Pharmaceutice rationalis: or, The operations of medicines in humane bodies. The second part. With copper plates describing the several parts treated of in this volume. By Tho. Willis, M.D. and Sedley Professor in the University of Oxford.

SECT. I. CHAP. VI. Of a Phthisis properly so called, or of a Consumption arising by fault of the Lungs.

A Consumption doth so frequently and usually proceed from the Lungs being de∣praved, that some have termed it the peculiar Disease of this Bowel: and that it very often so comes to pass, the reason is; because (as we have shewed before) the pining of the body doth for the most part more immediately proceed from the blood depraved and unapt for nourishment, it is manifest, that as its perfection is acquired in the Lungs, so from these being ill-affected the same is most of all vitiated, and degenerates into a languishing and corruptible state. For in the Lungs rather than in the Heart or Brain, the threads of life are spun, and there they are oftnest defiled or broken.

A Phthisis is usually defined to be A pining away of the whole body,* 1.1 taking its rise from an Ulcer in the Lungs. But less true: because I have opened the dead bodies of many that have died of this disease, in whom the Lungs were free from any Ulcer, yet they were set about with little swellings, or stones, or sandy matter throughout the whole: for from thence the blood, because it could neither be freely circulated in the Praecordium, nor animated enough by the nitrous air, and when in the mean time it is

perpetually polluted by its proper dregs deposited in the Lungs, is frequently vi∣tiated and made incapable of nourishing thereby: wherefore a Phthisis is better defined, that it is a withering away of the whole body arising from an ill fromation of the Lungs.

The Ancients following Hippocrates,* 1.2 for the most part have assigned only two causes of this disease, viz. a Catarrh, and the breaking of a Vein, to which some have added an Empyema: and others exclude a Catarrh from this number: for what is vulgarly affirm∣ed, that flegm falling from the Head into the Lungs, and abiding there putrifies, is most commonly the cause of a Phthisis, or is often brought by it, we have formerly intima∣ted to be altogether erroneous, and shall presently shew it more clearly. In the mean time to shew what the matter is that generates a Consumption as often as it arises with∣out an Empyema or Haemoptoe going before,* 1.3 it must be considered after how may manners and by what ways any thing disagreeable or heterogene can enter into the Lungs; which diligent search being made, it will easily appear, that any thing that is an enemy to the Lungs creeps in and is admitted chiefly either by the Trachea or by the pneumonic Arteries,* 1.4 yea and sometimes haply by the Nerves, but nothing by the Veins or Lymphaeducts, whose function is only to carry back or away the blood or Lympha, and to leave there nothing at all.

As to the Trachea, it is manifest it is ordained for this end, that by its passages or pipes the air might be conveyed in or presently carried back by a constant recourse from whence it comes;* 1.5 moreover, whether any matter being hurtful or mortal to the Praecordia may be admitted the same way, shall be now our present disquisition. And that the Lungs frequently incur a pernicious pollution by this entrance is clear from hence, because the moist air of some regions, repleat with fumes, or abounding with malignant vapours, doth frequently induce the consumptive inclination; nevertheless the affection thereof is wont to be communicated only by aerial minute particles (whereby either the temperament of the blood or the conformation of the Lungs or both are prejudiced.) But whether besides this a serous matter or some humor corrupt∣ing the Lungs doth enter them through this passage, is not without reason doubted: al∣though many do determine a Catarrh or a destillation of the Serum from the Brain in∣to the Lungs by the passages of the Trachea, the principal cause of a Phthisis. Which opinion being erroneously delivered by the Ancients, I admire any either of our mo∣dern Physicians or Philosophers have admitted thereof; for it is manifest by anato∣mical observations, that nothing from the Brain by the Glandula pituitaria which seems the only passage from thence) falls down into the Palate or Breast, but that the Serum there deposited is conveyed by appropriate passages to the jugular Veins, and is re∣manded to the blood. Moreover it is manifest to sight, that whatsoever relique of Se∣rum is laid aside in the Glandules of the Ears, Mouth, Nose, or Face, is conveyed from them all by peculiar passages, insomuch that no humor whatsoever destils from the Brain or the Palate into the Lungs.

But although matter exciting a Congh doth not destil from the Head by the Trachea into the Lungs, yet sometimes falling down from the sides of the Trachea into their cavities,* 1.6 it produces that disease commonly called a Catarrh. For the Aspera Arteria, like the Arteries beinging blood, are endued with a nervous and musculous Coat, and so do occasionally enjoy sense and motion, having also a glandulous Coat and full of lit∣tle vessels to sustain the vital heat and nourishment. These last Coats make those in∣terspaces, and as it were cover the Cartilages. Moreover the superfluous serosities proceeding from the blood watering the Trachea are deposited into this glandulous Coat, which for the most part presently sweating into the cavities of the Trachea, serves chiefly to make them slippery and most: but if the mass of blood be poured out too much, and precipitated into serosities (as it frequently happens, a cold being taken, or the swallowing down of acid things, and on many other occasions) for this cause a great plenty of watry matter sweats out of the Glandules of the Trachea and mouths of the little Arteries into its cavities, which soon doth cause a most troublesom Cough, and often much spittle (which afterwards comes to be consumptive.)

But surely this cause of Spittle and as it were a Catarrhal Cough very rarely comes alone,* 1.7 because while the blood watering the Trachea having suffered solution, throws in its serosities into the Glandules (whence presently they sweat into its cavities) and also the remaining blood being in like sort dissolved, it insinuates its Serum set apart within the pneumonic arteries, partly into the tracheal hollownesses, and partly into the Lympheducts, by the overflowing whereof the Lungs are as it

were overwhelmed and much incited, for the most part provok'd to Cough and conti∣nual spitting. A Cough and spitting of this kind as long as moderate,* 1.8 only throwing off the serosities of the blood, rather are beneficial than prejudicial; because the mass of blood, and the very lungs being throughly purged after this sort, those symptoms for the most part spontaneously abate, and from thence ensues a more perfect health. But if they be protracted a long time, the serous humour being on both sides laid aside into the tracheal passages, and from thence more plentifully daily heapt up, at length it will change into corruption; because as well the free enjoyment of air is impeded, as also the motion of the blood, and its temperature wholly perverted; from hence a Cough becomes more fierce, and breathing more difficult; nay rather the whole mass of blood in as much as it is defiled by the foul blood (which the Veins receive from the Lungs) degenerating by degrees from its benign properties, and being depraved, it not only continually pours forth the super fluous Serum, but also the nutritive Juice (which it cannot assimilate) out of the pneumonic Arteries into the tracheal passages;* 1.9 and so this mass of consumptive matter is daily increased, till the Lungs being more and more obstructed and filled, and the blood being defiled, and rendred unfit to perform any of its functions, the Cough and Spittle become worse and worse, and presently be∣come dangerous; Moreover breathing being hurt, the faintness and pining away of the whole body, the debility of all the functionx, and at length a hectick feaver, and a hasty declination to death follows.

When by the long continuance of a Cough and Spitting, leasurely encreasing,* 1.10 the humour is more plentifully deposited out of the mass of blood into the lungs, it first of all enters into the tracheal little bladders, and at length fills them, and somewhat distends them, from which while every morning by expectoration then more copi∣ously performed, it is almost entirely cast out from them, thence the Thorax is ex∣empt for a short space from the burden, and respiration seems more free: yet a little afterwards the blood being stuff'd again with Serum or nutritive juice, it pours down new matter into the lungs; and from thence again after meat or sleep the little bladders are fill'd, and the humours by the afflux daily encreased, are more distended and enlarg∣ed, and at length the sides of two or more of the little bladders, being burst, many little bladders are here and there framed as it were into one lake, within which the con∣sumptive matter being more abundantly collected, there it putrifies (for it is not en∣tirely prefently cast out) and from thence it corrupts the substance of the lungs, to which it is joined, and imparts a putrid defilement to the blood passing through it. This breach thus made in the lungs is daily encreased, and frequently more are at the same time formed in divers places, and by reason of the great plenty of humours heaped up and putrified in them, a heaviness of the breast is felt, like a weighty bur∣den upon them, the breathing is more hindrd; moreover from the tabid blood being more plentifully intermix'd with the mass of blood, frequent effervescences of it, destruction of the nutritive juice, also thirst, heat, loss of appetite, nightly sweats, and a pining of the whole body do arise.* 1.11 But the blood being polluted from the lungs, causes them to be punished with a reciprocal affection, that is to say from its peculiar pollution; because the blood in the veins receiving this purulent matter in every circuit, it immediately delivers it into the arterial; from whence, whereas it cannot be sent enough away by sweat, or by Urine, it is brought back by the pneu∣monic arteries to the lungs, where again being separated from the blood, it is every where conveyed as well into the little bladders of the Trachea as into the lesser passages; insomuch, that at length the whole frame of the lungs being filled, clefts or ulcers are formed consequently in many places, and all the other hollownesses are stufft with frothy quitter.

But sometimes it happens that there is one Ulcer or hole, or happily two formed in the Lungs, and the sides grow callous round about, so that the matter being there gathered together is not conveyed into the mass of blood, but is daily expectorated though in a vast plenty. They that are so affected, as if they had but an issue in the lungs,* 1.12 although they cast up much Spittle, and thick and yellow matter every morning, and a little sometimes all day, yet otherwise they live well enough in health, they breathe, eat and sleep well, are well in flesh, or at least remain in an indifferent habit of body, and frequently arrive to old age: insomuch that some are said to have been consumptive thirty or forty years, and to have prolonged the disease even unto the term of their life (for that cause not being shortened). And in the mean time others who cough or spit less, within a few months fall into a hectick feaver, and in a short while are hurried into their grave.

Hitherto touching the conjunct cause and formal reason of a Phthisis or pulmonary Consumption;* 1.13 what belongs to the other causes (that is to say, procatarctic and evident ones) they truly are various and manifold, inasmuch namely as they are more near or more remote, inward or outward, and lastly connatural or adventitious: That I may un∣dertake to design the powers, operations, and modes of effecting of all these in producing a Phthisis; primarily it is requisite that I shew, by how many modes, and by reason of what occasions the serous humour of (as folks commonly say) the Catarrhal, is laid a∣part out of the mass of blood into the little bladders of the lungs, and into other passages of the Trachea.* 1.14 Upon diligent search of this it is obvious to any one to percieve the morbific cause consists of two parts, and that the fault is in the ill temper of the blood sending an offending matter to the Thorax, and also the weakness or ill tone of the lungs easily receiving it.

As to the former, it is manifest enough by common observation, that the mass of blood being stuft with incongruous particles, viz. its proper ones degenerated, or with others from other places intermingled,* 1.15 doth boyl up for the expurging of them, and what is to be separated, when it is not easily sent away by any other ways, it is spread abroad into the lungs, (if they are of a weaker constitution) and cleaves to them.

There are many dyscracies of the blood, and those of divers kinds and affections, by by which its liquor being dissolv'd in its consistence, and as it were curdled, doth not rightly contain the serous and nutritive juice within it self; moreover sending away these and other excrementitions humours uncessantly from, it self, as sometimes it de∣posits them among other parts, so more often into the lungs.

1. The blood sometimes like Milk grown sour of it self, is depraved by little and little, and at length departing from its genuine faculty into a sourness, and being dissolv'd in its existence, doth cast abroad its serosities (too easily prone to separate themselves) out of the Pneumonic and also Tracheal Arteries into the tracheal passages. Thus to some it is ordinary once or twice in a year, without any mani∣fest cause to be afflicted with a grievous and troublesome Cough, with copious spitting, which in a certain process of time (after the blood purged from its dregs and excre∣ments recovers its temperature) doth spontaneously abate, and after doth succeed a more firm and durable health. By reason of such a Cough serving for a purge to the blood, I have known some often in a day, and especially every morning, who were wont to spit out spittle like black Ink, with a small endeavour of the Trachea; which distemper when for many months they had constantly labour'd under, after a greater Cough occasionally contracted, with much and yellow spittle, they have afterwards escaped altogether free from that former black spittle; the reason whereof it, that a heavier Cough abiding with plentiful spitting for several days, altogether purges a∣way those melancholy foeculencies from the blood, and moreover it alters the tem∣perament of the blood, or rather takes away the ill temperament thereof.

2.* 1.16 The nervous juice being frequently degenerated, and with an abundant lympha returning back out of the fibres and nervous parts into the blood, as it produces ill affects of the bowels, and of the reins (whereof in another place we have hinted) so sometimes it causes a fierce and very troublesome Cough. This kind of Cough one while is Catarrhal, inasmuch as the Lympha having pass'd through the mass of blood, is deposited in the Lungs by the arteries; another while it is convulsive, inasmuch as the Nerves and fibres, constituted to move the breast, are possest by that liquor, and are provok'd into convulsive motions: from either cause either conjunct or sepa∣rately it comes to pass, that more grievous passions of the brain and nervous kind frequently call on a troublesom Cough, or are wholly changed into it.

3.* 1.17 Besides the faults of the blood and nervous juice, frequently exciting a Cough, it is probable that it sometimes arises from the Lympheducts being obstructed, which be∣long unto the Lungs: for whereas very many Vessels of this kind are spread abroad through the Lungs, whose function it is to receive whatsoever is superfluous of the Lympha that is carryed through the Arteries into the Praecordia, and not immediately brought back by the veins, and to convey it to the trunk of the passage of the Thorax; if by chance it happens that these passages are stopt or obstructed by viscous matter, or compress'd or thickned by cold should not well discharge their duty, it must needs be that those watery excrements shut out from their wonted sluces, or whirling back into the blood, do incite its fierce boyling up, or being poured into the passages of the Trachea, do stir up a Cough.

4. Neither do the humors above-mentioned only,* 1.18 in as much as they either pervert or hinder the crasis or motion of the blood, induce a Cough (which frequently is the be∣ginning of a Phthisis;) but moreover any usual or wonted Evacuations suppressed, or let, do usually impress a fault upon the Lungs. The menstruous flux or the Haemorrhoids obstructed, often bleeding at the Nose it by chance it ceases, Issues closed up, Pustles, Scabs and Wheals driven back, do frequently affix a taint in the Thorax. If a plentiful spitting from the Glandules of the Mouth stops of its own accord, or be cu∣red by Medicine, afterwards sometimes a consumptive Cough succeeds; wherefore the same is vulgarly called a Rheum, which had lately fallen from the Head into the Jaws and Throat, and thence destilled deeper into the Lungs; when indeed it is no∣thing else but a certain superfluous serosity of blood, that being used to be put aside by the cephalic Arteries into the Glandules of the Mouth, now being excluded thence, is hurried through the preumonic Arteries into the Lungs.

Besides these private and periodical, or extraordinary Evacuations,* 1.19 whose suppressi∣ons incline to a Cough and Phthisis, there occurs another general and constant Evacua∣tion, viz. insensible transpiration; which being either stopt or suppressed, is oftner the occasion or parent of that evil than all the rest. For the steams that usually evaporate by the Pores of the skin being restrained within, ferment the blood, and soon pervert it, and cause it to be precipated into serosities; which with other excrements of the mass of blood being immediately laid aside in the Lungs, do stir up a troublesom Cough and often a consumptive one. Hence it is a common observatioin, that the catching of a cold, by which the Pores are stopt, whether it be by the blowing of cold air, or being wet by rain, or leaving off cloaths, or by what other means it may come to pass, disposes very many to distempers of the Thorax. Wherefore in our Idiom the cause being put for the effect, a Cough is called Catching of cold.

These are the chief causes and occasions which occur from the blood any ways de∣praved,* 1.20 and therefore depositing a peccant matter into the Lungs. There follow other causes in regard of the Lung it self, viz. those which dispose this Bowel more readily to a Cough or a Phthisis, of which there are three sorts. 1. An ill frame of the Breast.* 1.21 2. An innate weakness of the Lungs, or hereditary disposition to a Consumption. 3. Preceding diseases of the Thorax, as a Wound, a Blow, a Pleurisie, a Peripneumony, Empyema, Spitting of blood, the small Pox and Measles, &c. 4. The incongruity of air which is inspired (as deserving a place among the procatarctic causes.) By reason of any one of these causes, and sometimes of many together, the matter provoking a Cough, proving often after consumptive, doth easily assault the Lungs, and enters them, and frequently imprints a deadly hurt. On each of these we shall insist a little.

First therefore as to the frame of the Breast the case stands thus: viz. that the Lungs being still whole and sound, and free from any phthisical impression, may be kept for a long time in their office, it will behove that they sitll be exercised with a motion that is vigorous, and with stretched our sails as it were to discharge the strong interchanges of the Systole and Diastole; to that end, that the air being plentifully suckt in,* 1.22 may be admitted to their inmost apartments, and from thence immediately be cast back for the most part together with all the effluvia and sooty vapours at every change of breath. Wherefore since the action of the Lungs doth depend much on the frame of the Thorax, as being the moving Engine, it must needs be, that by reason of its ill fashioning, the function of breathing becomes defective in many things. There are two special kinds of a Breast ill framed, (viz. crookedness, and shoulders like wings) for which reason many are found prone to a Phthisis: the reason of which is, that in any such figure of the breast, being either depressed or made long, the Lungs do neither injoy a space so free and ample, nor can the moving Muscles be so strongly contracted as in a square breast.

2.* 1.23 The innate debility or hereditary disposition of the Lungs to a Consumption is so frequent and vulgarly known, that when any is found inclining to a Consumption, he is presently questioned, whether his parents were not obnoxious to this distemper? Very many of these being endued with a narrow breast and a neck somewhat long, and of a constitution very tender, contract a Cough from the least occasion; neither can they endure a cold or moist air. To some of these a mansion in a City is very preju∣dicial, where the air is breathed in thick and smoaky; on the contrary, to others prone unto the same disposition it is very friendly (the reason whereof we shall diligently in∣quire hereafter) To all of them a North-wind is for the most part an enemy, consider∣ing that it usually irritates a Cough, also a Spitting of blood, a Pleuisie, or Peripneu∣mony,

viz. the pneumonic or the thoracical Vessels being thereby stufft, and in the mean time the blood being rendred more rurgid and sharp, by reason of transpiration hindred, and the effluvia's restrained within the mass thereof.

For an hereditary disposition to a Phthisis doth chiefly consist in these two things:* 1.24 viz. 1. In regard the Patients being endued with a more sharp and elastic blood, do require a more plentiful transpiration; which perhaps if it be less granted, the matter that was wont to evaporate redounds upon the infirm Lungs. 2. If the pneumonic Vessels be too loose and tender, they do not duly contain the Serum and other recrements of blood within the dissolved mass thereof, but they sometimes suffer both them and a certain portion of the blood it self to break out into the Tracheal passages: whose moving Fi∣bres, when they are infirm, do not presently turn forth what is poured out into the ca∣vities; but they suffer it to abide and putrifie in the same place, and at length to degenerate into black filthy gore corruptive both of the Lungs and blood.

3.* 1.25 A Phthisis is sometimes the product or consequent of some other previous distem∣pers of the Breast. Those consumptive passions chiefly are Empyema's, Pleurisies, a Peripneumony, and Imposthume of the Lungs; and sometimes the small Pox, Measles: also irregular Feavers ill or slightly judged, do cause the same effect. The chief of these distempers, or at least those which are proper to the Thorax, together with the ren∣dring the reason of the causes, and how they dispose to a Consumption, shall be de∣clared hereafter, with the reasons and manner of procedure; in the mean time we are to take notice, that this kind of fault is common to them all, that is to say, they dissolve the unity and weaken the tone of the Lungs, and pervert the temperature of the blood; whence whatsoever incongruous or distempered thing is poured out upon them from its depraved mass, they do easily admit thereof, and difficultly or not at all drive it back.

4.* 1.26 The procatarctic causes of a Phthisis being now explained, viz. those which con∣sist as well from the blood as the Lungs, there is another common to them both, which may be justly added, and (although altogether extrinsec) hath great affinity with them both, viz. the condition or temper or the air breathed in. For such is the influence hereof to some consumptive persons, that the cause of the disease is sometimes wholly ascribed to the incongruity of the air wherein they dwell, and for a cure the alteration of air or soil is preferred to all other remedies whatsover. Hence many of our Country troubled with a Cough, or being in a Consumption, flock to the Southern parts of France; and others in the mean time who cannot go beyond Sea, or will not, presently hasten to remove out of the City-smoke into the Country as to a most undoubted re∣fuge: wherefore all our Villages near London, which injoy a clear and open air, are esteemed as so many Spittles for consumptive persons. Notwithstanding all do not alike receive help from such a change of places; for many either passing to France or to Coun∣try Villages, do in those places rather find their graves than health. And therefore London is not presently to be forsaken by all phthisical persons: for I have known may obnoxious to a Cough or Consumption to have enjoyed their health much better in this smoaky air than in the Country. So that for cure of the same disease, while some avoid this City as Hell, others flye to it as to an Asylum.

The reason of these things do clearly appear out of the Doctrine of Breathing before handled;* 1.27 for we do demonstrate the blood passing through the Lungs, both as to its kindling or vitality, and as to its motion doth chiefly depend on nitrous air suckt in; whence it is a consequence, that the tenor of this ought to be so proportioned to the temperament of that, that the blood being moderately kindled within the Pracor∣dia, may burn out clearly and vigorously,* 1.28 as well without smoak and sootiness as with∣out too intense a flame, and that it may pass the pneumonic Vessels freely, and without any hindrance or leaving of recrements. Wherefore a moist, and close air, as it is healthful to none, so to them that cough it is especially hurtful; on the contrary, a serene and mild air, moderately injoying the Sun and wind, as it is healthful to all per∣sons, so it is friendly to all consumptive persons. As to other conditions of the air, some escape a Cough, or lose it living in mountainous places exposed to the Sun, where the impendent Atmosphere being free from all thick, smoaky, and feculent va∣pous whatsoever, abounds with nitrous particles: for those whose thick and feculent blood abounds with an impure Sulphur, to kindle this duly and to waste the dreggi∣ness, there is need of a very thin and nitrous air. If the Lungs be not too tender, but firm and strong, they endure the more fierce assaults of its particles; on the other side, they who have a thin and subtil blood, easily dissolvable and endued with a more

pure but very little Sulphur, and having tender and soft lungs, very sensible, and of a finer texture; these persons being impatient of a nitrous and sharper air, are most at ease and best in a thick and more sulphureous one. Wherefore it conduces to these persons, that they breathe the gross and more fat air of a smoaky City; which to an impoverished and more thin blood, doth afford Sulphur (which fails sometimes) and also Nitre, and doth something thicken and fix its subtile consistence; moreover it dulls the substance or texture of a Lung too much sensible and more thin, and is a defence against the invasions of a more sharp and improportionate Air.* 1.29 It is manifest by frequent experience, that a thicker Air, provided it be sulphureous, proves very benign to some phthisical persons (that I do not say to all.) It is a common observation, that a Consumption seldom infests those Regions either in England or Holland, where fires are nourished by turffe, and do breathe a very sulphureous odour, yea rather those places are chiefly wholesom and frequently sanative to persons obnoxious to a Phthisis, or labour∣ing under it. To which we may add, that a suffumigation of Sulphur and Arsenic (which is filled with much Sulphur) is reputed for the curing of almost incurable Ulcers of the Lungs, although the last, yet the most efficacious remedy.* 1.30 Moreover add to this, that pectoral Medicines prepared of Sulphur are far to be preferred to any other; so that Sulphur is justly reported by Chymists to be the Balsam of the Lungs. By what order and by what means these Medicines do work; and so nota∣bly help in diseases of the Thorax, we shall hereafter make diligent search into: in the mean time that sulphureous Air is found helpful to certain phthisical persons, the rea∣son consists in these two things; viz. in the first place, as we now intimated, from such an Air suckt in there is help brought to the jejune and depauperated blood and to the tender Lungs. Secondly, that the sulphureous Particles being suckt in with the nitrous, do provide against,* 1.31 or take away the acidities of any of the humours (by which their flowings and extravasations into the Lungs do chiefly arife.) And for this reason it is that sulphureous Medicines, being also taken inwardly, do confer so excel∣lent a help to them that cough or are phthisical: therefore Sulphur, as I now hint∣ed, hath the report of being the Balsam of the Lungs. For as balsamic things applied to an Ulcer or Wound extinguish the acidity of the Ichor there sweating out and cor∣rupting and paining the little Fibres, soon ease the pain, and afterwards heal the wound; so also the sulphureous Particles, passed into the Lungs either with the air or with the blood, in as much as they provide against or abolish the acidities of all humors, i.e. the blood, the Serum, the Lympha, the nervous or nutritive Juice, they conduce to the prevention or cure of a Consumption. We shall in what follows more at large declare the cause, when sulphureous Medicines shall be particularly treated of. The conjunct and procatarctic causes of a Phthisis being thus handled, it will not be necessary to discourse much touching the evident causes. For in what manner a closing of the Pores by cold, a surfeit or tipling, and other errours of several sorts, in the six non-naturals, dispose to those distempers, and sometimes presently do bring them,* 1.32 is so clear, that it needs no explaining. Neither is there any reason we should be long delayed about the Semiotical part of this disease; nevertheless it is fit we observe the divers states or distinctive signs which certainly belong unto it. 1. When it is meer∣ly a Cough. 2. When it begins to degenerate into a Phthisis. 3. When it is a per∣fect and almost desperate Phthisis. From which things duly designed, the Prognostic of the above-mentioned affections will be very apparent.

1. And in the first place what belongs to a new Cough, and as yet alone,* 1.33 this taking its rise from any cause whatsoever in bodies predisposed to a Phthisis, will scarce ever be free from the suspicion of danger; but in a strong man, and one who hath often before endured a Cough Scot-free, it will not be immediately to be feared: for when being stirred up from a more forcible evident cause, without Feaver or indisosi∣tion of the whole body, it shall not be very troublesom, then it meerly passes for a cold being taken, and is altogether neglected, or in a short time is wont to be finished without many or very considerable Remedies. Moreover if a small Feaver with thirst and want of appetite accompany this, there is hope that the blood being restored to its due temperament, the Cough then will cease of its own accord: but if it be protracted longer, and not easily yield to vulgar Remedies, and produces much spitting, and that discoloured, it must not be any longer neglected, but be pro∣vided against by a method of healing, and by fit remedies and an exact course of diet. For then it may well be suspected, that the Lungs being prejudiced in their structure, do not circulate the blood entirely, but let fall the Serum and Lympha, and fre∣quently

the nutritive Juice; and moreover those humors so laid aside do putrifie; and from thence the blood is defiled, which by a reciprocal hurt prejudices again the Lungs.

2.* 1.34 But if to a Cough growing daily worse and worse with plentiful and thick spittle, a languishing and pining of the whole body, loss of appetite, difficult breathing, thirst, and fervent heat of the blood be added, there is great cause of suspicion that it is come at least to the first limits of a Phthisis (if not further.) Wherefore it will behove us to use all means, whereby the Lungs may be freed from the great quantity of matter heaped up together, and be defended from its continual assault or invasion; and also that the mass of blood may be cleansed from all dregs, and restored to its due tempe∣rament whereby it may rightly contain its serosities and other humors within it self, or transfer them to some other place than to the Lungs.

3.* 1.35 But if, beyond the state of this distemper now described, plenty of spittle, and that discoloured, shall be daily increased, and all other things growing worse and worse, a dejection of the whole strength, and a hectic Feaver with a continual thirst, night Sweats, an Hippocratical face, an utter decay of the flesh almost to the driness of a Skeleton, happen upon all these, then for the most part no place is left for Medicine, but only a dreadful prognostic; at least all hope of Cure being waved, we must insist upon Anodynes, whereby an easie death may be procured.

What therefore belongs to the cure of a Cough in general,* 1.36 according to the three above-mentioned states of this disease, a threefold method of healing ought to be ap∣pointed, viz. that bounds as it were being set, we may more distinctly prescribe what is to be done for the cure of a Cough, whilst being on this side the limits of a Phthisis, it passes only for a cold catched. 2. What manner of healing to a beginning Phthisis. 3. What to a Phthisis consummated, or desperate.

1. Although against a new Cough for the most part there are used only Remedies Empirical, and scarce any of the common people but are furnished with many and di∣vers of this sort, which every where without the advice of a Physician very many con∣fidently take, and without method, and give them to others: yet men of a delicate constitution, or inclining to a Consumption hereditarily, or sometimes formerly in ha∣zard from a Cough, ought immediately to provide against the first assaults thereof, and readily betake themselves to the Precepts of Physick; according to which, that the method of healing may be duly instituted, the curatory indications shall be chiefly these three;* 1.37 viz. 1. To appease or take off the disorder of the blood, from whence the fluxes of the Serum do proceed. 2. To derive the excrements of the blood and all exuviae, apt to separate from it, from the Lungs to the Pores of the skin, or to the urinary passages, and into the other Emunctories. 3. To strengthen the Lungs them∣selves against the reception of the Serum and other humors, and also to defend them against the invasion of outward cold, whereby they are wont to receive further hurt. Upon each of these we shall treat a little more plainly.

1.* 1.38 The first indication respects as well the boiling up of the blood, wherein by rea∣son of the effluvia's restrained, it grows too fervently hot, and boils in the vessels; as its dissolution, whereby being solved in its consistence, it lets go too much Serum and other humors from its embraces. For the taking away of both, a thin diet must be ap∣pointed, and, the injury from outward cold carefully declined, a little more sweating ought to be procured, or at least the accustomed restored. To this end let the Pati∣ent put on thick garments, and let him keep his bed or chamber, at least let him hardly go out of his house, evening and morning let a small breathing Sweat be pro∣voked by Posset-drink boiled with Rosemary or Sage. If notwithstanding all this the Cough increases, Phlebotomy, if the strength and constitution will bear it, is often used with success: after which Hypnoticks for the most part help, in as much as they retard the motion of the heart and consequently the too precipitate course of blood: moreover they cause it to circulate in the pneumonic Vessels gently and mildly without any great throwing out its serosities, and to send away what is superfluous either by Sweat or Urine. To this purpose pectoral Decoctions are also to be administred, in as much as they destroy the acidity of humors, and hinder the dissolution of the blood, and its melting into serosities. By the like reason and manner, Medicines prepared of Sulphur do so signally help against a Cough.* 1.39

The second indication, viz. that the Serum and other recrements of the blood, de∣rived from the Lungs, may be evacuated by other ways, is performed by Diaphore∣tics, Diuretics, and mild Purgers; which ought to be mixed with other Remedies,

or now and then used alone. Wherefore after Phlebotomy we use to prescribe a gentle Purge, and sometimes to repeat it. Among the Ingredients of the pectoral Decoction let the Root of Chervile, Butchers-broom, Elicampane, and other things that provoke Sweat and Urine be put. Hog-lice, volatile Salt of Amber, and other fixed Salts and Powders of Shells made into Pills with Turpentine are often given with success.

The third indication,* 1.40 that the Lungs and their passages might be desended against the flowing of humors, the encountring of cold, and the suppression of the Catarrh, as they commonly call it, is performed by Linctus's, Lohochs, and other private Reme∣dies, and chiefly respects two things; viz. that the mouths of the Vessels and Glan∣dules opening into the Trachea be shut with moderate Astringents, lest they should too much east out the serosities into it: and secondly, that the sides of the Tracheal passages may be made smooth and glib, that neither from the pouring out of the sharp Serum, nor invasion of any outward cold they may be offended, and continally provoked into a troublesome Cough; and moreover when those passages are made slippery enough, the spittle sometimes obstinately cleaving to their sides, might be the more easily coughed out. For the first intention it is, that Conserve of red Roses, Olibanum, Mastich, Lohoch of Pine-tree, Syrup of Jujubes, of dried Roses, of Cup-moss, and other Astringents are often put into the forms of Pectoral Prescriptions. For the second intention Liquorish, with the divers preparations thereof, is reputed a famous Remedy against any Cough: for this purpose Syrups and Lohochs, and all other sweet Pectorals seem to be ordained. To which is added Oyl of sweet Almonds, either administred by it self, or brought with pectoral Syrups after a long stirring of them together into a milk form liquor.

These are the chief Therapeutic indications, together with the apt intentions of healing, which seem chiefly to be of use for a new Cough, while as yet we have no suspi∣cion of a Phthisis, or at least that it subsists without the manifest limits thereof; it now remains, after this general method briefly shadowed out, that we subjoin certain choice forms of Medicines appropriated to every intention. These, though they are manifold and of divers preparations, yet those which are of chiefest note and most in use,* 1.41 are Mixtures, Linctus's, Lohochs, Tinctures, Balsams, Troches, Lozenges, Powders, Pills, Decoctions, and distilled Waters. Of each of these we shall set down some choice Receipts.

1. Mixtures.

Take of Syrup de Maconio, of Jujubes, of each an ounce and half; of powder of Oliba∣num a dram, the water of Earth-worms, or of aq. Hysterica, or Peony compound a dram, mingle them. The Dose is one spoonful at bed time and after midnight.

Take of the water of Snails, of Earth-worms, of each an ounce and half; of the liquid Laudanum Tartarizated two drams, Syrup of Violets an ounce. The Dose is one spoonful at bed-time.

Take of Snail-water ℥vj. Syrup of the juice of ground-Ivy, ℥iij. Flower of Brimstone ʒss. mix them. The dose is one spoonfull at bed-time, and soon in the morning.

Take of our syrup of Sulphur 4 ounces, Water of Earth-worms 1 ounce. Dose 1 spoon∣full after the same manner.

2. Linctus's.

Take of syrup of Jujubes, Maiden-hair of each one ℥ and half, syrup of red Poppys 1 ounce, mix them; to be lick'd with a Liquorish Stick.

Take Oyl of Sweet-Almonds fresh drawn, Syrup of Maidenhair, of each 1 ounce and half, white Sugar-candy 2 drachms, mix them by beating in a Glass-morter, or shaking them in a Glass Vial till it wax white.

3. Lohochs.

Take Conserve of red Roses 2 ounces and half, Lohoch Sanum 1 ounce and half, Spec. Diatragacanth. frig. 1 dram and half, flowers of Brimstone half a dram, Syrup of Vio∣lets or red Poppyes as much as sufficeth, let it be made a sost Lohoch. Dose 1 dram and half at night and early in the morning; at other times to be licked with a Liquorish stick.

Take of the powder of the leaves of Hedge-mustard, or Rockets, 1 ounce and half, clarified Honey 4 ounces, mix them for a Lohoch, let it be administred after the same manner. It agrees with cold Constitutions.

4. Tinctures.

Take of Tincture of Sulphur, without empyreuma 3 drams, Dose from 6 drops to ten in the evening, and early in the morning in 1 spoonfull of Syr. of Violets, or of the juice of ground-Ivy; I scarce know a more excellent remedy for any Cough, provided there be no feaver.

Take of Tincture of the Sulphur of Antimony 2 drams, Dose 20 drops evening and morning in one spoonful of the pectoral Syrup.

Take of the Tincture of Gum Ammoniack (prepar'd with the Tincture of Salt of Tartar) 1 ounce, Dose from 15 drops to 20. After the same manner the Tinctures of Galbanum, Assa foetida, Gum of Ivie (prepar'd after the same manner) are proper for a Cough in any cold constitution.

5. Balsams.

Take of Opobalsamum 2 drams, Dose from 6 drops to ten in a spoonfull or two of Hyssop, or Penny-royal, or any other Pectoral water.

Take of the Balsam artificially distill'd, commonly call'd the Mater Balsami, two drams, Dose from 6 drops to ten in one spoonfull of Syrup of Violets or Canary Wine eve∣ning and morning.

Take Balsam of Sulphur two drams, the dose from five drops to ten after the same manner.

Take of Balsam of Peru one dram, Dose from two drops to 4 or 6 in Conserve of Violets.

6. Troches.

Take of the Species of Diatragacanth. frigid. ℥ss. Liquorish ʒj. flower of Sulphur ℈ij. flower of Benzoin ℈j. Sugar Penids ℥iij. make a Paste with the dissolution of Gum Tra∣gacanth in Hyssop-water, form it into troches of the weight of ʒss. Take one often in the day or in the night.

Take of the seeds of white Poppies ʒ vj. of the powder of the flowers of red Poppies ʒj. extract of Liquorish ʒij. milk of Sulphur ʒss. Sugar Penids ℥ij. with mucilage of Quince∣seeds make a Paste, and form it into troches.

Take of the Species Diaireos, of the lung of a Fox, of each ʒss. Sugar Penids ℥ij. with the dissolution of Gum Tragacanth, make them into Troches.

Take of powder of Elicampane, Anniseeds, Liquorish, of each ʒij. flower of Brim∣stone ʒj. of Tablet Sugar ℥iss. juice of Liquorish dissolv'd, as much as will suffice, make Troches.

7. Lozenges.

Take of the Species Diatragacanth. frigid. ʒiij. powder of the flowers of red Poppies, milk of Sulphur, of each ʒss. of Sugar dissolv'd in Poppy-water, and boyl'd to make Ta∣blets, ℥iiij. form lozenges of ʒss. weight.

Take of Species Diaireos, of the lung of a Fox, of each ʒiij. flower of Brimstone, powder of Elicampane of each ʒss. of the whitest Benzoin ʒj. make them in a fine pow∣der, adding of Oyl of Anniseeds ℈j. Sugar dissolved, and boyled to a height to make lo∣zenges ℥viij. for lozenges of ʒss. weight.

8. Powders.

These though more seldom, yet are sometimes given with success in a Cough, and pneumonic distempers.

Take of the tops of Ground-Ivy somewhat reddish, a sufficient quantity, bruised let them be form'd into a Cake, which dryed presently in the hot Sun, reduce into fine powder, and keep it in a glass. This Plant keeps its virtue with smell and taste longer than any either Conserves or Syrups, and greatly profits in a grievous and pertinacious cough. Take from ʒss. to a dram, in distill'd water, or pectoral decoction twice in a day.

After the same manner Powders of other pectoral Plants are prepared, and taken with benefit.

Take of Cup-moss or chin-cups ʒiij. milk of Sulphur ʒj. Sugar-candy ʒss. make a pow∣der; the dose from ℈j. to ʒss. twice in a day. This powder is given with great benefit to those labouring with a chin-cough.

Take of the flour of Brimstone, Olibanum, Ceruse of Antimony, of each ʒij. divide it into xii. parts, take one part in the morning, and another in the evening in a spoonfull of a convenient vchicle.

9. Pills.

Take of Aloes rosata, or rather of Ruffus's his Pill, flower of Brimstone of each one dram and half, flowers of Benzoin ℈ j. Juice of Liquorish dissolv'd in as much Snail-water as will suffice to make a mass, form it into small pills to be taken 4 at night, to be repeated every or every other night.

Take of powder of Elecampane, Liquorish, flower of Brimstone, of each one dram, flowers of Benzoin half a dram, Tarr as much as is sufficient, form it into small pills, the Dose 3 or 4, evening or soon in the morning.

Take of Millepedes or Hogs-lice prepared ʒ ij. the powder of the seeds of Nettles, Bur∣dock of each half a dram, Oyl of Nutmegs distilled ℈ j. Salt of Amber half a dram; Juice of Liquorish what will suffice, form it into small Pills, take three in the morning and in the evening.

10. Decoctions.

These are taken either by themselves, or with the addition of Milk. Among those which are of the first kind, 1. The Pectoral Decoction according to the London Dispen∣satory, offers it self. Which is taken twice a day from ℥ iiij. to vj. or ℥ viij.

Take of the leaves of Ground-Ivy, white Maiden-hair, Harts-tongue, Coltsfoot, Agri∣mony, of each one handfull, Roots of Chervil, Knee-holm, of each one ounce, Carthamus and sweet Fennel seeds, of each half an ounce, boyl them in 6 pints of Spring-water to the con∣sumption of half, adding towards the end Liquorish three drams, Raisins stoned two ounces, Jujubes, n^o vi. or clarified Honey three ounces, make an Apozeme, clarifying it with the white of an Egge; Dose 6 ounces warm, 2 or 3 times in a day.

Decoctions taken with Milk, are used morning and evening instead of Breakfast and Supper, according to the manner following.

Take the flowers of greater Daisies one handfull, three cleansed Snails, half an ounce of candied Eringo roots, Barly 3 drams, boyl them in a pint and half of water to a pint. Take 6 or 8 ounces warm, adding a little milk; and afterwards the quantity encreased by little and little.

After the same manner, Cup-moss, Ground-Ivy, St. John's-wort, and other pecto∣ral herbs are boyl'd and taken with Milk.

The Decoction of Woods often does conduce much to the cure of a stubborn Cough, especially if appointed in the place of Beer, for ordinary drink, and taken for some time.

Take of the roots of Sarsaparilla 4 ounces, China two ounces, white and red Sanders of each half an ounce, shavings of Ivory and Harts-horn of each 3 drams, let them be infused, and boyled from 8 pints of Conduit-water to 4, adding Liquorish 6 drams, Raisins stoned an ounce and half; in a phlegmatick or colder constitution, adde of sha∣vings of Lignum vitae.

11. Distilled Waters.

Every one may compound manifold and divers forms of these as occasion requires, and appoint according to the constitution of the patient, sometimes simple Milk, sometimes Milk with some part of Wine, sometimes Ale, or Brunswick Mum. For a Sample we will prescribe the form of these.

Take of the leaves of ground-Ivy, Hyssop, Penny-royal, of each four handfulls, of Snails half-boyl'd in their shells two pounds, Nutmegs sliced no. vj. Ʋpon all being cut small pour eight pints of fresh milk, let it be distilled in the common Organs, i.e. a Pewter-Still.

The dose 3 ounces twice or thrice in a day by it self or with some other Medicine.

Every dose let it be sweetned when it is taken with Sugar-candy, or with the syrup of the juice of Ground-Ivy.

In a constitution less hot, especially if there be no fervent heat of the blood or Praecordium, to six or seven pints of Milk, adde one pint or two of Canary wine; and in a phlegmatick or old body, instead of Milk let the Menstruum be Ale or Bruns∣wick Beer, i. e. Mum.

Moreover, in Winter-season when Snails cannot easily or scarcely be procured at all, there may be substituted in their stead Lambs or Sheeps Lungs, also sometimes Calves, being half-boyl'd and cut small, with the forementioned ingredients, and a fit Menstruum being added, let them be distilled in common Organs, or Rose∣stills.

To this form,* 1.42 treating of a Cough not yet arrived to a Phthisis, ought to be re∣ferred the convulsive or suffocating Cough of children, and in our Idiome called the Chin-cough. This assaults chiefly Children and Infants; and at certain seasons, viz. Spring and Autumn especially, is wont to be epidemical. The diseased are taken with fre∣quent and very fierce fits of Coughing, wherein namely the Organs of breathing do not only labour in pain, but also being affected convulsively, they do variously suspend or interrupt their actions; but for the most part the Diaphragma convulsed by it self, or by the impulse of other parts, doth so very long obstinately continue the Systole, or Diastole, that Inspiration, or Expiration being suppress'd for a space, the vital breath can scarcely be drawn; insomuch that coughing as being almost strangled they hoop, and by reason of the blood stagnating, they contract a black∣ness in their countenance; if perhaps, those organs not in such a measure convulsed, they are able to breathe any thing freer, notwithstanding they are forced always to cough more vehemently and longer, untill they wax faint.

The formal reason or conjunct cause of this disease,* 1.43 consists in these two things, viz. that there is present a quick and vehement irritation of the lungs, whereby they are almost continually incited to throw off something troublesom by Cough; and al∣so that the motive parts of the Thorax, viz. the Nerves and nervous fibres being pre∣disposed to convulsions, as often as they are irritated, do excite a Cough not regular but convulsive, and such as is opposite or injurious to the usual function of breathing.

The matter provoking the lungs so frequently into a Cough seems to be the Serum,* 1.44 uncessantly soaking out of the mass of blood, by reason of its frame being too much loosened, and troubling the parts belonging to the breast, inasmuch as it destills as well through the tracheal arteries into the hollowness of aspera arteria, as that it is poured in plentifully through the pneumonic arteries into all the open passages.

The convulsive disposition of the moving parts,* 1.45 as in other convulsive distempers, seems to proceed from a heterogene and elastic matter falling from the brain through the nervous passages, together with the nervous liquor, into the small moving fibres of the breast; wherefore, when the spirits that are contained in those little fibres, are stirr'd to perform violent motions of breathing out, they pass into convulsive motions.

What relates to the Prognostick of this distemper,* 1.46 this Cough although it be sel∣dom very dangerous or mortal, yet it remains very difficult of cure; and frequently it rather ceases by change of the season than is extinguished by remedies. The cause whereof is, that here not, as in an usual Cough, the blood onely ought to be altered, and its recrements to be derived out of the Lungs, to be conveyed to the habit of the body by sweating, but moreover an amendment of the nervous juice ought to be procured.

About the curing of this disease,* 1.47 the way of healing used in other kinds of Coughs doth rarely profit here; wherefore old women and Empiricks are oftener con∣sulted than Physitians, and the rational curatory method being postponed and neglected, remedies for the most part onely Empirical are brought into use.

Among the many remedies of this kind, these two following are preferr'd to all others, and chiefly wont to be used; viz. Cup-moss or Chin-moss or Chin-cups, and the various preparations thereof and compositions are taken inwardly, and if there

shall be need of any further medicine, that some Bugbear being presented, the Child la∣bouring with it may be cast into a sudden fright. But if the wished success be wanting to administrations of this sort, Ptisans, Syrups, Julips, or Decoctions, and other pecto∣ral helps are rejected, and frequently they desist from all other Medicines, expect∣ing untill the disease either at length of its own accord determine, or be cured by reason of the succeeding change of the year.

1.* 1.48 Chin-cups or Moss is in most common use in our Countrey against the Coughs of Children, and is vulgarly enough known as to its form and manner of growing. It is of an astringent nature (as far as we gather by its taste) and contains in it self par∣ticles somewhat sharp and biting, and smelling of plenty of volatile Salt: from whence we may safely conjecture that its use is to fix the blood, and to appease the fluxes of Se∣rum,* 1.49 and moreover by volatilising the nervous juice, to take away the convulsive disposi∣tion. It is usually administred in form of Powder, Decoction, and Syrup; according to the following Receipts.

Take of Chin-cups in powder one dram, Sugar-Candy one scruple, mix them; divide it into three or four parts, take a dose morning and evening with a fit vehicle.

Take of the same Cup-moss two drams, milk of Brimstone two scruples, powder of Anni∣seeds one scruple, divide it into six parts to be taken as the former.

Take of the same Chin-moss or cup-moss one dram boyled in milk for one dose; take it morning and evening. To those with whom milk doth not agree, or to whom it little profits, let it be boyled in Spring-water or Hyssop-water, or in any other pectoral water, and let it be given from two ounces to four, twice in a day, sweetning it with Sugar or some fit Syrup.

Take of this Muscus Pyxidatus or chin-moss one ounce, boyl it in two pints of some pectoral water to the consumption of half: To it strained adde of Sugar-Candy one pound, and evaporate it in a gentle bath, to the consistence of a syrup.

2. The other remedy for the convulsive Cough is wont to be,* 1.50 that they be cast in∣to some sudden fright; from hence, whenas medicines effect less, with the vulgar it is a familiar practice, that, to fright them, while a great Mill is driven about with a screeking noise, and a dreadful aspect of the wheels, the distempered be put into the Trough or Receiver of the Grain or Corn, and from thence the sudden cure of this disease sometimes happens. The reason whereof without doubt consists in this, that the Animal spirits being put to flight and forced into fresh distractions, they relin∣quish their former disorders; moreover, the convulsive matter is either dissipated by that disturbance, or is forced into other nerves where it is less troublesome.

The Empirical cure of this disease being described after this manner,* 1.51 together with the remedies vulgarly used, and the rendring a reason of the cause at least probably unfolded, from hence it will be lawfull to design a rational method of curing, and per∣haps more efficacious against childrens Coughs of this kind. Wherefore, in such a case sometimes successefully enough I have prescribed according to the following forms. And seeing we ought to begin with purging,

Take of the syrup of Peach flowers one spoonfull, of Aqua Hysterica one scruple, mix it,* 1.52 and let it be taken with government.

Or, take of Mercurius dulcis 6 grains, Scammony prepared with Sulphur, Resine of Jalap, of each three grains; make a powder, give it in a little Pulp of a preserv'd Cher∣ry to a lad six years old, and let the dose be encreased or lessened according to the age, let the Purge be repeated in 6 or 7 days.

If the Patient (as it often happens) be prone to vomit, Take of Oxymel of Squils 6 drams, Salt of Vitriol 4 grains, mix it for a child of six years old, and according to this proportion let the dose be accommodated to others. I have known a Vomit of this kind taken every morning for four or five dayes together with good success.

Vesicatories or Medicines drawing blisters are in daily use,* 1.53 and are applyed some∣times to the Nucha or nape of the neck, another while behind the ears, then to the inside of the arms near the arm pits, and as soon as these sores begin to heal in these places, let others be raised in other places.

Instead of Beer let the following Decoction be used for ordinary drink.

Take China-roots an ounce and half, of all the Sanders of each half an ounce, the sha∣vings of Ivory, and Harts-horn of each three drams, let them be infused and boiled in six pints of spring water to the consumption of half, adding Raisins stoned an ounce and half, Liquorish three drams.

Take of Spirit of Gum Ammoniac with Salt Armoniac a dram,* 1.54 Syrup of Chin-moss three ounces, Aq. hysterica an ounce: the dose is a small spoonful in the evening and morning fasting.

Or, Take of tincture of Sulphur two drams, dose three drops in the evening and first in the morning in a spoonful of the Syrup of Cup-moss.

To some endued with a hot constitution, and while they cough their countenance is spread with redness, or rather blackness, I have prescribed Phlebotomy or drawing of blood with Leeches to two or three ounces with good success.

Take Hog-lice living and cleansed two ounces, powder of Aniseed a dram, Nutmeg half a dram, fine Sugar an ounce, bruise them together, and pour upon them six ounces of Hysop-water, of Magistral Snail-water two ounces, stir them together a little, and press them out hard: the dose two or three spoonfuls twice a day.

Hitherto of a Cough and its Remedy, while it is only an entrance to a Consumpti∣on; now it remains to treat throughly of the distemper it self, having passed the li∣mits of this dangerous disease, and to design a method of curing, and the forms of rome∣dies, which are proper to heal an inveterate Cough, when either being neglected, or not easily giving place to remedies, it begins to degenerate into a Phthisis; namely when it arrives to that state, that the blood being dissolved in its consistence, doth not only pour out the superfluous Sorum, but also the nutritive Juice, and perhaps the ner∣vous, the Lympha, and other its superfluities on the Lungs, and lodges them within its passages;* 1.55 and in the mean time the corruption of the Lungs is so much increased, that the little Bladders being distended, or many of them broke into one, so that a solution of continuity or an Ulcer being caused, a greater plenty of corruption is daily heaped in; and moreover the matter in that place gathered together, because it is suffered to abide there long, putrifies, and for that reason doth still more corrupt the Lungs themselves, and defile the blood flowing through. In this case the Therapeutical indications shall be chiefly these three:* 1.56 viz. in the first place to stop the dissolution of the blood, which is the root of all this evil, and to make provision that it pour not out the matter any longer in such abundance upon the Lungs. Secondly, by expectorating the purulent mat∣ter heaped up within the Lungs, and to evacuate it quickly and sufficiently. Thirdly, to strengthen and dry the Lungs loosned from their unity, or being too loose or moist or otherwise infirm, lest they be daily more and more corrupted, and give more reception to the morbific matter. Every of these indications suggests various intentions of heal∣ing, and requires remedies of divers kinds and many ways of administrations. The chief of which we shall here briefly treat of.

1.* 1.57 Therefore what the first indication suggests, that the dissolution of blood may be prohibited, these three things (as much as may be) ought to be procured: viz. First that the mass of blood may contain and assimilate whatsoever of nutritive juice it may be furnished with; and that it be so proportioned, that it neither offend in quality nor in quantity. Secondly, that the acidities either generated in the blood, or poured into it from some other place, may be so destroyed, that the blood retaining as yet its mix∣ture or temperament, may not be prone to flowings and pourings out. Thirdly and lastly, that all the excrements produced in the blood may be derived from the Lungs to other Emunctories and places of Evacuations.

1.* 1.58 As to the first intention of healing, viz. that the nutritive Juice may be pro∣portioned to the blood, let it be advised before all things, that they who cough and are phthisical abstain chiefly from drink, and that they take liquid things in a very small quantity; for that the blood being infirm in its temperament, so long as it is not too much imbued with fresh juice, may be able to digest small portions, and retain it within its own consistence. Moreover, let that fresh juice consist of such kind of particles, which being mild and thin, may be tamed by the blood, and assimilated without any effervescence or heat. Wherefore Asses milk, also sometimes Cows or Goats milk; also Water-gruel, Cream of Barley, Ptisan, Almond-milks, and other simple nourishments will better agree and nourish more than Flesh, Eggs, and Gelly-broaths,

strong Ale, Wine, or any other kind of richer fare. Secondly,* 1.59 that the blood retaining its own temperament, be not easily dissolved into serosities injurious to the Lungs, it behoves that as well the acidities of it self as of other humors mixt there∣with, and chiefly the nervous and limpid ones be destroyed: which intention Medi∣cines prepared with Brimstone will best accomplish; which for that cause in this case (provided a hectic Feaver be not present) may be more frequently and in abundance taken. Wherefore the Tincture, the Balsam, the Syrup, the Flowers, and Milk of Sul∣phur in somewhat a large Dose may be exhibited twice or thrice a day. For the same reason traumatic or vulnerary Decoctions, also Decoctions of the pectoral Herbs com∣monly so called, also of the Woods, are to be taken instead of ordinary drink. Moreover the Powder of Crabs eyes, Hog-lice, and other things endued with an Alcali or volatile Salt are often administred with great success.* 1.60 The third intention of healing respect∣ing the first indication, viz. that the superfluous dregs of the depraved blood, (if they shall be very much predominant) being commanded out from the Lungs, may be dis∣charged by other Emunctories, suggests very many ways to be used for their dispatch. For besides Phlebotomy, Diuresie, and sometimes a gentle Purgation (which take place in all Coughs, yea in the beginning of a consumptive Cough, or Phthisis) hither also ought to be referred Baths, taking in a more warm air whereby they may more freely transpire, also Frictions of the extreme parts, Dropaces, Issues, Blisterings, or Depilato∣ries, Errhines, Gargles, and other private or public sluices either of humors or vapors.

The second indication in the beginning of a Phthisis, viz. that the consumptive matter laid aside within the Lungs may be easily and daily evacuated,* 1.61 is performed by expectorating Medicines. These are said to operate after a twofold matter, ac∣cording to which their virtue is conveyed two ways to the Lungs. For of those be∣ing taken by the mouth, some immediately dismiss their active particles into the Tra∣chea, which partly by making the way slippery, and loosning the matter impacted, and partly by provoking the excretory Fibres into Convulsions, do procure expectoration: in which number are chiefly accounted Linctus's and Fumigations. The expectorating Remedies of another kind, which deservedly are accounted more available, do exer∣cise their energie by the passage of the blood. For whereas they consist of such kind of particles which cannot be digested and assimilated by the mass of blood, being spread through the blood, because they cannot be mixt with it, they are presently again exterminated, and so penetrate from the pneumonic Arteries into the tracheal passages; where lighting on the matter they divide, and attenuate, and so disturb it, that the little fibres being irritated from thence, and successively contracted while they cough, the contents of the Trachea and of its little bladders are ejected upwards into the mouth. Medicines proper for this use besides Sulphur and the pre∣parations of it, are artificial Balsams distilled with Oil of Turpentine, Tinctures and Syrups of Gum Ammoniac, Galbanum, Asa foetida, Garlick, Leeks, and such like yielding a strong scent; from which also Lohochs and Eclegma's are prepared. And these work both ways, partly by slipping into the Trachea, and partly by entring the Lungs by the circulation of the blood, and assault the morbific matter both before and behind, and so exclude it with the greater force.

3. What belongs to the third indication, viz. that the frame of the Lungs being hurt, or their constitution vitiated, may be either restored or amended;* 1.62 such things are of use as resisting putrefaction do cleanse, heal, dry, and strengthen; to which intent also Remedies prepared of Sulphur, Balsamics and Vulneraries do agree. Hence some Empirics do not only successfully prescribe the smoak of Sulphur vivum, but also of Auripigmentum, to be suckt through a Pipe or Funnel into the Lungs. Moreover it is for this reason, that change of air and soil, viz. from Cities to the Country or sulphureous air, or the passage from one Region into another that is hot∣ter, is of such a signal advantage.

Hitherto of the Method of Healing, which seems to be of use against the more pain∣ful Cough, or Phthisis beginning; now it remains according to all those curatory indi∣cations to subjoin certain select forms of Medicines, which also, according to the way of healing described above in a slight Cough which is short of a Phthisis,* 1.63 we shall distin∣guish into certain ranks, viz. which are Mixtures, Linctus's, Lohochs, Tinctures, Bal∣sams, Troches, Lozenges, Powders, Pills, Decoctions, and distilled Waters. We shall set down some Examples of each of these: whereto also may be referred some of the forms of Medicines before described for a beginning Cough, and not as yet consum∣ptive.

1. Magisterial Medicines and Syrups.

Take of our Syrup of Sulphur three ounces,* 1.64 water of Earth-worms an ounce, tincture of Saffron two drams, mingle them. Take one spoonful at night, and first in the morning.

Take of Syrup of the juyce of Ground-Ivy three ounces, Snail-water an ounce, flour of Brimstone a dram, mix them by shaking. The Dose one spoonful at night and morning.

Take of tincture of Sulphur two drams, Laudanum tartarizated a dram, Syrup of the juice of Ground-ivy two ounces, Cinamon-water two drams: the dose one spoonful at bed∣time, and if sleep be wanting, towards morning.

Syrupus Diasulphuris. Take of Sulphur prepared after our manner half an ounce,* 1.65 best Canary wine two pints, let them be digested 28 hours in a water or sand Bath; which being done, take of the finest Sugar two pounds dissolved in Elder-flower-water, and boil to a height to make tablets: af∣terwards pour to it by little and little Wine coloured with Sulphur and warm, let it boil a little on the fire, strain it through woolen. You will have a most delicate Syrup of a gold colour, and for coughs and other distempers of the lungs (where a hectic Feaver and heat of the Prae∣cordium is absent) most profitable: the dose a spoonful morning and evening by it self or with other Pectorals.

Syrup of Garlick. Take ten or twelve cloves of Garlick stript from the little skins, and cut into slices, Ani∣seeds bruised half an ounce, Elicampane sliced three drams, Liquorish two drams, let them digest for two or three days in a pint and half of spirit of Wine close and warm; strain it clear and hot into a silver dish, and add a pound and half of fine Sugar, the dish standing upon hot coals, let the liquor be fired, and while it burns stir it; and strain it through wool∣len, and keep it for use.

Syrup of Turneps. Take Turneps sliced and fine Sugar of each half a pound, put them in a glased pot a lay of Turneps and a lay of Sugar, the pot being covered with paper, put it into an oven to bake with the bread; when it is taken out, press the liquor, and keep it for use: the dose one spoon∣ful morning and evening.

Syrup of Snails. Take fresh Snails with their shells n. xl. cleanse them with a linen cloth, afterwards each being run through with a bodkin, let the open shell be filled with powder of Sugar-candy, and being put in a linen bag, let them be hung in a cellar, it will dissolve into a Syrup and drop into a glass vessel set under it: the dose one spoonful twice or thrice a day in a convenient vehicle, viz. Milk-water or pectoral Decoction.

2. & 3. Linctus's and Lohochs.

Take of conserve of red Roses three ounces,* 1.66 of our tincture of Sulphur two drams, mix them in a glass mortar: the dose the quantity of a Nutmeg evening and morning. To this sometimes to appease a troublesom cough add from half to a dram of powder of Olibanum.

Take conserve of red Roses four ounces,* 1.67 flour of Brimstone four scruples, fine oyl of Tur∣pentine a dram, powder of Fox-lungs three drams, syrup of the juice of Ground-Ivy as much as will suffice to make a soft Lohoch, to be taken after the same manner, viz. morning and evening; also to be licked at other times with a Liquorish-stick.

Take powder of Sugar-candy four drams, tincture of Sulphur two drams, mix it in a glass mortar: take it after the same manner.

In the place of Tincture of Sulphur may be administred other balsamic Tinctures, viz. Balsam of Peru, Opobalsamum, Gum of Ivy, Guajacum, Amber, with many others, which either may be mixt with Conserve of red Roses, or with the Conserve of the flowers of Colts-foot, or with Sugar-candy.

4, 5. Tinctures and Balsams of the same nature and composition, but in a larger Dose are convenient in a Phthisis, which we have above prescribed for a beginning Cough.

Take of Tar an ounce, Lime-water thrice cohobated two pints, distil it in a Bath to half;* 1.68 afterwards being filtrated, let it be drawn off to the consistence of Honey in Balneo; to which pour half a pound of tincture of salt of Tartar, let it digest in a close glass to extract the tin∣cture: the dose from 20 drops to 30 in a fit vehicle. After the same manner is prepared the tincture of the black oyl of Soot, liquid Amber, liquid Storax, and many others.

Take of our prepared Sulphur an ounce, adding Mirrh, Aloes, and Olibanum in treble quan∣tity, draw off a tincture with oyl of Turpentine, also with rectified spirit of Wine: dose from 15 drops to 20.

6, 7, 8. Troches, Lozenges, and Powders, because they chiefly respect a Cough, are almost of the same nature and composition with those before-described for a new Cough; unless that for the drying and healing of the Lungs things sulphureous and Vulneraries are required in a greater proportion.

Take powder of the leaves of Ground-Ivy a dram, flour of Brimstone two drams,* 1.69 of Su∣gar penids a dram and half, with juyce of Liquorish dissolved in Hysop-water make troches of the weight of half a dram.

Take of Yarrow bruised and dried in the Sun half a dram, flour of Brimstone, Olibanum,* 1.70 of each a dram; powder of dried red Roses half a dram, Sugar dissolved and boiled to a height six drams, oyl of Aniseeds a scruple and half, make Lozenges of half a dram weight: take one three times or oftner in a day, and especially evening and morning.

9. Pills.

Take a pint of the juyce of Ground Ivy clarified in the Sun, flowers of Colts-soot dried,* 1.71 the tops of Hysop, Sage, Pennyroyal, each a handful; Aniseed, Caraway-seeds, sweet Fennel-seeds bruised, each half an ounce; distil them in Balneo Mariae to half; strain it and distil it to the consistence of Pills, by adding half a dram of juyce of Liquorish, powder of Elicampane, flour of Brimstone, each three drams; flowers of Benzoin a dram, Balsam of Peru half a dram, tincture of Sulphur three drams, tartarizated Laudanum two drams: make it into a mass, and form it into small Pills to be taken three or four evening, and first in the mor∣ning.

10. Decoctions, as I have above prescribed for a stubborn Cough,* 1.72 are used with suc∣cess against a beginning Phthisis. In a case almost desperate I have prescribed the fol∣lowing Decoction to be taken twice a day, and also instead of ordinary drink with very good success.

Take Lignum vitae four ounces, China, Sassaphras, each two ounces; of all the Sanders each an ounce, shavings of Ivory, Harts-horn, each three drams: infuse them, and boil them in twelve pints of Spring-water to half, adding Liquorish an ounce, Raisins stoned four ounces: strain it.

11. Distilled Waters, such as we have before prescribed, are specific here,* 1.73 whereto may be added Solenander-water of Hogs blood and Turpentine; also Balsamic Waters distilled from Turpentine with Pectoral Ingredients.

Take leaves of Ground-Ivy, white Horehound, Hysop, Pennyroyal, each three handfuls; root of Elicampane, Orris of Florence, each two ounces; Turpentine dissolved in Oyl of Tartar four ounces, Hysop-water four pints, Malaga-wine two pints; distil them in a sand Bath: let all the liquor be mixed, the Oyl separated: the dose two or three spoonfuls twice a day, with a spoonful of Syrup of Ground-Ivy.

12. In the last place we must describe the forms of Vapors and Fumes;* 1.74 the admini∣stration whereof doth use to profit more than any other remedies in a Phthisis not yet desperate, for that they arrive at the very Lungs, and so purge them by an immediate affect, dry them, and keep them from putrefaction, strengthen and open all their passa∣ges. 1. Therefore a moist steam may be made after this following manner.

Take leaves of Hysop, Ground-Ivy, white Horehound, each two handfuls;* 1.75 Elicampane two ounces, Calamus aromaticus half an ounce, Aniseeds and Caraway-seeds, each an ounce: boil them in a sufficient quantity of Spring-water: let the vapor of the hot strained liquor be drawn by the lungs through a paper rolled up like a cone or funnel: and used morning and evening for a quarter of an hour.

2. A fumigation or dry vapour, is made one while more mild out of meer Balsamics, another while more strong out of Sulphurs, and sometimes out of Arse∣nicals.

Take of Olibanum,* 1.76 white Amber, Benzoin, of each two drams, Gum Guaici, Balsam of Tolu of each one dram and half, powder of red Roses, and red Sanders, of each one dram to be strewed upon burning coals.

Take Gum of Ivie,* 1.77 Frankincense, of each two drams, Flower of Brimstone one dram and half, Mastich one dram, with a dissolution of gum Tragacanth, form Troches.

Take of white Amber,* 1.78 Olibanum, of each two drams, prepared Orpiment half an Ounce, Styrax, Labdanum, of each one dram and half, with solution of Gum tragacanth, make Troches for fumigation.

Mountebanks do ordinarily prescribe the smoak of Arsnick to be suckt into the mouth,* 1.79 like Tobacco kindled in a Pipe, and sometimes with good success: Moreover, it is in practice with the Vulgar, to burn like Tobacco in a Pipe little bits of cloth stained with Arsenick (such as wherewith the walls of Taverns are hung) and so suck the smoak into the consumptive Lungs for cure.

3.* 1.80 These things being thus unfolded concerning a Cough, and a Phthisis begin∣ning, both as to what belongs to the Pathologie, and cure; it remains now lastly to discourse of a more painfull Phthisis confirm'd, and almost desperate; and to con∣sult what is to be perform'd, when the lungs being very much vitiated, and affected with one or more filthy ulcers, neither the air nor the blood do rightly pass through them, but choak or corrupt the mass thereof, by continually suggesting filthy cor∣ruption; insomuch that a hectick feaver and an Atrophie, by reason of nourishment being frustrated, infest the diseased, with the loss of all their faculties, and by daily weakening their strength precipitate them to the grave. The most certain sign of this disease growing desperate, uses to be accounted a pain very troublesome with an inflammation of the throat; for this symptom argues a great putrefaction of the lungs, from whence the putrid effluvia's exhaling are thrown about in the narrow passage of the throat,* 1.81 which wound and grievously irritate those tender fibres there. In this case the cleansing of the lungs, as also the drying up of the Ulcer are in vain designed: for all hotter Medicines ordain'd for those purposes, and fit enough in the beginning of a Phthisis, are not to be endured in a confirmed one; inasmuch as augmenting the inflam∣mation of the lungs, they procure a hectick feaver, thirst, wathings, and other more painfull symptomes, or call them back afresh. For truly in such a state of this disease where onely the prolongation of life is proposed with a light toleration and an easie death; those remedies help chiefly, which bridle the fervour of the blood, allay the heat in the Praecordia, and restore the sprits, and gently cherish them. Hence for food, Asses Milk, also Water-gruel, Barly-broths, Cream of Barly, and for drink, Ptisan, Emulsions, water of milk distilled with Snails and temperate pectoral herbs, are usually of greatest success.* 1.82 Syrups and Linctus's, which appease the inflammation of the throat and Lungs, and facilitate expectoration, but chiefly the more mild Hyp∣noticks, whereby moderate rest may be procured, may be frequently or daily taken. The forms of these are common enough; but however according to our method, we will annex some of the more select of each kind.

Take of Barly half an ounce,* 1.83 candied Eringo roots 6 drams, parings of Apples one handfull, Raisins stoned two ounces, Liquorish three drams, boyl them in three pints of spring-water to two, make a Ptisan to restrain thirst: take it 3 or 4 times a day, also in the room of ordinary drink if it agree.

Take the tayls of twenty Crevises, candied Eringo roots one ounce, a crust of white-bread, Raisins stoned two ounces, Liquorish 3 drams, boyl them in 3 pints of Spring-water to two, strain it, and take 3 or 4 ounces three times a day. After the same manner is prepared the Decoction of Snails.

Take of Snails half-boyled and cut three pound,* 1.84 ground-Ivy 6 handfulls, Nutmegs sliced numb. 6. crum of white-bread two pound, fresh milk 8 pounds, distill it in a Pew∣ter Still. The same way is distilled the water of Crevise-tayls. The dose 3 or 4 ounces three times a day,* 1.85 sweetned with pearl'd Sugar or Sugar of Roses.

Take ears of greeen Wheat as many as convenient, distill them in a common still; drink three or four ounces three times a day, sweeten'd with pearl'd Sugar.

Take syrup de Meconio three ounces, water of green Wheat 6 ounces, mix them,* 1.86 drink two or three spoonfulls at bed-time, every or every other night.

Take Conserve of Mallow-flowers wild or garden three ounces, Lohoch de pino two oun∣ces,* 1.87 Syrup of Jujubes two ounces, make a Lohoch, of which take often a dram and half or two drams.

What hitherto we have discoursed of concerning a Cough of every kind (whether it be solitary and simple, or the forerunner and companion of a Phthisis) also what is to be prescrib'd in every case touching the method of healing, it would be easily illustrated by the history of Cures, or by the Anatomical observations on those that have dyed by that disease. For instances of this sort, and very many examples are every where had, and happen daily; it pleases us here to annex a few of the more select, out of the large choice of these, accommodated to the chief kinds of a Cough, and Phthisis. And first I will endeavour to illustrate the type of a simple Cough by one history or two, and which takes its rise of it self, and is altogether void of the suspicion of a Phthisis.

It is now many years since I took care of the health of a certain Student,* 1.88 ob∣noxious to a Cough from his tender years, and who was wont frequently to undergo the more painfull affections of it, and those of long continuance. This person seem∣ed of a melancholick temper, of a sharp wit, of an indefatigable spirit, of a consti∣tution indifferently strong, but that his Lungs originally being infirm, did suffer when the blood dissolv'd into serosities. In Summer as long as he transpired freely, he lived healthily enough; but in the Spring and Autumn, when the blood changing its tem∣perament, those serous fluxes came upon him either of their own accord, or from any sleight occasion, he fell easily into a Cough with abundant and thick spittle; not∣withstanding this distemper frequently within six or seven dayes, as soon as the mass of blood was purged throughly by the Lungs, vanished leisurely without any great use of remedies. But if to the aforesaid occasions of this disease were added some stronger causes, as chiefly the obstruction of the pores, and errors touching his diet, sometimes a more prodigious and stubborn cough, neither presently nor easily yielding to remedies, and threatning nothing less than a Phthisis, did come upon him, then manifestly the patient for the first days suffered light shiverings in his whole body, and the sense of a Catarrh in his Larynx; afterwards by frequent cough∣ing with thin spittle, together with a giddiness, he was afflicted with numness of his senses, and a dropping at his nostrils.

In this state his best remedy was wont to be, and frequently tryed with success, to drink a little more freely generous Wine, and any other liquor very sparingly: for so the acidity and fluor of the blood being suppressed, and transpiration procured more freely, he was much eased, and sometimes recovered health in a short time. More∣over at night and early in the morning he was used to take seven or eight drops of the tincture of Sulphur in a spoonfull of Syrup of Violets, or of the Juice of Ground Ivy, or

Take Conserve of red Roses three ounces, spirit of Turpentine two drams mingled, the dose the quantity of a chesnut evening and morning.

If that these remedies together with the Canary Antidote and thin diet effected little, the disease not being so cured, spinning out into a long period, and pressing him sharply for many weeks, yea sometimes months, it reduced the sick to a remarkable leanness, and to the very brink of the Grave. For then the Cough daily encreasing and being very troublesome, did very much impede and break his sleep, his strength languished, his appetite was dejected, heat and thirst molested him; in the mean time spittle every day encreased, and was cast forth in great plenty; so that not onely the Serum of the blood, and the recrements, but also the nutritive Juice, and the drain∣ings of the solid parts being continually poured out upon the lungs, turn'd into cor∣ruption, which was abundantly cough'd out; moreover his breath was difficult, his joints very infirm, and his flesh very much consumed.

When of late our patient laboured after this manner, we prescribed the following method, and remedies, by the continued use whereof at length he recovered his health. First of all, a thinner diet being appointed him, and for the most part Ale being forbidden altogether, he took twice in the day of the following Apozeme about six ounces warm, and a little at other times cold to restrain his thirst.

Take of the roots of China two ounces, Sarsaparilla three ounces, white and yellow San∣ders of each one ounce, Ivory and Harts-horn of each three drams; infuse and boyl them in 8 pints of water to half, adding Raisins of the Sun 3 ounces, Liquorish 3 drams, strein it, and keep it for ordinary drink.

Take tincture of Sulphur three drams, take from seven drops to ten, at night and in the morning, in a spoonfull of syrup of Violets, or of syrup of the juice of Ground-Ivy.

When he began by continual use to nauseate this Medicine, in its place the fol∣lowing Eclegma was appointed.

Take conserve of red Roses three ounces, spirit of Turpentine two drams, mix them; the dose is one dram, at the same hours.

Afterwards instead hereof the following Powder was sometimes taken.

Take of the powder of the leaves of ground-Ivy dryed in the Summer Sun three ounces, Sugar-candy half an ounce, mix them, the dose half a spoonfull twice in a day, with three ounces of the following water.

Take Ground-Ivy 6 handfulls, Hyssop, white Hore-hound, of each 4 handfulls, Lambs∣lungs half-boyl'd and cut small, pour upon them eight pound of Posset-drink made with small ale, distill it in common Organs, the liquor being mixed, let it be sweetned to the taste as it is used with Sugar-candy or syrup of Violets.

To appease his almost continually troublesome Cough,* 1.89 he swallowed the following Troches, and sometimes a little of the extract of Liquorish.

Take of the species of Diatragacanth. frig. 3 drams, Annise, Carue, sweet Fennel∣seeds, of each half a dram, flower of Brimstone two scruples, flowers of Benzoin one scruple, extract of Liquorish dissolv'd in Hyssop-water; make a paste which form into Troches. Or,

Take of Species Diaireos, è pulm. Vulpis, of each two drams, flower of Sulphur, of Elecam∣pane, of each half a dram, Oyl of Anniseeds ℈ss. Sugar dissolv'd in a sufficient quan∣tity of Penniroyal-water and boyl'd to a body ℥ vj. form Lozenges of half a dram weight, let him eat one, swallowing it by degrees, as oft as he will.

In the midst of this course, although he was endowed with a weak pulse and more cold temperature, we breath'd a vein in his arm: moreover, with these remedies, the chiefest help accrued to him from the open air, which for the most part he daily enjoyed, either by riding on Horse-back, or in a Coach; for from hence he first be∣gan to recover his appetite, his digestion, and sleep; whereto afterwards a relaxati∣on of the other symptoms did sensibly follow, till at length he recovered his entire health. As often as he was afflicted since then with a stubborn and tedious Cough, he used a method like this, and with the like success; and now although he lives alto∣gether exempt from that distemper, notwithstanding he is constrained to decline care∣fully all occasions or causes whereby either the pores might be shut, or the flux of blood or its precipitation into serosities might be provok'd; which were chiefly his going by water on the Thames at London, and drinking of acid liquors, as Cider, French or Rhenish wine.

From the above-mentined history, you may easily conceive both the means and the reason of healing of the Cough, (which caused by the fault of the blood, is without the limits of a Phthisis): The other follows, which illustrates the nature of the same distemper, when it chiefly proceeds from the nervous juice.

A Boy about ten years of age,* 1.90 of a hot temper and fresh countenance, from his infancy obnoxious to a frequent Cough, in his succeeding years sustained more grie∣vous and lasting fits and assaults of this distemper, and by turns was used to labour with a strong and shrill Cough,* 1.91 without spitting, which almost continually afflicted him day and night, and so infesting him many days, yea weeks, brought the sick to utter weakness. Afterwards the period of his disease being come (which happened not but by consuming the store of th morbific matter) he again in a short time became healthy enough, and very free from any sickness of the Thorax: till the morbific matter (as it seems) being heaped again to great abundance, without any evident cause, the same di∣stemper

returned and performed its Tragedy with its wonted fierceness. About its first beginning the Cough was troublesom only morning and evening: after wards the evilby little and little increasing, he almost continually coughed whole days and nights, and if at any time sleep happening of it self, or by the use of Anodynes, afforded any truce, a more outragious fit of couhing succeeded his wakening. After this manner most frequently and fiercely coughing without any spittle, he laboured for three or four weeks, till he was brought to an extreme leanness and weakness; and then the sickness leisurely remitted, so that he coughed somewhat seldomer, and enjoyed moderate sleeps; afterwards in few days growing very hungry, being quickly made full of flesh and vigorous, he recovered his former health in a short time. Fits of this kind more sel∣dom infested him in Summer-season, but in the restof the year, repeated three or four turns, and brought the sick even into great hazard of life.

If disquisition be made of the nature, causes, and formal reason of this unwonted and as it were irregular kind of Coung, it is manifest it proceeds like all other, from the provocation of the Lungs; nevertheless as to the matter exciting, its seat, and manner of affecting it is doubted: because neither thick spittle, nor plentiful thin (as is usual in other distempers) is here cast out; neither doth the Patient complain of feeling a Catarrh, nor of any weight of the Lungs. Wherefore, not as in a common Cough, does the serous humour either slowly or plentifully sweating out of the Trachea or pneumonic vessels into the little bladders or pipes of the Trachea, induce the afore mentioned symptoms: But it is plain from thence that the passages of the aspe∣ra Arteria are wholly empty of the serous or thick humour, because the deep and sounding Cough throws off nothing. Moreover, neither from the blood impacted in the Membranes of the Lungs, doth this Cough take its origine, because neither fea∣ver, nor thirst, nor pain are present here as in a Peripneumonie. Besides, neither doth the morbific matter seem to adhere to the nerves or muscles appointed to the function of breathing; because then besides a Cough, Asthmatical or otherwise con∣vulsive fits would sometimes urge with a sense of strangling; which notwithstanding did not happen to our patient.

Having frequently and seriously meditated about the aetiologies of this very diffi∣cult case, I am at length induced to think, that a certain serous and sharp matter, as being loaded with a scorbutical taint, falling from the head by the passage of the nerves, doth enter into the nervous fibres and Membranes of the lungs or Trachea; which cleaving throughly to them, is by degrees encreased to a fulness,* 1.92 and at length be∣ing chaf'd, and grown turgid with a perpetual provocation, creates so troublesom a Cough. We have in another place declared the matter of this kind impacted in the Coats of the guts, and the neighbouring parts about them, not rarely to excite a scorbutical Colick, for many days, yea sometimes weeks, infesting them with vo miting and a most sharp torment; and what else is this Coungh, but a certain convulsive distemper of the lungs, whose taint notwithstanding, according to the capacity of the part labouring, is imprest rather and more on the motive, than on the sensitive Power. For the lungs however twicht adn hurt, do suffer small pain, or scarce any at all; not∣withstanding from any light occasion, they are invaded by storms and fits of coughing. Indeed we compare this distemper of coughing so much the rather to the Colick, because the subjects of either of them, that is to say, the Trachea, and the guts, as to their coats, vessels, little fibres and glandules, are after the same manner fashioned.

The chief cause of the Cough now deseribed, depends upon the morbific matter heaped together within the little fibres of the rough arteries, to a provoking fulness; wherewith when they are loaded, first a quick and painfull breathing infests onely, with amornings Cough; because from the beginning onely some small portion of that matter being disquieted provoke the part: afterwards when the whole mass thereof growing turgid, almost perpetually twitches the fibres, there follows a most troublesom cough; which also being often repeated, endures a long season; because the morbifick mass impacted in the parts affected, is neither presently cast off by the strength of na∣ture, nor easily gives place to any remedies.

For in all the fits of this disease, I have made tryal of various methods of curing, and of medicines of divers kinds, though with little success. That distemper begin∣ning at any time, is wont to make a long period, maugre all remedies. The medicines commonly called pectoral, as Syrups, Lohochs, Eclegma's, or Lambitives, have con∣ferred little benefit to its cure; not withstanding sometimes it hath seemed good to

admit of them into use for this purpose, that they might make slippery and moisten the Lungs, lest they run the hazard of being rent by a violent Cough, and their vessels burst asunder: for sometimes a more fierce fit troubling our sick Patient, he hath been wont to cough out a little blood, though no thick spittle.

A gentle Purge both in the beginning and declination of this distemper hath succeed∣ed well. Opening and diuretical Apozemes are ever administred with success, both which he used enough through his whole course instead of ordinary drink. Evening and morning he took some drops of the Tincture of Sulphut with the Milk-water of Snails; late at night I was sometimes constrained to administer a Dose of Diacodion or of liquid Laudanum: his belly for the most part loose enough, that it seldom required Clysters: in two of his fits he breathed a vein, whereby nothing of success ensued.

In the last fit,* 1.93 beinning about the Autumnal Equinoctial, which passed away a little more lightly and gently, this following method of healing was observed.

First of all this Purge was given,* 1.94 and after four days repeated. Take of Mercurius dulcis ten grains, Resine of Jallop four grains, mix and make a powder to be taken in a spoonful of Syrup of Violets.

Take China-roots sliced a dram,* 1.95 Grass-roots three ounces, Chervil an ounce, candid Erin∣goes six drams, shavings of Ivory, Harts-horn, each three drams; Raisins of the Sun stoned three ounces: boil these in three pints of Spring-water to two pints, strain it, and use it for ofdinary drink.

Take syrup of Jujubes two ounces,* 1.96 Diacodion an ounce, spirit of Salt Armoniac with Gum Ammoniac a dram, mix them: the dose a spoonful at night and early in the morning. He was mauch relieved with this medicine, notwithstanding he took it only every other or third day, and for change sometimes a dose of the tincture of Sulphur with syrup of Violets.

The disease declining a Purge was twice repeated, and afterwards, recovering his health by degrees, within two weeks he became healthy enough. But when I beheld him not only obnoxious to frequent relapses of coughing, but every fit to be irresisti∣ble when it assaulted him, and its stay very long notwithstanding the use of remedies, and all this threatning no less than a Phthisis at length; I advised that as well for his preservation, as for the more easie cure of the distemper, if it should return, he should travel into a hotter Region. Hereupon he did not much delay, but sails into France about the beginning of November, and from thence by a straight journey to Montpelier, where abiding half a year he was sick only twice and both tiems lightly: afterwards returning into England quite free from a Cough, praise be to God he enjoys his perfect health.

Notes

• * 1.1

  The definition of a Phthisis.
• * 1.2

  The cause assign∣ed by the Anci∣ents.
• * 1.3

  What the con∣sumptive matter is.
• * 1.4

  By what ways it enters the Lungs.
• * 1.5

  Sometimes by the Trachea, yet not destilling from the head.
• * 1.6

  But sweating out of the sides of the Trachea.
• * 1.7

  The consumptive matter brought into the Lungs rather by the pneumonic Arte∣ries.
• * 1.8

  A Cough and spitting some∣times healthful.
• * 1.9

  Yet often being too much is dangerous.
• * 1.10

  Why the Con∣sumptive matter affects, and by degrees hurts the lungs.
• * 1.11

  How an Ʋlcer of the Lungs is made.
• * 1.12

  An ulcer of the lungs covered with a callus less prejudicial.
• * 1.13

  The evident causes of a con∣sumption.
• * 1.14

  The primary causes of a Con∣sumption some from the blood, others in part from the lungs.
• * 1.15

  The ill temper of the blood disposes to it.
• * 1.16

  And sometimes it receives a consumptive taint from the nervous juice.
• * 1.17

  And sometimes by reason of a fault communi∣cated from the Lympheducts.
• * 1.18

  The fourth reason is usual evacua∣tions suppressed.
• * 1.19

  By reason of transpiration hindred.
• * 1.20

  Partly from the Lungs.
• * 1.21

  From the breast ill formed. From the here∣ditary disposi∣tion. From foregoing distempers of the breast. From incongrui∣ty of the air.
• * 1.22

  The reason of the former exposed.
• * 1.23

  What an heredi∣tary disposition is.
• * 1.24

  In what it con∣sists.
• * 1.25

  What the con∣sumptive disea∣ses of the breast are.
• * 1.26

  The influence of the air for exci∣ting a Consum∣ption.
• * 1.27

  The grosser and City-air to some consumptive per∣sons healthful, to others hurtful.
• * 1.28

  The reason whereof is in∣quired.
• * 1.29

  A sulphureous air healthful to some consum∣ptives.
• * 1.30

  Sulphureous Me∣dicines chiefly agreeing.
• * 1.31

  The reason there∣of discoursed.
• * 1.32

  The three times or distinct states of a Cough.
• * 1.33

  When new, there is no suspicion of a Consumption.
• * 1.34

  When it begins to induce a Con∣sumption.
• * 1.35

  When it becomes a confirmed Con∣sumption.
• * 1.36

  The curing me∣thod, and first against a begin∣ning Cough.
• * 1.37

  Three indica∣tions.
• * 1.38

  The first respects the effervescence of the blood.
• * 1.39

  The second re∣spects the deri∣vation of the Serum and other excrements from the Lungs.
• * 1.40

  The third in∣tends the sup∣pressing the Ca∣tarrh and strengthing the Lungs.
• * 1.41

  Forms of Medi∣cines which are most in use.
• * 1.42

  The convulsive Cough of chil∣dren call'd the Chin-cough.
• * 1.43

  The reason thereof.
• * 1.44

  The cause partly a Catarrh.
• * 1.45

  A convulsive disposition of the parts of the breast.
• * 1.46

  The prognostick of this disease.
• * 1.47

  Cures first Em∣pirical.
• * 1.48

  Chin-cups a great remedy.
• * 1.49

  The reason wherof is in∣quired.
• * 1.50

  Frights profit in this Cough.
• * 1.51

  The rational cure.
• * 1.52

  Purging.
• * 1.53

  Vesicatories.
• * 1.54

  Mixtures.
• * 1.55

  Of what sort the beginning of a consumptive Cough it.
• * 1.56

  Three indicati∣ons concerning its cure.

  • 1. To stop the dissolution of the blood.
  • 2. To draw out the filth from the Lungs.
  • 3. To heal the Lungs hurt.
• * 1.57

  The first indica∣tion suggests three intentions of healing.
• * 1.58

  The first intenti∣on, that the nu∣tritive juice may be propor∣tioned to the blood and assi∣milated by it.
• * 1.59

  2. That the a∣cidities of the blood and other humours be ta∣ken away.
• * 1.60

  3. That the ex∣crements of the blood be drawn off from the Lungs.
• * 1.61

  Second indica∣tion requires expectorating Medicines.
• * 1.62

  Third indica∣tion is perform∣ed by Balsa∣micks and vul∣neraries.
• * 1.63

  Forms of reme∣dies for a con∣sumption.
• * 1.64

  Mixtures.
• * 1.65

  Syrups.
• * 1.66

  Linctus's.
• * 1.67

  Lohoch.
• * 1.68

  Tinctures.
• * 1.69

  Troches.
• * 1.70

  Powder.
• * 1.71

  Pills.
• * 1.72

  Decoctions.
• * 1.73

  Distilled Waters.
• * 1.74

  Fumes and Va∣pours.
• * 1.75

  Formules of the former.
• * 1.76

  Forms of the more gentle Fume.
• * 1.77

  Of the more strong.
• * 1.78

  Arsenicals.
• * 1.79

  Smoak of Auri∣pigment.
• * 1.80

  Of a confirm'd Consumption.
• * 1.81

  The formal rea∣son thereof.
• * 1.82

  Forms of reme∣dies in a despe∣rate Consumpti∣on.
• * 1.83

  Decoctions.
• * 1.84

  Distilled wa∣ters.
• * 1.85

  Hypnoticks.
• * 1.86

  Hypnoticks.
• * 1.87

  Eclegma's.
• * 1.88

  The History of a Cough threaten∣ing a Consum∣ption.
• * 1.89

  Troches.
• * 1.90

  The second re∣markable Histo∣ry.
• * 1.91

  A hooping Cough.
• * 1.92

  The conjuct cause of the disease.
• * 1.93

  The usual method of curing.
• * 1.94

  A Purge.
• * 1.95

  A Drink.
• * 1.96

  A Mixture.