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. XIII. Of pestilential and malignant Fevers in Specie, and other Epidemick Fevers.

AFter having explicated the Nature of the Plague, according to the Order of our Tract, we ought to proceed to those Affects which seem nearest to carry its Nature; as are chiefly the Fevers called Pestilential and Malignant: for it is vulgarly known, that Fevers sometimes reign among the People, which for the Vehe∣mency of Symptoms, the mighty Slaughter among the Diseased, and the force of the Contagion, scarce yield to the Pestilence; tho because they imitate the Types of Putrids, nor do not so certainly kill the Affected, or infect others, as the Plague, they do not deserve the name of Plague, but in a milder Appellation, of a Pestilential Fever. Be∣sides these, there are Fevers of another kind, whose Destruction and Contagion are more remiss; yet because they are more dangerous than Putrids, and contain somewhat of Divine in them, as Hippocrates calls it, they are called, in a lower Expression than the others, Malignant Fevers.

These Fevers differ doth from the Plague, and from each other, ac∣cording to the Degrees and Vehemency of the Contagion and Destru∣ction; so that the Plague is a Disease contagious, and destructive to Mankind in the highest Degree: A Pestilential Fever is that which ge∣nerally reigns with a less Diffusion of its Miasm, and with a less Mor∣tality: when an Infection is only suspected, and only a treacherous or unsafe Crisis happens, above the Events of vulgar Fevers, it is said to

be a Malignant Fever: They may be describ'd yet more fully, thus:

When a Fever vulgarly reighs, which for the variety of Symptoms carries the Nature of a Putrid so called, viz. which has a Thirst, Burning, Lassitude, restless Pain, a Roughness of the Tongue, Watch∣ings, a Frenzy, Vomiting, loss of Appetite, Fainting, Swooning, a Cardialgia, and the concourse of other terrible Accidents joyn'd with it; if moreover, there be added to it Spots either like small Flea∣bites, or broad and black and blue like the Impressions of Stripes; we esteem this Disease of an ill Nature: again, if it does not discover it self after the wonted way of Fevers, but the Strength of the Sick falls without a manifest Cause, and Death often happens on a sudden, and unsuspected, contrary to the Prognostick of the Physician, there grows still a greater suspicion of Malignity: but if most of the Sick dye, and those that converse with the Diseased take the Infection of the same Disease, so that oftentimes the same runs through whole Parishes and Cities, it is called, above the Appellation of a Malignant, a Pestilenti∣al Fever; of which, a farther Proof is made if it generally rages in most with some common Symptom, as with a Quinsey, a Dysentery, or if a mortal Sweat, such as heretofore was famously known in Eng∣land, accompanies these kinds of Fevers.

But if a Fever arises, which affects many together living in the same Region for the most part after the same manner, which nevertheless in its Course observes the laws of a vulgar Putrid, and comes to a Crisis almost after the same manner, (but that in some, troubled with a mighty Cacochymia, it discovers certain signs of Malignity by an ap∣pearance of Spots or Buboes, sometimes by a mortal Crisis, and a Contagion spreading to others) this is not called a petilent, but only a Malignant Fever.

If it be enquired in which Classis of the Fevers above treated off, Pestilent and Malignant Fevers are placed, we put them only in the Rank of Continual Fevers, and exempt Intermittents from them, be∣cause by Intervals these grant such firm Truces to Nature, and likewise observe regularly and exactly their Periods, which will not consist with a venemous Diathesis: we exempt also Hecticks from Malignity, because otherwise they would not protract Death so long, but, parta∣king of Venom, would kill sooner. Of Continual Fevers, tho we do not look upon Simple Sinochi, as free, yet we assert them to be seldom touch'd with this Taint; but most commonly, the Fever which gives marks of a pestilent Nature or Malignity, is such as imitates the Type of that we call a Putrid Fever: for since in these Fevers, besides the Phoenomena of a Virulency, we observe a continued Effervescence of the Blood, which, as in Putrids, passes through the Stages of a Be∣ginning, Increase, Height, and Declination, we justly conclude, that the sulphureous part of the Blood here, is heated, and kindled, and by

its burning brings the Fever: wherefore, in these kinds of Fevers two things are chiefly to be noted, to wit, the Effervescence of the Blood, and a Malignity joyn'd with it, of which sometimes this, sometimes that, excells, and in both there is a great Latitude, and there are many Degrees of Intension, according as the Fever becomes more or less acute, or malignant.

The Effervescence happens after the same manner, as it is said before of putrid Fevers, to wit, the sulphureous part of the Blood, growing hot above measure, by its fervour, takes to a Flame, as it were; whilst it burns it heaps together a vast Store of adust Matter in the Blood; on the subduing and exclusion of which, after the wonted manner of Fevers, the height and Crisis depend but besides, the Blood being infected with a certain venemous Miasm, begins, in burning, by reason of the malignant Ferment, to be coagulated, and to putrifie by Parts: wherefore, besides the usual Symptoms of a vulgar Fever, by Rea∣son of certain Portions of the Blood being congealed, or mortified, a Fainting and Dejection of the Spirits, also Appearances of Spots and Marks ensue. Moreover, the Venemous Effluvia, which part from the Diseas'd, by the force of the Contagion, are able to stir up the like Affect in others: wherefore, by reason of the Destruction and Conta∣gion, and the various Degrees of the same, it is call'd a Pestilential or Malignant Fever.

When the Blood, boyling over vehemently, is infected also with a malignant and venemous Ferment, not only Coagulations of its own Mass, with a Disposition to a Putrefaction are caus'd, but the nervous Liquor also readily contracts this Taint; whence being rendred dispro∣portionate to the Brain, and for the oeconomy of the animal Spirits, it stirs up great Irregularities in them: wherefore, not only Spots and Pushes, but oftentimes a Delirium, Frenzy, drowsie Affects, Tremblings of the Limbs, Cramps, and convulsive Motions, happen upon these Fevers. We often observe, that in certain Years malig∣nant Fevers are rife, which without an appearance of Marks, shew their Virulency chiefly about the Genus Nervosum; for in some, pre∣sently from the Beginning, a Sleepiness, with a mighty Drowsiness of the Head, in others obstinate Watchings, a Disturbance of Mind, with a Trembling, and convulsive Motions: but in most, either no Crisis, or a deceitful one; and instead of it, a Translation of the se∣brile matter to the Brain has followed. It has been farther observ'd, that these Fevers have past by Contagion into others, and that many have died of them; so that they deserve to be call'd Malignant.

Now these kinds of Fevers sometimes are first begun by a vene∣mous Miasm; and the Blood being blasted with the Particles of the Poyson, naturally falls into an over-vehement boyling, and is infla∣med; as when any one, by a Contagion, or by breathing a malignant Air, falls into a malignant Fever, without an evident Cause, or Prae∣disposition:

and sometimes a feverish Distemper arises from its own cause; and afterward the Seeds of the Malignity, either lying hid within the Body, exert themselves in the Blood boyling over vehe∣mently, or come from elsewhere from a contaminated Air, as a Few∣el to a Flame first kindled: for it is manifest by frequent Observation, that during the time an Epidemick Fever reigns, others, after what manner soever they arise, pass into it.

Malignant Fevers, as also Pestilential, for the most part are Popular, and seise many together; but sometimes they are peculiar and spora∣dical, that haply they seise only one or two in a whole Country. In such a case we may imagine, that they proceed, not from an Infected Air, or Epidemick Cause, but from a morbid Disposition of the Bo∣dy; for I have often observ'd, that when, Spring or Fall, a pretty common Fever has reign'd in some City, or Village, of which a great many Sick escap'd; haply some one, on whom an evil Praedisposition, and a strong evident Cause, brought the Fever, lay seis'd with more dreadful Symytoms, and great Notes of Malignity: in which Case, that Malignity is not to be said a common Fever, but only a sporadical and accidental one.

Tho the greatest Difference whereby these kinds of Fevers are distin∣guished betwixt themselves, and from others, consists in their Morta∣lity and Contagion; yet sometimes they are mark'd by some peculiar Symptom, from which both the note of Malignity, and the name they are called by, are taken for that time: hence in some Years an epi∣demick Fever reighs, which causes in most that are affected with it, a Quinsey, at another time a Peripneumonia, Plurisie, Dysentery, or some other Affect, and that often dangerous and contagious: so that not only the Seeds of Diseases deriv'd from Parents ex traduce, disclose their Fruits, by a certain Destiny, as it were, in the same Part or Member; but also such as are received from a venemous Miasm generally reign∣ing, produce in all Persons Affects of the same manner and form: which nevertheless I judge to happen, not because the Seeds of the venemous Miasm regard this or that Region of the Body by some peculiar Ver∣tue: but they affect thus the Mass of Blood after the same manner in all, forasmuch as, for washing off that taint, a Crisis must of necessity be attempted after the same manner in all; for when without Malig∣nity, the Blood is apt to be extravasated by reason of Coagulation, or haply for other Causes, the usual Places in which the Portions of the same extravagated are wont to be fix'd, are, the Throat, Pleura, Lungs, and Intestines: wherefore it's no Wonder when a Congelation, and therefore an Extravasation of the Blood is procur'd from a malignant Cause, if the Disease lodges it self in the usual seat of Nature.

As to the Signs of these kinds of Fevers, besides by the Contagion and Mortality, the Malignity of the Fever is shewn by a sudden Deje∣ction of the Strength, a weak and uneven Pulse, an evil Affect of the

Brain and nervous Parts caus'd on a sudden, violent Vomitings, a blackness of the Tongue, an over-spreding of Blackness over the whole Body, but especially by an appearance of Spots, Buboes, and other Marks.

For the Cure of Fevers, both Pestilential and Malignant, there is need of a greater Judgment and Circumspection than in any others whatsoever; for there being two primary Indicants, to wit, the Ma∣lignity and the Feverish Distemperature, and since we can scarce provide for the one without the Detriment of the other, it will not be easie to judge which we must obviate first, and chiefly take care off: in respect of the Fever, Purging, Bleeding, and cooling things, chiefly conduce; but whilst these things are used, the Malignity, for the most part, is increased, and they being neglected, it diffuses it self farther. Against the Malignity, Alexipharmicks, and Diaphoreticks are required; but these greatly intend the Fever, exagitate, as by a blowing of Bellows, the Blood and Spirits kindled before, and put them in a manner all in a Flame: wherefore there is need here of a great Quickness of Understanding, that these things be duely compared betwixt each other, and that the curative Intentions be there directed where most danger shews it self; tho so, that while one is taken care of the other be not neglected: but in these Cases, besides the private Judgment of each Physician, Experience furnishes us with the chief method of healing; for, when these Fevers first grow rise, almost eve∣ry particular Person trys particular Remedies; and from their Successes compar'd together, it is easily learnt, what kind of Method we must insist on, till at last, by a frequent Tryal, as it were by the Foot-steps of Passengers, a common, and Road-way as it were is made to the Cure of these kinds of Affects, being fortified with various Observations and Precepts.

Besides these kinds of Fevers, which assail many together, and by reason of their Contagion, Mortality, and conspicuous Marks of Viru∣lency, deserve to be called Pestilential, or Malignant; there are found some other Epidemick or Popular Fevers, which almost every Year, either Spring or Fall, grow very rise in certain Countries, of which a great many of the Inhabitants are wont to fall sick, and not a few, es∣pecially of the more elderly People, to dye: in which, nevertheless, no Signs of a pestilent or malignant Nature appear; nor does the Disease seem so much by Contagion to pass from some incontinently to others, as to seise many together by reason of a Predisposition communicated almost to all. Now these kinds of Affects depend chiefly on a forego∣ing Constitution of the Year; for if a Season very intemperate, by reason of excesses of Cold or Heat, Drought or Moisture, has prece∣ded, and has so continued a long time, it changes our Blood, for the most part, from its due Temper, whereby it is apt afterward to fall into severish Effervescencies; and hence a Fever, sometimes of this,

sometimes of that Type and Idea, is produced, which presently becomes epidemical, because it draws its Origine from a common Cause, where∣by the Bodies, in a manner, of all Men, are affected together. Now such Fevers, in as much as they depend on the Blood, getting a Dis∣position, sometimes sharp, sometimes austere, or of another kind, ac∣cording to the Temper of the Year, for the most part they are of the number of Intermittents, tho they are wont to be mark'd with a pe∣culiar Apparatus of Symptoms, according to the peculiar Constitution of each Year. We cannot comprehend these under a certain com∣mon Rule, or formal Consideration, which aptly answers to each of the Particulars of this Nature, because they vary yearly according to a great many Accidents: tho however, of these kinds of Fevers reign∣ing of late Years in this Country, we shall give the Descriptions taken at that time; and shall set them down as a Conclusion at the end of this Work.

It remains for us still to add to the number of Malignant Fevers, certain other private Fevers, partaking of no Contagion, as are those especially, which are wont to happen to Women in Child-bed, by reason of their difficult Labour, or for that the Lochia are detain'd; for it is manifest enough, by common Observation, that these are very dangerous, and often mortal: for if the Parts of the Womb being injured, or upon the admission of Cold, or haply for some other Cause, the Lochia are stopt, and the Humour which ought to have been voided forth, comes to be mingled with the Mass of Blood, it fouly defiles it with a certain venemous mixture, as it were, that thereby presently a Fever is raised, which for the most part is at∣tended with an ill Company of Symptoms, viz. a Heat, and violent Drought, a Vomiting, a Cardialgia, and Watchings, and generally comes either to no Crisis, or a very difficult one; because, unless the flowing of the Lochia after their wonted way be again restor'd, after the Blood has undergone an Effervescence for some Days, the Taint is wont to be communicated to the Brain, and the Genus Nervosum; whence presently a Delirium, Frenzy, Convulsions, and other very ill Affects for the most part are caused, which often terminate in Death. But these kinds of Fevers deserve a peculiar Consideration; which we resolve to have more fully beneath, in a Discourse appro∣priated to this purpose: mean while we must give some Instances or Examples of the Fevers above treated of, viz. of the Pestilential and Malignant.

The pestilential Fever, of late Years, has reign'd more rarely in these Parts, than the Plague it self. I shall give you briefly the Descripti∣on of the only one of this kind which has occur'd to our Observation. Anno 1643. when in the beginning of the Spring the Earl of Essex besieg'd Reading, kept by the King's Garrison, in both Armies a very Epidemick Disease began to arise; tho however, he pursuing his work

till the Besieged were forced to a Surrender, The Affect so prevail'd, that in a short while afterward there was a Cessation on both sides, and thenceforward, for many Months, there was a Conflict, not with the Enemy, but with the Disease. Essex withdrawing his Forces, seated himself at—, and the adjacent Places, where, in a short time, he lost a great Part of his Men: and the King returned to Ox∣ford; where the Souldiers first keeping themselves in the open Field, and afterward being disposed off in Towns and Villages, he underwent a loss not much inferiour; for his Foot (whom it chiefly seised) being lodg'd a great many of them together in streightned Lodgings, when they had filled all Places with Nastiness and Filth, and stinking Odours (that they seem'd to have defil'd even the Air it self,) fell sick many of them together, and as it were in Files: at length the Fever, reaching farther than the Souldiery, assailed every where the weak Multitude, to wit, the Persons of the Houses where the Souldiers lodged, and others, tho many of them at first (the Contagion being yet but mild upon them) escaped, yet lying a long time in a very languishing Condition. About the Summer Solstice, this Fever began to psread it self with a worse Attendance of Symptoms, and to seise a great many Husband-men, and others living in the Country: and afterward it reigned in this our City, and the whole Neighbourhood, for at least ten Miles round about; mean while, those who liv'd in other Countries far from hence, as tho they were beyond the Sphere of the Contagion, continued free from harm. But here that Disease grew so general, that the greatest part of Mankind was infected with it: whatsoever House it entred, presently it set upon the whole, that there were scarce enough remaining in Health to attend those that were ill; such as came to them from elsewhere, or Hirelings called to attend the Diseased, were presently seised with the same Infection: that at length, for fear of the Contagion, such as lay sick of this Fe∣ver, were shunn'd by those that were in Health, in a manner, as Per∣sons troubled with the Plague.

Nor did a small Mortality or Destruction of Mankind attend this Disease; for a great many old Men, Cachectical, Ptysical, or otherwise unhealthy Persons, fell under this Fate: also not a few Children, Youths, and such as were full grown. I remember, that in certain Villages, all the elderly People, in a manner, were carried off this Year, that there scarce remained alive any for unpholding the Cu∣stoms and Priviledges of the Parish, by the Traditions rcceiv'd from their Ancestors.

When this Fever first began it carried somewhat the Type of a pu∣trid Synochus, but it came with difficalty to a Crisis, and when it seemed to be solv'd by a Swear, or a Loosness, it was wont presently to wax worse again: but for the most part after a Deflagration of the Blood, continued for six or seven days, this remitting, and in∣stead

of a Crisis, the adust Matter being convey'd to the Brain, the Diseased lying a long time, sometimes raving mad, oftner with a Drowsiness and a great Weakness, and sometimes with convulsive Motions, scarce escaped at length with Life. About the middle of the Summer, beside the Contagion, and the frequent Mortality, this Disease discovered its malignant and pestilential Force, by open Signs, viz. by the Eruption of Pushes and Spots; for about this time, without any great burning of a Fever, the Pulse in many grew un∣even, weak, and very disorderly; also, without a manifest spending of the Spirits, the Strength presently became languid, and very much dejected; in others, lying ill after the like manner, Pimples some∣times small and red, sometimes large and livid, appear'd; in many, Buboes (as in the Plgaue) about the glandulous Parts; some of these, without any great Conflict of the Spirits, or feverish Excandescence raised in the Blood, died without noise and on a sudden: mean while, others, growing presently raving mad, as long as they continued in Life, underwent horrible Distractions of the Animal Spirits. Such as escap'd from this Disease, recovered not but after a long time, and that without a laudable Crisis (unless by a Sweat procured by Art) the Brain at length, and the Genus Nervosum being affected, and they be∣ing seized with a Dullness of the Senses, Tremblings, a Vertigo, a Weakness of the Members, and-convulsive motions. During the Dog∣days this Disease still infesting, began to be handled not as a Fever, but as a milder sort of Plague, and to be overcome only by Alexiphar∣mick Remedies; Bleeding was always thought fatal to it: Vomitories and Purges were used now and then, tho not so frequently; but the chiefest method of Cure was placed in Alexipharmicks, and a Sweant seasonably procured. For this purpose, besides the Prescripts of Phy∣sicians taken from Apothecaries Shops, certain Empirical Remedies deserv'd no small Praise: then first in this Country, the Countess of Kent's Powder began to be of great Fame; and another ash-coloured Powder was not of the least note, which a certain Courtier, coming by chance to this City, gave to many with good Success, and sold it others, who approved of its use, at a great rate. The Diseased were wont, upon drinking half a Dram of this in any Liquor, to fall into a most copious Sweat, and so to be freed from the Virulency of the Disease: that Diaphortick (the Preparation whereof I learnt after∣ward from the Authors Sisters Son) was only the Powder of Toads, cleansed with Salt, and afterward washed with good Wine, and light∣ly calcin'd in an earthen Pot. Autumn coming on, this Disease re∣mitted by Degrees of its wonted Fierceness, that fewer fell sick, and a great many of them recovered; till upon the access of Winter, a state of Health was again entirely setled in this City, and in the ad∣jacent Country.

Let us here consider the Rise, Progress, and lastly, the End of this Fever, which at first was only belonging to the Army, and at length became pestilential and epidemick: that the Disease first began in the Souldiers Camp, it seems that it ought not only to be imputed to their Nastiness and stinking Smells, but in some measure, to the common Fault of the Air; for, since these Fevers do not happen yearly, their Origine will be somewhat ascribed to the peculiar Constitution of the Year: for a light Distemperature of the Air being thereby contracted, tho it does not ill affect such as use a wholsome way of living, yet in an Atmy, where, to the general Procatarxis, evident Causes, viz. a great many Errors in the six non-natural things, are joyn'd, those kinds of Sicknesses must of necessity be more easily rais'd. Now the Vernal Constitution of this Year was very moist, being almost conti∣nually attended with wet Showers; to which afterward a hot Sum∣mer succeeding, both rendred still more depraved the Miasms of the feverish Contagion reigning here before, and more disposed all Bo∣dies to receive them: wherefore, that this Distemper became in a manner peculiar to this Country, and epidemick at this time, it was long of its Seminary, arising in the first place from the Army lying round about: but in as much as becoming afterward pestilential and very epidemick, it infected the greatest part of Mankind here living, and killed not a few; the cause was, the ill Affect of the Air, which being unwholsome through the Distemperature of the year, became moreover so vicious at length, by the continual breathing forth of stinking Vapors from the Souldiers Camps, and the Cohabitation of the Diseased, that the Miasms of this Fever, disperst in it, were greatly exalted, and rise almost to the Virulency of a Pestilence. Diemerbro∣chius relates, That from such a kind of Camp-Fever, rais'd in the Summer, in the Town of Aquitane, afterward another malignant and pestilential, and at length the Plague it self grew: and that this our Fever at last stood in competition with the Plague it self, besides the great force of the Contagion, and the great Mortality, the very ill Af∣fects of the Blood and nervous Liquor, presently caused in all from the same, did declare; for the Strength dejected on a sudden, the weak, intermittent, and formication Pulse, the Eruption of Pushes and Bu∣boes, argued the Coagulation, and corruptive Disposition of the Blood. Moreover, a Delirium, Mania, Frenzy, Deadness, Sleepy∣ness, Vertigo, Tremblings, convulsive Motions, and other Affects of the Head of divers kinds, shew'd a mighty Annoyance of the Head and Genus Nervosum.

For setting forth the Type, or Idea of the Malignant Fever to the Life, there are a great many Observations or Stories of Sick Persons ready at hand: Of many Examples of this Disease, I shall here insert only a few, which some years since happened in the House of a Vene∣rable Person, after a manner to be lamented, and not without some Admiration.

About the Winter Solstice, Anno 1655. a Boy about seven years of Age, being ill without a manifest cause, was affected with a great Pain in his Head, a Sleepyness, and a mighty Heaviness; there was withall a Fever, tho not intense, with an indifferent Burning, which nevertheless, by unconstant Fits, had its time of being intended some∣times once, sometimes twice within the space of twenty four Hours. Presently, from the Beginning of the Disease, he slept almost continually, he was wont also to cry out in his Sleep, to talk idly, and oftentimes to leap out of Bed; being stirred up, and sometimes awaking of his own accord, he was straitway present to himself, and always desired Drink: his Urine was ruddy, and fill'd with Contents; the Pulse was uneven, and strong enough; the Contractions of the Tendons in the Wrists were light: in the Neck, and other Parts of the Body, certain red Spots, like Flea-bites, appeared. On the first days, a gentle Purge was ordered, and a frequent easing of the Belly by the use of Clysters: Cordial Juleps with Alexipharmicks were daily taken: Vesicatories were applyed to the Neck, and other Plaisters to the Soles of the Feet. On the sixth day, a little Blood dropt from the Nose. On the seventh the Fever very much remitted without a manifest Crisis, the Heat, being only mild, was perceivable by the Touch, and the Urine was pale and thin, without any Sediment; nevertheless, a Sleepyness, and Heaviness of the Head prest far more severely, so that the Urine, and Excrements of the Belly, flowed from him insensibly: however, being call'd upon by Name, he knew the Standers by, and answered to things asked. Those Affects, notwithstanding Remedies, daily grew worse and worse. About the fourteenth Day the Diseased became so stupid, that he could neither understand, nor speak, yet he still swallowed down things put into his Mouth, tho unminded by him, and his Pulse was laudable enough: about this time he had a Looseness, naturally happening to him, for four Days; which at length ceasing, a whitish and chalky Crust, as it were, began to cover the whole Cavity of his Mouth and Throat, which being cleansed off often in a Day, presently a new one arose. When he had been troubled after this manner for four Days, he was better as to his Understanding and Sensation; so that he could know Friends, give a Nod to what was said, and do some things he was ordered: but as the sensitive Faculty began to be restored, so the Evil increased as to the Organs of the Speech, and Swallowing: doubtless the Matter being fallen from the Brain into the Beginnings and Ductus's of the Nerves. The Heaviness and Stupidity were follow∣ed by a Palsie in the Tongue and Throat; which Affect grew so much in a short space, that afterward the Diseased was not able to swallow at all, but things put into his Mouth presently came forth again, nor did any thing descend into his Stomach; when, besides the Violence of the Disease, there was danger, lest he should dye through Hun∣ger, an Instrument was made of a flexible Whale-bone, and a Lawn

Button fix'd to the end of it; and this being thrust into the Throat, opened for a time its Closure, that a Passage was made for Food giv'n; after the use of this a Day or two he could swallow again, and after∣ward take in Food enough; and within a few days he began to speak, to discern every thing, and growing wonderfully hungry, to desire all day long Food of all kinds, and most greedily to devour all things giv'n him: mean while, through his long-continued Sickness, and the nervous Parts being sorely injur'd, he grew so lean, that at length the Skin scarce sticking to the Bones, he exactly resembled a living Skele∣ton; tho afterward by the diligent, indefatigable, and prudent Care of his Mother, as to his Dyet, he recovered a perfect Health, and continues still well.

At the Time that this Boy was about the height of his Sickness, his Brother, about two years elder, fell sick almost after the same manner, on the first day of January. First, he was affected with a Dullness, and a heaviness of the Head. On the third day growing fe∣verish, he had a Sleepiness and Stupidity: he began in his Sleep to talk light-headed, and upon his Awake, scarce to be present to him∣self. After four or five Days these Symptoms increased; he could understand little, nor speak without tripping of his Tongue, and scarce arciculately: his Urine was thick, and opake, without an Hypo∣stasis, or subsiding of the Contents: red and small Spots like Flea-bites appear'd, as in his Brother: the Excrements, as well of the Belly as of the Bladder, pass'd from him insensibly; but the Pulse held still strong and even: the Hypochondres were extended, and blown up with a Swelling of the Abdomen. About the eighth day a little Blood dropt from his Nose: On the eleventh day of the Sickness he fell into a Looseness, whereby he had seven Stools, of a bilous, thin, and very stinking matter, within five Hours; whence there was some hope, that the Condition of the Diseas'd would change for the better; tho the next day after, the Loosness ceasing, a Pain, and Gripes, violently tormented him in his Belly, that crying and howling, he complain'd most sorely Day and Night: the Hypochondres and Abdomen were swollen, and very much distended like a Drum. Not receiving any thing of ease by any Remedies tryed by the most exquisite Endea∣vours of many Physicians, he died on the fourteenth day, convulst in these Tortures.

A little after the Death of this, viz. on the 15th. of January, his El∣dest Brother, about eleven years of Age, a very hopeful Lad, began to be feverish, being affected with a Dullness, and a Heaviness of the Head, as the former, tho less intense: but in his Blood, which was of a hot Temperament, a greater Effervescence and trouble appear'd, that on the first six days, besides a Heat and Thirst, he was molested with a continual Effort of Excretion, sometimes by Sweat, sometimes by a Loosness; his Urine was ruddy and troubled; certain red Spots,

as in the others, brake forth. On the seventh day an Haemorrhagie happened to five ounces, which ceasing, a mighty Dullness followed, that for all that day, and the following Night, he was scarce able to open his Eyes. On the eighth day a very copious Haemorrhagie of the Nostrils happened again, that there was danger of pouring forth his Soul together with the Blood; the Blood sprang forth so copiously from the left-Nostril, that, being received into a Bason, it made vast Bubbles by its fall: when he had lost above two Pounds of Blood, and being all in a cold Sweat, began to lose his Strength; Reme∣dies being at length applyed, the Flux was stop'd with great difficul∣ty; the Haemorrhagie being appeased, the Lad slept a sound Sleep, and became sleepy all that Night; tho often waking, he was present enough to himself, and had a quick Sense and Understanding: being asked concerning his Health, he said he was pretty well; the Urine which before was ruddy, and troubled, appeared then pale, thin, and with a laudable Hypostasis, that the Diseased (especially because free from Thirst and an immoderate Heat) seemed to be come to a perfect Crisis, and free from the Fever. The Morning following, the ninth day of the Fever, he continued still dull; but being stirred up, he seemed without a Distemperature, and to be chearful in a state of Convalescence, only that he began a little to faulter in his Speech: in the Evening, when things were not suspected, the Fever being kindled again, he fell on a sudden into a Lethargy, that he was scarce able to be awaked from his Sleep, and being pull'd up, hardly to know any one, or to speak articulately: Tho so great a loss of Blood had preceded, his Pulse was again quick, high, and strong, and his Urine was ruddy; after deriving and revulsing Remedies used all that Night, this noble Youth seemed somewhat in a better state; so that the next Morning he kept himself longer from Sleep, began to turn his Eyes this way and that, and to raise himself a little, tho without Speech, or Knowledge of the Standers by; before Noon, his Eyes being clos'd again, he wholly lost the use of every Animal Faculty, and lay, as it were, Apoplectical for three Days, with a high and vehement Pulse, a Palpitation of the Heart, and a short and broken Respiration: the Pulse at length growing less by degrees, he died on the tenth day of the Fever.

On the 18th. of February, his little Sister, having a feverish Di∣stemperature and a Thirst, began to complain of a Pain, and Gripes in the Belly, a trembling in the Hands, and a painful Tension in the Muscles of the Neck. On the last day of February, being more openly feverish, she was not able to keep out of Bed; moreover, she was affected with a running Heat, sometimes in the Hands, sometimes a∣bout the lower Parts; she became also drowsie and sleepy; awaking from her Sleep she did not forthwith come to her self. On the first of March she was gently Purged with an Expression of Rhubarb, which

gave her ease; the Urine was thick and ruddy, also red Spots like Flea-bites (as in the rest) were plain to be seen. We gave her after∣ward frequently for four days, to wit, every six hours, Ten Drops of Spirit of Harts-horn, in a Spoonful of a Cordial Julep: the foresaid Symptoms afterward remitted by degrees, and this sick Person reco∣vered her Health, tho slowly, without a manifest Crisis.

About the same time a Brother of these, the youngest of all, fell sick almost after the same manner; who nevertheless, through a Loos∣ness naturally happening, voiding bilous and green Excrements for many days, more easily recovered. Also in the same Family, a great many other Domesticks, and some Strangers, who came there as At∣tendants, fell ill of the same Disease, the Taint, as it were being pro∣pagated by Contagion: all of which, notwithstanding, escaped at length with a difficult and long Convalescence, without any Crisis re∣gularly made.

That this Fever was malignant, it seems to be manifest, from the Contagion, Mortality, the appearance of Spots like Flea-bites, and many other Tokens; tho that infecting Miasm, whereby it passed from one to another, was torpid and less efficacious: for betwixt the Sicknesses of each, many Days, and often Weeks, interceded, that the Infection of this Disease, tho acute, and its Propagation in many, were scarce ended within four Months space in the same House: the Fever about the first Beginnings seem'd mild and gentle, not very ter∣rible by its Burning: but the Matter heap'd together after the Defla∣gration of the Blood, presently became masterless, and difficult to be exterminated, also offensive to the Brain and Genus Nervosum; where∣fore in each, the Beginnings of the Disease were known rather by a Drowsiness and a Sleepyness, than by a Sweat and Burning: also the Crisis, tho attempted various ways, to wit, by a Sweat, a Loosness, and an Haemorrhagie, did not succced well; but for the most part, the Blood growing turgid by a critical Motion, was forc'd to transfer the febrile Matter from its own Precincts into the mansion Places of the Animal Spirits; nor did it self, notwithstanding, become purified after this manner; but about the height of the Fever, both Humours (to wit, the Blood and the nervous Juice) being vitiated together, and sorely blasted with an impure Mixture, made the Event of the Disease either fatal, or very dangerous.