The remaining medical works of that famous and renowned physician Dr. Thomas Willis ...: Viz I. Of fermentation, II. Of feavours, III. Of urines, IV. Of the ascension of the bloud, V. Of musculary motion, VI. Of the anatomy of the brain, VII. Of the description and uses of the nerves, VIII. Of convulsive diseases : the first part, though last published, with large alphabetical tables for the whole, and an index ... : with eighteen copper plates / Englished by S.P. esq.

CHAP. XI. Of the Kinds, and Cure of a Putrid Synochus, or conti∣tinual Feaver.

ANd thus much for a Putrid Synochus in general, in which is described its for∣mal reason, according to the accidents and symptoms which are commonly observed in its Figure; there are besides, (I shall not say species but) some varieties, or irregularities of this Disease, in which, this Feaver somtimes declines from this common Rule, and by reason of some accidental Distempers, gets new names and distinctions.

In the first place therefore, a Putrid Synochus is wont to be divided into Sympto∣matick, and essential; It is called Symptomatick, which draws its beginning from some other Distemper, or Disease before excited in the Body, so that the Feaver, is on∣ly a symptom, coming upon that other Disease: of which sort is accounted, what de∣pends upon the squinancy, plurisie, the inflamation or imposthume of the Lungs, or any imposthume from a wound, or ulcer in a principle part, or its neighbourhood, of which we think a little otherways, viz. That truly no Putrid Feaver is merely Sympto∣matical; perhaps it may arise occasionally, from some other Distemper; but it is founded immediatly, in the Sulphureous part of the Blood being made too hot, and as it were inkindled: for without a Procatarsis, or preceeding indisposition of the Blood, the aforesaid Distempers, rarely, or not at all, cause a Putrid Feaver.

As to what respects the squinancy, plurisie, the inflamation or imposthume of the Lungs, and the like; I say, that these are the products of the Feaver, or Distempers following it; but by no means the cause of it; for most often the evident cause, went before, which produced the Feaverish effervescency of the Blood, as a taking of cold evacuation being hindered, &c. then, altho the sick do not openly grow presently into a Feaver, yet a greater ebullition of the Blood, than was wont, is stirred up, as may be easily conjectured from the Urine, Pulse, and inquietude of the whole Body. After some days, ••nhw sooner, now later) an Inflamation is brought forth, in one part or other; the reason of which, may probable enough be said to be of this sort: The

Blood, by reason of the effluvia being retained, (which are like ferment) is increased in its bulk, and grows more turgid than its wont, in the Vessels; and when for want of Ventilation, it is streightned in the space of its circulation, it easily springs forth, where it can find a passage, through the Arteries, and being extravasated, from the broken thred of Circulation, it gathers together into a Tumor: and because from this kind of tumor, an heat, and pain, are increased in the part, the Blood is more di∣sturbed in its motion, and so the Feaver, at first inkindled, is more aggravated.

Further, in these kind of Distempers, we may take notice, of a certain aptitude of the Blood to be coagulated, whereby it is made less fluid, so that it is apt to be con∣gealed in the lesser Vessels: even as it is to be perceived in Milk, when it begins to sour, for then it will not be boiled, nor heated over the fire, without coagulation: and in like manner, there is to be suspected in the Blood, a certain disposition to growing sour, by reason of which, it is made more obnoxious to coagulation; for it easily ap∣pears, that in a plurisie, a peripneumonia, the squinancy, and the like Diseases, the in∣flamation, or extravasation of the Blood, does not always depend on the exuberancy of the Blood, and plenitude of the Vessels: for oftentimes, the Blood is stopped in its motion, with a weak pulse, and a sinking down of the Vessels, and being extravasated in the side, or elsewhere, causes a most acute pain, yea being driven from one part, by and by it is fixed in another: and somtimes it begins to stagnate in the heart it self, and there oftentimes induces a deadly oppression: wherefore, some pluritical people, are wont, when the pains are gone, to complain of a great burthen, and as it were weight, fixed about the region of the Heart: And when we have opened the dead Bodies, of such as have dyed of these kind of Diseases, we have seen the Blood to be gathered together, in little bits, or oblong gobblets, in the secret parts of the Heart, and round about the cavities of the Vessels. But for that these Diseases, are wont to be handled apart from the Feaver, therefore we shall say no more of them here.

It only remains, that we inquire, whether the Feaver which accompanies these Di∣stempers, is to be esteemed in the rank of those, that are called Putrid, or not? To which we reply, that most often, they are simple Feavers, in which only a subtil, and spirituous part of the Blood is inflamed; and therefore, it the extravasated Blood may be restored to circulation, by a plentiful detraction of the Blood, or an emptying the Vessels by sweat, presently the growing hot of the Blood is appeased, and the Fea∣ver shortly allayed. But somtimes, when a predisposition, as in a Plethora, or fulness of good humor, or in a great Cacochymie or fulness of evil Juices, brings it on, to∣gether with the same kind of distempers, a Putrid Feaver is inkindled, wholly from the same cause.

Among the symptomatick Feavers, is reckoned that which is commonly called the slow Feaver: they who are sick of this, are more than usually hot, especially after eating, any motion, or exercise; the Urine for the most part is red, the Spirits are feeble; and strength cast down, as to their appetite, and rest, they are indifferently well, they have neither Cough, nor much spitting, but they daily (like those in Con∣sumptions) grow lean, without any evident cause. The fault for the most part is ascribed, to obstructions in some inward, (as the liver, spleen, or mesentery) by whose default, the aliment is not well Cooked, nor rightly dispensed. But it seems to me, that this sort of distemper, is immediatly founded in the evil disposition of the Blood, by which it is inclined, into a too salt and sour temper, and therefore is rendred less apt for nutrition, and an equal circulation. For the Blood in the Heart, just like oil in a Lamp, if it redounds too much with saline Particles, is inkindled not pleasantly, and equally, but with a noise, and great evaporation of the parts; whereby indeed, it is sooner wasted, and exhibits but a languishing, and weak flame. I opened one, somtime since dead of this Disease, in whom the Viscera destinated to concoction, were well enough, but the Lungs were without moisture, and dry, and beset through∣out with a sandy matter like Chaulk. Also oftentimes, in this Disease, the Mesentery is beset, the glandules being filled with such a Chaulky matter: But whether the Blood being made more saltish, doth first bring in these kind of distempers of the Viscera, or whether the Dyscrasie, or evil disposition of the Viscera, first brings it upon the Blood is uncertain: it seems probable, that either distemper depends upon the other, and that the causes of either evil are reciprocal.

But the Feaver, which chiefly deserves to be called Symptomatic, is that which is ex∣cited in Phthisical persons, from an Ulcer, or Consumption of the Lungs. For the whole Blood, whilst it passes thorow the Lungs, in its circulation, often impresses on this

Inward, the ideas of very many Diseases; and on the other side, receives the same from it, being evilly affected, whatsoever impure thing is conteined in the mass of the Blood, as the flowring of New Wine, is cast forth by extremities of the Arteries; wherefore, when Nature being made more weak, it cannot transfer its recrements into the superficies of the Body, it deposes them, by a more near Purgation into the Lungs. From hence a Cacochymia, or fulness of ill juices, and many Chronical Diseases, end in a Consumption: in like manner, when the flesh of the Lungs wasts, or abounding with an Ulcerous matter, becomes half putrid, the Blood passing through it, is infe∣cted with the purulent matter, or tabid infection, and for that cause, is stirred up into a continual Effervescency, by reason of the confusion of somthing not miscible, and wherefore, it induces an assiduous Feaver, and wholly perverts the Alible Juice. The same reason is, of Feavers, form an Ulcer, or Imposthume, oftentimes raised up in other parts: for these, even as the tabid constitution of the Lungs, cause oftentimes a Consumption, and Hectick Feaver. The full consideration of these, are not for this place, wherefore, we will return, whence we have digressed, to a Putrid Feaver pro∣perly called, or essential.

The Essential Putrid Synochus, is wont to be divided, into a Putrid (such as is al∣ready described) into a Causon, or hot burning Feaver; and besides into a Quotidian, Tertian, and Quartan: The Putrid Synochus, but now delineated, ought to be the rule or square of the rest, to whose type, most Feavers, which are of this kind, are to be composed. As to the rest, but now mentioned, according as they vary their kind, I shall briefly subjoyn.

The Causon, or Burning Feaver, is that which performs its course, with a greater heat, almost intolerable thirst, and other symptoms, arguing a greater inflamation of the Blood: The formal reason of it, by which it is differenced from the rest, consists in this; that the temper of the Blood is hotter, that is, abounds more with fireable Sulphur; therefore, when it grows fervent, it is inkindled in a greater plenty, and with its deflagration, diffuses the Effluvia of a most intense heat, through the whole Body: its motion is acute, and quickly comes to its standing, it is compassed about with more horrid symptoms, hath a difficult Crisis, and an even full of danger.

But as to what respects those periods, or fits, in which a Putrid Feaver somtimes is wont to be more cruel, at a set time; and (as if intermitting) now every day, now every third, or fourth day, repeats as it were the Feaverish fit; the reason of this seems not easily to be explicated: especially, if we reject from this cense, the fewer humors, to the spontaneous motion of which, this distemper is commonly ascribed, concerning this mat∣ter, what seems most likely to me, I shall doubtingly propose. In a continual Feaver, there are two chief things, (as we have already noted) which for the most part induce the Ef∣fervency of the Blood; to wit, the exaltation and inkindling of the Sulphureous part of the Blood, then consequently, an heaping together of the adust matter, and remaining after the burning of the Blood, to a swelling up: upon the former the continuance of the Feaver, upon the other, its standing, and critical perturbations, depend: to these some times, a certain third thing happens, to wit, a fulness, and swelling up of the crude Juice, from the Aliments newly taken; which in a continual Feaver, (as in the fits of Intermit∣ting Feavers) induces a greater Effervency, at set intervals of times. But why this does not always happen, nor wholly after the same manner, the reason is this: when the Putrid Synochus is very acute, and the whole Blood almost is quickly inflamed, and highly rages, whatsoever of Nutritious Juice, is poured to the Blood, is presently burnt, and consumed by the fire; wherefore, little or nothing of it, is conteined in the mass of Blood, for the matter of a fit. But if this Feaver be less acute, and the Blood only flames forth moderately, and in parts, the supplement of the crude Juice, is not wholly consumed, by the burning; but is perverted, by a more gentle fire, into a Fermen∣tative matter, which, when it arises in the Vessels to a fulness of swelling up, con∣ceives a Flux, and by its Effervency, makes stronger the Feaverish heat, before glow∣ing in the Blood, as it were by the coming of new fewel. The flowring of this matter doth not seldom begin with a light shivering, or cold, and somtimes end with sweat: but for the most part, it is exhaled by insensible transpiration. In every fit, besides the provision of the degenerate Nutritious Juice, somthing from the adust, and burnt matter of the Blood, evaporates; wherefore, the Crisis of the Disease, is drawn forth longer, that tis hardly cured, under eleven or fourteen days; yea (for the most part) in this sort of Feaver, with fits and remissions coming between, the perfect Cure of the Disease happens, scarcely within twenty days: and somtimes leisurely, without

any through Crisis, it remits, and then, by a long declination, it is ended in Death, or Health.

But that this kind of remission, and acerbation or growing more violent, are va∣ried, according to the type of an Intermitting Feaver, that they repeat their turns now every day, now every other day, and somtimes not but within four days, the reason of this is to be sought, from the Doctrine before delivered, of Intermitting Feavers: to wit, that according as the Dyscrasie of the Blood, diversly appears, the suppliment of the degenerate Nutritious Juice, arises to the fulness of swelling up, either sooner or later; and for that reason, its Effervency, causes now more frequent, now more rare fits in this Feaver.

Concerning the Cure of Putrid Feavers, of every kind, there are four general in∣tentions, on which, the whole stress of the matter depends. First, that the Blood, (if it may be done) may be defended from burning, and the flame, or fire inkindled in its Sulphureous part, be wholly suppressed; which about the first beginning of this Disease, happens to be often brought about. Secondly, that when the Blood having taken fire, cannot be presently extinguished, that at least it may perform its burning more mildly, and with lesser hurt. Thirdly, the deflagration being ended, that the Liquor of the Blood, be freed from the recrements of the adust and burnt matter, and afterwards restored, to its Natural temper and vigor. Fourthly, that the symptoms chiefly troubling may be timely helped, the which, unless taken away, will frustrate the work both of Nature and Medicine.

As to particular Remedies, with which these intentions may be served, there are various prescriptions, and forms of Medicines, not only among Physicians, but also among old women and Emperies, ordinarily in use: from which however, like a Sword in a blind mans hand, used without difference, and exact method of healing, more hurt than good, most often accrues to the sick. There will be no need here to repeat the forms of Purges, Cordials, and of other Medicines, eligantly enough de∣livered among many Authors: I will add in few words, some chief indications, and Medical Cautions, which ought to be observed in the course of this Feaver, according to its various times, and divers symptoms.

1. At the first beginning of this Disease, the business will be, that the Feaver may be presently suppressed; and the inflamation of the heated Sulphur, may be inhibi∣ted: to which, the opening of a Vein doth chiefly conduce; for by this means, the Blood is eventilated, and the heated Particles, too much heaped together, and almost ready to be fired, are dissipated one from another: as when Hey, apt to burn, if ex∣posed to the open Air, its firing is prevented. Besides, let a slender diet be instituted, in which nothing Spirituous or Sulphureous ought to be administred; The Viscera, and first passages should be freed from the load of excrementitious matter; wherefore, Clysters are of necessary use; somtimes also Vomits, and gentle Purges; by which, somtimes timely and with judgment administred, the Feaver presently after the be∣ginning, is extinguished, the Food of the fire being drawn away. If that notwith∣standing this method the burning spreads more abroad, and more and more, dayly snatches hold of the Sulphureous Particles of the Blood; it must be indeavoured, (as much as may be) that the deflagration proceed gently, without great tumult.

2, When the Feaver is augmented, if the Blood be too hot, and distends the Ves∣sels very much, with a vehement and strong Pulse; if watchings, a Phrensie, or a pain of the Head cruelly urge, the letting of Blood may be again repeated; Transpira∣tion (as much as may be) should be freely procured, wherefore, let the sick keep in bed, for the most part; let the diet be sparing, of the most slender Aliments, also drink small, and plentiful, that the burning Blood, may be diluted with a more plentiful Serum: Clysters are administred safe enough, and in truth commodiously; but Me∣dicines, whether Cathartics, or Diaphoretics, and which too much exagitate the Blood, are to be shunned, with the same industry, as blasts of wind to burning houses: but rather Opiates, and Anodines which fix and bind up the Blood, and Spirits, are to be made use of; also Juleps, and Decoctions, which refrigerate the burning Viscera, attemper the Blood, and cherish the Spirits, are often to be exhibited: acetous Liquors of Vegetables, or Minerals, also putrified Nitre, because they restrain the rage of the Blood, and extinguish Thirst, are truly convenient. Hot waters, and Spirits, Cordial, and Bezoartic powders, (so long as the Disease is not malignant) are not to be meddled with. If that the Blood be unequally circulated, and is carried more towards the Head, than the Feet, Epithemas are profitable, of the warm flesh, or Inwards of Animals, applyed to the soles of the Feet.

3. When the Feaver is at its standing, the motion of Nature is diligently to be at∣tended, whether it will make a Crisis, or not; Wherefore, nothing rashly is to be attempted by the Physician; the opening a Vein, or strong Purgation, is wholly to be forbid; but after that the Feaverish burning is somwhat remitted, from the defla∣gration of the Blood, and signs of concoction appear in the Urine, if that the motion of Nature be slow, a Sweat, or gentle Purge may be admitted; which however are bet∣ter, and safer done, by the Physician, when Nature first, by a critical motion, hath entered upon the seclusion of the Morbific matter. If that all things are crude, and troubled, the Urine yet turbid, without sediment, or separation of parts, if the strength be languishing, the Pulse weak, if there be no Crisis going before, or only in vain, any evacuation, either by Sweat or Purge, is not to be attempted, without manifest danger of life: but it must be longer staid for, that the Spirits of the Blood may recover them∣selves, may by some means overcome the excrementitious and adust matter, and then by degrees may separate it, and put it forth; in the mean time, the Spirits are to be cherished, with temperate Cordials, the immoderate Effervency of the Blood (if it still be) is to be stopped, and its due Fermentation sustained, which in truth is best per∣formed, by Corals, Pearls, and such kind of powders; which indeed are dissolved by the Ferments of the Viscera, and then Ferment with the Blood, and greatly restore its weak and wavering motion. In the mean time, (whilst Nature is labouring) all obsta∣cles, and impediments are to be removed, and especially the provision of excrements, heaped up in the first passages, is to be brought away, by the frequent use of Clysters.

4 By what way or method, the symptoms chiefly urging, ought to be handled, will not be easily prescribed by certain Rules; because, they themselves require somtimes to be presently appeased, and quieted, and somtimes to be quickned forward: and what is somthing more, perhaps at another time, they are to be left wholly to Nature. Some of these are too opposed, with gentle and lenitive Remedies, but others with more sharp and irritative Physic: yet in the mean time, it is a precept to be held in all, that you dilligently wait upon the footsteps of Nature: which if it works wrongfully, its disorder is to be reduced; if rightly, yet too vehemently, to be bridled: If she works rightly, yet too slowly, or more weakly than she should, the business will be, that her endeavour may be incited, and helped, by the help of Medicine.

5. In the declination of the Feaver, when after a perfect Crisis, Nature is stronger than the Disease, the business goes well, nor is there much business left for a Physician: It only remains, to propose an exact manner of diet, that the sick may soon recover strength, without fear of relapsing: also it is requisite, to exterminate the Reliques of the Feaverish matter, with a light Purgation. About Diet, they often fall on the Rock of relapsing, viz. by the too hasty eating of flesh meats, or more strong Food, the sick relapse into the Feaver: for when the Viscera are weak, and the Aliments (unless very slender) not easily digested, and when also the disposition of the Blood, is weaker, that it does not assimilate the more strong nourishing Juice; if any thing im∣proportionate is brought to either, the regiment of Nature is again perverted, and all goes ill. Wherefore, those growing well, should for a long time refrain from flesh, and when at length they use it, it should not be unless the Urine shall be like that of health∣ful people, and no more troubled by the cold: and then indeed it will be safest, to begin with broths made of flesh, and then by degrees, to proceed to more strong Aliments.

6. When from an imperfect Crisis, things are grown doubtful, and remain yet un∣determined; then is the Physicians most difficult task: The motions and strength of Nature are carefully to be waited on, whether it begins to prevail on the Disease, or to yield to it: If signs of concoction appear, and that there is strength, a gentle evacu∣ation, and only by leisure, is to be celebrated. In the mean time, the symptoms most urging, are to be succoured, with convenient Remedies, all impediments to be taken away, and strength is to be sustained (as much as may be) with Cordials, and a right manner of living or diet.

7. When from an evil, or no Crisis, all things turn to the worse, and when the Phy∣sician almost dispaires of Curing the Disease, he may predict its event suspected, and much to be feared, But yet, he ought not to trust to a naked Prognostication, to hin∣der all things else, but that as yet, what is in the Medical Art, should be consulted for Health, tho desperate: Remedies may be administred, to the symptoms most infe∣sting; the Spirits of the Blood almost extinct, may be restored by Cordials. When we despond of Health, life should be prolonged as long as it may, and at least a fair exit procured.

According to the various types but now described, of a Putrid Feaver, I might readily add very many Histories of sick people, and particular observations, made about their Cure; for these kind of examples are usually met with in our dayly practice, so that they are sufficient to fill a great Volumn; out of these however, with the good leave of the honest Reader, I will briefly propose some few, respecting the several kinds of the aforesaid Feaver, by which their Doctrine, and Method of healing them, above delivered, may be illustrated.

A Noble Matron, about fifty years of Age, of a slender habit of Body, little sta∣ture, indued with a ruddy Complection, when on the fifteenth day of June, by reason of the Summers heat, she had put on more thin Garments, than she was wont, felt herself ill in the Evening; from thence she was distempered with a nauseousness, and oppression of her Stomach, she felt wandring pains, troubling her now in her shoul∣ders, now in her back, very thirsty, yet without any immoderate heat: on the second, and third day, almost after the same manner, on the fourth day after a Vomit, Viz. of the infusion of Crocus Metallorum one Ounce given, she cast forth yellow bile four times, and had three Stools, and seemed to be eased: the night following, she slept som∣thing better: but on the next day, the Feaver being throughly inkindled, she com∣plained of thirst, a burning of the Praecordia, and of a pain, now in her side, now in her back; presently blood was taken to eight Ounces, her Urine was of a very deep red, thick, and troubled without any Hypostasis, or setling of the Contents, her Pulse unequal, and often intermitting, the following night without sleep: on the sixth day of the Disease, early in the Morning, a small Sweat broke forth, from whence the heat somthing abated, which in the Evening again grew stronger: on the seventh day, a very acute heat, with thirst, burning, an inordinate and intermitting Pulse, as also with a mighty restlessness, and tossing of the whole Body troubled her, on the eighth the symptoms were somwhat more remiss, also in the Urine, some marks of an Hypostasis; she took that day posset-drink, with Meadow-sweet boiled in it, and sweated plentifully; and was cured of her Feaver. All the time of her sickness, for Food they gave only smal Beer, Posset drink, Barly broth, or Grewel, also frequently Clysters; Drink, and a cooling Julep, they gave her at her pleasure.

This Noble Lady, through transpiration being hindred, fell into a Putrid Synochus: the Effluvia, wont to be evaporated through the skin, being retained within, (together with the Choler flowing out of the Choleric Vessels) and fixed to the Viscera, did overthrow the dispositions of their parts, and especially gave trouble to the Stomach, and raised up pains and Convulsions, in the parts filled with Muscles and Membranes: the Pulse was unequal, and intermitting, not because of the malignity of the Disease, as in the Plague, but by reason a certain proper disposition of the Heart, by which in∣deed, its ferment being not well constituted, the Blood growing fervent, is not pre∣sently equally inkindled, and wholly leaps forth, but a part of the Blood, in flowing in a small, then a greater, and after some turns the graatest proportion, stoping for a mo∣ment of time, in the Bosoms of the Heart, produces the unequal and intermitting Pulse. I have known in many others, clearly, the like distemper of the Pulse: to wit, so long as they were free from intemperance, the Pulse was altogether equal, and or∣derly, but if they were more strongly heated than usually, by any sudden passion of the mind, or too great agitation of the Body, presently they were affected with an un∣equal Pulse, and between the vibrations or strikings, intermitting perhaps 4, 7, 10, or 20. and as often as they fell into a Feaver, the Pulse shewed it self after this irregular manner. When this habitual irregularity, concerning the Pulse, was not yet made known to me, by frequent experience, I was wont to suspect still a malignity in the Disease, and to foretel a fatal event, which hapned otherwise.

On the fifth day, in this sick person, the Feaver, although slowly inkindled, came to an augmentation, and from thence past through the rest of the stations with a swift motion: on the sixth a light emptying of the adust matter, arising to a fulness, a sweat being risen, and so a certain remission of the Feaverish heat followed: on the seventh day, this adust matter arising to its height of increase, made the standing of the Disease, to which, at length on the eighth day, a plentiful sweat, with all things re∣quisite to a good Crisis, followed, and perfectly Cured the Feaver: because (as it ought to be) those three things went before this critical evacuation, viz. first a full and suffi∣cient deflagration of the Blood, as appeared by the very strong heat, and plainly fiery, continued for three days before: also secondly, a congestion of the adust matter to a plenitude, as was collected by the high disquiet, and tossing about the preceeding

and then a certain Pepasmus or Concoction of the same matter, and a begun secreti∣on in the Blood, which a ceasing of the symptoms and signs of Concoction in the Urine, shewed: wherefore, the Copious sweat, coming upon so laudable a sign, so long as there was no suspition of malignity, portended nothing but good.

About the beginning of the year 1656, a Gentleman endued with an active habit of Body, without any manifest cause, (unless that being much addicted to study, he used no exercise after it) became ill; at first he complained, of a nauseousness and want of Appetite, with a great Headach: on the second day, he was affected, now with a shi∣vering, now with heat, several times reciprocating, besides, with thirst, and burning of the Praecordia, with a scurfieness of the Tongue, and an ingrateful savour. On that day, he took ten drams of an Emetick Liquor, by which he Vomited seven times, and cast up a great quantity of yellow bile, and had four Stools; the night following he was unquiet, and almost wholly without sleep, and in which the sick person grew more Feaverish, with an increased heat: on the third day, when the aforesaid symp∣toms were grown worse, he was let Blood to ten Ounces: his Urine was red, thick, and with a copious sediment; his Pulse quick, and vehement; at night he sweat a little, with a short sleep, but disturbed: on the following morning, he seemed to be a little eased: yet in the evening all things grew worse, with most strong wakings, heat, and thirst: on the fifth day, by a light sweat, the heat somwhat remitted, which yet a little before the evening, returned with its wonted fierceness, The night again was wholly without sleep, with a continual tossing up and down of his Body: In the mor∣ning, by a little gentle sweating, he felt a little ease; in the evening an encrease again of all things more cruelly; the night also was very unquiet: about the beginning of the next day, a sweat, as before succeeded, and a little more plentifully: on this day was a manifest change towards health; the heat and thirst was a little less vehement; his Urine was less red, with some Hypostasis; thence, for three days, the Feaver leisurly declined; yet every night he had a certain fit, but more remiss than before on the eleventh day, he sweated more plentifully, and was perfectly Cured: all the time of his sickness, he used a most spare diet, taking truly nothing of Aliment, besides small Beer, and Posset drink made of it; he somtimes took drink, and cooling Juleps, of boiled Barly, and distilled waters; dayly, if his Belly was not loose of it self, an emol∣lient Clyster was administred: he used no other Physic besides, to wit, neither Purge nor Cordial. But the Feaver being allayed, he was twice Purged, and from thence quickly grew well.

This Feaver was a Putrid Synochus, as may be conjectured by the shivering about the beginning, and then with continual heat, thirst, watchings, and other symptoms grieviously infesting, for many days: but forasmuch, as its intemperature was exaspe∣rated every night, it might be called a continued Quotidian: This Disease, made its first assault without any evident cause, because the Blood being little ventilated, like Wine growing hot of it self, had conceived an ardour, from the exalted Sulphur; the Choler flowing forth from the Choleduct Vessels, and likewise the Purgings of the raging Blood, being poured about inwardly, (as it is wont to do for the most part in Feavers) presently stirred up troubles, and disorders in the first passages: therefore by reason of the excrementitious matter there heaped up, there was procured a depletion, and soon after the beginning, a Vomiting: notwithstanding which evacuation, and likewise a more strong Purging of the Belly by Stool, if administred, the Feaver be∣ing wholly inkindled, because they too much agitate the Blood, and disturb greatly the Concoction of the adust Feaverish matter, for that reason bring more damage for the most part than benefit to the sick: The first station of this Disease, viz, until the whole Blood was fired, was extended to the third day; and then from thence, when the Blood flaming forth was burthened with adust recrements, its greater ebullition, with a frequent endeavour of expulsion by sweat followed: on the seventh day, when the Blood for the greatest part had flamed forth, and the adust recrements, heaped up in its bosom to a fulness of swelling up, began to be troublesom, the critical motion was stirred up: by which nevertheless, that matter not being as yet wholly subdued, nor ready for separation, the Disease was not perfectly Cured; but after another peri∣od, the same increasing, at last being stirred up, on the eleventh day, brought on that other, and perfectly Curing swelling up: in the days between, because, besides the recrements remaining after the deflagration of the Blood, and reserved for a Crisis, also from the Nutritious Juice not presently taking fire, but after a peculiar manner de∣praved, other matter in the bosom of the Blood, apt to a swelling up, was gathered to∣gether; therefore, from the continual increase, and Flux of this, there hapned to this Feaver continual fits, (such as are wont in Intermitting Feavers) on set days, and hours. 〈4 pages missing〉〈4 pages missing〉

suffocating Catarrh: For this kind of distemper (as also the Cough with great spit∣ting) arises not, for that the watery humor (as is commonly said) falls from the head, into the throat, and lungs; but because the serous Latex is poured forth, now from the pneumonic vessels, immediately into the lungs, now dropping forth from the Arteries opening into the larynx, falls down on the breast; on the third day, from the same serous humor, with a portion of the Blood, being fixed in the side, the acute pain arose; for the Blood beginning to grow fervent, when as yet it did contain in it self a crude matter, and (as it should seem) somthing sour, from the degenerate alible juice, deposed the same, (because it could not cast it forth of doors by sweat) by a proper lustration or purging through the intercostal Arteries, into the membrane surround∣ing the Ribs; and there (as it is always wont in a Plurisie) either by coagulation, (which may be lawfully suspected) or by the shutting up of the vessels, the Blood being intangled with the same matter, is stopped in its motion; then being increased in its bulk, by a new coming still of the Blood, it causes a break of the union, and so an acute pain. That in this sick woman, the same kind of matter, disturbing the mass of Blood, with a portion of it extravasated, was fixed about the Pleura, it from thence hapned, because the pain urging, the urine was clear, and not full of contents: then, when the vessels, by reason of Phlebotomie, being emptied, they supped up again that matter, into its mass, before exterminated from the Blood, the urine presently be∣came troubled, and again big with contents: The pulse was unequal, and intermit∣ting, because of the idiocrasie or proper disposition, which she was wont to have in every intemperature: for when I cured this woman of a Feaver, many years before, her pulse being unequal, and intermitting, had struck a fear in me, and others, of a sad presage, concerning the event of the disease, which however at that time, (as also in this sickness) ceased, prosperously, without any horrid Symptom.

A strong young man, and corpulent, after immoderate exercise, about the Summer solstice, and then a sudden cold coming upon the heat, found himself ill: At first, a want of Appetite, nauseousness, and cruel pain of the head, as also thirst, and a more intense heat than usual troubled him; on the second day, an acute pain invaded him ••n his right side with a Cough, and difficult breathing; Blood being presently taken plentifully from the Arm of the same side, that pain remitted somwhat, which yet in the evening returned, being made more cruel by a Cough, and bloody spittle. The night followed, without sleep, and very unquiet: on the third day, he was again let blood, besides Liniments, and fomentations were applyed to his side; Moreover pou∣ders, Juleps, and antipleuretick decoctions, being taken inwardly, about night the pain almost wholly ceased. Then by and by, he was afflicted with a cruel headach, and a vertigo: on the fourth day, a stream of Blood fell from his right nostril, about two ounces, by which the pain of his head clearly ceased, and the vertigo; but in the Evening, the pain in the side before distempered, returned with greater fierceness: In the mean time his Pulse was small, and weak, that when it was consulted upon, for the letting him blood again, 'twas thought dangerous, lest his dejected strength would not admit of such a remedy: wherefore, Phlebotomie was performed only, in a very small quantity, and a fomentation, and a Cataplasme was prescribed to be diligently applyed to his side; besides twenty drops of the spirit of Harts-horn, to be taken in a spoonful of Cordial Julep, and the same to be repeated continually, with∣in the space of six hours: He sweat that night very much, and the pain much re∣mitted, his spitting was but little, interspersed with Blood, which, within a day wholly ceased, and the pain also leisurely vanished. The sick man took twice a day, a scruple of the same spirit of Harts-horn, and within a few days, he grew perfectly well, without relapsing.

This Feaver was a simple Synochus, stir'd up from the evident cause, viz. a Con∣striction of the pores: as soon as the Blood began to be somwhat filled with adust re∣crements, and so to swell up more, the matter, which should have been separated, by reason of its peculiar evil, was transferred into the Pleura, and being there fixed, com∣pelled the Blood coming to it, to be coagulated, and therefore to be stopped in its circulation, and (when it could not be received by the veins) presently to be extrava∣sated: from hence hapned the acute pain in the side, and bloody spittle, by and by, after the beginning of this Disease; then afterwards, the same matter being thrust out of that nest, which it had got, and being supped up again into the mass of Blood, was fixed in the head; and there inducing the like stagnation of the Blood, and (as it is probable) coagulation, caused the vertigo, and cruel pain; which nevertheless was quickly cured, by the hemorrhage being arisen, by reason of the extravasated Blood. A part of the morbific matter, being after this manner drawn away, the other part

resumed by the Blood, was again conveyed to its usual nest, to wit, the side before distempered; where depositing its latex, (to wit, a portion of the Blood) it did coagulate it again, and compelled it to be extravasated or to flow out of the vessels: For that pain being renewed on the fourth day, with the bloody spittle, from the ebul∣lition of the Blood, too extreamly, and therefore flowing out of the vessels, would not be brought away; because at that time, the Pulse was small and weak, with a falling down of the vessels, that indeed the Blood was thought to have been run all out of the vessels, for that being coagulated by the morbific matter, (and therefore tho ex∣pulsed the Arteries, yet not being able to be carried back by the veins) it was stop∣ped in its circulation. Upon this, an acute pain followed, because the Blood being heaped together by its frequent approach, and elevated into a Tumor, made a dissoluti∣on of the union; also, by and by from the beginning, a bloody spittle came upon it, because the Blood being restrained within, in the Body, somwhere in its motion, by reason of the most tender, and easily opening little mouths of the vessels, ran forth into the Cavities; when to the same outwardly extravasated, by reason of a more thick skin, and the mouths of the little vessels being locked up, no way lay open, un∣less by its being made and ripened into an Imposthume. The opening of a vein pro∣fited in the beginning of the Pleurisie, because it restrained the Blood, somwhere hindred in its circuit, from too great effervency; but especially, for that, when the vessels were by that means greatly emptied, they did again receive, and render fluent, what∣soever humors were before exterminated, and also the Blood beginning to stagnate in the distempered part. Also, the remedies helping most, about the beginning of this Disease, were of that sort, which hinder the coagulation of the Blood, or dissolve it in the coagulating; such they are, which abound very much with a volatile, or an alcha∣lisate Salt: to wit, spirit of Soot, of Blood, Harts-horn, also spirit and salt of Urine, the pouder of the claws and eyes of Crabs, of a Boars tooth, or the Jaw of a Pike, are of known use. Among the common people, it is a custom to drink an infusion of Horse dung; which medicine indeed, I have known often to have brought help, in deplorable cases. In the mean time, all acid things whatsoever, because they more coagulate the Blood, and hinder expectoration, are highly hurtful in this Disease.