A few queries relating to the practice of physick with remarks upon some of them : modestly proposed to the serious consideration of mankind, in order to their information how their lives and healths (which are so necessary, and therefore ought to be dear to them) may be better preserved / by H. Chamberlen ...

A FEW QUERIES Relating to the Practice of Physick, WITH Remarks upon some of them. Modestly proposed to the serious Consideration of Mankind, &c.

Q 1. WHether every Sickness and indisposition in humane Bodies, as well Acute as Chronical, doth not arise from the change of useful, nutrimental,

and natural humours into vitious; and whether such change is not chiefly, if not only caused by an Error of some of the six Non-naturals in the sick Patient; or, if Hereditary, in their Parents?

The Author is inclin'd to believe, that all Diseases proceed only from the alteration of Good Humours into Bad; for all Persons may enjoy per∣fect Health, if some change within them did not hinder. Nor doth it appear to this Author, that any other entrance for Diseases hath been an∣ciently or lately discovered, besides the said six Non-naturals, which are agreed to be as Follows, 1. Air, 2. Meat and Drink, 3. Motion and Rest, 4. Sleep and Watching, 5. Ex∣cretion and Retention, and lastly, the Passions of the Mind. Under some of which, as Excretion and Retenti∣on, may be justly comprehended, Stinging, Bruising, Wounding, &c.

2. Whether Sickness, or that preter∣natural Something, thus introduced, can ever be removed, till such vitiated Humours shall be either changed again into good, or expell'd the Body?

If there is a third way to free Pa∣tients from Diseases, besides Evacu∣ation and Alteratives; such as know it, will do well to oblige the World with it.

3. Whether these bad Humours can be any more altered and reduced to their primitive Excellence and Order, than Curds and Whey can be reduced again to good sweet Milk?

If this be impossible, as the Author is apt to believe it is; then 'twill be in vain to hope for the recovery of Health by Alteratives: For, though the Body and Blood can be alter'd by superinducing natural Juices, as the bad wasts, yet the bad parts of the Blood, or the ill Humors mixt with it, can never be changed to any good

purpose. And that which probably deludes some into a contrary Opinion, is, that when Health is restored by in∣sensible Perspiration or Evacuation by Urine, &c. without any more manifest discharge by Siege Sweat or Vomit∣ing: Tis presumed though it be no natural consequence that the same individual bad Humours are totally changed into Good, for life being a continual Flux, daily wasting and requiring daily supply, 'tis not to be doubted, but, as the bad are consum∣ed, Nature is daily furnished with a better Juice from wholesome Food; so that the bad decaying (which is a sort of Evacuation) faster than they are again recruited, Health re∣turns of course after all the vitious Humours have been so consumed. But there hath been farther objected against this Opinion, that Pleurisies have been sometimes cured by Altera∣tives only, without Bleeding or o∣ther

manifest Evacuation; and that prickt and decay'd Wines have been also recovered from their Acidity, &c. by Alteratives: In answer to which may be offer'd to second Con∣sideration, that Non causa pro causa hath made many, if not most of the mistakes in the World, and this pro∣bably amongst the rest: For 'tis not unlikely, but that such Pleurisies were cured, either by Evacuation, though less manifest, as by Urine or insensi∣ble Perspiration; or else by precipi∣tation or depositing the peccant mat∣ter on a less noble part, separating thereby the Humours from their Im∣purities: For, if the whole Mass of Blood had been corrupted, it had been impossible to mend it, and the Patient must have died; because in this acute Disease Non dantur induciae. And, when there is only a Separation from the Blood of the corrupted Hu∣mours mixt with it, without any ex∣pulsion,

it can be but a truce, or shifting off the present inconvenience, and no cure; a kind of purging the Blood, but not the whole Body, which still remains affected, though possibly not after the same manner.

As to the Wines 'tis certain, that the greatest part of them was no o∣therwise Acid, than Water made so with a few drops of Spirit of Vitriol, which are sometimes cured by an Al∣kali, or by the heavy parts setling by their own weight to the Bottom, as new River-water is purified when Muddy; and sometimes by the help of a Ferment as in compound Li∣quors, where the lighter parts flying upward, becoome a Cap or Head, as they call it, on the top to preserve the Liquor, and the heavier parts are precipitated to the Bottom, leaving the Wine pure and sound in the Mid∣dle; but this change is no other, but a Separation of the Acid or Noxious

parts from the rest of the Wine, which (the Cask still retaining all the hurtful parts within it, as before, though not in the same manner and mixture) will upon every the least disturbance be again out of Order.

4. Whether 'tis possible Health can be restored by any other means than Eva∣cuation only, either by a natural Crisis, or by Art?

Such as grant the Premises can ne∣ver dispute this Point; but the fol∣lowing instance, amongst many o∣thers, that might have been quoted, may end the Controversie, viz. Pa∣tients recovering out of the Small Pox, where no Art was made use of, might have been saved only by a criti∣tal Expulsion of all the peccant mat∣ter through the strength of Nature. And, whenever that matter recoils, or is struck back, and not afterwards sufficiently expell'd by Nature, the Patient must die, if Art doth not assist

to drive it out by Sweat or otherwise.

5. Whether when Poison is received into the Body, there are not very few, if any, that dreams of curing such a Pati∣ent by only Alteratives? And whether they do not rather unanimously agree to expel it by all the skilful ways, and with all the speed possible?

If this be daily practice, as the Au∣thor doubts not, the same reason may hold for Diseases, which are as truly Poisons bred in the Body, as the o∣ther that is taken inwardly, and eve∣ry way as Dangerous: And as there are degrees of Poison, so there are of Diseases, some more some less inju∣rious or mortal; but, still all must be expell'd sooner or later, the Weaker as well as the Stronger.

6. Whether in a strict sense there is any such thing as Poison?

Some say Van Helmont was of Opi∣nion there was not, and the Author sees no cause to differ from him; for,

God made all things good and use∣ful to Mankind, but our folly, and ignorance of the right use and just Dose of many things, makes their ex∣cess Dangerous and sometimes Mor∣tal: Even Roast-beef, Brandy and Opium in too large Doses surfeit and kill, when Arsenick and Precipitate, if justly dosed or under dosed, do no hurt, but many times much good. Now that hath only been esteem'd Poison, which can kill in small quan∣tities, and not that which can only kill in great, though they were equal∣ly injurious to the Persons kill'd by them; nor is there any great diffe∣rence betwixt Poison bred in or re∣ceived into the Body, when equally hurtful, both being preternatural, and to be expell'd, before the Patient can be safe.

7. Whether it is not absolutely ne∣cessary for a Physician to be able to de∣termine skillfully, with respect to Pa∣tients,

Disease, Age, Strength and Sex, what Evacuation is most suitable as to Manner, Season, Quantity, and Num∣ber?

Hipocrates say, Quo natura tendit tinde, dum Natura movet move, and if Evacuation only cures, 'tis fit it should be well understood.

8. Whether a Physician who treats his Patient with as much Art and Dili∣gence as any other could, omitting no∣thing requisite, nor directing any thing hurtful or unnecessary, may justly be blamed, should such a Patient miscarry by some unexpected dangerous accident, lurking in secret beyond any Mans dis∣covery?

Whenever the like happens, the Physician ought not to be blamed, because it was not his Fault but his Misfortune, and not within the pow∣er of any known Art to be prevented; for, no Man blames a skillful and in∣dustrious Husbandman, because (af∣ter

he hath cultivated his Land with all the Care and Art imagi∣nable) his Hopes are blasted, and his Crop destroyed by an unexpected ill Season. Hence may be observed, that good or ill success alone is not sufficient to guide our Judgments, but that we must suspend our Cen∣sures till well instructed in e∣very minute circumstance; for the interposition of sundry Ac∣cidents, not always to be fore∣seen, may much alter the Case; nor must a Physician by such ac∣cidents be frightned into too strict caution, which may be as preju∣dicial as too forward Rashness. He that regardeth the Wind, saith Solomon, shall never Sow; and though all that may happen, deserves mature consideration;

yet if that should hinder Action, Physicians must resolve to sit still, or do no good. General success in like difficult cases, may direct our judgment, though 'tis not advisable to be too forward to censure the success of Physicians or their Methods, without being very well acquainted with both, least it prove not only injurious to them, but very prejudicial to such as might have received be∣nefit from them, had it not been for such Scandalous, Foolish, or false Reports, which may some∣times unintended injure the re∣porters Friends as well as others. No Physician is to be blamed when his Patient dies, unless his own greater care, or anothers bet∣ter skill could have prevented it.

9. Whether any Patient who is likely to live without purging can be too weak to be relieved by Evacuati∣on? Since, as before proved, no re∣lief can be reasonably expected with∣out it: And whether the sooner 'tis submitted to, it is not the better?

If they are able to live with∣out artificial Relief, and removing their Disease, they will certain∣ly be much more so, if part of, or all their Disease shall be remov∣ed; obsta principijs, sero medicina paratur, is a known rule and very fit to be followed.

10. Whether Patients, too weak to be relieved by proper Evacuati∣on, can be strong enough to recover Health without it?

It is not likely, because that Disease which hath reduced them from full strength to so low a

degree of weakness, must cer∣tainly if it continues, increase the weakness, if not destroy the Pa∣tient; but, if Purging carries off most part of the Disease, which weakens the Patient, Nature hath the less to contend with, and consequently may master the remainder, and recover strength: Therefore a Patient's weakness can be no sufficient argument a∣gainst Evacuation, unless the Dis∣ease be already quite expelled by Nature, and then there may be no need of it. For a thinking Soldier will hardly ever judge his condition the worse for having the numbers of his Enemies les∣sened, let the success be good or bad.

11. Whether the most powerful and effectual Evacuations, by some

called violent, are not when dis∣creetly used, the most proper for the weakest Patients, and to be persisted in with the smallest Intervals of rest.

Certainly they are, and to be continued, if weak Patients have little or no time to triflle away. The Fatal consequences of timo∣rous and needless delays ought by all means to be prevented, and Diseases not suffer'd to increase again by long respits, as they as certainly do, as Hair and Nails grow after cutting. If indeed strong Patients squander away some time, they have still enough left with strength to recover such loss; though such hazards are never commendable; for seeming weak Diseases have by delays at length kill'd the strongest Pa∣tients, and where Life and Health

are concern'd, nothing ought to be put to an Adventure. The Doses are to be proportioned to the weakness of Patients, but the Indication is still the same: For Example, if nothing besides a Vomit can cure some Diseases, the Vomit must be taken in a smaller Dose, than robust Pati∣ents do, or the Sick Person must die.

12. Whether the loss of Strength, occasioned by Diseases, can be ever restored whilst the Disease continues in the same Vigour? And whether weakness proceeding from the Opera∣tions of Evacuating Remedies, doth not usually cease soon after the Ope∣ration is over?

Effects alwaies wait upon their Causes, ablata causa tollitur effe∣ctus, and where no impediment

hinders, Nature soon recovers Strength.

13. Whether simple weakness be∣ing only an impotency or incapacity of Nature to perform the necessary duties of Body and Mind, and al∣waies free from any sort of Sickness, Fever, or Pains, else it must be more than simple weakness, may not be removed by good Diet only?

Probably it may.

14. Whether a weak Patient may not as well hope to recover his perfect Health without Evacua∣tion, as that he shall grow stronger under his Disease without it?

Neither is very probable, and therefore tis imprudent to ven∣ture it. That some recover with∣out Art, 'tis certain, but very many do die for want of it, who might very well have been saved

by it, if they had timely applied themselves to Artists.

15. Whether the benefit a Pati∣ent afterwards receives by expelling with artificial Evacuation the mor∣bifique matter, doth not abundantly compensate his present loss of Strength and Spirits?

This is daily confirmed in Pa∣tients, that, though they are weakned for the present by eve∣ry sort of artificial Evacuation, soon after find sensible relief and great ease. Ex conferentibus & laedentibus sumuntur indicationes.

16. Whether Patients are not more strengthened by a purge which expells the Disease which weakens, than by Cordials which do not.

That which removes the weak∣ness is more likely to strengthen than that which cannot. Im∣pura

Corpora quo magis nutrieris eo magis laeseris. The most which can be expected from Cordials, which do not empty by Sweat or Urine, is a speedier supply of Spirits to encounter the Disease: though too many of them, as well as of nourishing Diet, may sooner surfeit and destroy than comfort: And 'tis certainly much better to save the Spirits that la∣bour and remove the Distemper by Evacuation; for fewer Spirits can better vanquish a Disease al∣most master'd, than greater plen∣ty can a Disease too mighty for them. Nor is there any Reason, why Purges and other Evacuati∣ons should be so terrible, for they are but a kind of ferment given to awaken Nature to co∣operate. Where violent Exer∣cise

Weakens, rest and moderate re∣freshment Strengthens; but where Diseases weaken nothing but their total removal can give Na∣ture afterwards an opportunity to be strengthned by a good Di∣et, which can signifie little or nothing before.

17. Whether the inactivity, want or dissipation of Spirits, which renders Men dull, weak and faint, doth not proceed either from the Spirits being clog'd with preterna∣tural humours for want of due ex∣ercise, or from an unusual expense of Natural Humours and Animal Spirits; either exhaled by unseason∣able Hot-weather, or consumed by tedious labour or violent exercise, or lastly wasted by large preternatural, or imprudent Artificial Evacuati∣ons?

All Weakness or Faintness without question comes by the want or oppression of Spirits, which cannot alwaies without help extricate or exert themselves when fettered or suffocated with ill humours; nor can they con∣tinue, if not daily supplied and increased by good Humours, which often corrupt for want of suitable Exercise, therefore a Pa∣tient must necessarily be faint without new supplies, when his Spirits have been wasted by any of the forementioned ways.

18. Whether any Patient can be either too old or too young, any more than too weak or too strong to use Evacuations, whenever there is occasion for them?

Surely none can, for if Pati∣ents too old or young may be

cured without Evacuating Me∣dicines, Persons in their prime may also be so cured, and then away with the Profession; but if they cannot, 'tis not a tender∣ness but a cruelty to refuse them; besides they can but die with E∣vacuation, and may live, having a chance for it; when without it in all probability they must die. Praestat anceps remedium quam nul∣lum; extremis morbis extrema re∣media conveniunt.

19. Whether the speediest way to restore strength and flesh to Patients exhausted and emaciated by long Sickness, is not to forbid them strong nourishing Food, and order them a spare plain Diet, to use ex∣ercise and to be cheerful.

If this proves the best Method, then certainly the common pra∣ctice

of the kind Ladies and Nurse-keepers, to stuff the Sick with strong Broths, and good Jellies, must needs be destructive. It is for the most part good things only hurt; because they being agreeable and very nourishing, soon surfeit before one is aware.

20. Whether, if no Specifick, Cordial, or Alterative Medicine can relieve sick Patients, and expell their Diseases so well as Vomits, Purges, or other Evacuations, any Person may be too weak to take them; and whether 'tis fit any Patient, though never so strong, should be treated with them, if they can only weaken and disorder and can do no more, or not so much as the other Remedies?

If in this last part 'tis true that Vomits, &c. can do no good but trouble and offend a Patient,

then all Physicians are highly to blame, that have ever prescri∣bed Evacuations; but, there are Millions of instances to prove, that Evacuations discreetly or∣der'd have not only done no wrong, but abundance more good, than all other Remedies; for there cannot be one Example given, from the beginning of the World to this day, of any one Patient, that ever recovered with∣out some sort of Evacuation Na∣tural or Artificial, the contrary being a contradiction in Nature not to be supposed.

21. Whether Vomits, or any o∣ther evacuating Remedies have of∣ten, if ever, caused or hastned the Death of any Patient; or rather whether 'tis not always, or at least for the most part Diseases, which,

for want of Vomits, &c. soon e∣nough or oft enough repeated, destroy Mankind?

That thousands of Vomits, and other Evacuations have been gi∣ven in all Cases, to all Ages and Sexes, not only without hurt, but also with much benefit, is as clear as the Sun, and also that Dis∣eases daily kill without the help of Medicine. Such therefore, as maintain the contrary, will do well to shew which way Vomits or other Evacuations kill, but, unless he can prove that he hath kill'd as many by Vomits and Purges, as others can prove, they have saved by them, he will do well to spare his labour. Note also that there can be no more danger, nor greater sickness in vomiting with a Vomit, than

without one; which few Wo∣men with Child, and very sick Persons can avoid or are the worse for.

22. Whether 'tis not very true, that most die without taking Vo∣mits, tho some may die that have taken them?

This few, if any will deny.

23. Whether any dies with a Vo∣mit, who could probably have lived longer without it?

This some may believe, but 'twill be a great service to Man∣kind if they can well prove it.

24. Whether very many have not died for want of Vomits, who had most certainly remained alive, if they had taken them?

This can never be proved, but may be strongly presumed.

25. Whether 'tis not the cause or morbisick matter still remaining be∣hind,

which is dangerous, protracts the Disease, or hastens the death of the Patient, and neither natural nor artifical Vomiting, Loosness, nor other Flux, nor Boils, Pimples, nor other Eruptions whatsoever?

Few suffer by what breaks forth or is Evacuated, but by that which remains behind.

26. Whether, if Vomits must be given, when there are indications for them, and no considerable con∣traindications, they ought not also to be repealed, whilst the indication so circumstantiated continues, sup∣porting Nature in the intervals by true Cordials and good Nourish∣ment?

The same reason which directs a Vomit at first, directs repetiti∣ons whilst it continues with rea∣sonable intervals, if nothing new appears to prohibit it.

27. Whether (though Vomits are so very uneasie in their Operation as to make Patients to apprehend them very dangerous) there is really any more danger in taking them, than in taking a Caudle or a Cordial?

There is oft-times greater dan∣ger in forbearing, than in taking Vomits, because the Disease may kill, which they may possibly o∣vercome; but to answer directly, the usual Vomits unless over Do∣sed, (which is no more than where any other Medicine is so, and therefore not to be supposed to be given by any Physician, though of small Experience,) are not dan∣gerous, for neither the material they are made of is inimical to Nature, nor the action of Vomit∣ing dangerous; for what must

then become of most Sick Per∣sons, Women with Child and even New-born Babes, who are all generally inclin'd to and fre∣quently do Vomit? Indeed Vo∣mits are so safe, and generally so effectual, that many pretenders to Physick, cherish these terrible apprehensions of them in their Patients to discourage them from their use, that so they may keep them the longer in hand, before they will be cured.

28. Whether Purging, Vomit∣ing, or other Evacuations, usually called Violent, can be ever so dan∣gerous and uneasie, as Diseases are first and last, or as ineffectual gen∣tle Medicines and Methods are?

That is, no Physick, judici∣ously given, can be so dangerous as the Disease, which gentle and

ineffectual Remedies can never lessen nor vanquish; and that which makes them esteemed vio∣lent is the Uneasiness, Sickness, and Gripings in their Operation, which is effected by only moving the vitious humours, cause of the Sickness, and therefore ought to be courted and not avoided, since Health cannot be purchased at a cheaper Rate, or without more uncertainty and longer time.

29. Whether too long intervals of time, betwixt the repeating Eva∣cuations, loseth not many lives?

Most likely; for the Disease recovers in those spaces as much or more strength and vigour, than it lost by the preceeding Evacuations; but, if indeed Dis∣eases could have their Progress stopt the while, there might be

some pretence for a delay till the Patient recovered strength; but they having once gotten an exi∣stence, do daily draw to themselves Humours for their support. Thus we plainly see Corns and Warts to continue and increase many years, and so do several other Diseases for their time, though not so apparently.

30. Whether the Stomach is not originally, or by Sympathy with some other part of the Body affected in most Distempers? And whether therefore all cures ought not to be be∣gun there?

Whilst the offending matter is in the Stomach, and primae viae, 'tis much the better and shorter way to expell it by Vomits or Purges, than to drive it through all the Meanders of the Body out by the

Pores. Indeed, where it hath left the primae vivae wholly, and is entred or past the Blood, the safest way may be to protrude it by sweat; though as long as there are any remains in the Stomach, notwithstanding part is already past beyond, Vomits and Purges are most proper and beneficial, and ought to precede Bleeding and Sweating, because, if the first region is not well clean∣sed the others must continue foul; as no Cistern can run clear which comes from a muddy Spring, nor can you clean an inner Room without fouling again the out∣ward Room, having imprudent∣ly cleaned the outward first; for every part of the Body derives its Nourishment originally from the Stomach, and an Errour com∣mitted

there can never after be corrected in any other part; but by sending forth those peccant Humours by the Pores, though their gross parts can never pass them easily, but may lodge by the way among the small Vessels and cause Obstructions.

31. Whether, if Patients re∣fuse to continue under cure, and to pursue Directions till the Disease shall be subdued, it is not probable it will return again?

If so, then Remedies are not to be neglected, till Dise•••••••• 〈…〉〈…〉 shall be rooted out, and 〈…〉〈…〉 Health restored; for 〈…〉〈…〉 natural for Diseas•••• 〈…〉〈…〉 their force, if you 〈…〉〈…〉 ••••••¦ing before the•• 〈…〉〈…〉 for a Boat 〈…〉〈…〉 Stream to 〈…〉〈…〉

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into it, when you cease to row against it without fastning the Boat.

32. Whether a Fever (being on∣ly a greater heat than ordinary un∣naturally kindled in the blood by the admission of bad humours) ought not rather to be assisted in driving forth such humours, than to be checkt by the Jesuit's Pouder or the like?

Most certainly, if the Fever or Ague Fit is not the Disease nor ••••use of it, as there is great rea∣•••••• 〈…〉〈…〉 believe, but a strife only 〈…〉〈…〉 ••e expulsive Faculty and 〈…〉〈…〉 ••••••¦mours, in order to 〈…〉〈…〉 Sweat, which is 〈…〉〈…〉 by Nature only. 〈…〉〈…〉 ••ot true, 'tis 〈…〉〈…〉 never re∣•••••••• 〈…〉〈…〉 by the

strength of Nature without Art. Now, if all or part of those preter∣natural Juices had been carried off by Stool or Vomit, whilst they continued in the primae viae, the Fever had either been quite overcome, or in a great measure so moderated, that there would have been the less work for Na∣ture. The Jesuit's Pouder seems in∣deed to cure an Ague, but oft-times it leaves the Patient in as bad, or a worse condition of Health than before.

33. Whether 'tis not possible for the present to extinguish, quiet or qualifie the heat of many Fevers long before the Patient recover his per∣fect Health, or even without con∣tributing the least towards it; and whether there doth not then remain matter in the Body like embers ra∣ked

together, ready for a relapse or the production of seeming new di∣stempers afterwards?

Most Fevers are without doubt daily so quieted by the Jesuits Pouder, leaving the Patient ma∣ny times in a worse condition without the Fever, than before with it. And the new Diseases which after appear, are believed but by few to be the effect of the preceeding ill cured Fever, tho a little patience and care to observe may convince them, that there is scarce an Ague cured by the Jesuits Pouder, without pre∣vious or subsequent Evacuation, but is soon followed by a return of the same, or by a seeming new Distemper; especially Chronical, which had its Original only from the foregoing Ague.

34. Whether 'tis not possible with God's blessing to prevent the Ra∣ging, Spreading and Progress of the Plague, and to save many thou∣sands, who in all probability must have else died in a Plague Year?

If it were not possible, such Magistrates as have made reason∣able provision against it, and such Physicians, who have by their advice incouraged the Magistrates to do so, have been very ill em∣ployed; but the possibility may be demonstrated almost to a cer∣tainty.

35. Whether 'tis not as much the Magistrates Duty as their Pru∣dence to provide against the Plague as well as against an Enemy upon an approaching War?

Both the Plague and Sword are esteemed God's Judgments,

and if it were not lawfull to pro∣vide against the Plague, because 'tis a Judgment; for the same reason we ought to make no pro∣vision against an Enemy; but the last is allowed by most part of Mankind, and the same reason justifies the former.

36. Whether the many Persons murthered in Plague Years by Nurses, or dying for want of Care, Skill, Food, or Assistance, could not have been saved alive by a suita∣ble Provision?

The Truth of this will not be denied; and though all infected with the Plague were under a ne∣cessity of dying as they are not, yet if the above-mentioned might with care be saved, they well deserve it.

37. Whether most infected with the Plague, receive it not from o∣thers?

If this is granted, then a sea∣sonable and timely separating the whole from the sick might save them from such infection; so that though all infected were in∣curable, all the whole by a pru∣dent and skillful foresight may probably escape the infection and live.

38. Whether most of the Cities, infected in these Northern Coun∣tries, have not the Plague brought to them by infected Persons or Goods from Abroad, instead of receiving it from a pestilential Air, as ma∣ny Believe?

If it were not communicated by contact, how came it to pass, that in the last great Plague in

England, there were fourty Towns infected by Persons or Goods, known to be brought from London, for any one that had neither; and if it proceeded from the Air, 'twas wonderful how Mortclack could be so much Infected, and Richmond and Barnes, but a mile on each side from it, but very little; besides Rains and variable Winds, do always cleanse and change the Air?

39. Whether any Disease could last long, if not daily supplied from the Body, as Hair and Nails are?

There is little reason to think it would: But Diseases once ex∣isting have a vegetative life like Plants, and will according to their respective Kinds and Dura∣tion, unless interrupted by Art or Nature, support themselves by

attracting Nourishment out of the Body; and this was apparent in a Patient the Author had ma∣ny years ago, and recovered, after she had been wasted by a loose∣ness of Three Years standing, in which time she must have dis∣charged by Stool, at but half a pound a day, above 547 pound, which was near five times her own weight; if therefore it had not been supplied, it must either have ended the Patient or it self in few Months.

40. Whether all such cures must not fail that are not as justly pro∣portioned to the Disease, as to the strength of the Patient?

Few will doubt but they must; for, suppose an ounce of peccant matter to be daily prepared, and no more emptyed either by Na∣ture

or the Remedy, the Disease must necessarily remain in the same state; but if less be empti∣ed, the Disease must increase; if more, it must mathematically have an End. What is further to be considered, is, how to avoid making too much hast for the Patient's strength, with violent Remedies so called, or large Do∣ses; or too little to save his life; for when Diseases ride post, Re∣medies must not follow a snails pace, curable Diseases must be headed and out-run according to their pace. Extremis morbis ex∣trema remedia conveniunt.

41. Whether (when vitious hu∣mours received, bred, or alter'd with∣in the Body, happen to be put into motion, either by their quantity, quality, or other accident) the ex∣pulsive

faculty is not thereby excited, without ceasing or by fits, to drive them from one part to another, till they shall be either quite expell'd, or the remainder thrown upon some out∣ward or ignoble part, where it becomes a setled Pain, Tumour, Ʋlcer, Fi∣stula or the like, unless Death ends the strife before.

It is evident how small a mat∣ter is uneasie to Nature, a Moat in the Eye and a small Fibre be∣tween the Teeth gives great di∣sturbance, even our natural Hu∣mours out of their proper Vessels, as extravasated Blood, as well as the preternatural Humours, puts Nature upon an endeavour to free it self, from what can be no longer useful to it, and thus are both Acute and Chronical Di∣stempers formed, and that which

continues their periods, is either the Weakness or Situation of the part, or a preternatural Ferment lodged in it, which is a prepared matter like tinder ready to catch Fire, assoon as any Foreign spark falls on it.

42. Whether, before a Patient recovers, many ill fits do not return in the course of a Disease; and whether, before a patient dies, he hath not many lucid Intervals?

This is so known to practitioners that it must not be denyed, there∣fore the first ought not to mini∣ster fear or despair if other circum∣stances are good; nor the last to give hopes when they are not.

43. Whether Health is not pre∣served by the several fluids or hu∣mours of the Body in a natural or healthy State; and Sickness intro∣duced

by like fluids in a preterna∣tural or unhealthy State?

This seems to be self-evident.

44. Whether the Spirits, or finer parts of those Natural Fluids, are not active for our preservation; and the Spirits or finer parts of the pre∣ternatural Fluids as active for our Destruction?

This appears no less manifest than the last.

45. Whether the natural Fluids are not preserved and supplied by a right use of the Six Nonnaturals; and the preternatural introduced by a wrong use or abuse of the same Non-naturals?

This few will deny.

46. Whether the proportion of strength and quantity of good ani∣mal Spirits is not according to the quantity of the natural Humours;

and whether the quantity of evil Spirits and their activity and con∣trarity to our Natures is not pro∣portionable to the quantity of preter∣natural humours?

If this be granted, as it can∣not well be denied, then must the Duration, Power, and Dan∣ger of Diseases with their extent to part or all the body bear ex∣act proportion with the quantity of such preternatural Humours.

47. Whether as long as there is life, there is not hopes, and whether any Remedy is not better than none?

Dum spiro spero, praestat anceps remedium quam nullum. For Pa∣tients have been reduced to that desperate Condition in the Opini∣on of By-standers, as no appear∣ance of life remained, and yet

by God's blessing directing to the right means, they have beyond hopes recovered, so that none ought to be forsaken before they are dead; besides, what hurt can there be to try to save a Patient tho the greatness or progress of the Disease should give little En∣couragement; they can but die? Tentare non nocet. Many who in all appearance were past Hopes, are now alive and well, and must certainly have died, had not pro∣per means been used in Season.

48. Whether a frequent unrea∣sonable fancy, if not very accidental and occasional, is not as much a Disease requiring help, as a Fever or the Scurvy?

The Arch-bishop of York in his Sermon of the Government of the Thoughts, fully grants this quere

saying, That he doubts not but ex∣travagant Fancies are as properly a bodily Disease, as a Fever or Fits of the Falling Sickness. Madness is only extravagant Fancies, and the Spleen but some degrees be∣low it; if therefore the Spleen and Madness can be cured, why not Fancies, which, though a Dis∣ease, is much less.

49. Whether Persons in perfect Health ought ever to take Physick, or Purge; and whether the Ʋnheal∣thy ought to neglect it one Mo∣ment?

Health ad pondus is not to be expected on Earth, but Health ad justitiam may, and such are to take no Purging Physick, except in a visible Plethora; because it will certainly carry off some Hu∣mours which ought not, and pro∣tempore

weaken the Patient by wasting without any necessity or benefit so many of his Spirits, there being no ill Humours to be workt upon which might have recompensed that loss and trou∣ble; but on the other side, a sick Patient ought to lose no time in hopes of being well to Morrow, which deceives many out of then lives; for the sooner they begin, the sooner they'll be cured, and the less serves turn, and they re∣cover with much greater speed and certainty, and less charge than if they delay till they be∣come weak and the Disease strong.

50. Whether 'tis not sufficient that Medicaments are beneficial, without expecting they should be either easie in Operation or pleasant in Tast?

For Medicaments were made for necessity only and not de∣light, though Food was made for both; because we cannot live without Food: But, if Mankind was wise enough to follow in these matters the dictates of Nature, there would be little need of Physick; so that 'tis God's Mercy we can have our Healths upon any Terms, and the worse the better for a punishment to make us wise and wary to pre∣serve our Healths by Moderation and a Regular Life.

51. Whether 'tis not as vain to expect to be freed from Diseases with∣out Pain or Sorrow, as for a Woman to expect to be delivered of her Children without Pain?

Whatever satisfaction there may be in their Causes, the Pro∣verb

tells us, Sweet Meet must have sowre Sauce; so that which is sweet in the Mouth may be bitter in the Belly, and for want of true Wisdom (which is a fa∣culty of discerning remote con∣sequences beyond the deceitful appearance of things) most People are ensnared to their ruin; for Evils have Beautiful out-sides but rotten insides; when Good hath comfort in the end, though not outwardly so charmingly a∣dorned.

52. Whether 'tis not very pru∣dent, to study to preserve our Healths, to recover it the shortest and safest way when lost, and to sub∣mit (before 'tis too late) to stron∣ger means, when gentle are insuffici∣ent?

If Health is the most precious Jewel next the Soul, the wise, that know it, will both study to preserve and recover it, and al∣ways use the means though seem∣ingly violent by which they may attain their end with greatest cer∣tainty.

53. Whether violent Medicines ought to be neglected or their use delayed where gentle will prove in∣effectual and endanger a Patient?

If gentle Medicines are equal∣ly profitable, 'tis imprudent to use the violent; but, where they are not, 'tis as imprudent to ne∣glect them; extremis morbis ex∣trema remedia conveniunt. But much of this doubt would be solved, if the word (Violent) were well understood; some mean dangerous by it, and then such

Medicines deserve alwaies to be rejected; others powerful and ef∣fectual, and then they ought ne∣ver to be out of use; for 'tis al∣waies better to make use of vio∣lent Medicines that will certain∣ly cure, than to trust to the wea∣ker and lose time with hazard to the Patient.

54. Whether all Persons must not either Labour, Fast, use Phy∣sick, or be Sick?

For such as will not Exercise, must eat Sparingly, and if they'll do neither, they must take Phy∣sick or be Sick, unless they have by the benefit of Nature, Evacua∣tions proportionable to their Feeding and Sloth. The follow∣ing rule of Health is not con∣temptible Eat when Hungry, Drink being Thirsty, Sleep when

Drowsie, and be never Idle.

55. Whether great Feeders, if not as great Labourers, must not daily grow from a Horse-load to a Cart-load, or empty a Barrel of Ex∣crements?

For whatever is not discharged in proportion to what is received, must still remain behind, either for Fat, Diseases, or both.

56. Whether 'tis not the peccant matter, moved by the Physick, and not the Physick, which in Purging and Vomiting, gripes and makes the Patient so Sick?

For the same matter gives the like Sickness and Pain, when moved by Nature without Phy∣sick; and Physick gives little or no disturbance, when there is no diseased matter in the Body or none moved by it; Seneca says,

Remedia nulla sunt tam salutaria, quam quae faciunt dolorem. It must needs therefore be a sign, when Evacuating Physick neither gripes nor indisposeth, that ei∣ther the Patient needed none, or that what was taken, was too weak and improper to do him any good.

57. Whether 'tis not much bet∣ter to give strong and powerful Re∣medies at first whilst the Patient is vigorous, and the Disease weak, than to delay so long with gentle Medi∣cines, as is too frequently practised, till the Disease is grown strong and the Patient feeble?

Where the Disease cannot cer∣tainly be overcome with gentle means, 'tis never prudent to ha∣zard life by delay, whereby ma∣ny a Patient hath been lost who

might have been saved by an earlier application of true and powerful Remedies. Post est oc∣casio calva, & sero Medicina paratur.

58. Whether Soldiers and Sea∣men, seasoned by the recovery out of epidemical Distempers, attending Camps and Fleets, are not after∣wards less subject to fall ill again by disorders, and usually continue in Health a long time after?

The reason for this seems to be, that such Diseases for the most part consume the greatest part of, if not all, the preterna∣tural Humours at that time in the Body; and it will require again some considerable time before a sufficient quantity can be colle∣cted for another Sickness. Be∣sides, Diseases usually fall on the Men, before custom and use hath

hardened them; so that every lit∣tle unusual Disorder, which pre∣judiced them at first, hath after∣wards no power over them.

59. Whether any Flux what∣soever had better be stopt in the be∣ginning with Astringent Remedies, or be cured by removing the cause with Evacuation?

If no Flux or preternatural E∣ruption can happen, but by some∣thing received into the body of a loosening or purging quality; or else by the strength of Nature, en∣deavouring to free its self of some offending Humours, the first if it ceaseth not of its self, must be removed by some other evacuant the same way or some other; the last if nature proves insufficient to save it self by a critical Eva∣cuation, must have the cause re∣moved

by artificial cleansing, and not be kept in to a worse purpose by Astringents.

60. Whether there is not the same reason and necessity for the Sick to take Physick, as for the Healthy food?

Tho some may live many daies without Food and not be starved, and some Sick may live without Physick, and it may be, recover; yet none in their wits will volun∣tarily and knowingly make the experiment, unless they either want Money or Faith in Physick, for Medicine is as much Food for the Sick, as Food is Medicine for the Hungry.

61. Whether God Almighty hath not as well furnished the World with Medicines for the Sick, as with Food for the Hungry?

God made nothing in vain; e∣very Herb, Animal, and Mineral have their distinct uses, and pro∣perties; and 'tis the duty of Phy∣sicians diligently to examine, and carefully to observe what they are, and how they may be best applyed for the service of Man∣kind, which is truly called the Art of Physick, and came down from Heaven.

62. Whether this Art of Phy∣sick, or a right knowledge of Na∣ture, and skill in Medicines with their various Operations in Humane Bodies, under different circumstan∣ces and affects, is not sometimes bet∣ter acquired by faithful Instructi∣on, by diligent Observation, and plain demonstration by Practice, than always by hard Study and Read∣ing only?

If Reading and Study, with∣out Instruction and Practice, were the best and only Method of at∣taining to the highest knowledge in Physick, then ought all Per∣sons, that intend to follow the Practice, to continue at least Fifty or Sixty Years studying in the University, and, when they shall have Read and digested all the Physical Authors and form'd to themselves the best Method of Practice out of the confused heap of Contradictions to be met with amongst them, which is next to im∣possible, let them then commence Practice: But this at best can be but like a Traveller without a Guide, wandering up and down to the hazard of poor Mens lives. When under the conduct of an a∣ble Instructor, the shortest and

best ways are Trodden, and the Dangerous and Tedious avoid∣ed, and the ready way learnt for the future.

63. Whether every Doctor in Physick is an able Physician? And whether he that hath most Practice is always the Ablest?

If Medicus est qui sanat, non qui garrit, & sanitas est finis Me∣dicinae, non lucrum; Then he must always be the best Physici∣an that cureth most in the same Number and like Cases, and not he that doth not, though he hath taken all his Degrees and the o∣ther none; and for such as are not well instructed, they ought to spend some longer time under the care of an Ancient Doctor of Skill and Experience, that they may not verifie the Proverb, That

young Physicians must kill such a Number, before they can be fit for Practice. Again, if bread is not to the wise, &c. it doth not then always follow, that he, who hath most Practice, is the Skilfullest: For, there are many little Artifices to bring Men in∣to Practice, as Bribes, tatling Gossips, &c. which are much more effectual than the greatest Skill without their Assistance, and which no skillful Physician will stoop to use, when on the contrary Ignorant, Mercenary Pretenders diligently courts them.

64. Whether 'tis not honester to prognosticate the Truth, at least to Friends and By-standers, though not always to the Patient; than constantly to foretel Danger, even when none appears?

Physicians of mighty Prudence and small Integrity ever gain by Frightful Prognosticks; for, if the Patient dies, their early Prog∣nostick gives them great Reputa∣tion for knowing so long before, what must come to pass at last, and if the Patient recovers, the cure is the more Miraculous, be∣cause the condition was so De∣sperate.

65. Whether Women with Child, and in Child-bed may not safely, when the Disease requires, both Vo∣mit, Bleed and Purge, provided it be with good Caution?

'Tis very probable, that the Disease which would have kill'd them for want of those Operati∣ons, when not with Child, or in Child-bed, would much sooner do it in both these cases; because

Nature hath not only the strength and power of the Disease, but the hazardous circumstance of a great Belly, or the weakness of Child-bed to struggle with.

66. Whether a Physician should be chosen for Favour and Affection; or for his Skill and Integrity?

Wise men choose their Physi∣cians only for the help they ex∣pect from them in time of need, which they could have no rea∣son to hope for, if they were not both able and honest. A skillful Turk is preferable to an igno∣rant Christian.

67. Whether the practice of Phy∣sick is not of late become more a Trade or Profession to gain a Live∣lihood, than an Art to restore Health and save Lives?

The present Methods of Pra∣ctice seem to be accommodated rather to answer the first part of the Quere, than the last.

68. Whether Anatomy and A∣strology, the first absolutely necessa∣ry for a Surgeon, and both very or∣namental to a Physician, can bet∣ter qualifie him for the healing of inward Diseases, than Fidling can qualifie a Barber for Shaving.

It would be a good Service to the Publick for any to undertake to demonstrate plainly, wherein ei∣ther helps the cure of any one inward Distemper; because ma∣ny Students lose too much time in these inquiries, which might have been better spent in observing the Practice of Physick and some great Practitioners; and also because many are apt to put too great a

value, as most necessary, when in comparison of other more essenti∣al requisits to a Physician, they seem but trifles.

69. Whether any can be so well qualified to Treat of Diseases, their Nature, Cause and Cure, as a Physician of long Experience, and much Observation?

Young Physicians should not then be forward to attempt this Province.

70. Whether success doth not e∣ver attend the Seasonable use of proper means?

Then, when Success is want∣ed, 'tis because the wrong means were mis-taken for the right, or the right too late apply∣ed, or misapplyed.

71. Whether, as often as God blesseth Persons or things with Suc∣cess,

he doth not direct to the sea∣sonable use of means proper to the end aimed at and expected?

To expect God's Blessing with∣out the use of proper means, is not to trust, but to tempt God; His blessing never turns Stone and Sand into good Food and Nourishment, nor preserves any from drowning, who presumes to walk upon the Sea from Dover to Callais; things improbable may, by God's Blessing, answer a Mans Expectation, as a Man in necessity may sometimes cross to Calais in a Wherry, or rotten Vessel, and Escape: But to under∣take impossibilities is affronting, not trusting the Deity.

72. Whether 'tis better for a Physician to be a Knave and in∣crease his Practice by humouring the

Fools and letting them die their own way; or to be honest and lessen his practice in saving them with me∣thods displeasing, because really there are no other can help them.

An ingenious Gentleman was pleased to say upon this, That 'tis better for the Patient, the Physician should be honest; tho 'tis better for the Physician to be a Knave.

73. Whether the Practice of Physick doth not very much want a just and due Regulation, and is not capable of great improvements for the benefit of Mankind? And whether it doth not well deserve such Reformation, since it concerns Life and Health, the dearest earth∣ly injoyments?

If the Government would un∣dertake this task, besides the cha∣rity

to Mankind, it would won∣derfully increase their own Glory, Riches, and Power by the in∣crease of Subjects, in saving so many more lives. And that the Government might not be per∣swaded, they are not fit for such an Undertaking, they may please to consider it was first the Government, that constituted a College of Physicians, which they would never have done, had they not been able to judge of the usefulness of the Art, and 'tis as much in their Capacity, as their Power to reform the Abuses, e∣ven as 'tis in Judges to determine Differences in matters of the same Trade, amongst the members of the Trade, when the Argu∣ments of both sides are brought and argued before them. This

would give a more faithful ac∣count of the Abilities of Physici∣ans than common fame now doth, wherein Interest and Affection generally rules.

74. Whether there can be con∣trived (if the Government please) any just and proper Test or Standard whereby to try the several Abilities of Physicians much more truly and cer∣tainly than any we have at present?

This were at least to be wisht, if there were no hopes to reduce it to practice, for not to know how to distinguish the skilful Physicians from the ignorant is next to having none, for want of which most wander without a Guide, and with the Proverb, sooner light on a Snake than an Eel, there being so many preten∣ders for any one truly qualified

for the Practice. Wrong ways are not wanting to misguide Pa∣tients, as common fame, which u∣sually proves a Liar; some few mercenary Apothecaries, Mid∣wives, and Nurses, who discredit the rest, by preferring their private gain to the Patients welfare: like the Porters at Billings-gate, who prefer the Oisters of that Boat they ply for though they really stink, before all others, that are truly good, for no other reason than their own Gain. Fa∣ction, Party, and the fractions of Religion; Relation, Acquain∣tance, and good Fellowship; Time and Chance; together with a Plausible, Fawning and Flatter∣ing behaviour; a good faculty of Gossiping, and using cramp Words; the reputation of a Scho∣lar,

or Traveller, though it were but very little to purpose; and in fine any thing, but real skill, which slights all indirect Artifi∣ces, finds not many just and fit Judges, and therefore, stragling in the Dark, but few have the good fortune to meet it. There are commonly two other previous Tests, the first at the University, whether fit to be made a Do∣ctor, the last at the College, whether fit to be made a Mem∣ber; but neither of these reach the true and necessary Qualifica∣tions of a Physician, which is the thing wanted and now desired.

75. Whether 'tis not a necessary Duty of a Physician to consider di∣ligently the Patients Strength as well as his Disease, and so to ad∣apt the Remedies, as they be nei∣ther

too strong for the sick Pati∣ent, nor too weak to do them good?

Cito tuto & jucunde, is an old known Rule in Physick, in which this duty is certainly included and always observed by a good Phy∣sician; for as, on the one hand, a Medicine too strong may de∣stroy a Patient: So, on the other, one too weak may let them die, which differs little to the Patient. An Eminent Doctor long since Dead, had, in the absence of the Author, prescribed a Course for a person of great Quality's young Child: upon the Author's return he gave (being demanded) the fol∣lowing Opinion of it, That the prescription was proper to the Disease, but not well accommoda∣ted to the particular case of the Child, for the Method could not

take effect in less than a Fort∣night, and the Child would die in two daies, as it did. This Query is thought necessary to be here inserted; because, no cau∣tion is so much urged by the Re∣lations and By-standers, as to re∣gard the Patients strength, which is altogether needless to good Physicians, and very prejudicial oft-times in discouraging them to proceed as they ought. Riveri∣us observing the many mischiefs by Womens Gossiping, cannot forbear taking notice of it in these Words, Nostratium mulie∣rum nequitia, omnes infaustos e∣ventus Remediis ascribentium, ef∣ficit, ut etiam prudentiores medici metu calumniae ab utilissimis inter∣dum abstineant.

76. Whether the most effectual Method to sweeten the Blood, so much and often desired by many, is not to carry off by Evacuation, that which sowres and spoils it?

The remarks upon the third Query may not impertinently be here considered. All the sweet∣ners in vogue, either purge by U∣rine, Sweat or insensible Perspi∣ration, as Tunbridge, Spaw, Sarsa, crude Antimony, Pearl, Asses Milk, &c. or else 'tis the work of Air and Time, though Reme∣dies often have the credit of the Cure.

77. Whether the mineral Wa∣ters sweeten the Blood by some spe∣cifick quality, or not rather by a purging or diuretick quality?

We are certain they do this last, the other is not so apparent.

78. Whether the Mineral Wa∣ters abstracted from Air, Exercise, Company, and the like, are in any respect more effectual or convenient, than other Remedies prepared by A∣pothecaries, and formerly more in use?

It is certain the great quantity required to make them effectual is none of their best Qualificati∣ons, they may distend the part, and over cool too much, cause Cholicks, and Convulsions; and as all other Remedies are vary'd to the Patients case, so here you must diligently inquire, whether the Patients case will fit the Wa∣ters, which 'tis most certain all that go thither do not.

79. Whether, to make a right Judgment of the Waters for the publick Benefit, a Register ought not

to be kept by a qualified Person, of the Diseases and Inconveniences of all that drink the several Waters; of the accidents that happen in the drinking them, and the success and health of the Patient for at least six Months after?

By this means there would be a true History of the Cures, to inform the judgment of Physici∣ans much better, which can only by chance now direct the Patient right, and consequently 'twould prove much for the Patients ad∣vantage.

80. Whether a Cure may not be wrought by a course of Physick, some weeks before the Patient plain∣ly perceives it?

'Tis as reasonable to judge it may, as for Diseases not to ap∣pear till long after the occasion

given, which causeth it, and of this there are many Examples. A Cancer in the Breast is not found in some Years after a Blow given, which was the cause. A Woman may not mis∣carry, in some Weeks after a Fright, which occasioned it. And it is this which makes so many mistakes, both of the Causes and Cures of Distempers. That oft∣times cured the Patient, which he believed would kill him, and a Cordial had the credit, which contributed nothing to it. The last Physician and Medicine com∣monly hath the Reputation of curing though it was the first that did it indeed. If this were not so, there could ne∣ver have been so many cures for a Tooth-ach, which certain∣ly fail the next time they are

tryed; but, hapning to be ap∣plyed, when the pain was going off for the present (as no Di∣stemper though never so vio∣lent, but hath Remissions if not Periods) they being the last ap∣plyed were recorded for the cure, when any other at that time, must have had the same good Success.

81. Whether more Patients have not died by not hindring, or not re∣moving the Disease with proper and seasonable Evacuations, than by at∣tempting to remove them with Eva∣cuating Remedies?

Most Persons that die before extreme old Age, might by a na∣tural possibility have had their lives prolonged to Old Age. To Moral possibility many things must concurr, as the Obedience

and Wisdom of the Patient, the Skill, Care, and Honesty of the Physician, besides outward ac∣cidents, as Murther, Drowning, the falling of a House, and infi∣nite others, without the Power of either Physician or Patient. V. the 21 Query.

82. Whether the Jesuit's Pou∣der makes not double work for the Doctor?

Without doubt, his first Busi∣ness is to cure the Ague with it; the next to cure the Patient of it.

83. Whether most Fevers do not take their rise from the primae viae?

Most certainly, for though the Air was Pestilential, or the pas∣sions Extravagant, if there were not suitable matter treasured up

in the primae viae, no sort of Fever would ensue.

84. Whether, if Fevers begin in the primae viae, and are main∣tained from thence, Bleeding can be so proper a Remedy as Vomiting or Purging; or whether it is ne∣cessary at all to Bleed, or fit to begin with it?

Whatever is seated in the pri∣mae viae is sooner and easier ex∣pelled by Vomit and Stool. It may be often convenient to bleed in Fevers, tho 'tis but seldom necessa∣ry: But it seems preposterous to begin the cure of any Fever with Bleeding except a Plethora.

85. Whether Patients are not more weakned by Bleeding than by Vomit or Purge?

If the animal Spirits arise im∣mediately out of the Blood, as

'tis generally agreed, and that they give strength, then 'tis most probable there are more Spirits contained in an ounce of Blood, than in an ounce of the expell'd Excrements.

86. Whether it is not highly reasonable to believe, that Choler is the cause of the Disease, and Vomiting the cure; when Patients, that are very Sick, are wonderful∣ly easied and relieved, after having Vomited of themselves without Me∣dicines a quantity of Green, Yel∣low, or Black Choler?

This scarce deserves a Dispute, since there is seldom a sick Per∣son, but hath experimentally found a manifest relief after spon∣taneous Vomiting, though very dangerously ill before. And so, as oft as they Vomit, they are

sensible of a temporary ease, which deserves their careful ob∣servation to convince them of the Truth hereof.

87. Whether every powerful An∣tidote against Poison doth not plen∣tifully operate, either by Vomiting, Purging, or Sweating, and by dri∣ving out Botches, Blanes, Soares, or Swellings, all which are mani∣fest Evacuations?

88. Whether a Patients weak∣ness proceeds not from the want of homogeneal Matter, or natural Hu∣mours for the Spirits to dwell and delight in, wasted by preceding or present Diseases, or by natural or critical Evacuations?

89. Whether Men, after being tired with hard labour, are not for the present Weakned, by Emptying or Wasting of so much Humour and

Spirits by Sweat through the Pores, which competent rest and food sup∣ply again?

90. Whether any of the last Thirty Years discoveries, or pre∣tended improvements in Physick, Chymistry, or Anatomy have ena∣bled Physicians to cure one Disease more, or any one sooner, safer, or easier than formerly. Or rather whether, being trusted to, they have not delay'd, if not frustrated the cure of many, helped before by old Methods.

Fluxing with Mercury was both an invention about an hun∣dred Years since, and a real im∣provement: But what have we got by Spirit of Sal Armoniack, Harts-horn or Goddard's Drops? What benefits appear by the modern use of Steel or Opium

more than formerly? What do the mineral Waters, which Whey and Diet Drinks could not? and there may be added, What migh∣ty good can the Jesuit's Pouder boast of to compensate the many mischiefs it hath caused? Agues were formerly cured, so as it be∣came a Proverb, to be Physick for a King: But now they are so cured, as to plague the Patient many Months and Years after, if not shorten his days.

91. Whether to begin with the Theory, and after proceed to Pra∣ctice, is not a preposterous and un∣natural way of Teaching, or learn∣ing any thing?

Languages are naturally acqui∣red by Practice, and Grammars are formed afterwards. All or∣dinary people learn foreign Lan∣guages

by practice abroad, and not by Rule. Every Mecha∣nick is taught his Handicraft by Practice, and such, as labour at them by Speculation, bungle al∣ways at the Practice: The Law∣yers join the Practice with the Theory, by spending some time in the practice with an Attorney, or by frequenting the Courts, Assizes, and Sessions. Skill in Physick is best acquired by Edu∣cation in the Practice under an Eminent Physician. Some of our great Men had that Advantage. Besides the use of Rules is more to preserve the memory of what we have seen and read, and to confirm our Opinions, they being drawn from the practice of many Physicians. Agendo discis agere.

92. Whether any Physician or others ought, considering the many contingences in humane affairs, to tie themselves up so strictly to rules or Method, tho never so well esta∣blished; as not to depart from the same upon any accident or success whatsoever?

Pro re nata is a rule in Physick, 'tis therefore presumed, an honest Physician will always govern himself with judgment and cauti∣on according to Accidents and Variety of Circumstances.

93. Whether perfect Health doth not deserve to be purchased, though upon its own unacceptable Terms?

No doubt, unless People could be perswaded, they might recover it as well upon their own pleasing Conditions. But, since these de∣sireable methods cannot possibly

answer any Man's wishes, how much are they to blame, who deceive Patients to the great ha∣zard of Life and Health, with such false plausible pretences?

94. Whether 'tis not unreason∣able to blame a Physician for not curing his Patient when he would, neither take what was prescribed, nor according to direction?

This seems to be one of the greatest hardships, that can befall Physicians in their Practice, to be condemned by incompetent Judges, when innocent; and some∣times by strangers, who know no∣thing of the matter, but by im∣perfect hear-say, at the same time, when the Friends present are well satisfied, there is no cause of blame. To this purpose a most ingenious Lady of high Qua∣lity

was pleased to ask a Physi∣cian upon making this complaint, Whether he had never been com∣mended, when he did not deserve it, to which, being granted by him, she was pleased to Reply, You must set one against t'other, which, tho it was a most witty Repartee, is far from being equal; for one adversary shall do you more hurt, than ten Friends can do you good.

95. Whether wise Men do lazily believe all they hear, or do not ra∣ther critically examine the truth of it, especially if it is of so great mo∣ment as well to deserve the trou∣ble?

Some men despise all that comes from others; some will not spare time from their pleasures, tho to save themselves, and the

Nation; and some out of modesty distrust their own parts; all these commonly resign up themselves, and are led implicitly by such as they have once an esteem of: but wise Men will never take any thing of moment upon trust, but will labour, till masters of it, and then as it deserves either reject or approve and encourage it.

96. Whether 'tis possible to dis∣cover by the Ʋrine, that the Pati∣ent keeps a Coach?

Tho the inspection of Urines is of great use to a Physician, by which much may be discern'd for the benefit of the Patient, and therefore not fit to be laid aside; Yet all, that foolish People inquire after and expect, is as far from being thereby known, as whe∣ther the Patient keeps Mares or Horses for their Coach.

97. Whether is the more desirea∣ble qualification in a Physician, skill or the usual Policy exercised in Practice?

The first makes a Doctor able to serve his Patient; the last hin∣ders him from being willing, ex∣cept when he finds it his interest; therefore (when it appears bet∣ter for him to let Patients die their own way with comfortable Cordials; or at least to struggle with the Disease without true help to the manifest hazard of their Lives, than to save them with Medicines in Taste, Opera∣tion or their, prejudice disagreable to their Humours and Fancy) his Policy makes his skill and integri∣ty to submit to his interest, and to prescribe something, tho very insignificant, to amuse the Friends,

that they may not think him careless and idle; and then fight Dog fight Bear: fight Nature fight Disease; and, if it succeeds well, the Physician hath the Cre∣dit and the more Money, because cures by Nature are not so soon wrought as by Art. And, if ill, he yet preserves the Reputation of a Careful, Tender Hearted, Safe Doctor, and is not in the least blamed.

This indeed is a common, but not a very honest way of pro∣ceeding, occasioned at first by the Patient's Folly, and continued after by the Doctor's Cunning, not easily tempted to Sacrifice his Reputation to the censures of an unthinking People, that do not, and hardly ever will, under∣stand their own good.

98. Whether the same Reason which persuades many there is an Antidote against every Poison, may not as well convince them, there is a Remedy in Nature for every Evil: only we want skill to discover the Remedies, at least, to apply them in due Season.

99. Whether 'tis not safer for a Doctor to let his Patien••s die their own way with a gentle wrong Me∣thod, than to endeavour to help them with a rough right one, and to miss?

'Tis very probable it is, for the gentle method displeaseth none, and the Doctor, though he never endeavoured to save the Patient, still continues his Inte∣rest and Credit in the Family, because the Patient and Friends believe he did, not being able to judge; but on the other hand,

the Doctor, that endeavours to save, and misses, shall be esteem∣ed a murtherer, because of the seeming violent Medicines used and be discarded and hated, though he used the best skill then known to save the Patient.

A PROPOSAL For the better Securing of HEALTH, Intended in the Year, 1689. and still ready to be Humbly offered to the Consideration of the Honourable Houses of Par∣liament.

THe Bills of Mortality, as well as the many poor Dis∣eased, have given some a just oc∣casion

to Reflect on the great Numbers which Annually Die within the City of London, and parts adjacent, comprized in the Weekly Bills of Mortality; where∣of very many, by God's Blessing upon the true Methods of the Art of Physick, and an early applica∣tion for Help, might in all pro∣bability have been preserved a∣live.

Therefore, in order to so good and great an End, it is humbly proposed, that a more compleat practical Constitution of Physick according to the following Schem, may be upon rational Demonstra∣tion Established; whereby Care may be taken, that all Sick, as well Poor as Rich, shall be Ad∣vised and Visited, which needful, by Approved, Skillful Physicians,

and Surgeons; and furnished with necessary Medicines in all Disea∣ses, for a small yearly certain sum Assessed upon each House, not ex∣ceeding for the greatest Family, nor under for the meanest, that are not Objects of Charity: Which respective Sums will not be the third part of what is now spent, only in Apotheca∣ries Bills in a Healthy Year. And for this every Individual Person of the Family, as well the Lodger and Servant; as Master, Mistress and Children, shall, when there is occasion, be sufficiently accom∣modated: Whereas many at pre∣sent miserably perish without the least Care, and for want of time∣ly and skilful Assistance. In short, it's proposed to serve all the Families, Rich and Poor, Lit∣tle

and Great, within the City and parts adjacent, much better and cheaper than at present, with Visits, Advice, Medicine, and Surgery.

It is also further humbly offered, That effectual Care be taken that the Laws already in being may be revised and amended, which provide for the Sale of wholsome Flesh in the Markets; and that Bread may be well Baked; Wine not Sophisticated; Beer well Brewed; and the Houses and Streets well cleansed from Dirt and Filth: All these being very common causes of Diseases and Death.

This Constitution may consist of the following Members, more or few∣er, as the City Occasions and Ne∣cessities may require.

First, Ten Noble Curatores, both to Protect and visit the College.

Secondly, Physicians.

• One Super-Intendent or President.
• Two Sub-Intendents.
• Three Senior Heads of the College
• Four Junior Heads.
• Fourteen Senior Visitors.
• Seven Principal Secretaries.
• Fourteen Junior Visitors.
• Seven Sub-secretaries.
• Forty two Chief Itinerants.
• Forty nine Junior Itinerants.

• Seven Senior Amanuenses.
• Fourteen Junior Amanuenses. In all One Hundred Sixty Four.

Of this Number, besides the three Intendents in the chief Col∣lege in Warwick-lane, there will be Twenty Three Physicians more: As also Twenty Three in each other the Six Colleges. Se∣ven Colleges being thought at present more than sufficient to serve the Bills of Mortality, with Convenience and Ease to the In∣habitants thereof: In each of which Colleges there are as fol∣loweth.

• One Master, Head or Principal.
• Two Senior Visitors.
• Two Junior Visitors.

• One Principal Secretary.
• One Sub-secretary.
• Six Senior Itinerants.
• Seven Junior Itinerants.
• One Senior Amanuensis.
• Two Junior Amanuenses. In all Twenty Three.

The convenient Places for the Seven Colleges may be

• 1. The Present College.
• 2. Lincolns-Inn-Fields.
• 3. Near Charing-Cross.
• 4. Near the Poultry.
• 5. Southwark near the Hospital.
• 6. Near Bishops-gate.
• 7. In or about Goodmans-fields.

Which places are to be pub∣lished in Print about a Fortnight before the Settlement, that all

may know where to apply for help.

Thirdly, Chirurgeons.

• One Master.
• One Deputy.
• Seven Wardens.
• Twenty Eight Assistants.
• Fifty Six Mates.
• Twenty Eight Junior Mates.

In all One Hundred Twenty One.

Of this Number, besides the Master and Deputy, at the chief College, there are Seventeen in each of the Colleges, viz.

• One Warden.
• Four Assistants.
• Eight Mates.
• Four Junior Mates.

In all Seventeen.

Some of which, besides Chi∣rurgery, shall be skilful in the practice of Midwifry, cutting for the Stone, reducing Dislocations, and drawing Teeth in each Col∣lege.

Fourthly, Apothecaries.

• One Master.
• One Deputy.
• Seven Wardens.
• Fourteen Assistants.
• Forty two Mates.
• Forty two Journey-men.
• Forty two Sub-Journey-men.

In all One Hundred Forty Nine.

Of this Number, besides the Ma∣ster and Deputy at the chief Col∣lege, there are Twenty one in each College, viz.

• One Warden.
• Two Assistants.
• Six Mates.
• Six Journey-Men.
• Six Sub-Journey-men.

In all Twenty One.

If the Number of any Exceeds the Inhabitants Necessities, it may be (as they die out) lessen∣ed, by not supplying: But if not sufficient, it may be Augmented, so that few or none of the pro∣fession may receive injury by this improvement; but all if possible some benefit.

Inducement for this New E∣stablishment of Physick.

I. TO preserve Health and save Lives, is always a Publick Good, but more especi∣ally in time of War.

II. That Medicine is highly useful to those great Ends, is and has been always the general Judg∣ment of Mankind.

III. That every Good Quo Communius eo Melius; but that as Physick is now managed, not on∣ly the very Poor, but meaner sort of Tradesmen and their Families, Servants, and Misers, deterr'd by Physicians Fees, and Apothecaries Bills, have little or no Benefit by Physick.

IV. That by these means, to∣gether with the want of timely and frequent Visits, many die yearly that might be preserved; and Epidemical and Contagious Distempers and Chronical Disea∣ses arise and are propagated.

V. That Physicians and Chi∣rurgeons may (and possible ma∣ny do) having no Check, or Su∣pervisors, for Lucre sake, prolong Cures, to the hazard of Life; and by new Experiments upon their own single Judgment destroy ma∣ny.

VI. That Apothecaries may be careless in their Mixtures, or Un∣skilful; or may Administer things improper or decayed, or tire their Patients with needless and nause∣ous Medicines for their own Ad∣vantage.

VII. Mountebanks, and cheats in Physick, are found by Experi∣ence, to conduce extreamly to the Ruin of Peoples Healths, and loss, oft-times, of their Lives, as well as of their Money.

VIII. That by this Constitu∣tion all those Ills will be prevent∣ed, all will have equal Help and Benefit: All will apply in time, since they hope for Cure without fear of Charge: Diseases taken early more easily removed: Fre∣quent Visits will be mad••, which in acute Diseases are most neces∣sary; changes therein being of∣ten so great and sudden, that life is frequently lost for want of a timely Visit. Consultations will be candid, and without Passion or Design, and to be had when necessary, tho of the whole Facul∣ty,

in difficult cases: Medicines publickly and faithfully prepared will only be given: And Moun∣tebanks, with such others, will hereby sink of themselves, with∣out Law or Trouble.

IX. Nothing will be here con∣cealed, that in its own Nature re∣quires not Secrecy. No Mans Ig∣norance or Negligence can here be prejudicial, for the Constitution directs all, inquires into and Su∣pervises all.

X. Physick and Chirurgery will be extreamly improv'd, and in a little time, by the multitude of Experiments, recording of Ob∣servations, and by mutual and can∣did Assistance of the Members, come near to a Demonstration.

XI. The Members of both Houses of Parliament as well as

all other Strangers, with their Fa∣milies, tho not House-keepers when in Town, will be attended Gratis: And indeed all the Inha∣bitants of every House, for the small Rate charged thereon, Vi∣sits, Physick, and Chirurgery therein included.

XII. The Advantages of this Constitution may be immediately extended to the great Benefit both of the Navy and Army.

XIII. The Improvement of Health, and Preservation of Life, Encreases People, and that Aug∣ments Consumption, Trade, Pow∣er and Wealth. And many Fo∣reigners will repair hither for Re∣medy, when incurable abroad, which will also improve Trade.

XIV. The Proposer is sensi∣ble that many Objections will be

raised by Prejudice, Interest, and for want of a true Information of the Nature, and Tendency of this Constitution; all which he is rea∣dy to answer, and hope the Pub∣lick Benefit will outweigh all bye, and little Ends.

XV. The regulation of the Practice of Physick, to make it more Beneficial and less Charge∣able, doth as properly belong to the consideration of Parliament, as Divinity, Law, State or Trade, all which daily fall under their Cognizance.