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. Of the Signs and Cure of the putrid Synochus, or continual Fever.

BEsides what is said before of the putrid Synochus in general, there are moreover certain Varieties, or Irregularities (not to say Species) of this Disease, by which this Fever somewhat de∣clines from this common Rule; and by reason of certain accidental Affects, gets new Names and Distinctions.

First therefore, a putrid Synochus is wont to be divided into a symp∣tomatick and an essential one. That is said to be symptomatick which draws its Origine from some other Affect or Disease first raised in the Body; so that the Fever is only the symptome coming upon that other Affect, as that is accounted which depends on a Squinancy, Plurisie, Wound, Ʋlcer, &c. in or near some principal Part; of which we think somewhat otherwise; to wit, that in Truth there is no Putrid Fever which is merely symptomatical; occasionally perchance it may arise from some other Affect; but it is founded immediately in the sulphu∣reous part of the Blood too much heated, and as it were kindled: for, without a Procatarxis or precedent Indisposition of the Blood, the foresaid Affects seldom, or scarce at all, bring a putrid Fever.

As to the Squinancy, Plurisie, and the like, I say that those are Products of the Fever, or Affects following it, but not Causes of it; for most commonly an evident Cause has preceeded, which has pro∣duc'd the feverish Effervescence of the Blood, as a taking of Cold, an Evacuation restrain'd, &c. afterward, tho the Diseas'd are not forth∣with openly feverish, nevertheless, a greater Ebullition of the Blood than usual is raised; as we may easily gather from the Urine, Pulse, and Restlesness of the whole Body. After some Days, (sometimes sooner, sometimes later) an Inflammation is produced in this or that part; whereof a probable Reason enough is thus assigned: The Blood by reason of the Effluvia retained (which are like a Ferment) is in∣creas'd in bulk, and swells its Vessels more than usually; and when through defect of Ventilation, it is straitned in the space of its Circu∣lation, it readily finding a way, springs forth of the Arteries; and be∣ing extravasated, upon the course of Circulation its being interrupt∣ted, it is raised into a Tumour; and because by that kind of Tumour a Heat and Pain in the Part are made more intense, the Blood is more troubled in its motion, and so the Fever, first kindled, is more aggra∣vated.

Moreover, in these kinds of Fevers we may observe a certain apt∣ness of the Blood to coagulate, whereby it becomes less fluxile, and so apt to be congeal'd in the lesser Vessels: even as we find in Milk when it begins to turn sour, for then it cannot be boyl'd nor warm'd on the Fire without coagulating: in like manner we have reason to suspect in the Blood also a certain Diposition to turn sharp, by reason of which it is obnoxious to coagulation; for it plain enough appears, that in the Phrensy, Peripneumonia, Squinancy, and the like Disea∣ses, an Inflammation or Extravasation of the Blood does not always depend on the exuberancy of the Blood, and the plenitude of the Ves∣sels: for often with a weak Pulse, and a subsiding of the Vessels, the Blood is stopt in its Motion, and being extravasated in the side or else where, causes an acute pain.

It only remains for us to enquire whether the Fever which accom∣panies these affects, be to be accounted of the number of those which are called putrid, or not; To this we reply, that oftentimes they are simple Synochi, in which only the subtle and more spirituous part of the Blood is inflamed, and therefore, if after a copious taking away of Blood, or the Vessels being emptyed by sweat, the extravasated, Blood be restor'd to Circulation, presently the Effervescence is restrain'd, and the Fever in a short time is appeas'd: Nevertheless sometimes when a Predisposition happens, as in a Plethora, or mighty Cacochymia, a putrld Fever is kindled together with these kinds of affects wholly from the same occasion.

Among Symptomatick Fevers they place that which is vulgarly call'd Febris Lenta, those that are troubled with this grow hotter than they ought, especially after Meats, or any Motion, or Exercise, the Urine for the most part is ruddly, the Spirits are weak, and the Strength de∣jected; as to Appetite and Sleep they find themselves indifferently well, they are without a Cough, or much Spitting: but daily (like consumptive Persons) they pine away, and without any manifest cause: the fault for the most part is ascribed to Obstructions in some one of the Viscera (suppose the Liver, Spleen, or mesentery) by whose default, the Food is not well concocted, nor duely dispen'd: but it seems to me that this kind of affect is immediately founded in the evil Disposition of the Blood, whereby it inclines to an over-salt and sharp Temper, and therefore is rendred less apt for Nutrition, and an even Circula∣tion.

But the Fever which most deserves to be called Symptomatical, is that which is raised in Ptysical Persons from an Ulcer or Consumption of the Lungs: for the Blood, whilst it wholly passes through the Lungs in its circulation, often imprints on this entral the Ideas of many Di∣seases; and on the contrary, from the Lungs being ill affected, it re∣ceives the same. Whatsoever impure is contain'd in the Mass of Blood is cast forth of the extremities of the Arteries, as the flowrings

of new Wine: Wherefore, when Nature being become weak, is not able to convey its Recrements to the superficies of the Body, it deposes the same in the Lungs by a nearer way of purging it self. Hence a mighty Cacochymia, and many Cronick Diseases frequently end in a Ptysick. In like manner, when the flesh of the Lungs con∣sumes, or abounding with an ulcerous Ichor, is become half rotten, the blood passing through it is infected with the purulent matter, or the consumptive filth, and consequently is put upon a continual Effer∣vescence, by reason of that immiscible Substance being confounded with it, wherefore it brings an assiduous Fever, and wholly perverts the nutritive Juyce: the like reason holds concerning Fevers caused from an Ulcer, or Absess often hapning in other parts: for those even as the consumptive Constitution of the Lungs, often bring the Ptyfick, or hectick Fever: a full consideration of these things belongs not to this Place, wherefore let us return to the putrid Fever properly so call'd, or essential Fever.

The essential putrid Synochus is wont to be divided into the putrid (such is above describ'd) inot the Causus or most sharp burning Fe∣ver, and moreover into the quotidian, tertian, and quartan. The pu∣trid Synochus even now describ'd ought to be the Rule or Square of the rest, according to the Type of which, for the most part Fevers which are of this kind are compounded, as to the rest even now mention∣ed, I shall briefly set them down according as they vary their Spe∣cies.

A Causus or burning Fever is that which performs its course with a great burning, an intollerable Thirst, and other Symptoms shewing a mighty Inflammation of the Blood: its formal Nature wherein it's dif∣ferent from the rest, consists in this, that the temper of the Blood in those that are affected with it, is hotter, that is, it more abounds with a combustible Sulphur; therefore when it rages, it is kindled in a grea∣ter plenty, and by its burning diffuses Effluvia's of a most intense heat throughout the whole Body; its Motion is acute, and soon comes to its height, it is attended with more horrible Symptoms than others, it has a difficult Crisis, and its event is very dangerous.

Now as to what regards those periods or paroxisms in which a putrid Fever now and then at a set time is wont to have a sharp fit, and (in∣termitting, as it were) sometimes every day, sometimes every other, or fourth day resumes its febrile accension as it were: the reason of this which seems to me most likely, is as follows. In a continual Fever there are two chief things (as we have hinted above) which for the most part cause the Effervescence of the Blood, viz. an exaltation and ac∣sion of the sulphureous part in the Blood; and then consequently a heaping together of the adust matter remaining after the deflagration of the Blood, to a Turgescency: on the former, the continuity of the Fever, on the other its height and critical Perturbations depend: to

these sometimes a third thing is added, to wit, a fulness and turges∣cency of a crude Juice from Aliments fresh gathered together, which at set intervals of times causes a greater effervescence in a continual Fever (as in the fits of Intermittents.)

Concerning the Cure of putrid Fevers of what kind soever, there are four general intentions, on which the whole stress of the Business lies. First, that the Blood (if it may be) be freed from its burning, and that the Flame or Fire kindled in its sulphury part be wholly supprest, which often happens to be done about the first beginnings of this Di∣sease. Secondly, that when the Blood, being set a burning, cannot presently be extinguisht, it may go on with it at least mildly, and with as little dammage as may be. Thirdly, that the burning being over, the Liquour of the Blood may be clear'd of the Recrements of the burnt and adust Matter, and be restor'd to its natural Vigour and Crasis. Fourthly, that the Symptoms chiefly pressing be seasonably obviated, without the removal of which the attempts both of Nature and Physick will be in Vain.

As to the particular Remedies, with which those intentions are ans∣wer'd, there are various Prescripts, and Forms of Medicines every where in use, not only amongst Physicians, but likewise old Women and Empricks; from which nevertheless, in regard they are us'd like a Sword in a blind Mans Hands, without differences, and an exact Me∣thod of Healing, more dammage than benefit often accrues to the Di∣seased. It will not be needfull for me to repeat in this Place the Forms of Purgers. Cardiacks, or other Medicines neatly enough delivered in many Authors. I shall briefly set down some of the chief Indications, and Physical Cautions which ought to be observed in the course of this Fever, according to the various Seasons, and divers Symptoms of it.

1. About the first Invasion of this Disease, you must endeavour that the Fever be forthwith supprest, and that the inflammation of the over-heat∣ed Sulphur may be stopt; to which breathing a Vein chiefly conduces; for by this means the Blood is ventilated, and the hot Particles too much crowded together, and even ready to fall a burning, are dissipated from each other, as when Hay, being apt to take on Fire, if it be expos'd to the open Air, its kindling is prevented: Moreover, let a thin diet be ordered: in which nothing spirituous or sulphureous ought to be us'd: let the Viscera and first Passages be freed from the Load of Excremen∣tious Matter; Wherefore Clysters will be of necessary use, sometimes also Vomits, and gentle Purges, which being now and then given sea∣sonably and with judgment, the Fever presently at the beginning, its Fuel for accension beig withdrawn, is extinguisht. But if notwith∣standing this Method the burning gets Ground, and daily more and more lays hold on the sulphureous Particles of the Blood: let it be pro∣cur'd

(as far as may be) that the deflagration goes on gently without any great Commotion.

2. Wherefore, when the Fever is in its Increase, if the Blood boyls too much, and very much extends the Vessels with a strong and ve∣hement Pulse, if Watchings, a Frenzy, or Head-ach, violently press, bleed a second time, and let as free a Transpiration (as may be) be procur'd: wherefore, let the Diseas'd, for the most part, lye in Bed, let the Diet be sare, of very thin Food; also, let the Drink be small, and plentiful, that the burning Blood may be freely diluted with Se∣rum. Clysters are given with Safety, and indeed, with good Effect; but let Medicines, whether Catharticks or Diureticks, and which too much exagitate the Blood, be avoided with the same Industry as Blasts of Wind are where Houses are on fire; nay, rather Opiates and Anodines, which fix and constipate the Blood and Spirits, are to be used: also, Juleps and Decoctions, which cool the burning Bow∣els, qualifie the Blood, and refresh the Spirits, are frequently to be given. Acetous Liquors of Vegetables or Minerals, also Nitre puri∣fied, because they restrain the burning of the Blood, and quench Thirst, agree well: let hot and spirituous Waters, cordial and Bezoar∣tick Powders (so the Disease be without Malignity) be let alone. In case the Blood circulates unevenly, and be carried more violently to∣ward the Head than the Feet, Epithemes of the warm Flesh, or In∣wards of Animals, applyed to the Feet, do well.

3. When the Fever is at its height, let the motion of Nature be diligently minded, whether it be about to make a Crisis or not; wherefore, nothing is to be attempted rashly by a Physician: breath∣ing a Vein, or strong Purging, are wholly forbidden: but aftenward, when the burning of the Fever is in some measure remitted after the Deflagration of the Blood, and signs of Concoction appear in the Urine, in case the Motion of Nature be sluggish, a Sweat or gentle Purge may be procured, which, nevertheless, are performed better, and with more Safety, by a Physician, when Nature before, by a cri∣tical motion, has set upon a seclusion of the morbifick matter. But if all things are crude, and in a Perturbation, the Urine be still troubled without a Sediment or a Separation of Parts, if the Strength be faint, the Pulse weak, if no Crisis, or only a fruitless one, has preceded, any Evacuation, either by Sweat, or Purging, is not attempted with∣out manifest Danger of Life: but we must expect longer, that the Spirits of the Blood may recover themselves, and in some measure subdue the recrementitious and adust Matter, and afterward, by de∣grees, separate them; mean while, let the Strength be refresh'd with temperate Cordials, let the immoderate Effervescence of the Blood (if it be so) be stopt; and let its due Fermentation be upheld, which, in truth, is excellently performed by Coral, Pearl, and those kinds of Powders, which are dissolv'd by the Ferments of the Viscera, and

afterward ferment with the Blood, and greatly restore its weak and wavering Motion. Mean while (whilst Nature labours) let all Ob∣stacles and Impediments be removed, and especially let the store of Excrements heapt together in the first Passages, be withdrawn by the frequent Use of Clysters.

4. After what way or method the Symptoms chiefly pressing ought to be handled, it is not an easie thing to prescribe by certain Rules; because the very same sometimes require to be forthwith restrain'd and appeas'd, sometimes to be moved on faster: and those that have somewhat greater in them, haply ar another time are to be left whol∣ly to Nature. This, in some, may be obviated with asswaging and le∣nifying Remedies, but in others with a rough and irritating Physick: mean while, it is a Precept to be stood to in all, that we religiously follow the Footsteps of Nature: which, if it acts amiss, its Disorder is to be reduced; if rightly, but too vehemently, it is to be cheekt; and if rightly, but slower or weaker than it ought, it must be our bu∣siness to encourage and aid its Effort by physical means.

5. In the declining state of a Fever, when after a perfect Crisis, Na∣ture has gotten the upper-hand of the Disease, things are in Safety; nor is there much left for a Pyhsician to do: it only remains, to pro∣pose an exact form of Diet, that the Diseased may soon recover their Strength without fear of a Relapse: also it is good to clear the Re∣mainder of the febrile matter by a gentle Purge. Concerning the Diet, Men very often incur a Relapse, to wit, by an over-hasty eating of Flesh or strong Food, the Diseased fall back into the Fever; for since the Viscera are weak, and do not easily concoct Food, (unless it be very thin) and since the Crasis of the Blood is so weak what it does not assimilate a strong nutritive Juice, if any thing disproportionate be brought to either, the oeconomy of Nature is again perverted, and all things run amiss. Wherefore, let such as are upon Recovery frobear a long time from Flesh, and let them not use it till their Urine is become like that of sound Persons, and is no longer troubled by the Cold: and indeed, then it will be better to begin with diluted Broth of Flesh, and afterward by Degrees to rise to stronger Aliments.

6 When, after an imperfect Crisits, the thing hangs in doubt, and is not yet come to a Determination, then the Physician has a hard Task: let a diligent Eye be had to the motion and strength of Nature, whether it begins to prevail over the Disease, or yields to the same: if there are signs of Concoction, and the Strength holds good, a gen∣tle Evacuation, and only per Epicrasin, is to be put in practise: mean while, let the chiefly pressing Symproms be obviated by fit Remedies, let all Impediments be removed; let the Strength be upheld, as much as may-be, by Cordials, and a true method of Diet.

7. When after an evil or no Crisis all things grow worse, and when the Physician, in a manner, despairs of the Cure of the Disease, he may declare the event of it to be suspected, and greatly to be feared: nevertheless, we must not so yield to a bare Prognostick that Fear shall put us by of all things else; but still, as much as lies in the Art of Physick, let Care be taken for a Recovery, tho the Case be desperate; let Remedies be used to the Symptoms that are most dangerous; let the Spirits of the Blood, almost extinct, be reinvigorated with Cor∣dials. When we despair of a Recovery, let Life be drawn out in length as long as it may be, at leastwise let an easie Death be pro∣cur'd.

I shall now briefly give you some few Examples having regard to each Species of the foresaid Fever.

A noble Matron, about fifty Years of Age, of a thin habit of Body, a low Stature, and a fresh coloured Countenance, having cloathed her self thinner than usual on the fifteenth day of June, by reason of the Summer-heat, in the Evening was taken ill, and upon it, was seised with a Nauseousness, and an Oppression of the Stomach: she had wandring Pains troubling her sometimes in the Shoulder-blade, some∣times in the Back, being very thirsty, tho without any immoderate Heat. On the second and third day she found her self almost after the same manner. On the fourth day, after a Vomit given her, viz. un ounce of the Infusion of Crocus Metallorum, she vomited four times a yellow Choler, and purging thrice by Stool, she seemed to receive ease: the following night she slept somewhat better; but the next day, the Fever being kindled throughout the Body, she complain'd of a Thrist, a burning of the Praecordia, and of a Pain sometimes in the Side, sometimes in the Back, presently eight Ounces of Blood were taken from her; her Urine was of a very saturated Redness, opake, and troubled, without an Hypostasis, or subsiding of the Contents; the Pulse was uneven, and often intermitting: the following Night was without Rest. On the sixth day of the Disease, early in the Morning, a small Sweat arose, whereupon the Heat became somewhat more mild, which grew more intense again in the Evening. On the seventh day there was a very sharp Heat, with a Thirst, Burning, a disorderly and intermittent Pulse also a mighty Restlessness of the whole Body. On the eighth, the Symptoms were somewhat more remiss; also in the Urine there were some Tokens of an Hypostasis: she took on that day, Whey with the Leaves of Meadow-sweet boyl'd in it; she sweated freely; the Fever came to a Crisis. All the time of her Sickness her Diet was only small Ale, Whey, Barley and Oat Broaths; Clysters were frequently us'd; Drink and cooling Juleps were given her at her Pleasure.

About the beginning of the Summer, Anno 1656. a worthy Man, of an athletick habit of Body, without any manifest Cause (unless that

being very much addicted to Study, he used no Exercise besides) fell ill: first he complain'd of a Nauseousness and a want of Appetite, with a violent Head-ach. On the second day he was affected with a cold Shivering, sometimes with a heat coming upon him by Turns; and likewise with a Thirst, and burning of the Praecordia, with a rough∣ness of the Tongue, and an ingrateful Savour: on that Day he took ten Drams of an Emetick Liquor, after which he vomited seven times, and threw up a mighty quantity of yellow Choler, and had four Stools: the Night following was restleAss, and in a manner without Sleep; at which time, the Diseased, the heat being increast, grew more intensly feverish. On the third Day, when the foresaid Symptoms increast, ten ounces of Blood were taken from him: his Urine was reddy and thick, with a copious Sediment; the Pulse was quick and vehement; in the Night he sweated a little, with a short, but troubled, Sleep: the Morning following the seemed somewhat relieved; but in the Evening all things grew worse again, with Watchings, and a most intense Heat and Drought. On the fifth day, after a light Sweat, the burning somewhat remitted; which, nevertheless, return'd again with its wonted Fierceness a little before the Evening; the Night again was without Sleep, with an almost continual tossing of the Body: in the Morning, upon a gentle Sweat, he found a little Relief; in the Evening again there was an Exacerbation of all things; the night also was very restless. About the beginning of the Day following a Sweat happened as before, and somewhat more plentifully: this day there was a manifest Change toward a Recovery; the Heat and Thirst aba∣ted by degrees; the Urine was less ruddy, with somewhat of an Hy∣postasis: afterward, for three days, the Fever leisurely declin'd; yet he had every Night a certain Fit, tho more remiss than before. On the eleventh Day he sweated more freely, and came to a perfect Crisis. During the whole time of the sickness he used a very spare Diet, as desiring no Food but small Ale, and Whey made with it: he took now and then cooling Drinks, and Juleps of a Decoction of Barley, and distill'd Waters; every day, if he had not a Motion to Stool of his own Accord, an emollient Clyster was injected: he used no Medi∣cine beside, viz. either Cathartick or Cardiack; but the Fever being over, he was twice purg'd, and afterward soon grew well.

A young Student, about twenty five Years of Age, of a pale Coun∣tenance, and a melancholy Temperament, without a manifest Cause, in August, 1656. began to be sick: first he complain'd of a feverish Di∣stemper, with a Thirst, a spontaneous Lassitude, and a want of Ap∣petite. On the second day he was troubled also with a Pain in the right side, and a Distension of both Hypocondres, also with an almost continual Vomiting, Watchings, and a violent Head-ach. On the third day, a Physician being called, presently twelve Ounces of Blood were taken away: in the Evening he grew hotter and deliri∣ous;

afterward a Sweat, tho small, hapning, he was better the next Morning. On the fourth day, he presently threw up again whatso∣ever was given him, and was troubled with an almost continual stri∣ving to vomit; the giving of a Vomitory being propos'd by the Phy∣sician, both the sick Person, and his Friends, refused to admit of it, being taught by Experience of the Danger of it before: a Clyster be∣ing given him, he had six Stools, and seem'd to be somewhat relie∣ved, and the Night following he slept a little. On the fifth day again there was a frequent Vomiting, with a continual Thirst; he burned inwardly; but the sense of that immoderate Heat was not per∣ceivable outwardly to the Touch, because the Recrements of the boyl∣ing Blood, which ought to have breath'd forth through the skin, seemed to stagnate within, and so float the Viscera; therefore in the Evening, for provoking a Sweat, this Bolus was given, Conserve of Ro∣ses vitriolated a dram, Gascoins Powder a Scruple, Laudanum dissolv'd in Bawm Water a Grain: That Night he slept indifferently, and a co∣pious Sweat ensuing, the Symptoms seem'd to be mitigated: never∣theless, on the sixth day all things grew bad again; a Heat through∣out the whole Body, a Thirst, and a burning of the Praecordia prest violently. On the seventh and eighth days the Pulse was uneven and disorderly: for the most part, he spoke delirous, and if he was stirr'd in his Bed he fell frequently into a fainting Fit. On the ninth Day the same Symptoms continued; moreover, he was troubled with a Contraction of the Tendons, in the Wrists, and with Convulsive Mo∣tions of other Parts, so that we despaired, in a manner, of his well∣doing. That Morning, because Nature seemed to yield her self over∣come, it concerned us to do what Art could afford; wherefore, in∣tending a copious Sweat as the last Refuge, I gave him at one taking, a Dram of Spirit of Hart-born in a little Draught of a Cordial Julep; from thenceforward, for four Hours, being very restless and raving, he could scarce be kept in Bed; but afterward, Sleep stealing upon him, he sweated very much, and his Case was soon brought to be out of danger: the following Night, in order to continue the Sweat, I ordered a Dose of the Powder of Contrayerva to be given him every six Hours. The Fever, and the Affects of the Genus Nervosum, ceas'd in a short time, and the sick Person recovered.

A Woman about thirty Years of Age, of a robust Body, and a melancholy Temperament (as we might guess from her very austere way of Behaviour) in the third Month after Child-birth, as she gave her Infant suck in the Night, the Cloaths falling from her, took Cold, and shortly upon it fell into a cold Shivering; a Heat, greater than usual, followed it, which afterward (a gentle Sweat arising) soon re∣mitted. On the second and third days she was very thirsty, and had no Appetite, tho without any immoderate Burning, that she scarce yet believed her self in a Fever; every Night she lay quiet, but

wholly without Sleep, the Urine was intensly ruddly, and somewhat thick and opake through the multitude of contents, which neverthe∣less being not disturbed by the cold, continued still after the same man∣ner without an flypostasis or subfiding of the parts: on the fourth day, the heat was, kindled throughout the whole, wherefore a Physician being then first called, about twelve ounces of Blood were taken from the Arm: after the letting Blood, and the Belly being co∣piously emptyed the same day by a Clyster given, in the Evening she fell into a Sweat, by which Nevertheless being not relieved, she past the Night without Sleep as before, tho an Anodyne Medicine were given her: on the fifth day, after a Clyster injected she had three stools, and found ease: the Urine still continued the same, ruddy and troubled: when it was prescribed her to have Blood taken from the Vein running under the Knee, the Diseased earnestly refused it, thinking herself upon a Recovery: the Night following, after that she had lain with∣out Sleep, and restless for a long time, at length she fell into a sore fit, such as is vulgarly said to be Hysterical, and in the first place she was affected with a certain Numness or a Sense of pricking, which seised the extream parts of the Body, especially the Feet, Leggs and Thighs, and withall with a Flatus violently distending the Intestines, Ventri∣cle and Hypochondres: she selt in the lower part of her Belly a cer∣tain great and heavy things, as it were, to rise up gently, which when it was risen to the Heart, and thence to the Brain, presently the Di∣seased failed in her Understanding, and for all the Night afterward lay delirous and talkt light-headed: on the sixth day, after the Belly's be∣ing loosned by a Clyster she came to her self again, was very sound in her Mind, and seemed to be indifferently well: but in the Evening, as she was moved in her bed, she began to feel an invasion of such a kind of fit, as before, to wit, in her whole Body she had a sense of Pricking, as tho she were stung with Nettles: and withall in her Bel∣ly she felt a Ball, as it were, which creeping upwards distended the in∣testines and Ventricle, so that store of Flatus'd and Belchings were thence caused: for relief she desired cold Water might be given her to drink, moreover Remedies usual in Hysterick Affects, as Castoreum, a smell of Assafetida, Fumes of Feathers burnt, Ligatures, and Frictions of the Legs and Thighs, and the like things were used, by which she seemed for the present free from the said affect, and was wholly cleared from it for four hours; but as she lay on her Back in the Bed, settling her self to sleep, on a sudden she complained that the same Symptoms pervaded her whole Body together, and presently upon it fell into a Delirium, all the night without sleep, howling and crying, she talkt light-headed; on the day following, she lay with her Eyes open, without Motion or Speech; in the Evening again, as the Fever increast, the Diseased grew raving, that she could scarce be kept in her Bed; and so for three dayes, sometimes she lay delirous, orying and

howling, sometimes stupid as it were without Motion or Speech, but still she was troubled with convulsive Motions about the Tendons of the Muscles; on the tenth day she feteht her Breath deep and short, with a weak, and as it were formicating Pulse, in the middle of the night she dyed.

A Learned Young Man, of a thin habit, and a pale Countenance, in the beginning of the Spring, not being conscious of any errour in Diet, began to complain of a Lassitude and a Debility in walking, also of a Drowsiness of his Head, and a Sleepiness: on the second day he was withall tormented with a Thirst, a loss of Appetite, and a burn∣ing of the Praecordia; on the third day, a Physician being called, he took a Vomitory, after which when he had thrice vomited, and had voided five times by Seige hot and bilous Excrements, he became somewhat more cheerful, and the following Night slept indifferently well: on the fourth day he bled a little at Nose: afterward the Thirst and Heat were very much increas'd: the Urine was ruddly, with a copious Sediment and somewhat of an Hypostasis: but because after signs of Concoction in the Urine there appear'd an effort of Nature, opprest as it were, for voiding something without a sufficient Evacua∣tion, therefore seven ounces of Blood were taken away, and thereup∣on he seemed to be very much relieved: Nevertheless, in the Evening all things grew worse, and thence forward for three dayes the Fever seemed still to be rendred more intense, on the seventh day he com∣plained of a great Drowsiuess in his Head, and of a Dimness in his Eyes: in the After-noon a very large Haemorrhagie happened, that through the vast loss of Blood the strength of the Diseased was almost wholly spent, and there was an extream need of physical aid for stop∣ping the Blood: for this purpose, when Blooding in the Arm, Ligatures, Evithems applyed both to the Head and the lower part of the Belly, and a great many other Remedies (the instantancous occasion of Cure pres∣sing for it) prescribed by all Persons, were tryed in Vain; at length, by the persuasion of a Woman being there by chance, a red hot Iron was held to the Nose as it dropt, and on a sudden, upon the receiving of the Fume of the burnt Blood into the Nostrills, its Flux was stopt: I have known this Remedy used since in many others with good suc∣cess: by that copious Haemorhagy the contrinual Fever came to a Crisis; tho an intermittent Quotidian followed it, which after∣ward was soon cur'd according to the Merhod above delivered.

A Matron sixty years of Age, lying a certain night in Sheets not well dryed, began to be ill: first she was affected with a suffocating Catarth, that through the serous Mass of filth distilling on the Larynx, she could soarce breath, much less fleep: the next day after she had a Nauseous∣ness and a want of Appetite, with somewhat of a Thirst and an Excess of Heat: on the third day an acute Pain seized her fide, with a Cough and an increase of the Fever, the Urine was ruddy, and clear, with a

laudable Hypostasis; the Pulse was uneven and intermitting. A Phy∣fician being called, ten Ounces of Blood were taken away; also, on that day a Clyster being giv'n, she purg'd freely: about night the Pain vanish'd, and she slept indifferently: the Urine then was ruddy, troubled, and filled with Contents. On the fourth day the Fever was somewhat more increast; in the Evening the Cough was very troublesome, being followed with an acute Pain in the same Side as before; the Urine was again with an Hypostasis: the Pain, upon letting Blood again, soon ceas'd. On the fifth Day the Fever was some∣what more remiss; yet the Night was restless with a Heat and a Tos∣sing of the Body, but without Pain: the next Morning she sweated freely, and was relieved: afterward, by a thin Diet used for some Days, and being once pnrged, she recovered without a Relapse. It is worthy to be observ'd, that the Pain pressing, the Urine was clear, and with an Hypostasis; nor was it troubled by the Cold: which nevertheless, the same being appeased, presently grew thick and more ruddy, and fill'd with Contents.

A robust Young-man, and well in Flesh, about the Summer Solstice, after immoderate Exercises, and then a sudden Cold coming upon the Heat, fell ill. First, he was affected with a loss of Appetite, a Nauseousness, a violent Pain of the Head, also with a Thirst, and a Heat more intense than usual. On the second day, an acute Pain in the Right-side, with a Cough and a difficult Respiration, seized him; Blood presently being plentifully drawn from the Arm of the same Side, that Pain somewhat remitted; which nevertheless, returned more violently in the Evening, with a Cough and a spitting Blood; the night past without sleep, and very restless. On the third day Blood was taken away again; and moreover, Liniments and Fomen∣tations were applyed to the Side pained; Antipleuritick Powders, Ju∣leps, and Decoctions, were inwardly taken: about night, the Pain, in a manner, wholly ceas'd; presently after, the Diseased was affected with a violent Head-ach, and a Vertigo. On the fourth day he bled two ounces of Blood at the Nose; after which, that Affect of the Head clearly ceased; but in the Evening the Pain returned in the Side first affected, with a greater Fierceness: mean while the Pulse was low and weak; that when it was consulted concerning letting Blood, there was danger lest the dejected Strength would not admit of such a Reme∣dy; wherefore, Blood being taken only in a small quantity, it was prescribed, that a Fomentation and Cataplasmes should be diligently applyed to the Side; moreover, that twenty Drops of Spirit of Harts∣horn should be given in a Spoonful of a Cordial Julep, and that the same should be still repeated every six Hours: he sweated plentifully that Night, and the Pain very much abated; the Spittle was but little, sprinkled with Blood, which wholly ceas'd within a Day, the Pain al∣so vanishing by Degrees: the Diseased took twice a day a Scruple of

the same Spirit of Harts-horn, and perfectly recovered within a few Days, without a Relapse.