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. V. Of the Intermittent Quotidian Fever or Ague.

NExt after a tertian Fever, by reason of their Affinity and the likeness of the Fit, follows a Quotidian. viz. whose access is wont to return every day. It is the Opinion of some that this Fever is only a double Tertian, and that it arises from the matter being disperst, and getting possession of a two-fold focus; to which never∣theless I do not agree, and I judge that its rise is to be attributed to a peculiar Discrasy of the Blood: in this the symptoms of Heat and Cold are more remiss; but the access holds longer, and is often wont to continue eighteen or twenty hours: this Fever for the most part follows upon a Tertian, for when the vital Spirit is much spent by a frequent Deflagration of the Blood, and (the feverish Disposition still remaining) the Blood is become weaker, it less concocts, or brings to perfection the nutritive Juice, and perverts it in a manner wholly into a fermentative matter: wherefore it is sooner brought to an increase, and is heapt together to a plenitude of Turgescency in half the time as before: but because the matter heapt together partakes as well of cru∣dity as adustion, therefore the heat of the fermentation is more re∣miss and more uneven, and (like green Wood laid on the fire) it burns more flowly; wherefore the fit is of a longer continuance.

Sometimes it happens that a Qutidian Fever arises first without a foregoing Tertian, viz. when a feverish affect seises a Body that is ca∣cochimical, and filled with evil Juices: for then the Blood, being poor in Spirits, perverts the nutritive Juice in a greater store, and heaps it together in a shorter time to a plenitude of Turgescency: and that which at first is a Quotidian often changes its Type, and becomes a Tertian: even as a Tertian often passes into a Quotidian, there being a great vicinity betwixt these Fevers, and their Causes; and a little change of the Constitution of the Blood makes a transition of the one into the other. An intermittent Quotidian Fever is not so easily cur'd as a Tertian: for whether that comes first simply, or follows upon an∣other intermittent; however it is raised drom a stronger cause, and ar∣gues a greater Discrasy of the Blood, which does not presently yield to Remedies: Moreover, this Fever if it be of Long eontinuance, or comes upon another Cronick Disease, besides the vice of the Blood, it has most commonly joyned with it infirmities of the Viscera: to wit, the Blood being vitiated, easily fastens its Impurities, heapt toge∣ther by degrees on the Viscera, as it passes through their Involutions.

(Hence in a quotidian Fever; a loading of the Ventricle, a tension of the Hypochondres, obstructions, or Tumours sometimes of the Liver, sometimes of the Spleen, or of the Mesentery, are joyn'd) tho these kinds of Affects are not the cause of the Fever (as is vulgarly thought) but only its products. Wherefore in this Fever, besides the simple Method of Cure which is indicated in a Tertian, many other Intents or Coindicants come in consideration, viz. We must use all our Endeavours that the Ventricle be purged of its load of Humours, that the stuffings of the Viscera be clear'd, that their Infirmities be strengthned, and together with these, that the Discrasy of the Blood be amended, and the feverish accesses stopt, so that by reason of these various kinds of Intentions, we must proceed by a longer way to the Cure. In this case Vomits, (if the Strength will bear them) will be of use above the rest; also Purges, with which the assiduous increase of the excrementitious Matter may be sent forth, must be often repeated; besides these, digestive Remedies and deobstruents which restore the Ferments of the Visce∣ra and of the Blood, and correct their Discrasies are frequently to be used. Wherefore, fixt Salts of Herbs, their extracts, the acid Spirits of Minerals, and sometimes Preparations of Steel do excellent∣ly well. Concerning these means there is a difficult task, since, because of the manifold evils, many things are to be done together, whereas, by reason of the assiduity of the feverish fit, the Diseased can use only a few. In affects thus complicated, tho the way of Method requires first a removal of Impediments, and then to cure the Disease, yet I have known this kind of Fever cured often without method, and empirically, in a cacochymical Body, attended with many other af∣fects; to wit, after a light provision for the whole, febrifuge Remedies outwardly apply'd have first taken away the feverish access, that af∣terward, time, and occasions of curing, might be the better afforded for the other affects. I lately went to see a Lady of Quality, who having long had a cachectical habit of Body, and being weak and fee∣ble, a month after Child-birth, was seized with an intermittent Quo∣tidian; after fix or seven accesses of which, her strength was so cast down, that she was not able to rise from her bed, or scarce to be rais'd up in it; nor could she take ever so little food, tho very thin, but it caus'd great disturbances in her Stomach: Moreover, the Region of the Stomach, and of the left hypochondre, was all beset with a hard Tumour, and violently paining: By reason of the strength being ex∣tremely cast down, there was no place here for evacuation besides the use of Clysters; and the Stomach being mighty weak, refus'd all other Remedies, unless they were pleasing, and in a small quantity. In this difficult case, and pent up within narrow limits of Curing, I advis'd these few things, viz. that she should take twice a day this mixture; viz. Magistral water of Earth-worms two ounces, Elixir Prprietatis

six drops: moreover, I ordered a fomentation to be apply'd to the Stomach, of the Leaves of Pontick Wormwood, Centory, Southern∣wood boyl'd in White-wine with the roots of Gentian, the Vessel covered; and that after the somentation, a toast dipt in the same Liquor should be worn on the Stomach; besides, I had febrifuge Epithems bound to her Wrists; and by these Remedies alone, on the third day she mist her Fit, and continued free from the same afterward, and then by the use of Chalibeat Remedies, she grew perfectly well within a short time.