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. VIII. Of a Peripneumony, or Inflammation of the Lungs.

APeripneumony is usually defined to be, an inflammation of the Lungs with an acute Feaver, a Cough, and difficult breathing. They who labour with this distemper are greatly sensible of a notable inflammation in their breast with a swelling of the Lungs, and sometiems a pricking pain, they draw a painful and short breath, or, as Hippocrates affirms, a deep breath; the Feaver presses with great thirst, watching, and painful Cough; whereto also bloody spittle, or streakt with blood, suc∣ceeds. By which Symptoms it clearly appears, that this disease arises, in as much as the blood boiling feaverishly, doth not easily pass through the lesser pneumonic Vessels; but sticking in their passages, begets first an obstruction, afterwards being more heaped and extravasated, propagates a Phlegmon or inflammation with heat, a Cough, and dis∣coloured spittle. Moreover in as much as the blood so accumulated and stagnating, puffs up these passages of the Lungs, and compresses them, a difficulty of breathing is caused; and in as much as it pulls or distends the nervous Fibres, a pain frequently arises.

But if it be asked, how a Phlegmon should grow together in the frame of a Lung meerly bladdery and excarnous; and after what manner it is distinguished from that distemper which is wont to be stirred up in musculous flesh, or the substance of a bowel? We must answer, although the above-mentioned parts vary as to the texture, notwithstanding the reason of the affect is altogether the same in each of them. For the small sanguiferous vessels do every where alike embrace, bind, and variously gird about both all the Tracheal passages in the Lungs, and also the fleshy fibres in the Muscles, and lastly the little fibres and nervous threds, with the thickest foldings like clusters, of the Parenchyma. But that which produces a Phlegmon is the blood it self, which, while it grows very hot, and is hindred in its passage, every where, and espe∣cially in the Lungs, whose vessels branch into very small foldings, doth first beget an obstruction, and then an inflammation.

Wherefore the formal reason and conjunct cause of a Peripneumony consists in these two things, viz. that the blood boils feaverishly, and sticking also within the more nar∣row passages of the Lungs, engenders there an obstruction causing inflammation. Un∣less these two things concur, there is an exemption from this disease; for in many other Feavers, especially in a burning Ague, though the blood, most intensly heated and inflaming all the Praecordia, as also in the longing of women, the Green-sickness and the Dropsie of the breast, is very clammy, yet though sticking very much in the pas∣sages of the Lungs, it does not stir up a Peripneumony: to produce which both distem∣pers must concur and join their strength. Nevertheless when there is an indisposition of both these, one while this, another while that, is first in act, and after a sort one is the cause, or at least the occasion of the other. For sometimes the blood irritated into a Feaver causes an obstruction of the Lungs; and the blood also sometimes finding a re∣mora in the Lungs, receives a feaverish boiling from its proper obstruction. Notwith∣standing, for the constituting the procatarctic cause of this disease, the blood ought to be fitted as well for the boiling, as for the obstructing the vessels of the Lungs.

Though it will not be easie to shew what this disposition of the bloody liquor is in∣clining to a Peripneumony, yet the reason thereof doth something appear by Phlebo∣tomy, always made use of in this disease with the best success. For the blood being drawn from any labouring with this disease, as also from those in a Pleurisie, after it grows cold, in its superficies instead of a Scarlet cream, it hath a little film somewhat white or otherwise discoloured growing on it, which also is very tough and viscous: whence we may conjecture, that the mass of blood being too strait in its frame, whilst that in the circulation it doth not discharge its recrements, grows too thick, and as it were clammy, and for that cause becomes too prone as well to boil as to stick within the narrow passages, and especially of the Lungs.

But if farther inquisition be made, from whence this disposition of blood proceeds, by which it becomes clammy and viscous like ropy wine; the general reason hereof is this, viz. that the more thick parts of blood are not made thin enough by the more sub∣tile; so that all of them being equally mixed and mutually incorporated, at length the

good humors separate themselves into their appropriate functions, and the superfluous are perpetually discharged by their proper Emunctories. But on the other side in as much as the sulphureous particles of the blood being combined together with the saline and earthy too much exalted, ensnare and entangle all the rest; for that cause its li∣quor containing within it self all its recrements and impurities, grows clammy as glue, and in that regard contracts an inflammable disposition.

For it is obvious to every person, that the blood that grows clammy in this manner, is rendred prone to obstruct the narrow passages of the vessels (which surely are very small in the Lungs); moreover for the same reason they are disposed to become fea∣rish: viz. because retaining obstinately within its own bosom all the feculencies and ecrements, from the same presently gathered into a heap, it is constrained into a great turgescence or swelling, whereby of necessity an inflaming obstruction of the Lungs takes either its origine or augmentation.

Moreover as to the procatarctic cause of this disease, very frequently the faultiness of the Lungs is joined herewith, and determines that general intemperament of blood to affect this part in such a sort. For as the clammy blood grows hot, the more strong and sound Praecordia do frequently discharge the designed mischief from themselves, and the taint being fixed to the Pleura, or about the habit of the body, a Pleurisie or Rheu∣matism is rather caused than a Peripneumony. Nevertheless the tender Lungs being bnoxious to a Cough, or formerly prejudiced in their frame either by spitting blood, or other distempers of the breast, from the blood boiling up (while it is too much bound nd clammy in its own consistence) they easily engender an obstructing Phlegmon.

Hitherto of the conjunct and procatarctic causes of a Peripneumony: as for what regards the evident causes, whatsoever suddenly perverts the temperament of the blood, or restrains its free transpiration ought to be referred hither, as chiefly are ex∣cesses of heat and cold, or the inordinate drinking of Wine or strong Waters, any ve∣ement exercise, and the drinking of some waters, and those especially icy. Besides, sometimes a malignant distemperature of Air doth engender this disease in many, and akes it Epidemical.

Authors in Physick do every where observe (and it is also a vulgar observation) a Peripneumony frequently succeeds or comes upon a Pleurisie; but nothing is more usual than in a Pleurisie a bloody and thick spittle, and as it were purulent to be void∣ed. Hence a regat disquisition arises, by what passage or ways the matter by spittle cast out, can be conveyed from the Pleura to the Tracheal passages. Some think, that this being fallen into the cavity of Thorax, is sucked into the Lungs as with a Sponge; and others suppose, that it is transferred thither by the Membranes adhering thereto, by which the Lungs often stick unto the Pleura. But truly either way seems impro∣bable, if not impossible. For first, that the Lungs do not suck in the contents of the hollowness of the Chest is manifest from hence, because in a Dropsie or wound of the breast, when they happen, the Lungs being unhurt, neither water nor blood is at all dis∣charged by coughing; though frequently great plenty of this or that humor be there, which presently flows out of its own accord from the Thorax, incision being made. But that Sometimes the Membranes growing from the Lungs, knit themselves tot he Pleura, is clearly manifest by Anatomical observation; yea and by this way of return I have sometimes known the purulent matter translated into the side, and there by an Issue, made by Art or Nature, to have been evacuated with a heathful Crisis: nevertheless such Membranes of the Lungs joined to the Pleura do seldom pre-exist, and in a Pleurisie, which is a very acute disease, they cannot, like a Mushroom, be the issue of one or two days: moreover, though sometimes those obscure passages may be ready at hand, which perhaps by some admirable instinct of Nature discharge something out of the Lungs towards the precincts of the Thorax; yet it seems against the Oeconomy of Nature, that they can derive any corruption outwardly engendered to this most noble part within, which surely is the fountain both of life and heat.

As to this, if it may be lawful to propound our Judgment, I am induced to think that a Peripneumony and Pleurisie are one while singular and separate affects, and ano∣ther while bred together and coexisting from the first, and another while are by course one after another or succedaneous. For the procuring cause being stirred up into act, so that the blood growing clammy, and boiling together, obstructs in some places the lesser vessels: the nest of the disease sometimes is fastned on the Pleura, or separately in the Lungs, sometimes in each of them together, and sometimes first in one, and then in t'other: but for the most part, the Pleura being first healed, presently the

same morbific cause invades also the pneumonic Vessels. Moreover we have known a various shifting of this affect; viz. that it has first troubled the right or left side, pre∣sently that being deserted, to have occupied the Lungs, and afterwards both being de∣serted, to affect the Brain, and frequently to transfer its seat from thence into the above-mentioned places. But for the reason aforesaid a Peripneumony not only suc∣ceeds a Pleurisie, but frequently a Squinancy, and sometimes other distempers: for while the blood growing clammy, and boiling together, continues a Feaver in the whole, it transfers the obstruction causing a Phlegmon variously hither and thither. And from hence the solution of that observation is clearly manifest, which has so much puzled Interpreters, viz. that a Palsie or dead Palsie of one side doth sometimes suc∣ceed a Peripneumony, because the blood that being clammy, had lately obstructed the pneumonic Vessels, afterwards stuffing certain foldings of the vessels of the Carotides, prohibits the engendring of animal spirits in this or that part of the head, and so re∣strains their influence into the respective nervous parts. From what hath been said, the chief differences of a Peripneumony are made plain, namely that it is either a simple distemper, or joined together with a Pleurisie, Squinancy, or some other, and then it is either primary or secondary. Moreover it is usually distinguished as to the Feaver and state of breathing: to wit, according as this is more or less prejudiced, and as it shall be more intense or remiss, this disease also is denominated either more or less acute.

As to the Prognostics of this disease, common experience doth attest, that it is a very dangerous disease, because many Patients either die of it, or very difficultly reco∣ver health. No less may we conclude this from the reason or Etiology of it; for a wound with much extravasation of blood, or a stagnation caused in the Lungs, is most difficultly cured, and the affected place is never restored unto its former conformation. The prognostic signs, which are of greatest note, are taken from the appearance of Symptoms and nature of things thrown out, and the state of strength.

1. A Peripneumony coming upon a Pleurisie or Quinzy, for the most part is worse than arising of it self, or succeeding either of them: but if upon this disease, after what manner soever begun, an acute Feaver follows with great thirst, watchings, and not breathing unless set upright, it is ill; and yet much worse, if upon it a Deli∣rium, a Fenzy, convulsive motions, or a Palsie on one side ensue. Moreover the Pa∣tient is not in less danger, if he be very pursie, if troubled with vomiting, or frequent swounding away, a weak Pulse, and a cold Sweat. For while these Symptoms are in∣stant upon him, the obstruction of the blood in the Lungs is not removed, nothing is digested or ejected by spittle; but the circulation of the blood being more and more hindred, and its kindling by breathing stopt, the animal spirits are throughly disorde∣red, and at length faint, until together with a prostration of the whole strength the vital flame is extinguished.

2. As to Prognostics from things excerned, we observe a Peripneumony to be dan∣gerous, wherein nothing is thrown out by spittle; next to this, then the spittle is thin and crude, mixed with blood; it is far better when the spitting is yellow and thick, streaked with a little blood. The Urine being yellow from the beginning, and of a good consistency, with a cloud in the midst, shews that almost all the recrements of the blood are lodged in the place affected; when from that state it is changed into a thick and turbid Urine, it shews the morbific matter to be swallowed up again from that part into the blood; but if such kind of Urine be suddenly changed into a thin one, then a Delirium or death it self is impendent. Much Sweat and plenty of Urine, a Diarrhoea, bleeding at Nose, flowing of the Menstrua's, or the Haemorrhoids do fre∣quently promise good in this distemper, yea any of these Evacuations happening sea∣sonably doth frequently discharge the disease.

3. The condition of strength is ever of great moment in forming a due Prognostic in this disease: for oftentimes when horrid Symptoms, as an intense Feaver, a Breathing very painful, with a Cough, watchings, and other ominous signs, shall be pressing, if the Pulse be as yet strong, and the animal spirits persist in their vigor, there is better hope of the Patient, than if these things being more quiet, there were a weak Pulse, and the Spirits should become drowsie and oppressed.

The first indication about the curatory Method in a Peripneumony is, that the blood being impacted in the pneumonic Vessels, and causing a phlegmonous obstruction, may be from thence discussed and restored to its pristine circulation. Which if not to be procured, the second indication will be, that that matter be duly digested or brought

to suppuration, and with all expedition voided by spittle.

While the former indication prevails, the intentions of healing will be these ensuing. First, that the more plentiful afflux of blood to the part affected be prevented, or pro hibited by some means. Secondly, we must endeavour, that the matter stagnated or extravasated in the Lungs, be swallowed again by the Veins into the rest of the mass, and caused to circulate. Which that it may be the better procured, thirdly, the hoold ought to be freed from its clammy viscousness, whereby its fluidity is impeded. Fourthly, that we apply to the Symptoms most urgent, viz. a Feaver, cough, Watch∣ings, and difficult Breathing, fit Remedies. But if notwithstanding all these another indication shall come into use, it will be requisite to prescribe maturating and expecto∣rating Medicines vulgarly so called, together with these.

1. That we may satisfie the first and second intention together, Phlebotomy is for the most part requisite in every Peripneumony, yea sometimes it ought to be more fre∣quontly repeated; for the vessels being emptied of blood do not only withdraw the nou∣rishment of the disease, but do also sup up the matter impacted in the place affected. Wherefore if strength remain, and the Pulse be strong enough, a more free breathing of a Vein is convenient at the very beginning; but otherwise let it be used in a little quantity, which however may be repeated as occasion offers it self. We intimated above, that blood drawn in a Peripneumony and also in a Pleurisie, after it is cold, con∣tains in its superficies a small viscous and discoloured film: moreover we may observe one while the blood entirely, another while only a portion thereof is subject to this change. For when the blood is received into three or four dishes, sometimes in all, but oftener in the second and third dish it is apparently bad, and in the first and last laudable enough: wherefore they commonly give it in precept, that blood is always so long to be emitted, till that which is so depraved begins to come forth; and if strength remain, the bleeding should continue till the good blood flows out again. Truly as common experience doth approve of this practice, even so doth reason it self; for in this disease, because the whole mass of blood doth not presently acquire that clamminess, the depraved portions are chiefly accumulated about the place of ob∣struction, and adhere on every side in the lesser vessels. Wherefore the blood first issuing by Phlebotomy is often void of any fault; afterwards the vessels being emptied receive the other morbific matter at first stagnated, and restore it to its circulation; and when the portions thereof being placed near, are carried as it were in a joint troop, they flow out together at the orifice of the opened Vein, and after that entire mass of bad blood hath flowed out, the residue being more pure doth succeed. Wherefore in this case ever let incision be made with a large orifice, and let the blood be drawn out not only with a more plentiful spouting, but also with a continued: for otherwise if in the midst of Phlebotomy, the bad blood issuing out, the orifice (as the manner of some is, lest the spirits should saint) be closed with the finger, when again it is opened, the blood pure enough will issue next, but the bad sliding by, if there be any remaining, will not return presently to that orifice. Besides Phlebotomy many other remedies, viz. whatsoever do repress the trugency of blood, and empty the passages thereof, whereby the morbific matter may be suckt up, are here to be used. Wherefore a very thin diet is prescribed for the most part meerly of Barley and Oats: and if Cathartics are alto∣gether prohibited, because they disquiet the blood, and hurry it more impetuously into the part affected; notwithstanding Clysters which gently loosen the Belly, and draw the recrements of the blood towards the Belly, ought to be daily used. Moreover Ju∣leps and temperating Apozemes which bridle the fervor of the blood, and draw out the superfluous serositles thereof, and which also do gently open the passages of the Breast, are taken with success.

3. The third intention of healing, which respects the withdrawing of the clamminess or obstructing viscosity of the blood, is altogether to be performed by remedies which unloose the frame thereof being too much bound, and dissolve the coupling together of its salts. And truly the remedies of this kind, which in this respect reason and analogy would dictate, are now received into use by long experience. For Powders of Shell-fish, the Tooth of a Boar, and the Jaws of a Pike, and other things endued with an Alkali Salt, also Sal Prunellae, for the most part are prescribed by all Practitioners, as well modern as ancient. I have more frequently known the Spirit of Salt Armoniac and of Harts-horn to have yielded notable relief in this disease: and for the same rea∣son it is, (viz. because the volatile Salt is useful) that the infusion of Horse-dung, though a common remedy, affords oftentimes singular help.

4. As to the Symptoms and their Cure, very many remedies appropriated to these fall in together with the former; for against the Feaver the same Juleps and Apozems which appease the heat of blood, and withal recreate the animal spirits are of most common use: to which besides in respect of the Cough and difficult breathing, temperate pectoral Remedies are added. The great difficulty is what ought to be exhibited against want of sleep, when it shall grievously oppress; for Opiates, because they do fur∣ther prejudice the breathing, which in this disease is already hindred, are scarce safely administred, nay sometimes become mortal. Wherefore Laudanum and the strong Pre∣parations of Opium are to be shun'd in a Peripneumony worse than a Dog or a Snake; nevertheless Anodynes sometimes, and mild Hypnotics, as water and Syrup of red Pop∣pies, are not only allowed, but accounted specific remedies in this disease and in a Pleu∣risie: but sometimes it will be expedient to use Diacodiates as long as strength en∣dures, and as long as the Pulse is strong and good enough. For the pain of the breast, if at any time it be troublesom, it is expedient sometimes to apply Liniments, Fo∣mentations, and Cataplasms.

The second curative inoication, whose intentions are to digest the matter impacted in the Lungs (if it cannot be discussed or suckt up) and to throw it out by spittle, re∣quires ordinary maturating and expectorating Medicines, both which notwithstanding ought to be temperate, that is to say, such as asswage thirst, and appease the feaverish heat rather than exasperate it. We have above recited in the Chapter of a Cough, the kinds of these sorts of Remedies properly called Pectorals; the more select Receipts, and chiefly accommodated to this affect, shall be annexed here beneath.

The Forms of Remedies.

1, 2. The Medicines conducing to the first and second intention are prescribed ac∣cording to the following Forms.

Take the water of Carduus Mariae ten ounces, red Poppies three ounces, Syrup of the same an ounce, Pearls prepared a dram, make a Julep: the dose six spoonfuls every fourth hour.

Take water of black Cherries, Carduus benedictus, Balm, each four ounces; powder of a Boars tooth a dram, Syrup of Violets ten drams: make it into a Julep to be taken after the same manner.

Take Grass roots three ounces, shavings of Ivory and Harts-horn each three drams, Rai∣sins stoned an ounce and half, Liquorish two drams, boil them in Spring water from three pints to two, to the strained iquor add Syrup of Violets an ounce, Sal prunella a dram: make an Apozem to be taken thrice a day about three or four ounces.

For the same intention, viz. that the Vessels being emptied may withdraw the nou∣rishment from the disease, or sup up the morbific matter, a Purge is prescribed by many. In the Practice of the Ancients against this disease, even as against many others, after Phlebotomy, Preparatives and Purgatives were usually appointed in a constant course, and of late the Chymists with greater boldness do recommend Vomits, and in a Peri∣pneumony prefer it to all other remedies. Yea Phlebotomy being omitted or counter∣manded, they place the chief Cure in stibiate Vomits: than which rash advice of theirs I know not any thing may be thought of more pernicious. Indeed in rustic and robust bodies sometimes this Cure has been effected without danger, notwithstanding for the most part no less unsuccessful; but in tender constitutions it ought to be reckoned little inferior to poyson. But for what respects Purgation, although it may not be presently convenient from the beginning, because it is then for the most part prejudicial, never∣theless the flowing of the morbific matter being finished, and the effervescency of blood being appeased, we may safely and gently evacuate the body with a loosning Purge.

Take of the decoction of Senna of Gereon four ounces, syrup of Roses solutive an ounce: mix them for a Potion. Or,

Take the best Senna three drams, Cassia and Tamarinds each half an ounce, Coriander-seed two drams: boil them in a sufficient quantity of Spring-water to six ounces, to which strain∣ed add syrup of Violets an ounce, clarified with the white of an Egg, and let it be given.

Purgatives are not always to be exhibited, nor ever unadvisedly in this disease: but frequent Clysters, and almost daily are in use; but let them be gentle and emollient

only, which easily loosen the belly, without any great agitation of humours or blood. For this purpose Milk or the Whey thereof is often convenient, with red Sugar, or syrup of Violets: Or, Take the leaves of either sort of Mallowes, of Melilote, of Mercury, of each one handfull, Linseed and sweet Fennel-seeds, of each half an ounce, sweet Prunes, numb. vi. boyl them in a sufficient quantity of Spring-water to a pinte, to which adde syrup of Violets one ounce, Sugar ten drams, sal Prunella one dram, make a Clyster.

3. Medicines for the third intention, viz. for the dissolving the Clamminess of the Blood, are wont to be administred in form of a Powder, of a Spirit, a Potion, or of a Bolus, according to the manner following.

1. Powders.

Take of Crabs eyes two drams, sal Prunella one dram and half, pearl'd Sugar one dram, make a powder for 6 doses, one to be taken every sixth hour, with a proper Julep or Apo∣zeme. Or,

Take of the Tusk of a Boar, (or the Jaw of a Pike) of Crabs-eyes, of each one dram and half, flowers of Salt Armoniack, Powder of red Poppy Flowers, of each half a dram, mix them for 4 doses.

2. Spirits and Chymical Liquors.

Take of spirit of salt Armoniack distill'd with Olibanum, 3 drams; the dose from 12 drops to 15 or 20, three times in a day. Or,

Take Spirit of Ʋrine or Soote, after the same manner, three drams.

Take of the sweet Spirit of Nitre, (viz. often cohobated with Spirit of Wine,) 3 drams, the dose from 6 drops to ten after the same manner.

Take half an ounce of Spirit of Tartar, dose 15 drops to 20 or 25, in a fit vehicle.

Take of the simple mixture one ounce: the dose is one scruple to half a dram, after the same manner.

3. Potions.

Take of Carduus-water one pound, fresh Horse-dung 3 ounces, dissolve it warm, and filtre it; the dose is 3 or 4 ounces, twice or thrice in a day, with half an ounce of Syrup of Vio∣lets or red Poppyes.

Take of the Leaves of Dandelyon two handfuls, bruised and infused in half a pound of Cardnus Mariae water, Treacle-water half an ounce, press it out, and adde powder of Crabs-eyes one dram: take 4 or 6 spoon-fuls three times a day.

The fourth intention of Healing in respect of the symptomes greatly urging, doth suggest divers sorts of preparations of Medicines. 1. In respect of the Feaver, the Ju∣leps and Apozemes above recited are convenient. Moreover, the use of Mineral Crystal ought to be frequent. 2. For the Cough and difficult Breathings, Linctus's, Eclegma's, and Decoctions, or pectoral Juleps are administred with success.

Take of Syrup of Jujubes, of Maiden-hair, of each one ounce and half, of Violets one ounce, flowre of Nitre one scruple; make a Linctus to be lickt now and then.

Take of syrup of Marsh-mallowes one ounce, Diacodium, red Poppyes, each half an ounce, powder of Crabs-eyes two scruples; make a Lohoch, to be taken the same way.

Take Syrup of Hyssop, of Liquorish, of each one ounce and half, red Poppy-flowers powder'd, one scruple, Crabs-eyes one dram, Lohoch de Pino 6 drams, make a Lohoch, take the quantity of a Nutmeg four times or oftner in a day.

Take the roots of Grass, Chervil, Marsh-mallows, of each one ounce, Figgs numb 4. Jujubes and Sebestens, of each numb. 6, Raisins one ounce, Liquorish three drams, Barly half an ounce, boyl them in three pints of Spring-water to two, strayn it; the Dose three or four ounces.

Take Raisins stoned one ounce and half, Filberds numb. 4. cut, Liquorish sliced 3 drams, of Hyssop-water a pound and half, infuse them warm in a closed Vessel 6 hours, strain, and adde Syrup of Marsh-mallows an ounce and half, make a Julep, the dose is 3 or 4 spoon∣fuls often in a day, swallowing it by degrees.

3^ly, Against Watchings, Take Poppy-water 3 ounces, Syr. of red Poppies 6 drams, Aq. Epidemica 2 drams, for a draught, to be taken at night.

If the Pulse be strong, and the strength agreeable, Take Cowslip-water 3 ounces, sy∣rup de Meconio half an ounce, for a draught at night.

4. If the pain be troublesome about the place affected, Take Oyntment of Marsh-mallows two ounces, Oyl of sweet Almonds an ounce and half, mingle them for a Liniment to be applyed with thin Lawn-paper.

Take of Oyntment of Marsh-mallows and pectoral Oyntment, of each an ounce and half, Linseed Oyle fresh drawn one dram, to which adde the Plaister call'd Emp. de Mucilaginibus, make a Plaister for the Region of the breast, to be applyed on the place affected.

Fifthly, For the last intention of curing which answers to the secondary Indication, and prescribes Medicines ripening and expectorating, the following forms are con∣venient.

Take Linseed Oyl fresh drawn three ounces, Syrup of Violets two ounces, Hyssop-water half a pound, mixe them in a Glass, take two or three ounces three times in a day, sha∣king the Glass first.

Take powder of Olibanum one dram, put it into an Apple made hollow, and roast it in hot Embers, let him eat it at night, repeating it three or four times.

Take Oyl of Almonds fresh drawn, Syrup of Maiden-hair, of each an ounce and half, Sugar-Candy two drams, stirre them well in a Glass-mortar untill they are perfectly mixt, make a Linctus to be taken often in a day with a Liquorish stick; also let a spoonfull be taken three times a day in a draught of Posset-drink.

As to the rest, Remedies prescribed against a beginning Consumption do also profit in this case.

It would be easie to heap up here many Histories and Instances of Patients affected with a Peripneumonie; but whereas the same order and figure of the disease, and the same reasons of the Symptoms are almost in all, it suffices here to note one or two Exam∣ples only. And while I was writing these things I am sent for to a Patient grievously sick with a Peripneumonie. He was aged about Fifty years, lean in body, and of a cholerick temper, by taking cold he fell into a Feaver, with a Cough, with pain of the Breast, and difficult breathing: when he had laboured thus four dayes without any remedy or physical administration, I found him in a notable Feaver, with thirst, and a huge inflammation of the Precordia, breathing very difficultly, with labour of the Thorax, and painfully, with a noise of the Bronchia, insomuch that he seemed evidently in the very Agony of death. His Pulse being strong enough (although quick and disturbed) I immediately prescribed Phlebotomy, to eight or ten ounces, by which when he received a little relief, after three hours intermission, a Clyster being first ad∣ministred, I ordered him to repeat his bleeding to twelve ounces: Moreover, I or∣dered Spirit of Harts-horn to be given twelve drops every sixth-hour, with an appro∣priate Julep, and in the distance between I ordered a dose of the following Powder to be administred:

Take powder of Crabs-eyes, sal Prunella, of each one dram and half, Pearles a dram, Sugar-Candy two scruples; make a powder to be divided into 8 doses.

Moreover, he took as often as he pleased a draught of a pectoral Apozeme. By the use of these within three hours all the symptoms began to abate, and the night following he sweat, and slept a little; the day after I repeated Phlebotomy, and after continuing the same Remedies in four or five dayes he intirely recovered his health. The blood we took from him was alwayes in the Superficies viscous and discoloured.

A certain Gentleman of a sanguine Complexion and a strong habit of body, after an immoderate drinking of Wine contracted a Feaver, with a most painful Peripneu∣monie, insomuch that thirst and heat mightily pressing him, sitting always upright in his bed or Chair, and breathing short and very frequent, he could scarcely, yea al∣most not at all suck in air enough to sustain the vital flame. Because he could not undergoe a large Phlebotomy, I drew blood twice or thrice day after day; frequent Clysters were administred: Moreover, Apozemes, Juleps, also Spirit of Armoniack, and

powders of Fish-shells were administred by turns. Within four or five dayes the Fea∣ver somewhat abated, also he began to breathe better, and sometimes to take short sleeps, yet he did always complain of a notable heaviness of his breast, and intolerable oppression of the Lungs; wherefore, when Phlebotomy was no longer safe, I applyed very large Vesicatories to his Arms and Thighs, the blisters in his arms dry'd up in a short space, but those on his legs did not only remain open, but after five or six days did run hugely, and afterwards almost for a month daily discharged great plenty of a most sharp ichor; in the mean time his lungs sensibly amended, and at length were delivered from all their burden; lastly, the little sores raised by the Vesicato∣ries very painfully and not without frequent Medicines could be cured.

Notes

• The description of a Peripneu∣mony.
• After what manner a Phleg∣mor is bred in the Lungs.
• The conjunct cause of a Peri∣pneumony con∣sists in two things. 1. That the blood boils. 2. That it sticks in the passages. Sometimes this disposition, sometimes that is first.
• What that is Phlebotomy dis∣covers.
• What affection of the blood pro∣duces it.
• The fault of the Lungs produces it.
• The evident cau∣ses of a Peri∣pneumony.
• It often succeeds or follows after a Pleurisie.
• The reason of this is inquired into.
• The differences of this disease.
• Prognostics.
• 1. From the ap∣pearance of Sym∣ptoms.
• 2. From what is excreted.
• 3. From the state of strength.
• The Cure hath two chief indi∣cations.
• The first indica∣tion suggests four intentions of cu∣ring.
• 1. The first in∣tention that the afflux of blood may be cut off. 2. That the ex∣travasated be reduced to oir∣culation.
• Rules concerning Phlebotomy.
• The third inten∣tion of healing is that the clam∣miness or visco∣sity of the blood may be taken a∣way.
• 4. That the most urging Sym∣ptoms may be helpt.
• The second indi∣cation respects the maturation and expectora∣tion of the mor∣bific matter.
• Juleps.
• Apozemes.
• Purgation.
• Purges.
• Clysters.
• Things dissolv∣ing the clam∣miness of the blood.
• Powders.
• Spirits.
• Potions.
• The cure of the Symptomes.
• Linctus's.
• Lohochs.
• An Apozeme.
• Against Watch∣ings.
• For Pain.
• Maturating medicines.
• Expectorating Medicines.
• The first History.
• The second Hi∣story.