concealed amon gst that confus'd heap of Remedies; even as Wheat is with more difficulty separated from much Chaff, than it is first gotten clean from the Ear. Therefore in this Case Provision being made for the whole, and then those things being given both by Dyet and Physick, which put a stop to or present∣ly appease the Turgecencies of the Blood, let the Medicines call'd Cephalicks, or such as remove the Disorders of the nervous Juice, be prescribed to be carefully taken: I shall set down some few Forms of these.

Take Conserve of Flowers of Betony, and Clovegillyflowers of each three ounces, Powder of male Peony Roots half an ounce, bastard Dittany a dram, lignum Aloes, yellow Saunders of each a dram, red Coral prepared, Pearl, Ivory, of each an ounce and a half, Salt of Vervain a dram and a half, syrup of Peony flowers what suffices, make an Opiate; let the quan∣tity of a Chesnut be taken, drinking after it of the following Julep, three ounces.

Take Water of Black-Cherries, Wallnuts simple, Vervain, of each four ounces, Water of Cowslip-flowers three ounces, compound Water of Peony three ounces, Sugar six drams:

Or, Take Leaves of Vervain, Mistletow growing on Apple-trees, of each ten handfuls, male Peony Roots two pounds, Mace, Nutmegs, of each half an ounce, Coriander Seeds an ounce, being slic'd and bruised, pour to them of fresh Milk eight pounds, (or of Milk seven pounds, Malaga Wine one pound) distill them with common Organs, let the whole Liquor be mixt. Let three Ounces be taken at a time.

Take Powder of male Peony Roots half an ounce, red Coral prepared two drams, Ivory, Pearl prepared, of each a dram, make a fine Powder of them all, add of Sugar dissolv'd, and boyl'd to a Consistency for Tablets in a sufficient quantity of Black-cherry Water, six ounces, Tincture of Co∣tal a dram, make Tablets according to Art weighing half a dram, let

three or four be eaten in the Morning, and at five a clock in the Afternoon, drinking after it a little draught of Tea.

Or, Take Tincture of Coral an ounce, take from fifteen drops to twen∣ty twice a day in a little Draught of the Julep or distill'd Water.

Those that are of a cold or flegmatick Temperament, may take twice a day a Dose either of the Tincture of Antimony, or of Spirit of Ar∣moniack impregnated with Amber or Coral, or of Spirit of Harts-horn, or of Soot in an appropriated Vehicle.

The use of Millepedes ought not here to be omitted, or set lightly by, in regard that their express'd Juice, distill'd Water, and also the Powder prepar'd of them, often contribute egregiously to the Cure of ancient and obstinate Head-achs. I might here propose many other Medicines of various kinds; nay, transfer hither, the forms in a man∣ner, of all those which I have formerly heap'd together against con∣vulsive Affects. But the most difficult thing of all concerning the Cure of the Head-ach, yet remains; viz. How the Conjunct, and fixt Cause of this Disease, consisting in the Weakness or injured Con∣formation of the Fibres, may be heal'd or remov'd.

Now this, though it will be sometimes incurable, as when a schir∣rous, or callous, or some other ancient and fix'd tumour, has possest the Meninges; nevertheless, since the Diagnostick of this is uncertain, and the Procatarxis of a Disease, how unconquerable soever it may seem, sometimes by a continued method of Cure is overcome; there∣fore in every kind of Head-ach, as long as the Patient will admit of Remedies, let not a Physician be backward in prescribing those things that shall seem most proper.

Therefore in the first place, as we hinted even now, we must di∣ligently endeavour, that the Fuel of the Disease being out off, and intercepted, the frequent Accesses of the Fits be stopt; for so the indisposed Fibres, whilst they are no longer molested, sometimes re∣cover their sound state, Nature alone effecting the Cure.

The helps of the Art of Physick, indicated in this Case, are taken from Chirurgery rather than from Pharmacy; for whatsoever is ta∣ken by the Mouth, passing through long Circuits, spends all its Vir∣tue before it reaches the Membranes of the Head.

Amonst Chirurgical things, first Topical Remedies occur, and of those, Plaisters are of most advantagious use, and often prove very be∣neficial. Let not these be extreamly hot, which may draw the Hu∣mours more to the place affected, but moderately discussing and cor∣roborative. I use to prescribe, Emplastrum de Minio, or Diasaponis, with a half quantity of Paracelsus's Plaister, to be applyed to the Place grieved after it is shaved, and to be worn for some time. As to the Ancients frequent use of Phenigms and Sinapisms, and to the present Practice of applying Vesicatories against violent Head-aches, sometimes to the whole hinder part of the Head, sometimes to the

Sinciput: if at any time ease has ensued these not Topicks, it was for this reason, Because by those Administrations a mighty store of sharp Serum was voided from the Part affected.

Liniments of Oyls, and Unguents, tho freuently us'd, do little; because (as I gess) in case they penetrate deep, they render more lax the Tones of the Fibres, whereby they lye more readily open to the Incursions of the morbifick Matter; moreover, they stuff the Pores of the Skin, that the Effluvia do not evaporate: for the same Reason, in a manner, it is, that warm Fomentations, prepar'd of Aromatick, or other cephalick Decoctions, oftner do Hurt than Good, because they draw Humours towards the Parts affected, and withall, open the Pores and Passages, whereby they are more readily admitted; and therefore also it is, that bathing of the Head, by pumping Water on it in hot Baths, is used to Persons troubled with the Head-ach with no better Success: whereas, on the contrary, it would be good for many to wash their Temples, Fore-head, and Sinciput, every Morning and Evening, with cold Water: nay, to bath their Heads every Morning by pumping cold Water on it, or at leastwise, to dip it in a deep Ves∣sel or Well.

Another Chirurgical help cryed up for the Head-ach, especially if violent and inveterate, is wont to be a burning or cutting of Issues in several parts of the Body: It's a thing without doubt, that these be∣ing made in the Arms or Leggs, are both less troublesome, and prove somewhat beneficial; viz. inasmuch as they withdraw the fuel from the Part, and lead it far away from the place affected: Moreover, an Issue in the Nucha, and a Setaceum in the Neck, also in the lap of the Ear, or near it; and likewise a pellet of the Roots of Wild Black Hellebore stuck in the lap of the Ear perforated, inasmuch as they evacuate much serosity, and cause more to pass towards the emuncto∣ries, viz. the Glands are often us'd with benefit. But there is a great deal of talk and a greater reputation concerning Cauteries ap∣plied to the place griev'd, or near it, so that large Issues are made in the crown of the Head, or near the Commissures of the Sutures. If we measure the fruit of this practice from the success, it will ap∣pear to be little and seldom beneficial, but often unfortunate; for I have not known any person cur'd by these kind of Cauteries, but ma∣ny aking Heads to have grown worse thereby. And truly Reason dictates it; for wheresoever an Issue is burnt, a serous humour flows to that place from the whole mass of Blood, and consequently from the whole Body; and it is often heap'd together there in too great a store, that it may be constantly voided by that emissary: Wherefore about Issues, Inflamed swellings, pustules, and various humours eve∣ry where arise: What therefore can we suspect less, than that Caute∣ries being applied near the place griev'd of the Head, but they will cause the Morbifick matter to be more heap'd together there.

There remains yet another Chirurgical operation, extoll'd by many for an obstinate Head-ach, but tryed as yet by none (that I know) to wit, the opening of the Scull with a trepand Iron near the place of the pain: Our famous Harvey endeavour'd to perswade a Lady of great quality to this, who was troubled with a terrible and inveterate Head-ach, promising her a Cure thereby; but neither she nor any other has been content to admit of the administration: Truly it does not appear to me what certainty we may expect from the Sculls being opened where it pains; if an Abscess lay hid there, this were the only way of Cure; but that is wont to cause the sleepy, or mortal Convul∣sive affects, rather than to take away the Head-ach: if an inflamed Swelling, or Pustules, or an Erysipela has seized the Diplois, I know not whether those tumours exposed to the naked Air will evaporate more easily, or whether remedies applied to them, when bare, will do any thing or not: And in case the pains arise by reason of the Me∣ninges being beset with tubercles, or a schirrous, or callous Tu∣mour, I judge the opening of the Scull will turn to little or no benefit.

But this being past by till it comes in practice, let us proceed to other things: And now let us consider whether Salivation be to be used for curing old and confirmed Head-achs; in truth if the pains arise from the Venereous Disease, I make no question but this way ought to be taken; but those that have tryed that kind of remedy, in Head-achs proceeding fro other causes, have not reaped a Harvest answerable to so laborious a cultivation; I confess the examples of certain persons have scared me from trying that method in those kinds of cases. A certain Lady of great quality (whose distemper I shall set forth beneath) for curing a violent and long continued Head-ach, has undergone three copious Salivations, viz. first by a Mercury Ointment directed by Sir Theodore Mayern, and afterward twic by ta∣king the late famous Powder of Charles Huis, and this without any relief, (and I wish it were not with some detriment to her) for since for many years, even to this day, she has given ground to the cruel Tyranny of this distemper growing by degrees upon her. It fell out somewhat worse than this with that excellent man. D.G.D. for the cure of whose ancient Head-ach, when a Mercury Ointment was ap∣plied to his Head pained, the Salivation raised thereby, made him blind, without curing the disease. Truly every man, duly considering the operation of Mercury in the Body of man, ought to dread these kinds of effects from the rash giving of it: For, not to ay that Mer∣cury is malignant, or wholly venemous, viz. inasmuch as from its united Particles little or no hurt is caused; so that often a great quan∣tity of Quick-silver is taken with safety enough; nevertheless, the Mercurial Corpuscles being divided, and separated from each other, (whether it be done by Chymical Salts, as in sublimated and preci∣pitated

Mercuries, or by percolation through the Pores of the Skin, when an unction is made) they presently become exorbitant and ma∣sterless, and raise more turbulent commotions in the Body of Man than any Medicines besides: they sometimes infest the Ner∣vous Parts first, wherefore by reason of the Fibres of the Ventricle, Intestines, and other of the Viscera being fretted, Gripes, horrible Vomitings, most sharp and often Bloody Stools, Cardialgias, Swoon∣ings, and other terrible affects frequently happen soon after the Medi∣cine is given: But sometimes the Particles of the Mercury, when they are not presently dissolv'd, without offending much the Viscera, scarce exert their forces before they are conveyed into the mass of Blood: Therefore being mighty active, and displaying themselves every way, they readily enter this, and presently infecting the whole, exa∣gitate it, and often (when they are more fully dissolv'd) stir it to a great effervescency: then the Blood, to clear it self of the disagreeing Particles, beginning to ferment, delivers them that way it may, to the humours contained within it self, viz. the Serum, and Nutritious Juice, and throughly mixes them in it, and withal endeavours to discharge it elf of those, being imbued with so preternatural a mix∣ture. Now this is not done easily, or plentifully enough by Urine, or Sweat, for the Liquamina of the Blood being become more viscid and gross, from the Particles of the Mercury incocted in it, than that they may pass the small colatories of the Reins or Skin, sometimes breaking forth (unless they are stopt) by the Caeliak Arteries, pass away upon raising a Diarrhoea or Dysentery, the intent of Salivation being thus letted or frustrated; but ostner the Latex being imbued with Mercury remaining within the Blood, which is also somewhat infected, and being carried violently with it hither and thither by the Veins or Arteries, butts against various Parts, and a way being made, either breaks forth outwardly, or is hurl'd into the Viscera, Membranes, and other Parts, often with great prejudice. Moreover, some Mercurial Particles also seem to penetrate the Brain, and insinu∣ating themselves into the Nervous Juice, t be diffused not only through all the inward parts of the Head, but through all the Ner∣vous Parts, and so in some sort to ferment the nervous liquor.

But in the mean while the Mercurial Serosities remaining in the Blood, are depos'd for the greatest part in the Glands, which are the proper emunctories of the Arteries: Wherefore, since about the parts of the mouth both a great many, and very great Glands are plac'd (to which a mighty store of Serum is sent for Spittle) and from those the open Ductus's by the excretory Vessels gape into the cavity of the mouth, certainly by this way chiefly, the envenom'd Latex of the Blood will find its passage forth, which it cannot readily do elsewhere. Wherefore, upon a Salivation being rais'd, the Blood long fermenting, like Wine or Beer purging it self, throws off by

the Ductus Salivales, and the innumerable Meatus every where ga∣ping into the Mouth, whatsoever extraneous and degenerate sub∣stance it may either contain within it self, or can drink up, or receive from elsewhere, be it from the Viscera, or solid Parts, or from other humours. Moreover, it is likely, that as the off-scowrings of the Blood, so also those of the Liquor that irrigates the Brain, and Ner∣vous Appendix, being stirr'd upon the entrance of the Mercury, are voided forth also this way, viz. by the Ductus Salvales.

Therefore a Salivation caus'd by Mercury, if haply it succeeds well, removes sometimes difficult and indeed Herculean distempers, and such as will not be mastered by any other Remedies, viz. foras∣much as this operation, by a long expurgation, throughly cleanses the Blood and nervous Juice, and other humours, destroys all exotick serments, quells the enormities of Salts and Sulphurs, and also exagi∣tates the morbifick matter sticking any where, or stagnating, and often leads it forth.

Nevertheless, this Medicine is not always free from danger, viz. because the Mercury being become exorbitant, and carrying with it a mighty store of most sharp, and as it were, envenom'd Serum, and rushing violently into the noble Parts, and especially the Brain; with the appendixes, both medullary and nervous, or into the Lungs and Praecordia, brings upon them an indelibel, and sometimes a mortal prejudice: Wherefore, in an ancient and fore Head-ach there is dan∣ger lest the indispos'd Fibres be more irritated by the Mercury per∣vading them with much and Corrosive Serum, and be put upon greater Convulsions and painful Corrugations: And also, lest upon the mighty recourse of Humours to the Head, the Brain be invaded, and consequently (which happens too often) lest the sleepy or Convulsive affects be caused: I would have discoursed more concerning these things, because it is of a great concern, but that we daily expect an exact method of Salivation, and a full account of it, as to its ways and effects, advantages or disadvantages, to be set forth by the Leanred Physician, Dr. Needham.

From Chirurgery there remains yet another famous remedy for cu∣ring inveterate Head-achs, viz. the opening of an Artery: Some of the moderns use this, and very much extoll it, it being greatly account∣ed of amongst the Ancients: Nevertheless, as far as it has appeared to our observation, success has often been wanting to that so much cryed up operation: Nor is it a wonder, because that ground on which the Ancients relying, blam'd the Arterious Blood, as differing from that of the Veins, and more exorbitant, and therefore advised it to be let forth, does not hold good: Nor indeed is thereany other reason, wherefore Blood drawn from an Artery rather than from a Vein near the place grieved, should give ease, but rather on the contrary we may expect a greater help from the opening of a Vein; because an

Artery being emptied, receives and draws away nothing from the part affected; but a Vein being opened, in the place of the Blood issued forth, draws from the whole Neighbourhood, and often drinks in again, and restores to circulation the Blood, and other humours heaped together, and Stagnating near the seat of the Disease. How∣ever, lest we recede too far from the practice of the Ancients, attribu∣ting nothing to Arteriotomy, we grant that sometimes haply it gives help tho, not immediately and causally, but only by way of consequent, and per accidents, viz. forasmuch as the ends of a cut Artery grow together, so that the passage for the Blood that way is stopt for the time to come; hence in regard somewhat a less store of Blood is brought towards the place by the Arteries, and an equal quantity is still carried away by the Veins, therefore it sometimes happens that the fuel of the morbifick matter is diminished, and that its flock is consumed by degrees. For this reason that administration has often succeeded well in distempers of the Eyes. Moreover, Farriers use a practice not unlike this for curing malignant tumours in Horses Legs; to wit, they take and bind the Artery by which the matter flows to the part affected; mean while that which was there sticking, partly evaporates, and partly is drunk up again by the Vein. I have heard that in a manner the same method was successfully tryed by our Har∣vey, for curing strumous and schirrhous tumours also in the Body of man. I might here set down many other kinds of Remedies, and also Prescripts and forms of Medicines which are wont to be used both by Physicians and by Empiricks, for curing Head-achet; but the Books of Physicians abound too much with these. I shall now give you some rare cases of Persons troubled with the Head-ach, and first some examples of a most severe continual Head-ach, which also, the cause being invincible, has often proved fatal.

A Woman, fifty years of age, after that she had been ill for about six months with a very great pain of her Head, troubling her almost continually under the Sagittale Suture, and yielding to no Method or Medicines, fell at length into a Lethargy, with a Partial resolution of her Limbs, from which nevertheless being in a short time reco∣vered by remedies seasonably administred, she had again the violent pain in her Head as before, and afterward within a fortnight or three weeks falling into a sleepy affect, she departed this life: The Scull being opened, on the side of the third Sinus, a schirrhous tumour three fingers broad grew to the Membranes, by the mediation of which, the Dura Menix also for some space grew to the Pla; and the Blood Vessels which ought there to open into the cavity of the Sinus, were stopt; moreover, both the outward Anfractus of the Brain, and ••its inward cavity, were filled with clear water. From these observations the invincible, and at length mortal cause of that Disease may plainly appear. I remember formerly to have observed

by Anatomy a case like to this, in a certain other Person. Moreover, in regard I judge that in many Persons troubled with the Head-ach, the Disease depends on such an invincible cause, I shall here give you one instance that is quite fresh of that kind of affect.

Some few years since I was called to see a Lady of Quality, troubled for above twenty years with a Head-ach, which at first was intermit∣tent, but of lat eis almost continual. She was endowed with admi∣rable gifts both of body and mind, so that she was excellently skilled in the Liberal Sciences, and all Learning, above the condition of her Sex; but (as tho Nature thought it too much for her to enjoy so great endowments without some affliction) she has suffered very sore∣ly from this disease: Before she was eight years of age, upon her recovery from a dangerous Fever, she became obnoxious to pains of her Head, which were wont to arise sometimes of their own accord, but oftner on some light occasion offered; the disease being not li∣mited to one place or part of the Head, sometimes infested the right side, sometimes the lest, and often its whole circuit. During the ac∣cess (which seldom ending within the space of twenty four hours, often infested her for two, three, or four days) she could not endure light, speech, sound, or any motion; but sitting upright in her Bed in a darkned room, she was able to speak with none, nor to take any rest, or food: at length, as the Fit declined, she used to fall into a deep and troubled sleep; from which awaking, she was wont to be better, and then by degrees to recover, and during the time of inter∣mission to be indifferently well. Formerly the Fit being raised only occasionally, seldom returned within twenty days, or a month, and then afterwards much more frequently; but of late she is seldom free from them. Moreover, through many occasions, or rather evident causes (such as are the changes of the Year, and of the Air, the great Aspects of the Sun and Moon, violent passions, and errours in diet) she is sorely tormented with them. Now tho this affect having sorely afflicted this noble Lady (when I went to see her) above twenty years, and pitching its Camp near the Confines of the Brain, had so long besieged its Royal Fort, however it had not yet gotten possession of it: But the diseased being free from a Vertigo, Scotomia, Convulsive affects and any sleepy symptom, had still the chief Faculties of her Soul whole and sound.

In order to the obtaining, or rather endeavouring a Cure, through∣out the whole progress of the Disease, a great many Remedies, pre∣scribed by most skilful physicians, as well of our Country, as Fo∣reigners, were used without any success, or ease: She tryed all the Great Remedies of every kind and form, but always in vain: a great many years since she underwent a long-continued, and most trouble∣some Salivation, by a Mercury Ointment, so that she incurred a great danger of Life. Afterward a Cure was twice undertaken by a Flux,

tho to no effect, by a Mercury Powder, (which the famous Empirick Charles Huis generally gave): She tryed hot Baths, and drank Spaw∣waters almost of every Country and Nature, with the like success as the rest: She was frequently blooded, and once in an Artery; she went with many Issues, made sometimes in the Sinciput, sometimes in the hinder part of the Head: She took the Air in divers Countreys, viz. besides her Native, that of Ireland and France: She took Medicines of all kinds what∣soever; to wit, Cephalicks, Antiscorbuticks, Hystericks, all famous Speci∣ficks, nay, and Empirical Remedies, given both by the learned and un∣learned, by Mountebanks and old Women; yet she declared that she had not received any where from any remedy, or method of Cure, the least help or relief: But the refractory and obstinate Disease, be∣ing deaf to all inchantments of Medicines, would not be mastered. Moreover, having possessed so long the precincts of the Brain, tho it could not enter its recesses, yet when I went to see her, extending its limits into certain other parts of the Genus Nervosum, it began to raise violent pains in the Limbs, also in the Loyns and Abdomen, such as are usual in a Rheumatism, and in a Scorbutick Cholick.

A worthy man, about forty years of age, robust, and sound, when, upon riding a whole day in the rain, he had gotten cold, by reason of the hinder part of his Head being continually wet, soon began to feel a pain in that Part, which in a short time being very much en∣creased, miserably afflicted the Diseased both day and night, and kept him in a manner, always without sleep. Blooding, Purging, Cly∣sters, Vesicatories, Hypnoticks; nay, and a great many Remedies of all kinds, diligently administred by the joint advice of a great many Physicians, did little or nothing towards the Cure of this affect: When the Disease, notwithstanding all these, daily grew worse, after six weeks, Glands, preternaturally swoln and painful, arose all over the Neck, the Hemicrania in the mean while abating nothing: Moreover, the Tendons of the Neck being very much distended, and stiff, pro∣ved very tedious to him; to which in a short time, Convulsive mo∣tions, and leaping of the Tendons succeeded in various Parts, with a Delirium; and at length the Diseased being worn out with pains and watchings, yielded to Death.

As in the foregoing cases, the Head-aches proceeded from Nodes and tubercles of the Meninges, so sometimes mortal and incurable Head-achs arise from a Phlegmon and Abscess. A while since, a University Scholar, after he had complained for a fortnight of a very great Head-ach, afflicting him almost constantly; at length the Fever becoming stronger, presently Watchings, Convulsive motions, and a talking light-headed ensued; at which time a Physician being called, Blood∣ing, Clysters, Playsters, Revulsives, Vesicatories, also inward Reme∣dies for withdrawing the course of the Blood and Humours from the Head, being carefully administred, he could do no good, but Death

in a short time followed. The Scull being opened, the Vessels spread over the Meninges were filled with Blood, and very much distended, as tho the whole mass of Blood had flown thither; so that the Sinus's being dissected and opened, above half a pound of Blood flowed forth: Moreover, the Membranes themselves being affected through∣out with a Phlegmonous tumour, appeared discoloured: These cover∣ings being taken away, all the Anfractus of the Brain, and its Ven∣tricles were full of clear water; and its substance being too much irrigated, was moist throughout, and nothing firm: For the Blood being there heaped together, when it could not circulate, threw off from it self a plentyof Serum, by which the whole Head was soon floated; so that the Disease, curable haply at the beginning by Phlebo∣tomy, afterward became mortal.

I remember another University Scholar, who after being constantly, and very sorely afflicted with a Hemi••••ania under the temporal Suture for three weeks, fell at last into a fatal Apoplexy. The Head being opened, a Phlegmon had grown in the Meninges near the place pain∣ing, from which at length suppurated and broken, the Sanies falling on the Brain, had affected its substance with a lividness and cor∣ruption.

But tho a continual Head-ach (especially if it be drawn in length for many weeks without intermission) be not without danger, never∣theless we must not presently despair of its Cure, because the cause of this, how fixed and immovable soever it may seem, is often cured by a long use of Remedies, nay, sometimes without them, by Time and Nature; tho in a case that is almost desperate, there is need of some Physick, lest the present affect pass into a worse, viiz. into a sleepy or Convulsive distemper. So much of the continual Head-ach; it now remains for us to propose some Examples, and some rare Instances of an intermittent Head-ach.

Therefore, not to set forth here cases of the Head-ach, whose Fits being erring and uncertain, proceed from the Blood or Serum rushing into the places affected, in regard that these are very frequent, and vulgarly known. I shall now set before you certain choice Ob∣servations of this Disease, being either periodical, or seeming to arise from some one of the Viscera, per Consensum. As to the Former, the period•••••• invasions of the Head-ach are produced either from the nu∣tritive Humour, or from the nervous Juice; I shall now give you example of both.

A venerable Matron, in the forty fifth year of her age, being of a thin habit of Body, and a bilous temperament, after having liv'd for a long time obnoxious to Head-achs wont to be occasionally rais'd; about the beginning of Autumn she began to be troubled with a peri∣odical Head-ach: This affect seizing her about four a clock in the Afternoon, was wont to hold her almost till midnight, till the diseased

being tired with watchings and tortures, was forced to fall asleep; then after a pretty prosound sleep, upon her awaking in the morning she was well. The Diseased having undergone daily Fits of this Disease for three weeks after this manner, delay'd the use of Physick, which she very much abhorr'd; but at length her appetite being dejected, and her strength worn away, she was forc'd to desire a method of Cure, and after a gentle Purge and blooding, she took twice a day, for a week or a fortnight, the quantity of a Chestnut of the following Electua∣ry, and grew perfectly well.

Take Conserve of the Flowers of Cichory and Fumitory, of each three ounces, compound powder of Aron Roots two drams and a half, Ivory a dram and a half, yellow Saunders, Lignum aloes, of each half a dram; Salt of Wormwood a dram and a half, Vitriol of Mars a dram, Syrup of the five Roots what suffices; make an Electuary.

The cause of this periodical Head-ach doubtless was, that the as∣similation of the Chyme, or nutritive Humour into Blood was hin∣dred. For when its store received into the mass of Blood could not be overcome, it was wont, after a little stay, to fall at odds, and fer∣ment with its particles: Therefore presently the Blood falling into a turgescency, that it might shake off that incongruous mixture, depos'd its recrements, as on other Parts, so chiefly, and with a greater sence of offence on the Fibres of the Meninges, being before weak, or injur'd in their conformation, so that the pain lasted till the heterogeneous particles, boyling by their mutual congress, either were subdued, or did exhale

A handsome, tall, and slender Woman, long and sorely obnoxious to cephalick affects, was wont to be infested sometimes for many days, nay weeks, with a violent Head-ach, which seiz'd her daily at her awake early in the morning, and afflicted her for three or four hours: In the mean space she was also affected with a heaviness of the whole Head, a deadness of the Senses, and a stupidity of Mind: which affects va∣nishing together with the pain before Noon, like Clouds disperst, left all things calm and serene: Till the next morning they possest again the Brain like a sogg and dark mist: For curing these distempers, I pre∣scribed parging Pills, a spare Bleeding, Vesicatories also, and the use of Spirit of Harts-horn, or of Soot, with Cephalick Juleps, or Waters.

In this Gentlewoman the pains of the Head rather followed sleep than was cur'd by it; because in this morning Head-ach the morbifick matter resided in the nervous Juice, whose greatest curdity, and ag∣gravation about the Head, happen presently after sleep; but the other evening fit of this disease, in regard it depended on the plenitude and turgescency of the nutritive liquor within the mass of Blood, therefore hapned so many hours after dinner, and was not mittigated but after sleep, which appeases the disorders of the Blood.

Tho the Experience and Complaints of sick Persons manifestly shew that Fits of the Head-ach sometimes arise by consent from the other Parts, viz. the Womb, Spleen, Stomach, &c. Nevertheless it as clearly appears from the accounts of them, and the Phoenomena being duely considered, that this is done by another means than by Vapours rais'd from the Viscera affected to the Head. And first, as to the pains of the Head seeming to be rais'd from a Womb, nothing occurs more frequently than for violent Head-achs to ensue upon the suppres∣sion of the menses or lochia: moreover, tho the menses observe their due course, yet some Women are wont to be afflicted with a violent pain of the Head just as they are coming, others as soon as they are past: But yet, tho at the same time that the Head is affected, the Womb is also, yet it does not follow that the Injury is convey'd immediately from this to that: but it is the Blood it self which fixes the morbifick matter on the Head; viz. it sometimes perversly conveys it, being en∣gendred within its own bosom, and design'd for the Womb, into the Meninges of the Brain: and sometimes withdrawing it from the Parts of the Womb, it delivers it to the Head with a greater mischief. This Aetiology agrees also with the Head-ach, vulgarly imputed to the Sto∣mach, Spleen, and other Parts.

A beautiful young Woman, of a thin habit of Body, and a hot Blood, having been obnoxious to an hereditary Head-ach, was wont to undergo frequent Fits of it, and those coming at random, to wit, some happening on a light occasion, and others arising of their own accord, that is, without any evident cause. On the day before the spontaneous access of the Disease, being very hungry in the Evening, she greedily eat a plentiful Supper, with a hunger-starv'd, not to say Canine appetite, most certainly fore-knowing by this sign that a pain of the Head would seize her next morning, which sign never fail'd of Event; for as soon as she awak'd, being afflicted with a most cruel torture throughout the Sinciput, she was affected likewise with a vo∣miting of a humour, sometimes acid, and as it were vitriolick, some∣times bilous, and extremely bitter; it hence seeming to appear that that Head-ach had its rise from the fault of the Stomach.

To undertake to give the reason of this, in the first place it is known that a vomiting ensues upon the Head's being injur'd, viz. after a stroak, Wound, or a fall from an high place; nevertheless, a pain of the Head seldom or never follows a vomiting, Cardialgia, or the Sto∣machs being otherwise troubled, unless an effervescency of the Blood happens. Wherefore, in the foresaid case of the Person diseas'd, since it plainly appear'd that the Meninges of the Brain were predispos'd for Head-aches, and that its Fits had raised an agitation of the Blood; hence it will be obvious to conceive, when the heterogeneous Parti∣cles by reason of the fault of Chylification, were heap'd together in the mass of Blood to a fulness, presently upon its beginning to flow in

order to the expulsion of that which was offensive, they being severed from the blood, as disagreeing with it, and partly being sent from the Arteries into the Ventricle, stirr'd up its ferment, and so produc'd hun∣ger, and partly rush'd into the predispos'd Meninges of the Brain, and there depos'd the fuel, or rather incentive of the Head-ach which was presently to ensue. This Patient loathing all Medicines, and refu∣sing undergo any method of Cure, became at length also obnoxious to paralitical and convulsive affects. From what is said it will be ea∣sie to give the Aetiology of any other Head-ach; viz. hypochondria∣cal, hepatical, or otherwise sympithical, so that it will not be needful to add here more Hystories or Observations.