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. VIII. Of the Ephemera Fever.

I Have said that the least degree of Effervescence which brings a con∣tinual Fever is placed in the subtle and spirituous Portion of the Blood, being too much agitated and heated: for this, like Spirit of wine, boyls on any light occasion, and gets a heat, being irritated either by too much Motion of the Body, or Perturbation of Mind; from an ambient heat, as that of the Sun, or of a Stove; by hot things inwardly taken, as drinking of Wine, eating of peppered Meats, and the like: for the Spirits of the Blood easily wax very hot of their own accord, and being violently moved, are not presently appeased, but exagitate, variously confound, and force to a rapid and disorderly Motion other Particles of the Blood: also by this Motion of the Spi∣rits, the Sulphur, or the oily part of the Blood is more boyled, a little more dissolved, and somewhat more freely kindled in the Heart, whence an intense heat is raised in the whole Body, but for as much as the Sulphur is heated and inflamed only by minute Parts, and not through∣out the whole, that fervour of the Spirits is soon allayed and ceases; Wherefore the Fever which is raised after this manner, is terminated

for the most part within twenty four hours, and therefore is called an Ephemera. And if by reason of a greater heat of the spirituous Blood, it be prorogued longer, it seldom exceeds three dayes, and it is called an Ephemera of many dayes, or a Synochus not putrid: but if it happens to be extended beyond this time, this Fever readily passes in∣to a putrid, to wit, from the long continued ebullition of the spiritu∣ous Blood, at length the grosser Particles of the Sulphur fall a burning, and involve the whole mass of Blood in this Effervescence.

An Ephemera Fever and a simple Synochus seldom begin without an evident Cause; besides the things before-mentioned, immoderate La∣bour, Watchings, a sudden Passion of the Mind, a constriction of the Pores, Surfeiting, also a Bubo or Wound, in Child-bearing Women an increase of milk are wont to bring these; the procatarctick causes which dispose to them are, a hot temper of Body, an Athletick habit, a Sedentary Life, and a Disuse of Exercise.

The first beginnings of this Disease depend on the presence of an Evident Cause; for either the Corpuscles of an extraneous heat mixt with Blood, make it boyl like Water on the Fire or a Fever is brought by motion, or by reason of Transpiration being letted, even as when Wines being heated, or stopt close in a Vessel, are set in a strong working: after what manner soever the inflammation be first rais'd, presently the Spirits make an effort, and moving hither and thi∣ther, force the Blood to boyl, and to inlarge it self in a greater space, with a frothy rarefaction: wherefore the Vessels are stretcht, and the membranous Parts are vellicated; hence a Pain, especially in the Head and Loyns, a spontaneous lassitude, and an inflation as it were of the whole Body ensue. But if with the Spirit of the Blood some sulphury Part withall be somewhat kindled, a smart heat is diffus'd through the whole, the Pulse becomes high and quick, the Urine ruddy; also Thirst, Watchings, and many other offensive Symptoms arise.

Concerning the Solution or Crisis of an Ephemera Fever, and of a Synochus not putrid, there are three things chiefly requisite, viz. a re∣moval of the evident Cause; secondly, a severing or difflation of the depraved or excrementitious matter from the Mass of Blood; thirdly, an appeasing of the parts of the Blood, and their restitution to a natu∣ral and even motion and site. According as these things happen, some∣times sooner, sometimes slower, and with more difficulty, this Disease is ended in a shorter or longer time.

1. The Evident Cause, which for the most part is extrinsecal, is ea∣sily remov'd, and Diseased Persons, as soon as ever they perceive them∣selves injur'd by any thing, are wont to avoid the presence of, or con∣tinuance with that thing: no Person being in a Fever upon drinking Wine, continues still to drink it; when any Person grows more hot

than usual by the heat of a Bath or of the Sun, it is irksome to him to continue in it longer.

2. As to the excrementitious matter which ought to be separated and blown off from the Blood, this is either brought from without, as when by surfeiting, drinking of Wine, standing in the Sun, or bath∣ing in hot Water, the Blood is infected with hot and fermentative effluvia's or Corpuscles, or that matter is ingendred inwardly, as when upon the deflagration of the Blood its Liquor is stuff't with adust Re∣crements or Particles; both these Matters must be separated and blown off from the Blood, and be sent forth either by Sweat, or insensible Transpiration, before the Fever is appeas'd: wherefore, when the Pores are clos'd, and Transpiration is hindred, the Ephe∣mera Fever continues a longer time, and passes from a simple Syno∣chus into a putrid Fever.

3. The Evident Cause being remov'd, and this degenerated Mat∣ter blown off, for a cessation of the burning heat there is required an appeasing of the Parts of the Blood, and a reducement of them to or∣der. for a rapid and disorderly motion begun in the Blood is not pre∣sently stopt, but ought to be allay'd by degrees: also the divers Parti∣cles of the Blood disorder'd after this manner, and being driven this way and that, by reason of the feverish effervescence, do not presently take to their former order of site and position, but it is necessary that they be extricated by degrees, and restored to their due mixture by little and little.

Tho this Disease, after the removal of the Evident Cause, ceases for the most part of its own accord, yet some Physical Remedies are ad∣vantageously applied to Use, especially where there is danger lest the Ephemera Fever passes into a putrid. The chief Intentions must be to allay the fervour of the Blood, and to procure a free Transpiration, to which chiefly conduce blooding, a very thin Diet, or rather absti∣nence, cooling Drinks, a withdrawing the excrements of the Belly by Clysters; but above the rest, Sleep and Rest do most good, which if wanting, they must be seasonably procur'd by Opiats and Ano∣dines.

A renowned young man, about twenty years of age, of an athletick habit of Body, by an immoderate drinking of strong Wine fell into a feverish distemper, with a drought, heat, and a mighty trouble of the Praecordia; being blooded, he drank a vast quantity of fountain-water, and thereupon a copious sweat presently ensuing, he soon recovered.

An ingenious young man, of a sedentary Life, and withall very much addicted to the study of Learning, when of late he had exercis'd him∣self above measure in the Summer Sun, began to complain of a Head∣ach, a want of Appetite, a trouble of the Praecordia, and a feverish distemperature over the whole Body. To whom (in regard he loath∣ed all Physick) I ordered a total Abstinence, unless it were from

small Beer and Barley-meats: On the second day, and again more on the third, the Symptoms remitted by little and little; at length, on the fourth, he became free from his Fever without any Medicine.