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. XIV. Of the Small-Pox and Measles.

IN the rank of pestilential and malignant Fevers we place next the Small Pox and the Measles, which in Truth are mixt Affects, both according to, and against our Nature: As to their Origine, they have a seminary Connate to us; but as to the Affects, they produce praeternatural Symptoms, and venemous, as the Plague it self; so that they constitute a certain peculiar sort of Fevers, which belong to all Mankind, and only to them, and that but once. If haply any one lives free from them all his Life, or some one falls often into those Affects, these are rare, and unusual Events of Nature, which do not derogate to common Observation: but it may pass for a Truth, that all, and only Mankind are obnoxious to the Measles and Small Pox, and that they are usually freed of them at one Bout. We shall speak of the Measles by themselves.

1. As to the Small Pox; The natural Praedisposition which inclines Mankind to it seems to be a certain Taint, or Impurity of the Blood, conceiv'd in the Womb with the first Rudiments of the Foetus. All Authors, in a manner, will have this ascrib'd to the menstruous Blood: which Opinion does not seem altogether improbable; be∣cause in the Womb of a Woman (otherwise than in most other Ani∣mals) a certain Ferment is engendred, which being communicated to the Mass of Blood, gives it a Vigour and Pneumatosis, and after∣ward procures, at set Periods of Times, a Turgescency, and an Ex∣cretion of the superfluous Blood; and at the time of Conception, when the Menses wholly cease, a great deal of this Ferment is commu∣nicated to the Foetus; and its Particles, being heterogeneous to all the rest whatsoever, are disorderly confounded with the Mass of Blood and Humours, as some extraneous thing; in which being involved, and being separated from each other, they lye hid a long time; tho af∣terward at some time being stirr'd by an evident cause, they ferment with the Blood, and cause in it an Ebullition, and afterward a Coa∣gulation; from which most of the Symptoms of this Disease arise.

2. The Evident Cause which stirs these Fermentative Seeds, and oftentimes brings them into Act, is said to be threefold; viz. Conta∣gion receiv'd from elsewhere, the Disposition of the Air, and an im∣moderate Perturbation of the Blood and Humours: Persons related soon infect each other; also those that are fearful, and mightily dread this Disease, fall more readily into it: for, by Fear the Particles of the

Miasm are convey'd from the Surface of the Body inward: at the time that the Contagion is rife, and the Small Pox is Epidemick, all other Diseases in a manner degenerate into this.

3. As to the Conjunct Cause of this Disease, to wit, what is the for∣mal Reason of it, or its way of coming to pass, the thing seems a little more intricate: It is vulgarly wont to be compared to the Effervescence of new Wine, or of Ale, when they are depurated in a Vessel, be∣ing put in a Fermentation by the mixture of some heterogeneous Sub∣stance; but if the thing be narrowly considered, a great difference will here appear: for, the Miasm of the Small Pox is as a Ferment, but corruptive, and forces the Flood to ferment, not towards a Per∣fection, but a Depravation; for when the venemous Particles of this Miasm light on a capable Subject, they presently stir up Corpuscles like themselves, and innate to us; with which being joyn'd, they pervade the whole Mass of Blood, and make it grow mighty turgid, and boyl, and after some Effervescence, to separate into Parts, and to be coagulated: to wit, the dispers'd Seeds of the Venom dissolve the Mixture of the Blood, presently subvert the more pure Spirits, and afterward gather to themselves the more gross Particles of it, and con∣geal them, as it were, by their Adhaesion. The Portions so coagula∣ted, together with the Seeds of the Venom mingled with them, being left by the rest of the Blood in its Circulation in the Extremities of the Vessels, are fix'd on the Skin: after which manner, if Nature being strong enough, sends off the whole Venom with the congeal'd Blood, the rest of the Mass of the Blood, tho depauperated, is never∣theless good, and capable of continuing Life; but, if the Blood being too much coagulated, cannot be cleansed after this manner; or if the Portions of the Blood closing with the Venom, do not fully break forth, they either restagnate inward again, and wholly corrupt the Liquor of the Blood, or fixing themselves on the Viscera, and espe∣cially the Heart, they destroy their Crasis and Strength.

The Portions of the Blood congeal'd with the Venom, about the fourth day (sometimes sooner, sometimes later) begin to break forth; for the Coagulation is caused not presently, but after some time that the Venom displays it self, and by its Effervescence ferments the Blood: first light Portions of the Blood being desil'd, and those but few in number, are fix'd in the Skin like Flea-bites; soon after these, more appear, and those which brake forth first, by the access of new mat∣ter, and by the continual Appulse of the congealed Blood, grow big∣ger, and are rais'd into a Tumour; afterward these Pushes, which at first are red, being encreased by degrees, at length turn white, to wit, the Blood extravasated with the Venom, by reason of the Heat and Stagnation, is chang'd into a Pus. About the seventh day after the Eruption, the white Tumours turn to a dry Scab; for the more subtle Part of the Matter being evaporated, the rest grows hard, which at

length, the Scarf Skin being eaten off and broken, falls from the Skin.

When the Miasm of the Small Pox is once gotten into the Spirits and Mass of Blood, it is very seldom that it can be destroy'd or clear'd off by Medicines or Bleeding, but the latent Disposition will break forth into Act; wherefore, first it diffuses it self gently, and inspires the Mass of Blood, as it were, with a Ferment: hence an Ebullition and Ef∣fervescence are produced in the whole Body, the Vessels are extend∣ed, the Viscera are irritated, the Membranes are twitch'd, till the Seeds of the Contagion, by fusing and coagulating the Blood, at length being involv'd in its congeal'd Portions, are thrust forth. The Essence of this Disease will be the better known, if I set down the Signs and and Symptoms which are observ'd in the whole Course of it, and give you in order the Reasons of them, and the Causes on which they de∣pend. Now these are either such as indicate the Disease present, or such as fore-shew the height of it, and its event.

As to the Diagnostick of this Affect, whereby it may be known whether any one, at first falling sick, will have the Small Pox or not. There must be considered at that time, the force of the Contagion, and the Concourse of the Symptoms first appearing; for, if by reason of the malignant Constitution of the Air, this Disease generally reigns, no one is then seised with a Fever without a suspicion of the Small Pox, especially if the Person never had it before: but if this Disease be more rare, and there be no Fear of Contagion, yet its unexpected Invasion in a short time discovers it self by these kinds of Signs and Symp∣toms.

1. There is an inconstant Fever, coming at random, sometimes intense, sometimes more remiss, observing no set form of Increase, or coming to a height, so that the Diseas'd one while are mighty hot, by and by, without an evident Cause, they are without any Fever; the Cause of which is, That the sermentative Seeds are not agitated with an even motion, but like Fire half extinct, one while they have an extraordinary Flash, another while they lye quiet, and dye, as it were, till the Burning spreading it self, the Flame breaks forth every where.

2. A Pain in the Head and Loins is so peculiar a sign in this Affect, that it alone, in a continual Fever, signifies an imminent Small Pox; the Cause of which, is vulgarly imputed to the great Vessels being ve∣ry much extended by the Effervescence of the Blood; tho it does not appear why the same Pain should not be as well caused in other Parts by reason of the like Extension of the Vessels, and why those kinds of Pains are rife in the Small Pox, rather than in the Causon, or other Fevers, where the Blood boyls more. Again, you may observe, that mighty Pains are pressing, sometimes in the Head, sometimes in the Brains, when, the Blood not being turgid, the Vessels are not enlarg'd,

viz. in the beginning of the Disease, when the Feverish Distempera∣ture is not yet conspicuous: while the Diseas'd are yet walking abroad, and have a good Stomach, the imminent Small Pox first discovers it self by these Pains; wherefore, it seems that the Cause of these kinds of Pains subsists rather in the Genus Nervosum; to wit, that those Pains arise in the Brain, and spinal Marrow, by reason of the Membranes and Nervous Parts being twitch'd by the Particles of the Venom; for it is likely that the innate Seeds of the Small Pox are chiefly stored up in the Spermatick Parts, and that the first Contagion of the Miasm for the most part seises the Animal Spirits: hence the first Efferves∣cence is raised in the Juice wherewith the Brain and nervous Parts, but especially the spinal Marrow, are irrigated; and thence the taint is communicated to the Mass of Blood: wherefore, in the beginning of this Disease, the Head and Loins are press'd with a violent Pain; afterward, the Venom being convey'd into the Blood, the feverish Effervescence is rais'd in the whole.

3. A great Irksomness and Restlessness, and sometimes a Swooning, infest the Diseased, to wit, by reason of the Motion of the Blood be∣ing troubled, and its even mixture being begun to be dissolv'd by the venemous Ferment, the Blood being hence apt to stagnate, and to be letted in its Circulation, causes the Affects even now mentioned.

4. A violent Vomiting, even when the Stomach is free from an im∣pure Mass of Humours, very often accompanies this Affect; the Reason of which is, because the Fermentative seeds being put in motion, are deposed in the little Arteries which open into the Tunicles of the Ventricle, upon each Appulse of the Blood, and raise a Vomiting even as the Particles of Antimony swallowed down: but afterward, assoon as a Sweat being procur'd, the Venom is driven outward, this Symptom ceases, and the Diseased are well in their Stomach, without any purging forth of offensive matter.

5. To these may be added the Symptoms, which, according to the various Dispositions of Bodies, happen after a various manner, as are, a great Sleepyness, Frights in the Sleep, Deliriums, Tremblings, and Convulsions, a Sneezing, Heat, Redness, a sense of pricking in the whole Body, involuntary Weeping, a sparkling and itching of the Eyes, a swelling of the Face, a Vehemency of Symptoms from the beginning that the Disease seems presently to have reached its height, &c.

2. As to the Prognostick of this Disease, it is indicated either to be safe, or mortal, or doubtful, by supervenient Signs.

1. Things seem to be in safety when this Affect has benign Circum∣stances; to wit, when it happens in a good Constitution of the Air, and of the Year, at a time that the Small Pox is not Malignant and Pestilent; also there is less danger if it happens in Childhood, or In∣fancy, if in a sanguine Temperament, and a good habit of Body, if it

chances in a Family to whose Predecessors the Small Pox has not been mortal: moreover, if in the whole Course of the Disease laudable Symptoms happen; if at the first Invasion there be a gentle Fever without a violent Vomiting, a Swooning, a Delirium, or other horri∣•••••• ••••••ts; if, about the fourth day, the Fever with the most pressing ••••••••ms are appeased, and then some red Spots begin to appear; 〈◊〉〈◊〉 second day of their coming forth, a great many more of those red Spots are conspicuous, which afterward grow by degrees into Pushes, and are ripened into a Pus; if about the tenth day, more or less, after the Eruption, the white Pushes begin to grow hard, and af∣terward to fall off by little and little; if after the time of their first breaking forth the Small Pox are soft, separate from each other, few, round, raised at the Top, possessing only the Skin, and not the in∣ward Part, we may presume the case of the Diseased to be in a good State.

2. The Phoenomena, which, in the Small Pox signifie the Case to be suspected and full of Danger, are these; if there be a Malignant Constitution of the Air, that this Disease is become pestilent, and many have died of it; if Persons well grown in Years are seised with it, if it chances in a cold and melancholick Temperament, or in a foul and cacochymical Body, where the Blood is neither readily circu∣lated, nor Perspiration duely perform'd; or if the Hypochondres or Praecordia are obstructed, any Viscera infirm, or affected with an Ul∣cer; or if the Habit of the Body be too gross, the Small Pox does not happen without great danger of Life: Nor is it less to be fear'd, when presently at the beginning a mighty Fever, a violent Vomiting, a Swooning, a Dejection of the Strength, a Frenzy, or Delirium, assail Persons, and give not over when the Small Pox are fully broken forth; for these things signifie an over-great Perturbation in the Blood and Humours, as also a Confusion and Contumacy of the mortifying Mat∣ter, which can neither be subdued, nor easily separated, or evenly ex∣truded from the Mass of Blood; if there be an Irksomness, and a great Restlessness, with a disorderly Effervescence, and Ebullition of the Humours; or if a mighty Thirst, and a difficuly of Breathing, also a Loosness, or Dysentery, they shew that Transpiration is letted, and that the Malignant Humours restagnate toward the inward Parts. The Small Pox breaking forth slowly, argue the Crudity and Unruliness of the Matter, and the Impotency of Nature: much more, when double and confluent, do they shew that there is an excess in quantity, and a Confusion, also a disorderly and irregular Expulsion of that matter, since it is not cast forth at determinate Pores or places of Vent, but indifferently on every side. Small Pox which are hard signifie the Incoctibility of the said Matter, and if flat, the weak Expulsion of it, and they are by so much the worse if black Spots appear in the midst of them; or if such Spots as are familiar in a Purple or Pestilential

Fever, are mix'd with the Small Pox, they shew a mighty Malignity and Corruption of the Blood, such indeed, as is found in the Plague. Finally, black, livid, or green Small Pox, threaten ill; because, besides the Coagulations of the Blood, they argue its Mortifications and Cor∣ruptions, as in a Gangrene, or pestilent Carbuncle: if when th•• 〈◊〉〈◊〉 Pox are come forth, they presently wither, and the swelling of 〈…〉〈…〉 remits, it indicates the Recess of the malignant Matter, or of th•• 〈◊〉〈◊〉 congeal'd with the Venom, and its Restagnation toward the Inward Parts; whence unless, upon raising a free Diaphoresis, it be again sent forth, a sudden Death for the most part ensues: for hence the Blood being more coagulated, falls into Corruption, and is apt to be letted in its Motion, and to stagnate in the Heart and Vessels. If after the Eruption of the Small Pox, a Loosness, or Haemorrhagie supervenes, it foreshews ill, because by this means the Venom, driv'n outward, is again call'd in; tho I have observ'd, that these Symptoms have some∣times hapned with a great Relief to the Diseas'd; to wit, Nature being before loaded and opprest, is eas'd by this means, part of the Burthen, as it were, being withdrawn, wherefore she sets upon the Work of Transpiration, and more readily dispatches the Expulsion of the of∣fensive matter.

As to what concerns the Cure, since the Course of this Disease has three Seasons, like so many Stages as it were, distinct from each other: the curative Intentions ought also to be accommodated to each of these; wherefore, the Therapeutick Method concerning the Small Pox, teaches first what is to be done as long as the Blood boyls inwardly, and ferments by the Motion of the Fermentative Matter, and the Small Pox do not yet appear; which Period for the most part is wont to be ended in four or five Days. Secondly, what form of Diet and Physick ought to be ordered, from the time of the Eruption of the Small Pox to the height of the Disease, to wit, till the Pushes are come to their height, and being fully suppurated, begin to wither. Thirdly, and lastly, what we ought to observe in the Declination of the Disease, till the Small Pox, being dryed, fall clean off.

1. As to the first, the Intention must be, that we remove all Im∣pediments of Nature, whereby the Blood being defiled with the Fer∣ment of the Small Pox, and apt to be coagulated, may retain still its even Motion in the Heart and Vessels, without Stagnation, and that fermenting, it may expell forth the Portions congeal'd with the Venom: mean while, a Caution must be had, that the work of Fer∣mentation, or Effervescence, be neither any ways check'd, nor too much irritated; for by this the Mass of Blood is forc'd into congeal'd Portions more than it ought, and by the other it is restrain'd too much in motion, nor are the venemous Particles sent away forth with the congealed Blood. Nature is wont to be hindred from the work of Secretion and Expulsion, by a too great heap of Excrements

in the Viscera, or by an over-abounding of Blood in the Vessels; where∣fore presently, at the first Invasion of the Disease, we must endeavour that an Evacuation by Vomit, or Seige, if need be, be seasonably pro∣cur'd: we must use only mild and gentle Medicines, that is, which do not irritate, or trouble the Humours; wherefore, at this time, sometimes Emeticks, Purges, or Clysters, these one while another while those have place; opening a Vein also, if there be a Plenitude, is used with good Success. During this Effervescence of the Blood, let a thin, and moderately cooling Diet, be ordered; to wit, of Oat and Barley Meats, Posset-drink, Small-Ale, and the like; let Flesh, and Broaths made of it, be avoided, with which the Blood, by rea∣son of their too great store of sulphureous Fuel, is too much kindled; also cold and all acid things, do hurt, for these congeal the Blood more, and contract the Mouths of the Vessels by Astriction, that the Small Pox do not break forth freely: also let hot and cordial things be cautiously giv'n, for by these the Blood and Humours are too much stirred, and put in Confusion.

2. When the Small Pox begin to appear, there are three things which we order constantly to be done to all Sick Persons; to wit, that a mild and gentle Diaphoresis be always continued in the Mass of Blood; also that the Throat and Eyes be preserved from the too great Eruption of the Small Pox; that the Blood gently boyling may push forth the Small Pox, Decoctions of Figs, of the Flowers of Ma∣rigolds, and of the Shavings of Ivory, in Posset-Drink, are vulgarly prescribed, and their use has grown rife for a long time, almost among all Persons, For the same intent, we are wont to give mode∣rate Cordials divers times in a day, but let such as are hot and strong be diligently avoided: Purging and Bleeding are here censur'd, and tho the Pretext of necessity may press for them, Physicians scarce dare use them for fear of incurring a Blame. For a Guard to the Parts of the Gullet and Throat, we are wont to fasten outwardly a Chin-stay with Saffron sewen in, and dipt in Womans Milk; for these, by opening the Pores, draw the Venom from the inward part of the Throat, outward: also, for this Purpose we give Gargarisms, and things to wash the Mouth, which by their restrictive Force repress the Small Pox ready to break forth inwardly. We fortifie the Eyes from the Incursions of the Small Pox by Epithemes of Rose-water, Womans Milk, Saffron, and the like, frequently iterated: Besides these, certain horrible Symptoms are sometimes pressing, which we must seasonable obviate with fit Remedies: sometimes there are Watchings, a Frenzy, Hae∣morrhagies, Vomitings, Loosnesses, Fallings in of the Small Pox. A prudent Physician knows how to provide against all these, and any others whatsoever, as occasion requires; in which, nevertheless, there is need of great Caution, lest while we take care of small things, the great Work of Nature be disturb'd through the over-great disquieting

of Physick: for, during all this time, there is one continued Crisis; wherefore, nothing is to be mov'd rashly. There is required a very great Care and Circumspection both in the Phyfician and Attendants, when this Disease is in its height; to wit, That when the Small Pox are fully broken forth, and raised to their greatest height, they do not hinder Transpiration; for then the Diseased are in danger of having their Fever renewed, and of the Restagnation of the Malignant Matter in ward, of which, while we endeavour to prevent either, we often cause the other.

3. When the Disease is in its Declination, and the Small Pox begin to wither away, and to grow hard, the Case for the most part is out of danger, nor has a Physician much to do: let the Diseas'd, tho grow∣ing very hungry, still be content with a thin Dyet, without Meat: if the Pox are slow in falling off, we are wont to hasten their Fall with Liniments and Epithemes, by which they are prevented from Pitting much. After that the Diseased, the Small Pox being wholly fall'n away, is able to arise from his Bed, and to walk in his Chamber: a Purge being repeated twice or thrice, let the Filth, and excrementiti∣ous Matter left in the Viscera, and Blood, be carried off, and afterward he may be permitted a more free Dyet.

The Measle are so allied to the Small Pox, that amongst most Au∣thors, they have not deserved to be treated of apart from them; but the Affects of both are deliver'd after the like Manner and Method together. The Essence and Cure differ as to more or less, or at least∣wise accidentally; because in the Measles the Pushes are not so much raised in height, nor are they suppurated: wherefore the Disease ends sooner, and with less danger. This Affect is wont oftentimes to reign among Children, but seldom seises such as are grown in Years, or old People; also those who have had the Small Pox before, are not after∣ward so obnoxious to the Measles, but in most they are allied Affects; to wit, the Taint contracted from the Womb disposes Men alone, all Men, and that but once to the Measles: A malignant Constitution of the Air, and sometimes Surfeiting, but most commonly Contagion, are wont to draw into Act the latent Disposition. There are Marks of Malignity, and the Disease often becomes Epidemical, with a Mortali∣ty, and Contagion.

To give you the thing in short; it seems that the Measles are a cer∣tain light Efflorescence of an extraneous Ferment, contracted from the Womb; whereby some Particles, being stirr'd to motion, cause the Blood to boyl gently, and to be a little coagulated: wherefore, the Pimples thence brought forth, are blown off by Evaporation, with∣out a breaking of the Skin. But the Small Pox are a more full and strong Agitation of the same Ferment, and in all its Particles, which causing a greater Ebullition and Coagulation of the Blood, produces a great many more Pushes, and those greater in bulk, and not dissol∣vabe

without Suppuration. When the Small Pox precede, there follows not only an Immunity afterward from the same Affect, but for the most part from the Measles also. The Measles, because they con∣sume only a few Particles of the Ferment, leave still a Disposition to the Small Pox; wherefore, old Persons, or such as are grown in years, are not so readily infected with the Measles, because having been be∣fore infected with the Small Pox, they are freed from the Contagion; or their Spirits being robust, easily resist the light Miasm of this Af∣fect.

Of the great number of Stories and Observations relating to Persons troubled with the Small Pox, I shall in this place propose only a few Cases, and those remarkable for certain Irregularities.

It is usuall thing to treat all Persons, affected with the Small Pox, with the like, or wholly the same method of Healing, and form of Diet; wherefore, a Physician is seldom call'd to the Vulgar, but the Business is wholly committed to certain Women-Tenders, who boast that they know this Practice beyound all others; and those are wont to boyl Marygold Flowers, and Shavings of Harts-horn, and sometimes Figs in the Broaths, and any other Liquors to be taken by the Diseas'd, and to give at Night a Bolus of Diascordium: such as do not recover by such a Management, are declared not to be neglected, but that they are incurable through the Violence of the Disease. But that this kind of Practise does not equally agree to all, nor is to be us'd to all indif∣ferently, the two following Relations plainly shew.

A Young-man about twenty Years of Age, of a thin Body, and hot Temperament, began to be severish in the beginning of the Spring: in the first days violent Vomitings, an Oppression of the Heart, fre∣quent Changes of a burning and cold Shivering, a Pain in the Loins, a Perturbation of the Fancy, and Watchings, infested him: On the third day the Small Pox appearing, those Symptoms remitted, tho the Fever still continued with a Thirst and Heat. To this Person, not on∣ly the Decoctions usual in this Disease, but Juleps also, neatly prepar'd not so much as sip of them without great loathing: as often as he took at Night Diascordium, or any other temperate Cordial, tho in a small quantity, for continuing a Transpiration, he passed the Night follow∣ing without Sleep, and with a great tossing of the Body, and in the Morning he had an Haemorrhagie, which hapning once, and then a second time through this occasion, after that the Small Pox were fully broken forth, the well-doing of the Diseas'd was mightily endan∣ger'd; wherefore, when I had found by Experience, that the Blood of this Person was apt to boyl immoderately upon a light Irritation, I ordered this Method, according as the Occasion required: All Physick whatsoever being laid aside, for quenching Thirst he took small Ale, and a simple Almond Drink at Pleasure: His Food, because he refus'd

all Oat and Barley Broaths, was only Apples boyl'd to a Tenderness, and then season'd with Sugar and Rose-water, which he ate at some certain times in the Day. Nature, content with this thin Dyet, and seeming to be disturbed by any other whatsoever, perform'd her work successfully, that the Diseased recovered without any sore Symptom afterward, the Small Pox ripening by Degress, and then falling off of their own accord.

In the midst of Autumn of the last Year, a noble Youth, having a sharp Blood, and being obnoxious to a frequent Bleeding at the Nose, fell sick of the Small Pox; his Blood naturally boyled immoderately, that the Pushes brake forth extream thick all over his Body: in this Person, Whey with Marygold Flowers, and other things usually boyl'd in it, also Juleps, or nay Cordials (tho temperate) gently promoting a Transpiration, did most certainly raise a Flux of Blood; wherefore I ordered him a like way of Diet as to the Diseased before mention'd, by which indeed he was better: however, in the very height of the Disease, (when, the Small Pox being fully broke forth, the Fever is wont to be renewed in all Persons by reason of a difficult Transpirati∣on) this sick Person fell into a copious Haemorrhagie; that after a large Profusion of Blood the Small Pox began to be flaccid; after that a great many Remedies for stopping Blood were tryed in vain: at length, upon hanging a Bag about his Neck (in which was a Toad dryed in the Sun and pounded) he first of all, and immediately, found ease; for the Haemorrhagie being hereby presently appeased, and not returning afterward, (he constantly wearing thenceforward this Epitheme in his Bosom) our sick Person using always a most thin and cooling Dyet, grew perfectly well: that it may really seem to be manifest hence, that tho the Blood in this Affect be mighty apt to coagulate, yet as long as the Vital Spirits are strong and robust enough, and have a go∣verning Power, relying on their own Strengty, by a certain prudent Discretion as it were, they excellently separate and send forth the congealed Portions of the Blood; and this Work is mightily disturbed when the same Spirits are to much irritated, and forc'd into a Con∣fusion by hot Cordials or a hot Dyet. But in the Plague it happens otherwise; for, in this, if delay be granted, the Spirits themselves are presently destroyed by the Venom: wherefore, here we must pre∣sently fight with open War; whereas, in the Small Pox a Physician ra∣ther restores things by protracting time.

Concerning letting Blood just upon the coming forth of the Small Pox, it is greatly doubted. Formerly, among our Country-men, this thing was stil'd sacred, nor was Blooding wont to be admitted under any pretext of Necessity: but of late it is proved by Experience, that it is altogether useful and necessary to let Blood in some Cases; which Evacuation, nevertheless, if it be used indifferently in any Constitution, or be done in too large a quantity, when there is need of it, great Da∣mages often ensue thereby.

Some years since, I went to see a Young-woman of Quality, of a florid Countenance, and a hot Temperament, who was fall'n very fe∣verish after the fourth Month of her being with Child: she was press'd with a violent Vomiting, a fierce Pain in the Loins, and also with a most intense Heat and Drought: her Pulse was very quick, with a strong and vehement Vibration: tho the Small Pox no where reign'd in that place, nevertheless, those Symptoms of that Affect gave us no small suspicion of them. Be it how it would, the very immoderate Effervescence of the Blood indicated, that some ought to be taken away: wherefore, I presently took about six Ounces; thereupon the Heat somewhat remitted, tho the Vomiting still continued, with the violent Pain in the Loins. At the time of her going to rest, I gave her a Cordial Bolus with half a Grain of our Laudanum, whence a qui∣et Sleep, with a mild Sweat, and an appeasing of all Symptoms, en∣sued. The next Morning the Small Pox brake forth, which, tho the Diseassed had very thick, yet without any dangerous Illness, or fear of Abortion, she recover'd, and perfectly compleated her Child. bearing.

In the last Autumn, a robust Man, of an Athletick Habit of Body, tho of a pale Countenance, and a cold Temperament, fell into a Fe∣ver. On the second day he was tormented with a Heat and a Drought, and a most violent Pain in the Loins; when, it was ordered that he should be let Blood in a small Quantity: a Quack Chirurgion being called, he took from him almost a pound and a half; a little after, the Diseased began to fall all into a cold Sweat, and his Strength fail∣ing on a sudden, to be seised with a Shivering, a weak and uneven Pulse, and a frequent Fainting: being called at this time, I ordered him temperate Cordials to be taken frequently: then upon the resto∣ring of his Pulse and Spirits the Fever was renewed, which afterward held the Diseased for many Days, nay Weeks, after a very irregular manner; for he was wont, for three or four days, to be very hot, also to be infested with Thirst, Watchings, a Head-ach, and other Symp∣toms, afterward to fall into a copious, and as it were, critical Sweat, all over his whole Body, by which indeed, in half a days time, he found himself better, tho afterward the Fever renewing again, fre∣quently heaped together a new Matter, still to be blown off by a second, and afterward by a third Crisis. After that he had lay'n thus irregular∣ly feverish for at least twenty days, at length the Small Pox broke forth here and there in each part of the Body, and then the Fever first be∣gan wholly to remit; tho within a few days, by reason of Errors com∣mitted in Diet, a great many Pushes subsided again, a few only being brought to a Ripeness: however, in the place of the subsiding Small Pox, a mighty Bubo grew behind the right Ear; which being suppu∣rated and broken within a short time, a great store of Pus flowed forth for many days; and so at length, the Taints of the Blood hardly

to be blown off other ways, were sent forth by degrees, and the Dis∣eased perfectly recovered his Health.