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.

A Description of an Epidemical Feavour chiefly infestous to the Brain and nervous stock spreading in the year, 1661.

IN this Country, before the last Summer, viz. 1661. we had been free for a∣bove two years, from any popular disease, unless such only as usually come in some places; but then, before the Summer Solstice, the small-Pox (a distemper here rarely Epidemical) being rise in many places, raged very much: After that Summer, which was extreamly hot and dry, an Autumn moister then usual follow∣ed: and after which, a most mild winter almost without any cold: in all which space, the Earth was hardly covered with snow, or was ever hard frozen, above three or four days; so that within a few weeks, after the winter Solstice, the Trees began to bud, and the vernal plants to break forth, from the bosom of the Earth, and to flower, and also the birds to build nests: to this mild season, not even∣tilated at the beginning of the spring, by the nitrous little bodys, that were wont to be blown from the North, a filthyness of showrs, and almost continual wet succeed∣ed. After the vernal aequinox, a certain irregular, and unaccustomed Feavour, seised upon some, here and there, which within a month, became so Epidemical, that in many places, it began to be called the New Disease; Raging chiefly among chil∣dren, and youths; it was wont to afflict them, with a long, and as it were a Chro∣nical Sickness: yea sometimes, old men, and men of middle Age, though rarely, were seised by it, and those indeed, it did sooner, and more certainly kill. The Distemper at first invading any one, did creep on them so silently, that the be∣ginnings of the sickness, were scarce perceived: for arising without immoderate heat, or more sharp thirst, it induced in the whole body a great debillity, with a languishing of the Spirits, and a torpitude or numbness of the function; The Sto∣mack was ready to loath any victuals, and to be grieved at any thing put into it, and yet not easie to vomit. The sick were unfit for any motion, and only lov'd to be idle, or to ly down upon the Bed: within a short time, also sometime at the first coming of the Disease, they complained of a heavy vertigo, a tingling of the ears, and often of a great tumult and perturbation of the brain. Which kinde of Symptoms, were very often esteemed, as it were the peculiar signe, of the ap∣proach of this Disease, if in some, those had been wanting, or hapned to be more remiss, instead of the head being affected after that manner, the disease took more deep root in the Brest, with an excited cough, as shall be told by and by. But whilst the brain, and the nervous Appendix, being after this manner affected, the animal Spirits, presently from the beginning of the sickness, were benummed, a slow and as it were hectick feavour, was inkindled throughout: but yet, the effervescency of the blood, which was hardly continual, but flitting, and uncertain, was according to the disposition of the blood it self, in some more in∣tense, in others more remiss; and therefore, thirst, the white scurf of the Tongue, and other Symptoms, which accompany a feavourish distemper, did more or less infest them: sweating did not willingly follow, nor could it easily, or by a light thing, be caused by Art: yea, neither this, nor any other evacuation, as it were critical, at any time succeeding, did suddenly help this disease; but it persisting for many weeks, and sometimes months, reduced the sick to the highest Atrophie, or wasting of all parts, and often infected them, with an incurable Consump∣tion.

About the increase of the disease, which hapned in most, within eight days, if the Distemper (as it was often wont) did settle chiefly in the head, and nervous System, most grievous Symtoms, in their Dominions, viz. a plain Phrensie or deep stupidity or Insensibility did molest them. For I often observed, in many children, and not seldom in women, after seven or eight days from their falling sick, that their knowledge and Speech failed them, and so the sick have lain, for a long while, yea, sometimes for the space of a whole month, without any taking notice of the by-standers, and with an involuntary flux of their excrements; but if they continued in some sort the use of Judgment, and Reason, they laboured with a frequent delirium, and constantly with absurd, and incongruous Chymera's, in their sleep. But in Men, and others of a hotter temperament, from the mor∣bific

matter, instead of a Crisis being translated to the brain, a Fury, or dangerous, and oftentimes deadly phrensie did succeed. But if neither Stupidity, nor great Distraction did fall upon them, swimmings in the head, Convulsive motions, with Convulsions of the members, leapings up of the tendons, did grievously in∣fest them. In almost all the sick, the belly was for the most part loose, casting forth plentifully now yellow, now thin, and serous excrement, with a great stink: it was rarely that vomiting fell upon any one: The urine in the whole process of the Disease, (unless when the morbifick matter, being caried more plentifully into the Brain, did threaten a phrensie) was highly red, so that some, by reason of the deep colour of the water, judg'd this feavour to have been plainly Scorbutick: which notwithstanding appeared to be otherwise, because antiscorbutic Remedies, (of which indeed many, and almost of every kinde were tryed) were little or nothing beneficial. It was most of all to be admired, how soon after the begin∣ning of this Disease, the flesh of the sick consumed, and they reduced to the lean∣ness of a Sceleton, when in the mean time, there was no great heat, that might by degrees consume the solid parts, nor any violent evacuation, which might greatly take them down.

Besides these evills molesting the region of the head, a distemper no less dange∣rous, oftentimes fell upon the breast. For in some, tho not in all, a cough very troublesome, with abundance of spitle, and thick, was excited: this hapned in some, about the declination of the disease, to wit, whilst the confines of the brain were serene, as it were the clowds sent from thence to the thorax, a great Catarrh suddenly rained down upon the Lungs. But in others, who especially had little infection of the disease in the head, presently after the beginning of the feavour, a cruell cough, and a stinking spitting, with a consumptive disposition, grew upon them, and suddenly, and unthought of, precipitated the sick into a Pthisis: from which nevertheless, they recovered, by the timely use of Remedies, often beyond hope. It was observ'd in some, that after a long ecclips of the sen∣sitive facultie, and oppression of the brain, from the morbific matter, at length tumors did follow, in the glandula's, neer the hinder part of the neck, out of which, being hardly ripened and broke, a thin and stinking ichor or matter, ran for a long time, and brought help. I have also seen watery pustles, excited in other parts of the body, which pass'd into hollow ulcers, and hardly curable: sometimes little spots, and petechiales, appeared here and there: yet I never heard, that any more broad, or blew, of these kinde, were seen in the sick. Not∣withstanding, tho this feavour was not remarkable for very many malignant spots, yet it was not free from Contagion. For that in the same Family, it invaded al∣most all the Children, and youths successively, yea not rarely those of more ripe years, and at mens estate, who looking to the sick, were familiarly conversant in their Chambers, or about their beds, were infected with the same infection: But indeed, there was not so much cause of suspition, that for it, the friends of the sick should be wholly interdicted, from commerce with, or visiting of them.

Altho the course of this disease, (unless when it intimately settled in the brain) did appear so gentle, and continued without any horrid Symptome; yet its cure being always difficult, succeeded not under a long time: For the sick rare∣ly grew well, within three or four weeks, yea for the most part, scarce in so ma∣ny months. If this disease fell upon men of a broken Age, or strength, especially those who were before obnoxious to cephalic distempers, as the Lethargie, Appo∣plexie, or Convulsion, it oftentimes kill'd them in a short space: but if there was any hope of recovering, it could be but slowly procured, (all Remedies what∣soever scarce bringing any sensible help) so that the sick, did no sooner come out of the sphear of this disease, than they fell into the confines of a Consumption.

If the formal reason, and courses of this aforesaid sickness be demanded, it here easily appears, the watering Liquor of the brain, and nervous stock, for the most part both together, with the blood, to be in fault, and the immediate cause, especially of the troublesome Symptoms: to wit, forasmuch as this water, pre∣sently after the first assault of the disease, was grown more poor then usuall, and as it were lifeless; therefore a Languishing, and enervation, with a spontaneous weari∣ness, and impotency to motion, hapned in the whole body, and with a sudden wasting of the body, in the sick. Further, forasmuch as the same Liquor, was stuffed with heterogeneous particles; viz. partly narcotick, partly explosive,

therefore, a numbness, a sense of pricking, leapings up of the tendons and muscles, and contractures, also the Virtego, giddinesse, and other more grievous Cephalick distempers did arise: Moreover, forasmuch as by reason of the evil of the nervous juice, being not quickly or hardly to be mended, the cure or hea∣ling of the disease, became so hard, and lingring. But for that the fault of this Latex, necessarily depended on the discrasie or evill disposition of the blood, also of the depraved constitution of the brain, what their morbid dispositions were, and by what means they brought forth the beginning, or tinder of the Symptom of the feavour but now described, let us now see.

As to the former, it seems, that at this season, by reason of the hot and hu∣mi'd constitution of the year, and no blast from the north (the little bodies of which imbue the blood, and juices of our body, as it were with a nitrous sea∣soning, and by agitating them, defend them against putrefaction) the blood in most men, and chiefly in children, youths, and women, became like standing-water, that so contracts a setling, very impure, stuff't with heterogeneous parti∣cles, and turning to a clammyness, and watrishness; in which, the more pure spirit and sulphur, being somewhat depress'd, the watery particles, being carried forth with the impure salt and sulphur, were too much exalted. Wherefore the blood, both by reason of its Crisis or constitution, being vitiated, also by reason of heterogeneous particles, being heaped up more plentifully in its bosome, was made more fit, either of its own accord, or occasionally, or because of the conta∣gion, to receive a feavourish Effervescency, so that from thence, very many fell at this time into feavours. But the blood growing hot, from the feavourish taint being received, did not presently burn with an open flame, but like green wood laid on the fire, with a flame as it were suppressed, and much incumbred with smoke. Wherefore, the morbific matter, being heaped within its mass, was not wont, (as in a regular feavour) to be consumed by the burning, and its re∣liques, at the set time, to be exterminated by the Crisis: but yet, a little after the beginning of the feavour, a great portion of this matter being powred into the head, at Thorax, or into both at once, and afterwards being continually supplied in those parts, it induced either the aforesaid distempers of the brain, and ner∣vous stock, or a cough, with a consumptive disposition, or both together, and for this reason, about the beginning of this disease, when a pulse quicker than it ought to be, and a high colour'd urine, and full of contents, did show the blood to grow hot with a feavourish distemper, the sick did not complain of heat, or thirst; because the blood growing hot, did lay up its impurities, and recrements, forthwith into the provision of the nervous Liquor, or into the Lungs; wherefore, within these receptacles, the Symptoms presently became worse; but afterwards the disease growing on, a somewhat sharp heat, with scurfness of the tongue, was wont to be troublesome to some: yea, in all, a slow, and as it were hectick feavour, continued throughout; which neither by sweat, nor by insensible tran∣spiration, could be so wholly removed, but that it was daily renued, chiefly af∣ter eating, tho never so small: which thing truly seem'd to happen, because the nervous juice being full of the feculencies, brought from the blood, did not after∣wards receive them in so great plenty, but that these recrements, together with the nutritious humour, (and for that this was not consumed by nourishing the so∣lid particles) remaining within the bloody mass, caused it then to grow fea∣vourishly hot.

2ly, Besides this morbid disposition of the blood, contracted from the intempe∣rance of the year, it seems, that the brain also, from the same occasion, was made prone to the aforesaid passions. For when, for a long tract of time, the southern winds did continually blow, with a moist constitution of the Air; from thence, the passages, and pores of the brain, being very much loosned, and opened, and its connexion too much dissolved, they gave an easie passage, to serous humours, and for all sorts of heterogeneous particles: wherefore the blood being very fe∣culent, and watery, as soon as it began to grow hot from the feavour, carried its serous recrements and filths, presently thorow the too open doors into the head: for whosoever he was, who did not complain of his head, being too much stuffed with a moist air, and numbness of spirits; on the contrary, his pores being bound together, by an intense cold, or dryer air, all his senses, and faculties, remained more quick and lively.

These things being thus premised, concerning the morbid provision of the brain, and humours, to wit, of the blood, and nervous humour, by reason of the con∣stitution of the year, whereby indeed, very many at that time, sell into a slow, unequal, and long continuing feavour, surrounded with Cephalick and Convulsive symptoms, and hardly curable: hence also it will be easie, to unfold the reasons, of the rest of the symptoms and accidents, chiefly to be noted in this disease.

For first of all, that this irregular Feavour, raged chiefly among Children, young men, women, and phlegmatick men, the reason was, because in those kinde of bodies, the blood was apt to be more waterish, and less perspicable, and from thence to gather a serous Colluvies, or watry humour, and heterogeneous feculencies; and also, the brain being more humid and weak, easily received any recrements of the bloud. Wherefore it may be observed, that those sort of per∣sons, were found more prone to Convulsions, arising by reason of any other oc∣casions.

Secondly, the noted Atrophie or leanness, came so suddenly upon this feavour, because, by reason of the depravation of the nervous juice, the officies of nou∣rishment, depending upon it (which, as we have elsewhere shown, are highly active) presently failed. For although we do not grant, the nervous humour to be only nutritious, but to dispense thorow the Arteries, a matter destinated to the nourishable parts, prepared in the bloody mass; yet it may be lawfull to think, that the Liquor watering the brain and nervous stock, by means of an effi∣cient cause, doth conduce very much to alimentation; for this growing turgid with animal spirit, actuates and invigorates the nutritious juice, brought to eve∣ry part by the blood, and admitting it into the passages, and most intimate re∣ceptacles of the body to be nourished, and as it were leading it in, assimilates or resembles it, Wherefore, when this houshold Liquor is so depraved, that it doth not rightly supply the animal spirits, requisite about the work of nutrition, all the members and parts of the stomach vitiated in its tone, either spues back whatsoever nourishment is brought, or cannot receive it to its proper use: where∣fore truly in this disease, the bulk or habit of the body, however fuller or fatter, was more sooner pull'd down, then in a continuall Feavour, where it might much more evaporate, by the intense heat, or copious sweats. The reason of which is, because in a burning feavour, altho the blood growing very hot, exhales more plentifully; yet in the mean time, it continually affords something of nourish∣ment, which the severall parts, help'd by the benefit of the nervous juice, easily received, and assimilated; but in this nervous pestilence, altho the nutritive mat∣ter was sufficiently provided, yet by the defect of the Nourishment of the spirits, the nourishment was altogether inhibited.

3. For the aforesaid reasons also, this feavour, being a long while protracted, was wont scarce ever to be critically helped, and difficulty cured, by the help of allmost any medicines: For the feavourish matter, creeping presently, from the beginning of the disease, into the nervous Liquor, could hardly afterwards, and not but of a long time, be exterminated from its bosome: for that this water, with a slow motion, and flowing leasurely in the streight vessells, does not as the blood, conceive of its own accord a purifying effervescency, or fermentation; neither can the forces of medicines, reach to it so easily, and unmixed: but ei∣ther they are first hindred by other parts, or because they are heterogeneous, they are wholly excluded from the brain, casting back whatever is incongruous. In truth for this reason, all distempers of the brain and nerves, as it were making a mock at Medicines, are most difficulty cured. Therefore in this feavour, if the evill impressed on the brain and nervous stock was taken away, either a cruell cough with plentifull spitting, ot tumours, or an Impostum in the neck did fol∣low: to wit, the morbifick matter being supped back, by the blood, and again deposited, setled either in the Thorax, or in the Glandula's, and emunctories, nigh the hinder part of the neck. But this disease, was the more contumacious, because the discrasie or evill constitution of the blood, was not easily mended: for altho from the beginning, its Latex, the recrements being poured forth, even into the nervous Liquor, grew but little and sluggishly hot; yet afterwards, these receptacles being filled, and the morbific feculencies, and besides the nutritious matter, not imployed in nourishing the parts, being resident even in the blood, did aggravate it, and for the exclusion of this trouble, not to be mixed with it,

did induce an Effervescency, such as is wont to be in an hectick feavour, either almost continuall, or presently apt to come again. For I have often observed in this feavour, from grewell, barly-broth, and other slender diet; no less ebuliti∣on of the blood to be stirred up, than from broth made of flesh: whether indeed the nourishing juice, supplying the blood from the chyle, because it was not im∣ployed in the work of nutrition, carried something heterogeneous, and not right∣ly miscible, as a trouble to the blood; and by reason of the particles of this super∣fluous juice, being copiously sent away with the serum, the urine became very thick, red, and very full of contents: Also, for the same reason, the belly was for the most part loose, forasmuch as the blood, filled full of the nutritious juice, did suck forth a lesser portion of the chile from the bowells, and did pour back a∣gain part of that which had been brought to it, on the intestines; the feavourish distemper did likewise stick so long in the blood, because, till the animal regiment being restored, nutrition was rightly performed, that superfluous matter was carried into the mass of blood.

We deliver the example, and the Aetiology or rational account of this aforesaid feavour, more largely for this reason, because the same disease, did fall upon our Countrey men, here and there also at other times: for that of late, in this City, all the younger people of a certain family, were sick of it: yea, I remember, that some time past, very many laboured with such a feavour; Out of the many histo∣ries and examples of sick people, which it rendred when it was epidemical, I will here propose one or two.

A strong and lively young man, about the beginning of the spring, 1661, fal∣ling [Observation. 1] sick, without any evident cause, without any great heat or thirst, he be∣came suddenly weak, and as if enervated, with a dejected appetite, and languor of spirits. Cathartick Remedies, Antipyretics or allaying of heat, digestives, and also antiscorbuticks, and others of various kindes, administred by the prescripti∣ons of the most famous Physitians, availed nothing: But notwithstanding the sick man, hitherto languishing with a slow and wandring feavour, with a quick and feeble pulse, a deep-colour'd urine, had kept his bed a fortnight; besides, be∣ing reduced to the greatest leanness, he complained of a giddiness, and as it were the fluctuation of a sound in his head, and a tingling noyse in his ears. Altho he was troubled with a great stupor, yet his sleeps were mightily troubled, and bro∣ken with delirious fables. After four days, when the feavour was not yet decli∣ned, it was thought good to take away four or five ounces of blood, by Leeches, from the sedal veins; from hence the feavour began to be much exasperated, for a great intense heat, with thirst, watchings, and almost continual tossing of the body, also the tongue dry, and scurfy, appeared; then quickly a troublesome cough, with abundance of discoloured spittle followed, to him were administred, almond, and barly-drinks, with temperate bechicks (or things to stop coughing) boyled in them; water of milk distill'd with snails, and pectoral herbs, the shelly-powders, prepared nitre, and often Cordial opiats; which notwithstanding scarce giving any help, the sick man still became more weak: when in this man∣ner being sick above two months space, the feavourish distemperature, and cough also, dayly growing worse, he seemed near death, at length a voluntary sweating arising, so that every night, or every other night, he sweat abundantly, and from thence finding himself better, using then the aforesaid Remedies, he grew well within six weeks.

Till I had seen many sick people after the same manner, I suspected this disease to be alltogether an hectick feavour, with a consumptive disposition of the Lungs; but when I saw many others at that time fall sick ordinarily, after the like man∣ner, I easily instituted the Aetiologie or national account of this feavour, such as I have already described: to wit, that the blood, because of the intemperature of the year, and perhaps from errors in dyet, had contracted a vitious procatarxis or remote cause: Then it growing feavourishly hot, and presently carrying its im∣purities to the brain, and so depraving the juice, watering it, and the nervous stock, induced the vertiginous distempers, with a stupor, a languishing of spirits, and an atrophy of the whole body: but so long as the blood did transfer its recre∣ments, from its own bosom, into the brain and nervous appendix, the feavourish heat continued more gentle and milde: But afterwards, when the tending down∣wards of the morbific matter, by the opening of the hemorhoid veins, was drawn

away from the brain, the same being first retained within the bloody mass, in∣creased the feavour; then being poured on the Lungs, excited the cruel cough; with plentifull spittle: but forasmuch as the flesh of the Lungs remained free from putrefaction, as soon as the serous water was sent away by a more plentifull sweating, the sick man became free, both from the feavour, and phthisis or Con∣sumption, that seemed so deplorable.

[Observation. 2] In the mean time, whilst he lay sick, I visited another, about 12. years of age, after the like manner affected. But this when I was fir••t sent for, having been sick above a month, was reduced to the leanness of a Skelliton: besides, he was troubled with a vertigo, with a noise in his ears, and deafness, and also with a violent cough, with yellow, and as it were consumptive spittle: his pulse was quick and feeble, his urine red and thick, his appetite much dejected, his spirits so languid, and his strength so cast down, that he could not keep out of his bed: I gave this youth to drink often in a day, water distill'd from milk, with snails and tempe∣rate herbs: besides I ordered him an open decoction, such as is in use for the Rickets, to be daily taken instead of his ordinary drink: by the help of which Remedies, he was restored to his health, in a months space. At this time I was sent for to many other people, of every age and sex, distemper'd by the same di∣sease, now clearly Epidemical; for it, running thorow whole families not only in this City, and the neighbouring parts, but in the Countries at a great distance, as I heard from Physitians dwelling in other places, increased very much. Those for the most part labouring with this feavour, so be they were otherwise whole, grew well, by the fit use, and order, of medicine and dyet: but it hapned very often but ill to those, who were indued with a weakly constitution of brain, and nervous stock, or broken with age; but not seldom the case of the sick became dangerous because the Physitians were not wont to be sent for presently after the beginning of the disease, yea, scarcely before it had more deeply spread abroad its roots, and the opportunity of healing was past.

[Observation. 3] For that reason, this feavour became very deadly, in the family of a certain Noble man, among his children, originally obnoxious to Cephalic distempers. About the vernal Aequinox, a Boy of about eleven years of Age, began to be sick: At first without any vehement heat, or thirst, a dejection of appetite, and want of strength came upon him: Besides, an almost continual giddiness did trouble him, with a frequent danger of fainting, that he often thought he was just dy∣ing. By the advice of a certain woman attending him, they dayly gave him Cli∣sters: then, when from the foulness of the mouth, and Tongue, manifest signes of a Feavour appeared, this Emperick on the fifth day, gave him a vomit of the In∣fusion of Crocus metallorum, and on the seaventh day a Cordial powder being ad∣ministred, she incited the sick youth covered with blankets to sweat: his skin hardly began to be moist: but presently he began to talk idly, complained that his Cap was fallen into the water, by and by becoming speechless, within four hours, whilst I was sent for, he expir'd before I came.

[Observation. 4] A little while after, the same disease fell upon his yonger Sister: whose sickness however, because it was accompanied with a frequent and humid Cough, was thought at first to be only a taking of Cold; but within a few days, this Cough became plainly Convulsive: so that, whilst she Cough'd, the Diaphragma being caried upward, and with a renewed Sistole, held so a long time, she made a great noise as if about to be suffocated: then this little maid growing more apparent∣ly feavourish, complained of thirst and heat, and lay all night without sleep, with a mighty agitation of her body, and began to talk idly, after the same manner as her brother, of her coat being fallen into the water; and when all things grew worse, she began to be tormented with Convulsive motions, first in her Limbs, by and by in her face, and then in her whole body: the Paroxysms coming by of∣ten turns, twice or thrice in an hour, did most grievously trouble her, so that this little wretch, within the space of 24. hours, after the Convulsive Distempers began to grow more grievous, her animal spirits being almost quite spent, she dyed; whilst the Convulsive Fits tormented her, her pulse was very much disor∣der'd, and often intermitting, also a frequent vomiting molested her. Being sent for to visit this maid, also too late, a little before her death; when I could con∣tribute nothing to the proroguing of Life, I endeavourd what I could, to finde out from her Death, the knowledge of the aforesaid disease, therefore having

got leave to dissect her body, the reasons, and marks of the Symptoms chiefly urging, in this feavour, more clearly appear'd.

Opening therefore first the lower belly, I found all the bowells in it sound e∣nough, and well furnish't: The ventricle, altho tyred with empty vomiting, con∣tained nothing besides the Liquor, lately taken in at the mouth: for neither in it, nor in its Appendix, were worms, or sharp humours found, which are wont oftentimes to give a cause to these kinde of Convulsions: the small guts, were in many places mutually involved: to wit, the Convex superficies of one part, was thrust into the concave of another, as into a sheath, and hid far in it, which in∣deed I judge to have hapned, wholly from the convulsive Motions of those bowels: for whilst by reason of the vehement Convulsion, excited from the nervous origine, the opposite fibres being drawn together, did work the same Intestine, into contrary motions, it easily hapned that a part of the Intestine of the Ilion being carried upward; might run into the hollowness of the other, being snatch'd downward.

The Thorax being opened, the flesh of the Lungs appeared very red, and as it were sprinkled with bood, yea in some places as it were livid, and almost black: out of the same whereever it was cut, there flow'd forrh a thin and frothy mat∣ter. Certainly this shew••d, that the feavourish matter, or the serous impurities of the boyling blood, being soon impacted in the Lungs, did so stuff up their pores and passages, that the blood it self, being in its wonted and free Circulation, there stagnating, and being extravasated, did excite a certain inflammation.

We found a no less clear track, of this so deadly disease in the head: for the shell of the skull being removed, presently the vessells, creeping thorow the meningae, were seen to swell very much with blood, as if almost the whole mass of blood, were gathered together in the head: for the veins being cut or broken, about the Inwards of the lower and middle belly, little blood flowed forth: Be∣sides, those membranes where they cloath the Cerebel, and being higher spread divide it from the brain, being sprinkled in very many places with extravasated blood, were noted to be of a black-purple colour; that it was not to be doubted, but the Phlegosis or Inflamation round about excited, was the cause of the so cru∣elly infesting Convulsions. These coverings being taken away, the substance of the brain was seen to be altogether moist, and watered above measure with a watery humour: yea, its rine or bark being taken off, all the ventricles were full of a limpid or clear water, of which kinde of very clear Liquor, there was judg'd to be more then half a pinte.

From these appearances, the Pathologie of the aforesaid feavour is easily Col∣lected: to wit, in this sicknesse, as also in many others, the blood feavourishly growing hot, presently deposes its recrements, both into the Lungs, and into the brain; wherefore a serous Colluvies, or watery heap, did presently overflow the constitution of either; then, because the blood being hindred, both here and there, from its due circulation, it began to grow into a very great heap, about the confines of the affected parts, and at length to stagnate, and to cause as it were a phlegosis or Inflammation: hence▪ by reason of the serum being plentifully heaped up in the lungs, and baked by the heat, the troublesome cough, with the thick and discoloured spittle, for the most part came in this disease; and by rea∣son of the like affection, excited within the head, the vertigo, swimming, stupi∣faction, and other Cephalic passions, constantly seased on the sick: which kinde of Distempers, in this little maid, and in her brother, by reason of the infirm con∣stitution of the brain, before in either of them, being made more greivous, ter∣minated in an Apoplexy. I might easily here propose many other histories, of persons sick of this feavour at that time, but from these but now recited, the Type of the aforesaid disease, may be sufficiently known: But because the same feavour happens almost every year, on some prae-disposed; and perhaps, by rea∣son of an evill constitution of the year, may hereafter at some time become Epide∣mical, it will be worth the while, to represent some Method about its Cure.

Concerning which, first of all take notice, that in this feavour, no Critical days were to be observed, as in the vulgar continual feavours: for the blood as soon as it began to grow hot, poured out a part of the morbific matter, as yet crude, and not overcome, from its embrace to the head or breast: wherefore it were vain to expect that the blood should suffer the heterogeneous particles to be

heaped together, in its mass to a fullness; that from thence a flowring or putting forth arising, at the set intervalls of times, it might thrust the same subtilities out of doors: yea rather this growing hot glows not with a great, and open bur∣ning: but like a fire covered over with chips, sends forth a moist smoke or breath, rather then a flame: But so, that from thence, by reason of the nervous juice being depraved soon in its disposition, and not rarely, because of the lungs being stuffed with the consumptive matter, the convulsive, or phthisical or consump∣tive symptoms, did molest chiefly, in the whole course of the disease.

It behoves us to designe the curative Intentions, according to the various times of the disease, and the diversities of the symptoms chiefly urging. About the be∣ginning of this feavour, the taking away of blood, seem'd convenient allmost to all: This kinde of remedy, I often experienced with success, in little Children: For that by the means, as it were another breathing place is opened, to the mass of blood, silently and covertly growing hot, and obtruding its soot or smoak, on the more noble parts; and for that reason, its impure efflorescencies or puttings forth, are drawn away from the brain, and lungs. Therefore, although this fea∣vour of an ill Condition, may be accounted as it were malignant, yet forasmuch as the blood is not presently apt to be coagulated, but to be too much poured forth, and to bestow its serosities on the nobler parts, to wit, the brain and lungs; therefore Phlebotomy, so it be administred in the beginning of the disease, is convenient allmost to all.

For the same reason, Cathartick Medicines, and chiefly vomitory, are admini∣stred at the very beginning of the disease; for these do not only evacuate the visce∣ra of concoction, and so draw away the chief fomenting of the disease, and as it were its originall, but besides, they draw forth the serosities from the blood, and so effect its cleansing, rather in the stomach and Intestines, then in the head and lungs. Further by Emeticks, for that the receiving Glandulaes of the Lymphe∣ducts, are pulled with a great shaking, the superfluities of the nervous juice, least they should evilly affect the brain, and its dependencies, are expressed forth into the lower bowells: also for this end, the belly is to be kept continually loose, by the use of Clysters. But in the mean time, whilst the blood being infected with the taint of this disease, threatens the brain or praecordia, with the evill, it will not be safe to attempt any thing with Diaphoreticks, or sweating medicines, or Diureticks or such as evacuate by urine, or also with Catharticks▪ vomiting and purging medicines: For these kinde of medicines, forasmuch as they greatly pour out the blood, and compell its serosities into more open issuings forth, all the re∣crements, being apt to fall away from the mass of the blood, are easily obtruded on the brain, or Lungs, when they are of a more feeble constitution: So in the youth above-mentioned, a loss of speech, came upon the raising of an untimely sweat: Also I have known, that Sudorificks, no other then chaly beats, in the morbid disposition of the lungs, have brought on a waisting or Consumption.

Phlebotomy therefore, and if need be vomiting, or purging, either one or other, or both, being to be made use of at the very beginning of the disease, the other Intentions shall be, to draw away the morbific serosities of the blood, apt to flow forth on the head or breast, and to derive them gently by other ways of evacuati∣on, and to put them forth of doors. To this end, Vesicatories or blistering plai∣sters, ought to be applyed, to the nape of the neck, or Parotida or jugular Arte∣ries, or to the Arm-pits, or the Groin, or about the thighs, or calves of the legs, sometimes in this part, sometimes in that; to wit, that the little Ulcers being here and there excited, and continually running, might plentifully pour forth the serum, imbued with the morbid, and heterogeneous particles.

But Remedies, gently carrying the serum, into the Reins, and urinary passa∣ges, are most often administred with success: For this business, diuretical Apozems, and Julaps, are to be ordained after the following forms.

Take of the Roots of Scorzonera, cherfoil, grass, and of Eryngoes candied each ʒ vi. 1. Apple cut, of the leaves of pimpinell, meadow-sweet, each i. handfull, of Raysons of the Sun, ℥ i ss. of harts-horn, burnt ʒ ii. being cut and bruised, let them be boyled on a clear fire, in four pints of spring water, to the Consumption of the third part; to the straining being cleared ii. pints, add of the Syrrop of green Cy∣torns, or violets ℥ ii. of sal prunella ʒ i ss. make an Apozem. The dose ℥ iiii. to vi. thrice in a day.

Or into that straining, put 15 blanched sweet Almonds, and of the four cold seeds, each ʒ i. being bruised, make an Emulsion according to Art.

Take water of Dragons, and of black-Cherries each ℥ iiii. of scordium compound ʒ ii. of Threacle water ℥ i ss. of syrrop of Clove-gilliflowers, ℥ ii. of the spirit of vitriol xii. drops, make a Julap.

Take oftentimes in a day, in small beer or posset-drink, half a dram, or ii. scruples of sal-prunella.

Besides, in this feavour, medicines gently sweating, of that sort chiefly, which restores the animal spirits, and defends them from any heterogeneous Copula, are of very great use: wherefore, either the powder of pearls, or the spirit of harts horn, or of blood, in a moderate dose, are administred twice in a day, viz. Morning and Evening.

Clysters are to be given almost every day, and if it be thought fit, a gently loos∣ning purge, may be taken once or twice in a week.

The dyet prescribed ought to be slender, as in other feavours, let them be wholly interdicted from flesh, or broath made thereof, only let the sick feed on Grewell, or barly-broth, and let their drink be small beer or posset-drink.

If that notwithstanding, any preventive physick, the morbific matter, should lodge in the brain, or Lungs, or both together, so that a dissolution, or inordi∣nation of the animal function, or also a violent cough, should assalt them, it must be consider'd, what is to be done in either state of the disease, carried forth after this manner, into an evill condition; but then the curative Indications ought to respect the stupor, or madness, or cough: and lastly, if in the declina∣tion of the disease, these symptoms do remit, proper Remedies are to be adhibi∣ted, against the Atrophie, as it were the last fortress of this Feavour.

1st. Therefore if the morbifick matter, as it is often wont, being brought to the brain, should bring in an Insensibleness, or a soporiferous or sleepy distemper, remedies drawing it another way, and deriving it some way from the head, and besides such as stir up the animal spirits, and take away the impure Copula ought carefully to be administred, wherefore in this case, the use of Epispasticks or such things that draw the water outwardly, should be much increased, and let the spi∣rit of Harts-horn, be exhibited allmost every sixth hour, in a little bigger dose, let blood be also taken, by the sucking of Leeches, more largely from the jugular veins, the Salvatella, or the sedal veins. If the distemper remits not, the head being shaven, let Emollient fomentations be often applyed thereto: Further, let Cupping-Glasses, Plaisters, and Cataplasms, be laid to the soals of the feet, and o∣ther means of Administrations, such as are commonly prescribed for the curing of the stupor, or Insensibleness, ought to be used: In like manner, if on the evill, or no Crisis of this feavour, a phrensie, or madness should come, remedies appro∣priate to those distempers, are made use of.

2dly, But if either with, or without this sort of displeasure, brought to the head, the Lungs also have taken the evill of this disease, so that the sick, not yet free from the feavour, seem to fall into a waisting, or Consumption, with a troublesome cough, with abundance of thick, and often discoloured spittle; Me∣dicines commonly prescribed for such kinde of Distempers, are convenient e∣nough; wherefore, pectoral Decoctions, Electuaries, syrrops, distill'd waters of milk and snails, and other remedies of the like nature, ought diligently to be made use of; the forms of which may be found, in the before-described Cases.

Thus far we have described the continual feavour, for the most part convul∣sive, and arising no less from the fault of the nervous juice, then of the blood: I will here further propose an example of a disease, having the likeness of an inter∣mitting feavour, but radicated chiefly in the nervous juice; the nature of which kinde of distemper, for that it is very rare, and truly pertinent to our convulsive Pathologie, will appear from the following history.

A noted Woman very young, and indued with a more weak constitution of brain, and nervous stock, and for that cause very obnoxious to convulsive di∣stempers, after she had conceived with child, about the fourth month of her be∣ing big, from cold being taken, she was grievously afflicted with Astmatical fits, and besides, with a frequent sinking down of her spirits: but by the use of reme∣dies, indued with a volatile salt, she grew well, within a fortnights space, but after that, about 14. days, an unwonted and truly admirable distemper, fell up∣on this Gentlewoman.

One morning, awaking after an unquiet sleep that night, she felt a light shive∣ring in all her body, as if she had had the fit of an Ague: frequent yaunings, and reatchings, with an endeavour to vomit followed thereupon: then her urine, which was but now of a citron colour, and of a laudable substance, became pale, and waterish, and was rendred at every turn, to wit, almost every minute of an hour: moreover, about her loins, and hypochondria, and in other places, pains with light Convulsions, running about here and there, were excited: which kinde of symptoms plainly convulsive, with her frequent making of a lympid urine, continued in the Morning allmost to Evening, in which space of time, a great quantity of water, at least three times more then the liquor she had taken, was rendred; in the mean time, neither was the heat great, nor did thirst trouble her, nor was her pulse encreased: In the evening the aforesaid distempers ceased, and her urine became citron colour, and moderate; and besides, all night she enjoy'd a moderate sleep, then the morning following, about the same hour, the fit retur∣ned, accompanied altogether with the like symtoms, and so dayly acted the same Tragedy.

Visiting this Gentlewoman, after she had been sick in this manner for 12. days, I framed the Aetiologie of the aforesaid case, to wit, that this disease, chiefly ra∣dical in the nervous stock, did depend upon the effervescency, and flux of the hu∣mour, watering the nervous parts: For it might be suspected, that this water being diffused from the blood, made degenerate by reason of the suppression of her Terms, upon the brain, and nervous stock, became more sharp, and serous than it ought to be, and for that cause incongruous to the containing parts: wherefore, being gathered together to a plenitude, by the nights sleep, it did stir them up, or provoke them, for the expulsion of it, every where into wrinklings, and contractions: hence shiverings, yaunings, streachings, and wan∣dring pains, were excited in the whole body: Furthermore, from the sollid parts, after this manner contracted, and shaken, not only the nervous Liquor, but also the nutricious, every where laid up in the sollid parts, but not truly assimilated, were shaken off: and then, either Latex, being exterminated from its recepta∣cles, and received by the veins, or Lymphaducts, or water-carrying vessells, was render'd to the Mass of blood: from whose bosome, before it had acquired a lixi∣viall tincture from it, being at last cast forth by the reins, constituted a clear, and Copious urine: But that this distemper observed such exact periods, the reason is, because the nervous water, being supplyed with an equall dimension, did a∣rise to a fulness of running over, dayly at the set time: Therefore also, the urine appeared concocted, and yellow, before and after the fit, because then its mat∣ter consisted only from the serum of the blood: Afterwards, during the convulsive fit, the limpid humour being shaken off, from the solid and nervous parts, and passing quickly thorow the blood, adulterated the colour and the quantity of the urine. I prescribed to this big-bellied woman, Phlebotomie, and besides, a powder composed out of Corall, pearls, ivory, and other Cardiacks, to be taken thrice in a day, in a proper Liquor; morning and evening she took of the tincture of Antimony, 12. drops (whose singular effect in the too great flux of urine, I have many times experienced): By the use of these, all the symptoms ceased, in a short time.

Notes

• The hystory of an Epidemi∣cal feavour raging in the year 1661.
• Its procatar∣tick or more remote cause.
• The symptoms.
• The reason of them.
• Why this di∣sease chiefly invaded chil∣dren, women, and phlegma∣tick men.
• The reason of the Atrophie coming upon this feavour.
• Why this fea∣vour was hardly curea∣ble.
• The reason of it.
• The kn••wledg of the disease found ••ut by dissecting the Carcase.
• The Pathologie of the aforesaid Feavour.
• The Curatory Method.
• Blood to be taken away at the beginning of the disease.
• Vomits and Purges, are to be admini∣stred.
• Blistering plaisters.
• Diureticks.
• A diuretick Apozem.
• An Emulsion
• Julap.
• A Power.
• Gentle Dia∣phoreticks.
• Glisters.
• Dyet.
• The Curatory Method in the unsensibleness and madness:
• In the Cough.
• A very rare Observation.
• The reason of it.