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A43024 A theoretical and chiefly practical treatise of fevors wherein it's made evident that the modern practice of curing continual fevors is dangerous and very unsuccessful : hereunto are added several important observations and cures of malignant fevors not inserted in the former impression / written in Latin by Gideon Harvey ... ; now rendered into English by J.T. and surveyed by the author.; De febribus tractatus theoreticus et practicus praecipue. English Harvey, Gideon, 1640?-1700?; J. T. 1674 (1674) Wing H1076; ESTC R23411 50,974 135

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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
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