naturae quia aut curabit eam aut manifestabit eam that is when you do not know the disease leave it to nature because either she will cure it or discover it Also they would contribute far greater advantage to the ease of the sick by expecting with Hippocrates the crisis than by a thousand tricks to circumvent nature for if they can do no good let them do no harm at least But now it is I am at leisure particularly to set down the order of this lazy practice Those that reject glysters in the beginning of a Fevor because they should not blunt the edge of the ferment too much do not at all perform their duty in the right administring of things since the rubbish of the body that is lodged about the turnings and windings of the guts and the hidden places of the mesentery not being expelled doth either by profusing steems into the vessels very remarkably increase the heat or by putrid particles creeping into the blood is apt to kindle the Fevor This rubbish because it is incapable of being concocted and is lodged without the vessels does easily yield to a gentle laxative potion or purging glyster without any fear of increasing the heat But since people here are such immoderate devourers of flesh that the belly being the sink of the whole body must needs abound with sordid excrements is not a laxative purge or Cathartick glyster very necessary But it must be given in the first preceding days or afterwards the greatest part of that filth and dirt is carried away into the vessels by the rapid torrent of the blood and therefore all purging is to be set aside for hereby nature would else be drawn from its work with a great disturbance and that without the least benefit Neither is that I have proposed just now contrary to Hippocrates as you may observe Aphor. 10. â—â—b 4. In acutis passionibus eadem die si fiâ—i potest medicandum nam in his cunâ—ari malum est that is in all acute passions you must give physick the same day if possible for to tarry is hurtful also Aphor. 29. lib. 2. and in Aphor. 30. lib. 1. he gives the reason for it Circa initia omnia debiliora in statu omnia fortiora quae purgationem fieri impediunt that is about the beginning all things are at weakest and about the state at the strongest which hinder that a purge should be given Secondly all bodies that are inclinable to Fevors or are fevorish are for the most part in the beginning oppressed with a Plethora ad vires or a fulness of the vessels more than their strength can bear whereby the spirits are pincht and through too great a condensation grow vehemently hot the circulation grows slug and dull and is carried in a disorderly motion and the pores are stopt how urgent is the case then that some blood be taken away immediately thence the spirits will be able to bestir themselves the motion of the blood from irregular will become regular the passages of the skin will be more free and the heat will be moderated But since it is not seldom that a Fevor being subdued by the first bleeding though not to an absolute extinction of the fiery heat the sparks raising the flame again the blood doth swell up a new and run violently up and down reason doth like wise advise that the veins are 〈◊〉 be deplenisht the second time that we may arrive to the same effects But those that indeavour to venture the opening of a vein e third time do unpunisht make a playgame of a mans blood for there is not so great a benefit reaped this third bleeding as there was by the two former as I have found by a thousand trials but the spirits and forces of the sick are barbarously destroyed by taking away their due food and nourishment and quite ruining their base and foundation for they inhere in the blood as their foundation and subject and from it they draw life Moreover neither is the blood then so turgid and impetuous because besides the former substraction of blood the parts of the whole mass are attenuated melted and dispersed through a great many little caverns and holes that before were filled Likewise there is now a close engagement between the vital spirits and the febril corpuscles what these are shall be told you hereafter so that if either you disturb the spirits or exhaust and lessen them by bleeding the fevorish miasms must necessarily get the victory and produce death for their trophy Thousands are killed by the slaughter of the lancet That you may understand the case more plainly I will illustrate it to you by an example of one that lieth sick of a malignant Fevor whom should you bleed but a second time or sometimes but once you would certainly bring his life into danger for neither Pulse or Urin do signifie any great heat that should be the cause of the swelling of the blood neither are the pores stopt by an abundance of soot wherefore there must by no means any blood be taken away because it doth in no kind of manner nor through its abundance annoy the spirits If however against reason blood should be extracted the spirits will be so much wasted that they will be rendred too weak for the encounter Secondly since the vessels by opening of a vein are so swiftly deplenisht the malignant matter that stagnates in the capillar vessels or elsewhere lieth hidden in remote holes and secret places is thereby most impetuously drawn into the great vessels that lead to the principal parts where joyning with particles of their own nature do with a joint force fall upon the strong holds of life certainly this is a most clear demonstration We must here unty the knots of two particulars that were asserted above The first is the manner of computing the bleedings whence the first is to be counted whence the second and third The other is why there are but justly two bleedings set down At the first assault of symptoms that are derived from the spring of a Fevor that is not intermittent as Hippocrates here and there calls it by which name are meant both continual and continent Fevors the same day there ought some blood be taken away out of the right arm to quiet and suppress the febril matter that it may not be mixt with the mass flowing through the great vessels nor fiercely fall upon the spirits for as much as this should happen so much the quantity of the blood that is to be extracted ought to be moderated Moreover the measure of blood that is to be drawn away is to be taken from the degree of the swelling of the blood for if the degree of intumescence or swelling be at the degree of eight and if unto this degree doth answer the taking away of ten ounces of blood then if the intumescence be at the degree of four the substraction of five or six ounces will be
thence vomiting up into the blood certain tumultuous miasms that force it into a heat As soon as the foresaid matter is thronged out of its lurking places and forcibly rushed into the great vessels the symptoms thereupon raging in heat do forthwith shew a countenance of the augment or increase And when the whole mine of febril matter is quite floated into the channel of blood then the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or vigour is near at hand At that time there is a close ingagement with the febril enemy and its force being broke Nature by her victorious arms doth expel those rebellious intestine corpuscles and separated humours into several sinks of the body the disease in this manner declining the sick man doth arrive safe and well This expedition doth contain some particulars very worthy of note 1. At the first of the ingagement nature doth encounter with the Fevor at a distance some steems being only scattered abroad before the gross of the preternatural matter lodging in the deep places without the vessels nor at all mixt with the torrent of blood 2. The Fevor increasing the lesser part of the matter is confused with the blood that flows by but the greater part doth as yet remain still and quiet in the spring 3. At the vigour all preternatural bodies are closely intermixt and confused with the natural From hence doth shine a light whereby the bottom of the difficulty wound up in the foregoing discourse may be plainly known and discovered Wherefore since fermentation doth tend to the same end concoction doth namely of subduing the heterogeneous quality of the adventitious minims that are got into the blood and that whilst the disease is yet in the augment only part of the Febril matter is crept into the blood and not throughly insinuated into the depth of the forementioned scarlet juice it will prove a help no ways deceitful if the sick man doth take a Diaphoretick draught well impregnated with volatil salts whereby he may be put into a smart sweat certainly a very proper means through which the vital power may free it self from those hurtful corpuscles since as yet the spirits are numerous and vigorous and are not so much ingaged by the intestine enemy whence consequently they have still a power of expelling the fumes and soot have not yet filled up the passages of the body nor pores of the skin being left open for natures cutaneous evaporation a part only of the Febril matter is here and there loosly intermixt with the blood and may easily be forced out thence From all which it doth plainly appear and is inferred that fermentation fie upon the abuse of the word is in this case to be rendred easie the liquor of the veins being thereby attenuated occasion is given to the spirits to fly together to make an united force to grind off the sting of the Febril matter and thereupon to expel it But though the fermentation is to be rendred easie it is by no means to be increased and intended for that would put the Bitumen of the blood into too high a flame and through the crackling and vibration of the salts would occasion a very dangerous storm in the blood Of this nature are almost all the remedies that are proposed by the Fermenters namely Aqua Epidemica Spirits of Hartshorn and all the other fiery cordials as shall hereafter be resolved more at large Neither do I esteem those reasons I have now produced so much but that the many experiences whereby I have delivered some hundreds after the manner aforesaid of their continual Fevors without suffering them to come to the height do more clearly discover the matter According to the mark spoken of before let us enquire what harbour this Rhomb of giving hot cordials by spoonfuls will bring them to undoubtedly if the Fevor be any thing outragious there is danger of shipwrack For things that are taken by spoonfuls contribute matter to the inflammation and fire increase the matter of the soot and really stop the pores moreover do not concoct the least part of the febril matter neither do they separate or expel it being concocted Wherefore if a Fevor is of its own accord carried on to the height without doing any thing and the febril matter be more closely and intimately knitted with the blood and spirits and the whole mine be disturbed and profused into the great vessels certainly in doing ill they must speed much worse What they have acted in the increment hath just now been shewed at present pray give your judgement are your toothless wifes in the country more dextrous in curing a Fevor or Fermentitious Physitians Neither are the sick themselves so void of sense but that they are sensible they are precipitated by the burning cordials of Fermentators in the state of their disease into their too early Tombs The forementioned Cordials derive their burning nature from an impure Sulphur which doth not only plentifully abound in the spirits of wine the menstruum of all those compounded alexipharmacal liquors but the ingredients themselves especially the aromaticks contain excrementitious Sulphurs and impure salts whence it happens that those that have liberally taken of them arrive sooner to the end of their fatal journey Wherefore it 's plain enough that by these things the fermentation is intended the mass of blood is forced into a fiercer fire and burning and the whole sink of the Febril matter which only partly flows to the blood and partly remains in its hidden station is violently suckt up and drawn in by the circulating juices and is united with them in every particle so that to give the prefaced cordials which increase the fermentation and do not at all render it easie by a most subtil and diaphoretick vertue is with purpose to kindle the body into a flame and rob the sick of his life However that inquiry may not be pretermitted what admirable effects do issue from the fore instanced Aqua Epidemica we are to be resolved from the examination of the context of the simples Tormentil Root is in the front whose power doth reside in a ponderous fixt salt and for that reason no part of it doth ascend the Alembick Liquorish in this place is termed alexipharmacal which was never attributed to it by any Physitian nevertheless it was possibly added to abate the acrimony of the other ingredients but since it doth also obtuse the attractive vertue of the Menstruum and render it incapable of attracting the salts of the simples neither doth the least particle of it climb out of the body to the head of the Still certainly it ought justly to be rejected hence Moreover who but a mad man would commend Mugwort Agrimony Betony and other such like herbs against the Plague according as they are inserted by the former age in this composed medicine These though they use some small force against the venom of the air yet other Alexipharmacals as long as they are far more deservedly
namely a Bitumen but not Sulphur being immediately extinguisht by water nor calx viva or lime there being no such fury of heat discoverable in the caverns of the earth as is requisite for its generation Wherefore in Bitumen only may be found a heat that is constant and scarce to be extinguisht for by water it 's apt to be kindled into a higher flame and to be nourisht by oyl and oylie bodies It is then in the heart where nature hath placed an abounding fountain of vital Bitumen on the purity and continuity of whose flame lise it self doth depend Neither must it be asserted that so great a proportion of this doth flow from the heart as to suffice to protract the life of it and of the whole structure for so many years but that it doth daily attract a bituminous nutriment from the streaming blood which being kindled into vital flames is by means of the pulse distributed into the rest of the small chanels of the body It must also be observed that all what we eat or drink the chyle and the blood do contain a certain proportion of Bitumen and as much hereof as there is abounding in them so much they are capable of being serviceable to the heart At present must be explained what and of what quality this Bitumen is namely a body grown out of a sulphureous oyl and a Colophony into a thick liquable and inflamable substance Such by distillation it 's also discovered to be in the analytick parts of the blood of a living creature to wit an oyl swimming a top the phlegm and a colophony with a part of fixed salt setled in the body of the glass-gourd withall a volatil salt passing the Alembick with the oyl which later namely the volatil salt it is that adds to the whole mixt body all its strength and power not unlike Gunpowder whose Nitro-salin particles being rendred volatil through virtue of the fire do assume so great a force that they strike any object whatsoever with the greatest alteration and the smartest blow imaginable when in the mean while the brimstone and the charcoal-dust only supply the place of a soporous matter From what hath been said the manner of the pulses may commodiously be extracted only conceiving that the Bitumen of the heart burning until the period of life and pour'd from the ascending vena cava into the left ventricle doth kindle the blood into a flame by vertue whereof the nitro-salin salt being blown into most volatile forcible particles is like Lightning or Gun-powder discharged out of a Gun propelled as it were by an elastick force into the Great and other Arteries CHAP. II. Concerning the differences of Pulses and their causes TO describe the difference and variety of the Waters of the Sea would prove a task less difficult than that of the pulsations of the Heart and Arteries which are subject to be altered by every passion wind and disease though Galen indeed counted them as if he had blown them out at his fingers ends among which notwithstanding scarce every third difference can be distinguisht by the feeling of a Spider Wherefore I shall only discourse of such which every one may almost discern in Fevors In the Pulse I use to mind first the strength or force next the swiftness of motion and thirdly the equality From the strength a pulse is called strong or weak hereunto are accounted a great pulse to wit full and strong and small namely empty and weak the causes of the strength of the pulse I state to be the abundance of volatil salt being vigorously and smartly discharged through the pulse of the blood and the strength of the fibres being well nourisht with the moisture of the brain On the contrary the defect of salt and emptiness of the fibres cause a weak pulse Here it 's worthy of your observance that the pulse in some sevorish Patients is found much stronger than it was in their state of health and what is more in some who were reduced to so low an ebb of strength that they were scarce able to keep death a day from their door I remember their pulse would beat the tops of ones fingers smartly which notwithstanding in my opinion ought not to be called a strong pulse but violent for the vital faculty being irritated by a corroding and reverberated kind of salt is forced into those violent pulsations whence falling at last into a very in all and most quick pulse is immediately attended with an Asphyxia or ceasing of pulsation It is an easie business to distinguish a violent pulse from a strong the former doth come full to the fingers the later empty Secondly I have oft met with a weak pulse in such as lay sick of Fevors that they seemed not to be able to hold out two days which notwithstanding have for a fortnight or twenty days strove very successfully with the disease This pulse proceeds from a thick and moist blood which by a continuated rarefaction and reiterated circulation being advanced to a higher degree of concoction doth revive the vital faculty whilst in the mean time there hath been sustained no great loss of volatil salt in those weak pulsations I have many times taken notice of this case in women that lay sick of Fevors wherefore it is warily pronounced by Hippocrates Aphor. 19. lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 i. e. The predictions of life and death in acute Fevors are not always certain and without doubt That we may avoid being mistaken we are to distinguish a pulse that 's really weak is empty and small and for the most part inequal in motion and weakness neither did it differ much from that degree since the beginning Under the motion of pulsation I take a slow and swift pulse likewise a thick and rare pulse A slow pulse is known by moving slowly from the systole or a contraction of the pulse to the diastole or a widening or dilatation of the pulse and again from the diastole to the systole A quick pulse is known by its quick pace from the systole to the diastole and so reciprocally A thick pulse to me is which is perceived by the finger by its frequent beatings or retreats a rare pulse contrariwise Here may be noted in my apprehension a pulse can scarce be discovered slow and thick at once when a slow pulse necessarily doth not return frequently or thick because it 's slow but according to the common maxim a thick and slow pulse may happen together because it is called thick in respect of the interval or rest between the systole and diastole namely which returns in a short space of time but a pulse may move slow from the systole to the diastole so that there is but a small interval between before it returns from the diastole to the systole and thence it 's termed thick But taking the matter into farther consideration there is scarce any such pulse as a thick or frequent one according
the same manner if you pour some drops of those forementioned volatil liquors into a small quantity of blood though crude and phlegmatick you will digest it into laudable blood and preserve it warm and slorid but upon dropping some oyl of Vitriol into it it turns immediately into a curd the serum or whey is depressed downwards and assumes a purple red colour Spirit of Nitre doth pervert the redness into a whitish or ash colour but doth not precipitate the whey suffering it to swim a top Upon the further pursuit of the matter I dropt a drop into a large proportion of blood almost coagulated whereby almost in a moment the tye of the coagulative particles was dissolved and indued with a shining lustre not at all inferiour to the best digested blood Neither doth it only from this external use deserve to be termed so admirable but that in a short time being used inwardly as I have oft made trial it hath singularly digested the crude blood of Asthmaticks Scorbuticks and of worfer habits A consistency between thick and thin signifies a vigour of concoction chiefly to be ascribed to the volatil salt living in the vital Bitumen The causes of the thinness or tenuity of urine in those that are sick of a Fevor are the scarcity of volatil and sixt salts not being separated from the torrent floating through the great vessels also the drying away of the mucilage of the blood through the heat or its dissipation through the pores The thickness of urine is occasioned by the whey or serum imbibing too great a quantity of salt and thick mucilage Touching the matter of the hypostasis or settlement of the urine there hath hitherto but little certainly been stated among Authors though most are of opinion it proceeds from the superfluous humour of the third concoction To me the sediment appears to be a mucilage partly imbibed by the serum or whey within the vessels partly deterged from the slimy substance of the intern tunick of the ureters and bladder wherewith they are liquored to prevent their most exquisite sense be not hurt by the urine that flows by This mucilage if you examine the Chamber-pot shall be found to be a glutinous thick and slippery slime moreover that it 's dissolvable by heat and apt to be thickned by cold like phlegm may be observed in turbid urines which as long as they continue warm after they are made are clear and perspicuous but a little after growing cold are turned into turbid and dark being deprived of the energy of the particles of hot volatil salts that dissolved the slime for if you do but hold the urinal a moment to the heat of the fire or hold it in warm water they will resume their former shape of clearness Bubbles that oft swim a top the surface I judge ought not to be imputed to a slatuous but lixivious constitution of urine for ashes soap and other lixivious things being dissolved in water render it subject to turn frothy and bubbly with the least stirring The colour consistency and contents are chief universals whence a Physician may extract what preternaturals lye hidden in the body The colour discovers the active qualities of the salts the consistency the state of the serum or whey and the contents the quantity of the foresaid salts and other excrements that had performed their office a further and particular explication of all these relating to the kinds of Fevors shall be reserved to the sequel of the book Lastly it is to be noted that in the contents are included the enaeorema and hypostasis CHAP. IV. Concerning the true and Spurious Essence of a Fevor IN the first Chapter we had hinted at the definition of a Fevor what concerns its explication we have partly referred hither That a Fevor is a derivative from the nature of fire is abundantly suggested from its destructive manner of acting most fierce heat the tongue and roof of the mouth being crusted with a black smoak likewise from other symptoms thence proceeding as thirst dryness and roughness of the skin and inflammation of several parts Here the Reader is to assume that the vital Bitumen of the heart and the whole body being kindled into a fire is the disease or Fevor or rather that the fiery distemper of the heart and the whole body or part is the disease but not the preternatural heat being that's rather to be counted a symptom immediately flowing from the disease in no wise differing from the manner the heat emanates from the fire Wherefore the definition which is extant among Academick Authors as Fernelius Sennertus and others ought justly to be rejected To wit A Fevor is a heat against nature kindled in the heart and from thence by means of the spirits and blood diffused throughout the whole body and doing hurt to all the natural actions The objections against this definition I offer you in these positions First I assert that the essence of a Fevor doth in no wise consist in an universal heat nor secondly that the heat which attends a Fevor doth not altogether arise from sparks glittering in the heart The argument that confirms the former is taken from the genus of a Fevor which is stated a disease but a disease is said to be the constitution of a part hurt or injured which kind of saying doth not at all agree with a preternatural heat that depends on the burning fixt Bitumen of a part or oft on miasms or steems blown from the heart the receptacle of the fire to all or most parts of the body but those torrid miasms are not to be taken for the disease but causes that in process of time through their heat may occasion a disease Here may be offered a probable objection that a Fevor is the kindling or heat of the influent spirits of each single or more parts whose hurt is to be imputed immediately to the heat of the spirits whence a Fevor may justly be judged a heat Hereunto must be replied that the name of a part of the body can in no wise be given to the spirits because they flow continually neither are they in any manner permanent but are assigned for the animation and nutrition of the parts and for that reason their distemper ought not to be taken for a disease if notwithstanding the subversion of the temperament of a part should flow from a tumult of the influent spirits and that thence they should be incapable of performing their offices nevertheless because it 's a mediate affection and to be derived from the burning of the spirits it 's not to be taken for a disease but a cause Secondly If from the general opinion you have a mind to instance that the putrid heat of all the parts of the body is a Fevor to wit a continual putrid one supposing likewise that the said heat is risen out of the blood only being through its means conveyed to the sanguin parts I answer it ought not be
inferred a disease since the blood also because it 's a fluent matter cannot justly deserve the name of a part but a cause of a disease or the vehicle of it Thirdly The bones cartilages and ligaments are not sensible of heat neither are they subject to receive any putrid heat because in a Fevor they are seldom or never observed to be taken with a putrefaction or rottenness how can then a Fevor be termed a preternatural heat of all the parts Likewise Fourthly Why ought the name of Fevor to be attributed to a fevorish heat more than to a shaking or fevorish coldness in the beginning of a paroxysm of a Fevor both the former and the later flowing equally as symptoms from a Fevor Fifthly An universal heat is erroneously ascribed to a Fevor for in a lipyrious Fevor a torrid heat doth torment the internal parts though the externals are cold moreover it oft happens that the hands and feet are stiff of cold and the entrails do in a manner glow with a burning heat Furthermore it may be observed that a Fevor doth sometimes only haunt one single part as the foot or hand Neither have I forgotten a certain Fevor whose heat extended no further than the head and face Hereunto add that those particular Fevors are not only inferred to be such because of the preternatural heat but also by reason of the preceeding cold shaking and ulcerous lassitude Sixthly those that swell so much with the Doctrine of Fermentation they do not altogether affirm that it is a preternatural heat that constitutes a Fevor since the forementioned heat doth take its rise from a heap of influent spirits striving to expel humours and such small bodies as are annoying which heat ought therefore rather to be judged natural than against nature In the second position we maintain that the heat that attends a Fevor is not always kindled in the heart as if the primar hearth were there which assertion is proved from the kinds of symptomatick Fevors for the Fevor that surprises a wounded patient or one that 's detained with an inflamation of an entrail as the Spleen Liver or Kidney certainly it 's not first kindled in the heart but in the part affected whence afterwards it 's dispersed throughout the whole structure Secondly If the heart were the only brand of fevorish heat the blood that passeth through its ventricles should retain a mark of being burnt and undergo some change of tincture when on the contrary thousands that have been bleeded in Fevors their blood that was extracted hath appeared to the eye to be of a pure scarlet and florid until the fourth and oft until the sixth and eighth day In the next paragraph I have thought fit to please my self with the examination of the vulgar opinion concerning the common seat of continual putrid Fevors intimating it to be the blood seething in the vessels and stained with putrefaction but how grosly this rabble of Physicians is mistaken may be extracted from what shall be proposed First If the sprout of a continual Fevor were ingraffed on the blood it would not be so refractory to cure but consisting of fluid and moveable elements by means of alteratives purgers diaphoreticks and emptying the vessels by opening a vein might in a short time be reduced to its former purity and temperament moreover through one nights seething of the blood nature doth oft expel those thin little bodies that float in it and the grosser it casts forth into pustules botches and other such tumors Secondly I cannot grant that what is stirred by motion and continual flowing as the blood is that it is easily taken with putrefaction for being full of vital spirits and living heat it 's held in a continual motion Thirdly Until the third fourth sixth eighth or tenth day computing from the beginning of the distemper according to the degree of the height of the Fevor the blood at the first phlebotomy is extracted pure and florid as I have observed in hundreds whence it 's evident that the primar matter of putrefaction and the seat thereof is erroneously placed in the blood though afterwards passing the entrails it be stained with a malignant quality loading it self thence with hot Miasms and Salts Fourthly pure phlegm or veiny gelly being watered with an immoderate quantity of a pale green and blew lymph or whey since it makes two thirds of the blood in the veins of those that are troubled with the Dropsie Green-sickness and other kinds of diseases why is not that blood which is so heterogeneous and so far remote from a temperature moisture abounding and the plurality of particles breeding putrefaction always forced into a fevorish heat And on the contrary why are hot and dry temperaments where choler is abounding constantly so inclinable to putrid Fevors whereas dryness doth so particularly resist putrefaction Summarily the blood according as I have asserted in the premises since upon no pretence it 's to be accounted among the parts of the body doth utterly exclude it self being capable to be a seat place or part affected If peradventure you doubt that I have hitherto receeded from the path of the received doctrine stating the heart or other entrail the seat in Fevors you have the liberty to take it from the fountain what is to be concluded concerning the matter Avicen fen 1. lib. 4. tract 2. cap. 43. dictates thus Dicamus quod Febris sanguinis est Febris putredinis Febris calefactionis ebullitionis that is Let us say that a Fevor of the blood is a Fevor of putrefaction and a Fevor of heat and ebullition Here is to be noted that the blood is inferred the subject matter and seat of a putrid Fevor Also Galen lib. 2. de Cris. cap. 12. Manentibus igitur in venis humoribus continuae ex ipsis Febres generantur that is The humors remaining in the veins continual Fevors are engendred out of them Likewise Aetius tetrab 2. Serm. 2. cap. 74. Putrescentes igitur humores aut intra vasa arctati continuas nunquam intermittentes usque ad perfectam morbi solutionem Febris efficiunt that is Wherefore humours putrefying or streightned within the vessels do cause continual Fevors and never intermitting until the perfect solution of the disease Here by the way observe though according to Galen Fevors are seated in the veins by their name Arteries are also described as lib. 1. de Crisib cap. 7. it 's by him more largely expressed Febres omnes sunt passiones venarum itaque in Febribus omnibus quoniam venosi sunt generis passiones nam arterias in hoc genere comprehendimus ad urinas praecipue attendere oportet the English is All Fevors are passions of the veins wherefore in all Fevors because they are passions of the veiny gender for we comprehend the arteries also in this gender we ought chiefly to heed the Urins On the other side they have destined the seat of intermittent Fevors to be without the vessels
as appears here and there by the writings of Galen and Avicen Notwithstanding I can scarce apprehend the foundation of these seats wherefore I desire to be satisfied in this doubt whether continual Fevors are said to bud forth in the veins because the blood that leaps out upon phlebotomy doth appear hot to the touch and shews deep red being mixt with a blew milky or yellowish whey But this blood is not different from any other that 's extracted in an intermittent Fevor or any other disease And whether the difference of seats is expounded to be such because the blood within the vessels having an immediate commerce with the heart is capable to foment a strong heat whereas entrails that are more remote from the heart do only by fits profuse those putrid and fevorish steems and under that shape do occasion an intermittent heat Certainly not Moreover the entrails being tyed to the vessels are not less commodiously situated by means of these small chanels that tend directly to the heart to foment a fevorish heat than if the cause were engendred within the foresaid vessels or whether because the vessels are of a just capacity wherein they may receive such a quantity of fevorish matter as may suffice to nourish a Fevor without intermission whereas the entrails are stated to be streight and not provided with a hollowness to retain matter enough On the other hand the entrails according to what the thing requires ought to ingurgitate a larger quantity of matter which might suffice to protract an intermittent Fevor to some months and years as doth oft happen But to touch the knot of the difficulty the cause of the continuation intermission remission and intention of Fevors is not to be imputed so much to the quantity as the quality of the fevorish matter as hereafter shall be treated more at large In the precited definition the heart is idly stated the part primarily affected for thence would follow that the greater part of Fevors should be mortal because the composure of its temperament being once subverted is not easily restored Secondly Suppose an inflammation of the Liver or other entrail attended with a Fevor which do you think the part primarily affected the Heart or Liver CHAP. V. Concerning the fopperies of Fermentation ALmost every Barber and Plaster-spreader have got the knack to buzze every patient in the ear the song of fermentation and know how to fit the tone of it to every disease but chiefly to a Fevor illustrating the exposition thereof with this commentary that the blood fermenteth and the humors are in a fermentation likewise the ferment of the Heart Spleen Liver and it may be of the Fundament too if they go not orderly to stool is depravated moreover if a Corn of the Toe doth but ake the distempered ferment is the cause of it Summarily fitting the word ferment to every disease cause and symptom they conceive the case to be very well handled and thence tell the Patient they will expel the disease by correcting the serment and so as if they had done their business mighty well they send the Patient home swelled with hopes Concerning this abstruse Philosophy borrowed from certain theorems of the Wine-press and chymical notions Anthonius Guntherus Theobaldius Hoghelandius Felicianus Betera Conringius Martinus Kirger and others have prosessedly treated whose Treatises if you peruse you will find the word fermentation to serve in divers significations the one in a large sense gives the description of it not at all different from Peripatetical mixtion excepting that this performs its task by qualities the other by action and reaction But fermentation in a narrower signification as it relates to fluids is stated an effervescency of any liquor tending to concoction At present we will examine whether a Fevor be a fermentation or effervescency of the blood To the resolving of this we must resume from what hath been said in the foregoing Chapter that a Fevor as it is a disease of the body doth necessarily inhere in a part as its subject and foundation but the blood cannot perform the office of a part therefore neither a Fevor or fermentation can be properly attributed to it Secondly Neither can the blood fermenting be probably conceived to be the continent cause of a Fevor because its fluid mixture is absorbed in a few days whereas a Fevor is protracted to some weeks Suppose a fevorish Patient to contain four and twenty pints of blood in his vessels whereof a quarter of a pint is consumed every day by abstinence and dissipated away through the pores into vapors and some days a whole pint or at least three quarters are drawn off by phlebotomy for it 's very familiar amongst the French the first and second opening of a vein to extract a whole pint of blood and every bleeding afterward which is commonly every other day to take away two Porringers containing three ounces a piece by this computation the whole mass should be drawn off in two weeks or less and consequently the fermentation must be quieted and stopt and the Fevor expelled But on the contrary if you should extract blood forty times as I have oft observed in France they have done the height of the heat will not be half a degree abated but rather augmented Who would then maintain the blood boiling through fermentation to be the cause of a Fevor However this experiment is observed to be true if you take off the third part of any liquor that is a fermenting whether of Wine Beer or any other mixture it will immediately be taken off from working but ofttimes the blood is tapt off to the half and sometimes to the last fourth part without the least quieting of the fermentation if I may call it so Possibly you reply that according as the vessels are emptied by bleeding sweating and other torments they swell up again by the food and drink that 's daily taken On the contrary there is a thin Diet ordered to such as are in a Fevor neither do most in the whole course of a Fevor allow their stomach so much as whereout the sanguifick faculty may engender a pound of blood add hereunto that their appetite for fourteen or twenty days is quite dejected But you reply that they take as much food as answers what is consumed to this I return that the blood which is daily ingendred and newly admitted into the vessels either it 's pure or stained if the former then it ought to dilute and temperate the fermenting mass which it doth in no manner do if the later it is not to be doubted but that it hath contracted its stain from the concocting and depurating entrails whence follows that the primar and principal cause is not to be attributed to the blood but the entrails Thirdly It 's confirmed by experience that fermentation doth happen to any mixt liquor and soft compositions as paste or dow electuaries and others which is observed to be a mild working of
℥ j. ss vel ℥ ij sometimes Syr. ros sol ℥ j. m. f. Pot. Capiat cras mane cum custodia Others make use of the Cold Infusion as they call it being made out of the said leaves of Sena in the same weight with or without a corrective infused all night in fountain water without fire dropping into it salt or oyl of Tartar ten or fifteen drops afterwards sweetning the expression with Manna syrup of Roses laxative or Sugar Rhubarb is set aside because of the heat that abounds in it and its binding faculty after it hath done working Although after this manner they give purges in the beginning of continual Fevors yet they do not contemn Hippocrates his precept 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 c. that is humors that are concocted ought to be purged and stirred not crude ones unless they swell and run up and down because they expel only such excrementitious humors that lye lurking without the vessels in hidden places of the mesentery and guts which certainly would never be concocted for feeding much on roots cabbage salletting milky diets butter-milk and other things that contain a great deal of excrementitious juice their bodies do abound with those kind of humours Wherefore the foresaid law of our great Physician doth only relate to humors floating within the vessels Afterwards they order a Laxative glyster to be given every other day for to suppress those violent flames of the Fevor and frame Iuleps out of cooling waters and syrups and sometimes Emulsions out of Almonds and cooling seeds The impaired vital faculty they relieve with a spirituous potion after this form according as their prescriptions here and there in the Dutch Apothecaries shops do plainly inform us R. Aq. 4. cordial ana ℥ j. Aq. cinam ℥ ss velʒvj Consect Alkerm ʒj Spec. Diamarg frig ℈ ij Syr. è suc citr vel granator ℥ j. m. f. Pot. Ofttimes to these cordial waters the same quantity of Aqua Melissae is added Sometimes instead of Aqua Cinamomi they put in Aqua vitae Mathioli also Confectio de Hyacintho instead of Confectio Alkermes Nature moving towards the extremity they fly usually to this cordial powder R. Spec. Diamarg frig ℈ ss Magist. Perlar. Coral ana gr v. Lap. Bez. or gr iij. vel iv m. f. Pulv. sumendus bis per diem mane sero in Iulap Cord. modico The animal faculty being much broken through want of rest they cause sleep by this following potion R. Aq. Bor. nymph pap Rh. ana ℥ j. Aq. Cinam ʒij Consect de Hyacinth ℈ j. Syr. Papav. Rh. ℥ j. vel ℥ j. ss m. f. Pot. Capiat hora somni They very seldom make use of Opiats in this case being much dissatisfied in their unsubdued narcotick force especially where the strength of the Patient is scarce proportioned to dissipate it The sick body being surprised with a phrensie they draw blood out of the foot or if his principal faculties are two languishing they revel the blood by cupping-glasses from the brain to the extream parts The Fevor declining and discovering a white sediment in the Urin they cause an evacuation by purge once or twice The French subdue putrid and malignant Fevors by bleeding the first time largely and afterwards repeat it every other day to five or six ounces the days that are between they prescribe a laxative glyster and sometimes a potion of the infusion of Sena Manna and Cassia which later is in great veneration among them La bonne Casse as they call it syrup of Roses laxative and Crystal mineral For the critical days they take no notice of them often saying that to expect the Crisis is to expect death and so by drawing of blood and purging with glysters they go on very diligently For their ordinary drink they allow ptisan which is to be sold ready made in the shops all France over The Germans do not differ from the Dutch except that having emptied the body by purging and bleeding they propose powders to expel the febril miasms and to cool composed out of Terra sigil Bol. Armen corn cerv ust ras ebor rad tormentil bistort and the like but before all these they prefer Pulvis Rubeus Pannonicus set down in the Augustan Pharmacopoea CHAP. V. Shewing that the modern practice of subduing continual putrid Fevors is barbarous and killing THat the practice of Fermentators is to be abominated and that it is killing who can deny Since among a great company of fevorish Patients the greater part whereof are probably strong young well slesht-men not being swelled or retcht in their Hypochonders or Belly yet scarce the third man recovers his former state of health What must be inferred from hence when in the rage of a Fevor though the Physician be sent for at the first minute of the Disease and that the strength of nature is more than proportioned to subdue the Fevor nevertheless the poor wretch dieth yes let all things be administred according to the most received rules of Physick let the highest cordial be given also Extractum Cardiacum Pearl Bezoar and the spirits of Hartshorn it self yet very oft to no purpose and the Fevors will triumph until the hour of death But if in favour of the Fermentators it be instanced that before our Aesculapius came to the assistance of the sick man the flame was kindled to the top and that the Fevor had taken deep rooting that the malignity of the disease had trodden down the principal or commanding faculties the cause of the fatal day is not to be imputed to the Physitian nor to his remedies but to the malignant distemper too much inraged by too long a stay Hereunto I reply notwithstanding that the Physitian was at hand at the very glimpse of the first spark of the Fevor which possibly then was of no such ill aspect as I hinted just now nevertheless the case will run to ruine But on the other hand if any one that liveth in the Country be he a Country man or come from the City be taken with a Fevor and the care be committed to an old wife immediately shegives him a certain posset that is throughly savoured with Carduus or Pepper and puts him to bed covering him well with clothes until he fall into a dew sweat this being once or twice repeated she commits the rest to nature wherein she proves so lucky that out of ten nine if not all for the most part get the better of their distemper Moreover the Divine old man scarce ever gave greater relief to any in a Fevor than by doing nothing and committing the whole business to nature and therefore he oft urgeth that nature be not interrupted in concoction Aphor. 22. lib. 1. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 c. that is do not move crude humours and Aphor. 24. of the same book It were better if they cannot discover the adequate remedy to follow Avicens document sen. 4. lib. 1. cap. 1. Cum ignoraveris agritudinem relinque eam
proportionable to allay it and according to this manner you must make your computation in the others But where the Orgasmus or turgid working of the febril matter is appeased and its malignant faculty suppressed you may safely next day or two days after by a cathartick potion expel the matter of a Fevor that is imprisoned in hidden places without the vessels and in the capillar vessels In the same manner is a malignant Fevor to be dealt withal at the first assault though otherwise it would certainly tend to the destruction of life yet by so managing your affairs the sick man will be released There ought a laxative or at least an emollient glyster to be administred before the bleeding Fevorish patients are oft in the beginning tortured with a violent shaking extream vomiting and frequent fainting in this case six or eight ounces of blood being extracted out of the veins the same day the swelling of the blood the plethory of the vessels and the violent working of the febril matter have been quite suppressed But possibly one may reply that if the blood should be preyed upon on every appearance of the foresaid accidents it would be oft lookt upon as a very careless and needless piece of work when ofttimes those symptoms do of their own accord the blood being appeased vanish away in six or eight hours as useth to happen in intermittent Tertians and some other kind of Fevors I answer that in such a case the overweight of blood is never lightned without great benefit by opening of a vein since the forementioned symptoms do issue from a plethory and a hot burning matter and granting that the violent working doth settle of its own accord it will return again upon the least occasion wherefore to relieve nature there must necessarily some part of the burden be taken off Secondly the nature of an Orgasmus or violent working is well known almost to every experienced Physitian whether it appears to be superficial and moveable or permanent and thence may easily conclude about the necessity of bleeding But since it often happens that sick people do not advise with a Physitian before the second third and fourth day or afterwards there first ought to be inquired whether the same or a greater or a lesser quantity of blood should be extracted than if a Physitian had had the occasion at the first assault to have given his advice Secondly whether nevertheless a Physitian coming the third or fourth day that substraction of blood ought to be accounted the first and whether the fifth sixth or eight morning after the opening of a vein ought to be repeated First there must be considered the degree of concoction and the ebb of the blood occasioned by fasting or thinness of diet must be taken notice of before any thing can be certainly concluded on Wherefore take it only for a supposition if hereafter you are not convinced of the absolute truth thereof that nature is imployed thirteen dayes and sometimes fifteen days in concocting the matter of acute Fevors and afterwards doth endeavour to separate and expel it the fourteenth or sixteenth day according to the course of the Moon wherefore Hippocrates pronouncing Aphor. 13. l. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is those whose crisis is growing on the night before the fit is very troublesom to them the concoction is brought to the height or 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 on the thirteenth because that is accounted the day that immediately preceeds the fourteenth on which according to the dictate of the same Hippocrates Aphor. 22. lib. 2. 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is acute Fevors come to a crisis in fourteen days the crisis of acute Fevors are wont to happen Now since the night before the crisis all things are very troublesom it must be that nature is at that time most busied and is at the highest point of concoction which namely is the thirteenth day or night immediately preceeding the fourteenth day being the day of the crisis on which namely the fourteenth day as I hinted now nature doth gradually separate and expel the concocted febril matter by stool vomit through the pores of the skin or hemorrhage but most frequently by urine in the shape of a white and heavy sediment if the concoction be perfect or reddish if imperfect Here is to be noted that crises which happen to bodies in hot and thin climates and whose blood floating in the vessels is very thin and the veins free from obstructions are very rapid and swift expelling the concocted matter by stool or through the pores of the skin all at once as it were and with a violence but those that lie sick in a northern climate because their blood being thick muddy and ropy doth in all parts promote obstructions and their skin is hard and thick and the faculty of their guts is dull for the most part they are freed by having the febril matter gradually sent down to the Kidneys and Bladder In the mean time it 's not to be denied but that the word Crisis by its first imposition doth denote a sudden change with disturbance either to life or death wherefore though I said above that the matter was by a crisis gradually expelled it is to be understood in respect of a more rapid crisis that 's proper to hotter countries and in respect of the lingring solution of the disease by translation of the matter it doth justly merit the name of a Crisis for the whole matter is expelled in four or five days more or less This by the way If then the thirteenth day be the top of the concoction and that the symptoms are gradually intended from the minute of the augment or increase which usually happens to be in true acute Fevors about the fifth or seventh day according to the variation of the Moon it will not be safe to open a vein past the seventh day because then the spirits are endeavouring to concoct and the swelling of the blood is suppressed by fasting if bleeding was not premised and thinness of diet what is it then you will exhaust the veins for If notwithstanding in the beginning of an acute Fevor which is defined to be the first four or six days because during that time the first appearance of symptoms is scarce altered the fevorish Patient hath beyond reason and necessity gratified his stomach and appetite and that thence the turgency of the blood hath been fed it may be convenient to take away some blood though it be the eight day so that those things are to be defined according to the swelling of the blood and the decrease thereof by a thin diet for if so much be consumed by a thin diet in the beginning or the first four or six days as is proportionable to once bleeding it will be advantageous to bleed once besides within the seventh day but those things are to be left to the judgement of every experienced Physitian yet let him not be unmindful that
as it 's commonly described neither is there a rare pulse because there is no interval of rest between pulsation for conceiving that the pulse is like a reciprocal swelling and falling like the tide of the sea there can only be inferred a point of reflection namely as soon as it swells up the next moment it falls again and as soon as it 's fallen the next minute of time it swells again Moreover this rising or swelling is attended with an impulse from the heart by means of the constriction of its fibres whereby like waves besides the forementioned swelling or turgescency the blood is propelled through the pores of the body out of the arteries into the veins Wherefore that I might not beyond necessity burden my self in my practice with notions I scarce am used to take notice of any thing else in the motion of the pulse besides its swiftness and slowness neither do I stand much whether it be hard or hot or pricking since this rather relates to the altered qualities than the pulse Thirdly It is to be observed that those whose pulse being naturally full strikes quick their vital faculty is very weakly wherefore in women and children the arteries strike quick but full Fourthly In malignant Fevors the arteries do oft move slowly in such a manner that one might judge them free from all putrid heat but this doth not happen unless death be ready to follow within a day two or three The natural swiftness of pulsation not in sick people must be imputed partly to the abundance of volatil salt but such as is not close and compact for as soon as it arrives to the ventricles of the heart it 's apt to be flusht into too volatile particles and soon after the salt being so copious follows immediately from the other parts of the salt whence another pulse is ready at hand partly it 's to be imputed to a Bitumen that is easily inflamed which quickly kindles and is kindled whence happens the frequency of the pulse By the way a small question might here be moved whether the pulse beating quick in Fevors there passeth more blood through the heart than when one is in a state of health First It must be agreed upon whether in every dilatation the heart is filled full of blood and in every constriction it be quite emptied some defend the affirmative part which to me doth not at all seem plain for those whose pulse at one time beats full and at another empty it must necessarily be argued that at one time the pails of the heart must be swelled up with a greater quantity of blood and at another with a lesser and from the consequents it's evident that reciprocally in divers pulses there must be expelled a various proportion of humors Secondly Since it may be observed that a large diastole of the heart is sometimes the next moment followed by a short and weak systole as appears out of the swelled diastole of the arteries of the wrist or any other part there oft following a short and weak systole whence it 's deemed there is more received into the receptacle of the heart and less expelled so that oft a proportion that 's admitted by one diastole is expelled in three or four systoles To answer to the question we assert that the blood is not circulated nothing near so rapidly or quick in malignant Fevors as it is in the state of health because the pulsifick faculty of the heart is languishing neither is the systole of the arteries or heart made with so much force but in putrid Fevors the systole and diastole being violent the blood is transfused somewhat swifter than in a healthful state Here is to be observed by the way if a swift pulse be perceived to go slower a day before and the day after to grow swifter a malignity is to be suspected The third particular worthy of observation is the equality or inequality of the pulse in reference both to motion and strength Wherefore in respect hereof a pulse is said to be equal or inequal in motion to wit swiftness and slowness and in strength namely fortitude and weakness The equality which Authors are wont to apply to a thick and rare pulse likewise to the tone or musical rithme we pass by being rather apt to occasion confusion to the practising Physician To unequal in motion are accounted the dicrotus or anvile-pulse caprisant or goat-pulse intercedent and some others A strong pulsifick faculty and not depraved likewise a temperate mixture of the blood being well depurated from heterogeneous particles are both some causes of an equal pulsation On the contrary blood that 's unequally mixt with the vital Bitumen and several sorts of salts occasions an unequal pulse both in respect of motion and strength As for other differences proceeding from the force of passion and other procatarctick causes we refer to another place CHAP. III. Of what is generally to be observed in Urins SInce the Urine for a more certain presage must give place to the pulse we have thought fit to discourse of this after the other Through the abuse of pispot-gazers and some Physicians that imprudently pretend to tell wonders the doctrine of Urines among some is fallen into disgrace nevertheless since it makes an ample discovery of the diagnosticks and prognosticks of diseases it ought not to be dismembred from the art of Physick First we shall set down what Urine is afterwards what particulars are to be observed in it To me the Urine seems to be a liquor melted from the volatil and fixt salts likewise of some excrementitious phlegm dissolved in the serum or water of the blood which being throughly filled and impregnated with the foresaid contents through its weight tending downwards is posted to the kidneys thence as if it were distilled by descent it falls down by drops towards the bladder But that the nature of urine may be made more plain to you some particulars are to be taken from the constitution of the blood and proposed here Those volatil salts I conceive to be the principal efficient of concocting the blood adding to it a scarlet tincture sweetness homogeneity and fluidity in which shape the blood arriving to the pores of the parts that are to be nourisht doth desert the salts which return with the superfluous blood to the veins and lymphatick chanels that afterward disburden themselves into the emulgents That those salts do not only illustrate the blood with a tincture but likewise the urine shall be demonstrated by sight You shall find that spirit of sal armoniack scarce differing from spirit of Urine or spirit of Hartshorn or spirit of Soot a drop or two being dropt into whitish drabbish and undigested urine shall immediately concoct it into a golden or vitrinous colour and an excellent consistency But if you effuse an acid spirit that 's forced out of a fixed salt you shall see it turn more drabby more crude and of a heavier weight In
puddle of salt and sharp water into great bubbles but those on whom the precited Vesicatories have been affixt where there hath been no concoction or separation before have had a small quantity of moisture extracted into low blains which for the most part is a mortal sign so that it doth appear thence that the cause of their cure and recovery is not to be ascribed to the Vesicatories but to the subduction and concoction of the malignant water and heterogeneous humours Secondly in Epispastick medicaments the Cantharides perform the chief work the relation of whose properties I judge may be advantageous They are of a most hot and burning nature they oft occasion Fevors great tortures and pains a disturbance of the humours in the vessels and a very sharp irritation which a dysury and bloody making of water do oft follow they are extreamly hurtful to the brain and sinews and suddenly destroy ones strength so that they are markt with a signature of the most malignant venom though only applied externally Wherefore if Epispastick plasters being thick spread with Cantharides are applied to a Patient that is ill of a malignant Fevor at the time of the vigour when his strength is decayed do they not increase the Fevor put the malignant humours into a rage heap up one malignity on another quite oppress the principal faculties destroy the forces and certainly deprive the Patient of his life Possibly here may be objected that though Vesicatories do occasion a great deal of hurt per se to a fevorish body yet per accidens they do abundance of good by exhausting the malignant serum and putting the external parts to pain whereby there is a revulsion made of hurtful humours and steems from the brain Hereunto is to be replied that in this case the blood is most frequently wanting of moisture whence the febril fire burneth the more violent so that it 's possible only to attract a very few drops whereby a heap of very great evils is brought upon the Patient Secondly since malign corpuscles are chiefly seated in fuliginous salts you cannot possibly by any device extract them for at the time of the state they are so very closely and intirely soldred to the humours that to draw them asunder is by no means feasible That these things are so is proved by this argument The Ichor or bloody moisture that by an Epispastick is attracted outward at the time of declination or concoction and separation doth swell out in a great quantity under the blains which when cut doth leap out being of a sharp tast fiery and salt because it 's laden with those foresaid fuliginous and malignant salts but being expelled at an unseasonable time appears limpid insipid and fresh Moreover I will now tell you what the vulgar will scarce give credit to namely that Vesicatories being applied at the declination to parts that are not so convenient have very suddenly snatcht sick Patiens away out of this sublunary orb A certain person that was ill of a burning and malignant Fevor aged thirty two after he had lain sick fourteen days not without some signs of perfect concoction and separation in manner that on the fifteenth he walkt several times up and down his room being attended with all characters of health to expel the latent malignity outwards had by the advice of two fermenting Physitians at the hour of Rest large Vesicatory Plaisters applied to the nape of the neck and the wrists The following morning the Fevor was bursted out again burning enough his speech was taken away and was grown light headed but that they might make an end of their task on the sixteenth they took the man out of the world Doubtless the malignant salts being attracted out of the whole body to the brain and nervous parts did very suddenly extinguish his forces and spirits Many other tragical cases I could produce for testimonials did not the purpose of a compendious tract disswade me wherefore take the precited in lieu of all It may be stated for a certain that at the beginning of a malignant Fevor especially when it hath attracted the seminary of malignity out of the air which seldom happens Epispasticks being applied to the remote parts the symptoms have been subdued immediately and the Fevor extinguisht but then they were applied within the third or fourth day Likewise being affixt to one that is taken with a pestilential infection they have been very advantageous In some cases they may also be applyed to convenient parts at the declination My business doth only permit me to premise these particulars in this first Section in the second section which will e're long follow I shall apply my self to give you a description of putrid continual and malignant Fevors likewise of the Small Pox and Meazels by their foundation subject and symptoms and likewise shall subjoin practical observations and the true method of cure and remedies In the third section shall discourse of the division of Fevors and in particular of intermittent Fevors Upon so important an affair as the Practical part of Malignant Fevors I ought not to make so sudden a recess as to leave those salutiserous maxims premised in this Tract only astipulated with reason but to recommend them to you confirmed by experience abstracted from those cures which for success and happy event are not to be conferred with the vuâ—gar methods Among the number of them I could here produce shall only insert some few of the last years date whence a proof sufficiently evident may easily be reduced The last preceding autumn I was called to one Mr. Van Mildert a Dutch Merchant of considerable note aged about twenty nine of temperament Pituitous and Melancholick not robust of constitution but of a rare texture of body On the Sunday he was surprised with drowsiness and heaviness of his head a Catarrhe in his throat an ulcerous lassitude a rigor or shivering and shaking a nauseousness or inclination to vomit and some other symptoms dependant on the former during the first four days he used the prescriptions of one of the elder City Physitians the chief whereof to the best of my memory directed some vulnerary vegetables for a decoction another was a decoction of Carduus B. in posset ale intended to move a gentle vomit and after that advised bleeding The fifth day I made my first visit and found the Patients sense of sight and hearing much diminisht his pulse extreamly languid inequal in motion and debility a little more frequent than in the state of health the urine thick turbid and a little high coloured the tongue scabrous red dry and fissured his thirst was so extream that no quantity of any former drink could in the least abate it By intervals his rational faculty was perverted with a Delirium that would continue several hours Touching his sleep some dayes and nights he was wholly restless other dayes soporous and comatick a case of greater difficulty I have not met with neither
yet occasion such an impression on the bowels and blood that in a sortnight or month or sometime longer either the Patient loseth his nails the hair of his head and the cuticula or upper skin of his body or falls into a Jaundice Consumption Dysentery or some other distemper The distempers that are posthumous to malignant Fevors are chiefly a tertian Ague a Pulmonick Consumption a Hectick Fevor Rhumatisms Scurvey Dysentery Yellow jaundice Cachexia and a Cephalaea Among these the Pulmonick Consumption seems to transcend the others in respect of danger and stubbornness of cure and doth very frequently grow out of the cinders of a malign Fevor One Mr. Martin a French Merchant his age not exceeding thirty and lodging in Fanchurch street partly through a hot temperament of his bowels that was natural partly through the fatigue of his journey from Plimouth hither and intemperance of diet fell into the burning flames of a malignant Fevor which his purpre spots breaking forth on the seventh day throughout the whole field of his skin did amply detect whereunto adjoyning his preceding vomiting and most importune hiccough his impatient thirst dry red fissured tongue deplorable head-ach flammy urine and low frequent inequal pulse spake the distemper to threaten an ill event Having ordained his diet to be very thin and prescribed a laxative Glyster in the morning being the second day of his Fevor advised eight ounces to be extracted by phlebotomy out of the right arm at four in the afternoon The blood appeared very thin and in point of colour tending towards a blew whereinto I instilled a few drops of spirits of Nitre to discover the constitution of it Upon the commixture the colour turned to a vitellin citrin an indication the blood was very sulphurous and hot and not easily to be reduced to a Crasis Six hours after bleeding he was to take a dose of this following mixture R. Rad. Scorzoner rec ℥ ij fol. ulmar. lujul. Rut. Caprar ana mij Sem. Citr ℥ ss Contundantur optimè in mortar marmor pistil lign sensim affundendo Aq. Card. Ben. scabios Ceras nigr ana ℥ iiij Liquor valide express digerendo calore leni Balnei depuretur in quo dissolv Syr. Borrag Melis sacchar perl ana ℥ j. m. f. Iulap Capiat ℥ v. bis per diem mane sero To every dose of this mixture was added half an ounce of my Aqua Alexiteria which wrought so great effects as in few days to extinguish this violent heat and expel the malignity His ordinary drink was the decoction of Hartshorn and Scorzonera root sweetned with syrup of Succory and Borrage His tongue growing very scabrous and foul he made use of this following collution with great success R. Mucilag sem cydonior ℥ iij. Suc. plantag ℥ j. Mell. rosar ʒvj Sal. prunel ℈ ij m. f. Collut quo saepe colluat os Iuly was scarce begun before this Patient had quitted his sick bed and was congratulated by all his acquaintance for the unexpected restitution of his health But what was usually subsequent to a malignant Fevor happened here also some three months after another distemper attempted his lungs in so violent a manner of coughing that in a short time the whole body was emaciated and depredated by a Hectick Fevor against which these remedies were prescribed R. Rad. buglos ℥ ss Iujub sebest. ana Par. ij Flor. borrag violar Pj. Glycyr ras ʒj Tamarind ʒiij Sem. faenis d. ℈ ij Coq in Aq. Font. q. s. In Colat. ℥ iiij Dissolve man Calabr ℥ j. Syr. ros sol ʒ ss m. f. Pot. This operated four times The next day I ordered a fontinel to be cut in the left leg above the knee The third day he began with this decoction R. Rad. Sarsaparil ℥ v. Lign santal citr Rasur Corn. cerv ana ℥ j. Coq in Aq. font lb. viij ad consump◠medietat sub fin addendo Rad. Personat maj ℥ ij Lapat Acut. ℥ j. Fol. Heder ter farfar ana m. iij. Iujub sebest. ana Par. xv Dactyl enuc Par. xij Passul mund ℥ iiij Glycyr ras ℥ j ss Sem. Anis ʒx In Colat. dissolv mel coct ℥ vj. Sacchar cand ℥ iij. m. f. Apoz Capiat ℥ iiij ter per diem horis medicis Besides an hour before he took the drink in the morning and an hour after at night I gave him twenty grains of my Specific antihectic mixt with a dram of sugar of Roses To these means we sensibly observed the disease give way daily by the digestion of the acrimonious matter and the facil expectoration of it and at the termination of three weeks his cough was quite ceased his appetite returned and began to increase in flesh and so to enjoy his health wherein he hath been happy ever since without the least relapse Another president of the subsequence of a Dysentery upon a malign Fevor I shall instance in the distempers of Mr. Cocu an Elder of the French Church in London whose age was little short of threescore his temperament bilious and melancholy and of habit of body very thin and maigre There was scarce ten weeks interval between a torrid Fevor he had sustained and a violent bilious diarrhaea that in the space of two or three days changed into a dysentery whose fury was discernable in insupportable gripes and vast discharges of blood by stool the weak pulsation of his arteries signified a great impair of the vital faculty A crazy constitution a declining age and a torminous Haemorrhagious dysentery imposed an obligation on me of proceeding cautiously and gently against the distemper but withall considering the quick motion it useth in its tendence to a fatal determination required medicines that should avert it by speedily stopping its career to the accomplishing of which was prescribed first this following bole R. Rhab. el. pulv ʒ ss Bezoard min. Ter. sigil ana gr xij Sal. Absynth gr viij Laudan opiat gr j. Conserv ros vet q. s. m. f. Boli duo deaurandi quorum capiat unum vesper sub ingr in lect alterum sequenti aurora These Boles gave two or three dejections more than he used to have ordinarily but without occasioning any gripes and moving at such great intervals between each stool did not at all diminish his strength Likewise sleeping moderately in those intervals rendred those turbulent humours very pacifick neither did he eject any blood all that day the following night slept very quietly The next day the number of his motions was much lessened but some tincture of Blood was still observable in the ordure The distemper continued at this degree some two or three days and then I gave order the forementioned Boles should be repeated which put an end to this great malady for the next day had not above two or three motions For his ordinary drink was advised this Emulsion R. Amygdal d. excort ℥ j. Sem. cucurb ℥ ij Sem. cydon ℥ ss Sem. papav alb ʒj ss contund in mortar marm pistil lign sensim