to drink a Quart three Pints two Quarts five Pints three Quarts of the Waters in Bed and likewise for her present use a little warm'd because of the coldness of that time of the Year for it was past the middle of September and to persist in the use of them a Month if they did but pass well by Urine and not work or go off by Stool and that she should be of good Courage if her Appetite began to return and her Thirst with the other Symptoms of her Fever were abated upon the use of them but if it happened otherwise that she should let me know it that I might presently do what I could to help her But being hindred by a great deal of Business I heard no more of her till three Weeks after she and her Brother came to me as I was in my Study she being now plainly free from her Fever Cough and Weakness and perfectly recovered from her Consumption to a Miracle and making no more complaint but of too great a greediness of her Appetite which yet I promised to reduce to a moderation as soon as she had got up the Flesh which she had lost by the long use of good Nourishment the truth of which she found by Experience in a short time Neither did I prescribe any Medicine but only that she should use a Diet-drink made with Antiscorbutick and Pectoral Ingredients the space of a Month for her ordinary Drink With which she recovered her perfect Health and is yet alive and continues well at her Father Mr. Minakin's House at the Sign of the King's Head in St. Martins near Aldersgate I could give several such Instances of the extraordinary Efficacy of the Chalybeate Waters in Curing a Hectick Fever and an incipient Scorbutical Consumption of the Lungs but that I endeavour to be as brief as I can CHAP. III. Of an Asthmatical Consumption THough every Scorbutical Consumption is of an Asthmatical Nature yet by this I especially understand that which proceeds from a true Asthma as the preceding Cause and depends wholly upon it Every Asthma has a tendency to a Consumption For every Asthma but especially that which is Humerose has a tendency to a Consumption because in this Distemper not only the Lungs are very often straitned and drawn together in the Nature of Spasms whereby the Tone of them is wont to be injured and destroyed and a thick viscid Humour is wont to be prest out of their substance into the branches of the Wind-pipe by that frequent compression which sticking fast there causes a Cough Wheesing and difficulty of Breathing but likewise from the previous disposition of the Blood to be viscid and tenacious the Lungs are almost always knotted from the very beginning of this Distemper which Knots or Tubercles in progress of time are wont to be inflam'd and exulcerated from whence there follows a true and fatal Asthmatical Consumption How this Consumption is distinguisht from others But this Consumption is to be distinguished from others especially by this that it is accompanied through the whole course of the Disease with a Wheesing and extream difficulty of Breathing because the Humour that is continually prest out of the Tubercles and substance of the Lungs into the Wind-pipe and branches of it as I hinted before is always thick and viscid sticking tenaciously and troublesomly to the sides of the Wind-pipe and its branches like Glew and so hindring the free passage of the Air. But this Consumption This Consumption is very Chronical though it is usually Fatal and Incurable yet in its own Nature it is very Chronical so that I have seen some who though they have been in an Asthmatical Consumption yet have lived several Years with the help of a due Government and of a thin Air. The cause of which thing seems to me to be the toughness and viscidity of the Humour thrown out by the Lungs in this Consumption For this Humour by reason of the great quantity of Salt contained in it easily and quickly admitting some concoction though into a viscid Matter loses a great deal of its corrosive Acrimony and thereupon becomes more benign leaving a less impression behind it upon the Lungs than where it is sharp thin and perfectly crude and admits of no Concoction at all Old Age is such a Consumption And indeed Old Age seems to me to be this kind of Chronical and Incurable Consumption because all Old People that are not seized with some Acute Disease languishing in this manner with a Consumption do at length come to the period of their Lives but not without such fore-runners as a Chronical Cough a difficulty of Breathing a wasted lean Habit of Body and something of a Hectick Disposition And we need not wonder at it when the small Fibres of the Substance of the Lungs by reason of a great Age losing their tensness are wont to fall together from whence it comes to pass that the whole Substance of the Lungs grows slabby like a Quagmire from the Nutritious Juice being seperated and stagnating there and upon that there is that plenty of viscid Phlegm a Wheesing Asthmatical stuffing of the Lungs difficulty of Breathing an emaciation of the whole Body and a Hectical Disposition And why should I use many words wh n there follows plainly a Consumption of Old Age Neither is a Milk Diet nor Opiates convenient in this Consumption 1. A Milk Diet is seldom convenient in this Consumption much less Opium because by increasing the thickness of the Humours it promotes the difficulty of Breathing and all the other Symptoms of this Consumption so that I have sometimes in this case seen the Life of a Patient brought into sudden danger with but one Grain of Opium A thin Air is necessary in the Cure of it 2. A thin and open Air is more necessary in the Cure of this Consumption than in any others Neither indeed can this kind of Consumptive Persons live long with the use even of the most Generous Medicines in a foggy or smoaky Air. Inciding Medicines are the best sort of Pectorals 3. Amongst the Expectorating Medicines the best are such as are Cleansing and Inciding as Honey Mead Syrup of Hedg-Mustard of the five Opening Roots of Vinegar We must avoid at least we must be very cautious in giving Incrassating things Balsams Gums Wood-lice but especially my Balsamick Pills are here of great use As also Spirit of Harts-horn of Salt Armoniack c. whenever the Consumption depends upon a Convulsive Asthma What is to be done in violent Asthmatick Fits 4. This kind of Consumptive Patients are many times taken with Fits of an Asthma to a great Extremity In which case it is necessary to open a Vein though the Patient be never so much emaciated and it is as convenient to give Riverius's Emetick Mixture of equal parts of Oxymel of Squills and strong Cinnamon-water or something of that Nature and to repeat it
Tonsils and Palate of her Mouth and the Parts which serve for swallowing the same that I observed to happen to Mrs. Thompson and to almost all Women that have a Consumption from giving of Suck Which appearance to me seemed to arise from the impoverisht and heated state of the Blood by reason of too great an expence of the Milk At length though too late following my Advice she weaned her Child and made use of a Milk Diet and the Chalybeate Waters with very much benefit But her Appetite not being restored by these means as not being made use of in time she could not make up a sufficient quantity of new Chyle to recruit the Mass of Blood and thereupon loathing all sorts of Medicines at length though she had the Advice of very good Physicians falling into a Consumption of her Lungs with a Cough shortness of Breath and Hectick Fever she dyed plainly choak'd CHAP. VII Of a Consumption from a Bloody-flux and from a Looseness MANY times in a Scorbutical Disposition of the Body A sharpness of the Blood often arises from the Scurvy the Blood grows sharp to that degree that being disturbed upon every little occasion it cannot assimilate the new Chyle to it self whereby it comes to pass that it is thrown out by the Glands of the Intestines in a continual flux like a stream Which Chyle if it is benign and more mild Which in a lower degree causes a Looseness In a higher a Bloody-flux forms a Distemper in the manner of a Looseness but if it be sharp and of a Malignant Nature produces one in the form of a Bloody-flux By this continual efflux of the Chyle the Blood is much impoverisht and grows hot so that although the Bloody-flux or Looseness be overcome by the use of Opiates and binding Medicines such as are particularly to be described in a Chapter of a Bloody-flux Which cause a Hectick heat c. and Looseness yet a Hectical heat still remains in the Blood together with an Atrophy and dryness of the Skin arising from the impoverisht and dispirited state of the Blood As it happened to mine only and most beloved Son and to very many others And this Consumption often terminates in a Consumption of the Lungs Which Consumption does very often terminate in a Consumption of the Lungs But the way to prevent it is after the Looseness and Bloody-flux are cured by proper Medicines by a long use of a Milk Diet the Peruvian Bark the Mineral Waters which are Chalybeate and of the white Decoction for ordinary Drink It often happens to Childrâ—n 〈…〉 of their Teeâ—â— This Consumption often happens to Children that breed their Teeth But by the long use of the white Drink of Pearl Juleps and binding Medicines mixt with some little Opiate it is easily cured History 1. Mr. Tindal's only Daughter a very fine Young Woman but Scorbutical and something Melancholick about Eighteen Years of Age upon the suppression of her Monthly Courses fell into a Colliquative Looseness with Stools that came away like Water which by degrees brought her in the space of a Year into an Universal Atrophy even to the degree of a Marasmus but without any sensible Fever or Cough or shortness of Breath or any other sign of any Distemper of the Lungs so that she was not at all taken for a Consumptive Body by the Physician under whose care she was before I was concern'd Being called to go and see her as one that had only a Looseness when she was now by reason of her Weakness almost always confin'd to her Bed I found her worn away clearly with a Consumption even to a Marasmus and that I plainly told her Friends as my Opinion although her Lungs did as yet seem sound neither was there any sign of a Hectick Fever But when this expensive Looseness which the former Physician for want either of skill or care had suffered to run on so long came once to be stopt by a due government and the use of Efficacious Medicines presently a Hectick Flame began to be kindled in the Habit of her Body and her Lungs also began to be affected with a Cough that was almost perpetual and a shortness of Breath which Symptoms being at length followed by Colliquative Sweats a swelling of the Legs and other signs of a Fatal Consumption of the Lungs soon brought the fair Virgin amidst the Lamentation of her Friends to the last period of her Life Two things were here particularly worthy of a Remark First that the more her Looseness was stopt so much the more always were her Lungs presently affected And Secondly that although this Consumption had prevailed upon her almost for the space of a Year even to a Marasmus before the Lungs did seem to be in the least touch'd yet in the Body when it came to be opened after 't was dead the Lungs appeared full of little swellings here and there and that not only such as were crude and hard but also some that were ripened into Apostemes History 2. My only Son before he was Eight Years old whilst I was out of Town was taken with a most severe Bloody-flux by which he seemed to be brought into a Consumption even to a Marasmus before I returned But after the Bloody-flux was plainly overcome by the diligent use of all sorts of convenient Remedies and his Body with respect to his Stools was reduced to its Natural state there still remained a Hectical heat a dryness of his Skin a quick Pulse with other signs of a Hectical heat Moreover his Appetite failed him very much a dry Cough came upon him and a thickness of Hearing with a dulness of his Brain But yet with the choice of a wholsom Air the use of a Milk Diet and afterwards of the Peruvian Bark and of a Plentiful Nourishment which afforded a good Juice he recovered a good Colour and his Flesh within the space of three or four Months without any other inconvenience but only that he has been ever since very subject to an Asthmatical Cough upon the least occasion CHAP. VIII Of a Consumption from a Diabetes or too great a Flux of Vrine A Diabetes is commonly called a Dropsie of the Chamber-pot What a Diabetes is and it is a continual Flux of the Nutritious Juice running down through the Kidneys The Causes of it which for the most part happens to those that are very thoughtful and to such as are drinkers of French Wines and Diuretick Liquors Whereupon the Urine by reason of the great quantity of new Chyle which flows to it and mixes it self with it being deprived of its Saltness becomes sweet even like Honey A Diabetes causing a poorness of the Blood and a Hectical heat produces a Consumption By this continual efflux of the Chyle the Blood is impoverisht and thereupon the Strength of the Patient grows extreamly languid By the burning Flame of the Blood a Preternatural Heat is kindled in the
Consumption who are always subject to Colliquations of the Serum by the Glands of the Guts and Salivatory Glands a Looseness is wont to arise and joyn it self to a Consumption not long before the Patient dyes For as it shews Nature to be in a very great flame so it strangely hastens and promotes its farther Destruction This Looseness is proportionate to the present state of the colliquated Blood This Looseness is sometimes moderate in as much as it is always proportionate to the present state of the colliquated Blood but in others it is violent and accompanied with racking pains which usually defies the power of Opiates and all manner of Astringent Medicines or at least returns upon taking of the least Cold or drinking a draught of Beer or omitting the use of Opiate Medicines And so long as the Looseness is stopt by the Narcotick Power of Medicines we usually have a difficulty of Breathing in which the Patient is almost choak'd or a Dropsie or some other Symptoms no less troublesome nor less dangerous arise For the Blood being once brought by degrees to an irreparable and incurable state of Colliquation the crude Nutritious Juice that is continually carried about in the Mass of Blood does when one Door is shut find some other and it may be one that is more prejudicial and troublesome to the Patient The colliquated Humours producing a Dropsie is another sign of a confirm'd Consumption Fourthly But when in this colliquative or melting state of the Blood the Nutritious Chyle that is quite dispirited does not find a convenient passage through the Glands of the Skin by reason they are stopt by the cold of the ambient Air or by the Glands of the Guts being shut up by the use of too many Opiates either a Dropsie of the Breast or else of the Belly and the lower Limbs does usually follow Yea a blouted swelling in the whole Habit of the Body if the passages into the aforesaid Cavities of the Body and the lower Limbs are either by Art or Accident stopt And in plain terms a Dropsie coming upon a Consumption of what kind soever it be And not only of a confirm'd but of a deplorable Consumption is to be reckoned amongst the signs not only of a confirm'd but likewise of a deplorable and incurable Consumption And that not only because it shews a very great flame in the Blood and that the state of it is extreamly colliquative but likewise because the Patient by reason of his too great weakness is not able to bear such an Evacuation of the extravasated Serous-water as is necessary by such Medicines as purge forth Water And for Diureticks they are plainly of no use in this case because even the strongest of them cannot promote a Flux of Urine but rather cause a greater Colliquation in the Blood by attenuating and heating of it more Whereupon there is caused a greater and quicker flux of the Water into the cavities of the Body and into the lower Limbs where it has a free passage so as to increase the Dropsie Fifthly and lastly At last the colliquated Humours are thrown out by the glands of the Throat In this universal Colliquation Nature sinking a little before the Person dyes makes it her business to throw out the Serum or Juice that is full of distempered and purulent Particles by the Tonsils and other Glands that are seated in the Throat as also by the Salivatory Ducts of the Mouth From whence arises 1. A heat in the Throat From whence there are wont to arise two new Symptoms and they very troublesome ones to wit a great heat about the Tonsils and the Parts that serve for swallowing Whereby it comes to pass that the Patient can scarce swallow any thing but with grievous pain Which Symptom is wont to proceed from a light Inflammation of these parts caused not only by the perpetual agitation of them by the Cough and external Cold but likewise by the separation and spewing out of the Feverish Serum and sharp Matter Secondly 2. A Thrush long and troublesome Thrushes disperst through the whole Mouth which arise from the distemper'd state of the Spittle But especially if the Looseness that they have been followed with has been violently stopt with Opiates and Astringent Medicines For hereupon Nature when the Door by which the Serum uses to pass is once stopt endeavours though in vain to force out her Enemy by the passages of the Spittle By which means it comes to pass that the parts of the Mouth being tinged with that sharp Humour happen to be inflam'd and ulcerated with the Acrimony of that distemper'd and feverish Serum which is separated and thrown out by the Glandulous Membrane of the Mouth Which indeed is the immediate cause of this Symptom which how troublesome soever it is does nevertheless plainly defie whatever either Art or Nature can do because the stock and fuel of it that is heaped up in the Mass of Blood This universal Colliquation quickly brings a Marasmus cannot be spent Thirdly this universal Colliquation through what Sluces soever of the Body it happens to be made uses very quickly to bring a Marasmus with a Hippocratick Face which is a total Consumption of the Muscular Flesh from the defect of the new Nutritious Juice which by adhering to the Solid Parts might repair the continual loss that they sustain And when the thing is at length come to this pass there are no hopes of the Patient's Life And therefore this Symptom has ever been reckoned by all Persons one of the most certain signs not only of a confirm'd but likewise of a deplorable Consumption Observations Besides these Diagnostick signs which I have already mentioned it may perhaps be beneficial to add likewise my Observations concerning the Pulse the Urine and the Matter which they bring up in their coughing in the several degrees of this grand and stubborn Distemper And first of the Pulse 1. Of the Pulse When there is only a Hectick Fever In the beginning of a Consumption whilst there is no other Fever but a Hectick as the preternatural heat is continual and moderate so likewise the Pulse is somewhat quicker than it ought to be according to the degree of the Fever yet for the most part it always observes the same strokes and is always alike but only that after eating as a feverish Heat so likewise a quickness of the Pulse may more easily be discerned And indeed some Persons in a Consumption that are more cold and Phlegmatick do use to perceive nothing amiss either in their Pulse or Temper at any time but only then When there is an Inflammatory Fever But as soon as ever the Peripneumonick Fever with an Inflammation of the Lungs seizes them the Pulse as it uses to happen in other Peripneumonies is not only quick but also hard and strong yea likewise rises up more in one place than in another so as to
by our Art And thus my dear Father who himself was a very skilful Physician though he was troubled with a continual Cough a difficulty of Breathing frequent Putrid Fevers a light degree of a Hectical Heat though continual did nevertheless by this means spin out his Life though he continued sickly from the thirtieth to the sixtieth Year of his Age and at last did not dye of a Consumption of his Lungs from which he seemed for the last three Years of his Life to be more free than he had been before but of that Epidemical that continued Putrid Fever which reigned publickly all over England in the Year 1658. The same thing I observed in Mrs. Davison a Merchant's Wife in London for the space of fifteen Years and in a certain Merchant that lived in Philpot-Lane who after several Inflammatory Fevers that returned often in a Year from every little occasion at length happened to have such an extraordinary exulceration of his Lungs that he dyed of it together with a Dropsie and the other usual Symptoms of a Fatal Consumption of the Lungs when he was about Sixty Years old I could likewise give several Histories of this Nature but at present I study brevity The cause of this difference As for the cause of this difference to me it seems to proceed from the different disposition of the Blood and of that Humour which is supplyed to the Tubercles of the Lungs and differs according to the various dyscrasy of the Blood For if the stuffing of the Lungs and the Tubercles which arise from it by reason of some peculiar dyscrasy of the Blood have their Original from some malignant or cancrous Humour or a Humour that is apt to cause a Gangreen as I remember it has sometimes happened the Distemper is not only certainly Mortal but also quick and very Acute and such as carries off the Patient in a few Months and it may be Weeks But if they arise from some benign mild and cold Humour such as is less apt for Inflammation and Putrefaction the Patient gains a longer though a miserable Truce for his Life But if the Mass that is contained in the hardned Glands be as it is often seen in some Scorbutical Persons and much more in those that are Scrophulous either not at all or at least but more slowly disposed to an Inflammation and Putrefaction the Distemper is very Chronical and the Patient living in a Consumptive and Sickly state for many Years is at length sometimes seized and carryed off by some other Disease as appears plainly from the instances I have before mentioned For so long as the Lungs are only stufft or the Tubercles that arise from that stuffing remain in a crude state the Person 's Life though it be miserable yet is not brought into any sudden danger though he is troubled with an Oppression of his Breast some difficulty of Breathing and a frequent Cough all which Symptoms are wont to be increased even from the taking of the least Cold or the committing of any Error in his Diet and that with the addition of an uncertain Fever for a time Likewise some degree of a continual Hectical Heat may be perceived in the Solid Parts but especially in the palms of the Hands and the soles of the Feet as also a redness in the Cheeks especially after eating and the drinking of Wine The Pulse also is something quick and sometimes intermitting the Appetite unconstant and for the most part weak at least upon the taking of cold There is likewise rather a lankness of the Muscular Flesh than a plain Consumption That which they spit is sometimes viscid and black or of an ash-colour according to the colour of the Matter contained in the swelled Glands Many times too a spitting of Blood uses to return pretty often upon the least occasion Which are the Symptoms or Diagnostick signs of a lingring Consumption of the Lungs which notwithstanding a Person though he must expect to be always crazy and sickly may many times live a long time but 't will not be safe for him to indulge himself in the free use of Wine and Meats without any distinction and the choice of such as are most convenient nor of several other things that conduce to the pleasure of Humane Life as others do But as soon as a new Inflammatory or Putrid and Colliquative Fever is produced by the Inflammation and Apostemation of these Tubercles all the Symptoms of a confirmed and deplorable Consumption are wont to follow which are more or less certainly and suddenly according to the Nature of the Swellings as they are more or less disposed to an Inflammation and a quick Exulceration And here perhaps it may be worth the while to add farther some particular Observations As for Example Observation 1. Tâ—â— Nature of the Sâ—â—lling makes the Fever more or less 〈◊〉 First As the Inflammatory Fever or the Putrid which arises from it is more or less acute and dangerous according to the Nature of the Swellings as they are more or less Malignant and disposed to an Inflammation and an Exulceration so likewise the Consumption from thence grows more or less quick and incurable Secondly The frequent taking of Cold Observ 2. Taking of Cold c. make a Consumption more Acute and often committing of Errors in their Diet Exercise and Passions of the Mind c. do by bringing Inflammatory and Putrid Fevers that return in the same manner upon the Hectick Heat they had before bring this Distemper sooner to a fatal end making that Acute yea very Acute which otherwise would have been in its own Nature Chronical Thirdly The Consumption of Young Men Observ 3. A Consumption more Acute in young than in old Persons that are in the Flower of their Age when the heat of the Blood is yet brisk and therefore more disposed to a Feverish Fermentation is for the most part Acute But in Old Men where the Natural Heat is decayed it is more Chronical Fourthly Observ 4. When is from Acute Distempers it is Acute A Consumption that proceeds from Fevers especially such as are from an Inflammation of the Lungs or from the Suppression of Malignant Ulcers is almost always Acute But when it depends upon a Scrophulous and Scorbutical disposition so in a cold and phlegmatick Temper it is Chronical Fifthly The omission of Bleeding Observ 5. For want of Bâ—eeding in the 〈◊〉 Fever makes a Consumption to be Acute or taking away too little Blood or bleeding too late in the Inflammatory Fever of such as have a lingring Consumption makes that Consumption which otherwise was in its own Nature slow and lingring very Acute and presently Mortal because the parts of the Lungs that are stufft and harden'd having been heated for some time do from that grow more apt to he inflamed to putrefie and to be exulcerated CHAP. VI. Of the Prognostick signs of an Original Consumption of the Lungs WHat will be the Event
we have before prescribed which yet are very necessary to the just and regular Cure of this Distemper Through their neglect their Lungs come to be knotted From which neglect it often comes to pass that the Matter having stuck a long time in the Lungs Tubercles or Glandulous Swellings are by degrees bred in them whereby the Cure in this second degree of the Distemper is rendred not only more difficult but likewise more uncertain the Disease admitting no Cure or at least but a palliative one And from hence it comes to pass that a Consumption has so ill a Name At first a Consumption is easily cured as if it were a Distemper altogether incurable in its own Nature when as far as I apprehend from what I have been taught by Experience it does admit of as certain a Cure as other Diseases so it be timely treated in a due Method Though it must be confest that as other evil Affections of the Body Vnless in some particular cases so likewise a Consumption where it seizes the Patient by Inheritance if it arises from an ill conformation of the Breast or depends upon an inexhaustible stock of Humours contracted by a long and habitual use of the six things which we call not Natural Or lastly where it proceeds from a peculiar Malignity a Cancrous or Gangrenous disposition of the Blood or something in the Nature of it that makes it apt to be quickly inflam'd it does not use to yield to any Regular Method of Cure though it be observed never so early But every day it runs on with speed to the third degree of a Consumption notwithstanding the use even of the most Generous Medicines The time from whence the second degree of a Consumption is to be reckoned But this second degree of the Distemper is to be reckoned from the first beginning of the Tubercles until those Swellings in the Lungs happen to be very much inflamed and to putrifie that is so long as they remain in a crude state The Tubercles are not all of the same Nature For these Tubercles are not all of the same Nature but they assume a various and very different disposition for sometimes they are Malignant of a Cancrous Nature apt to Gangreen and threaten a sudden Destruction But sometimes though they are more benign yet they are of the Nature of Inflammations Boyls or a St. Anthony's Fire accompanied with a pain and Inflammatory heat and subject to a sudden putrefaction and thereupon from their first breeding they cause a Peripneumonick Fever and have a very quick tendency to Apostemes Some quickly Apostemate and these make a quick transition to the third degree So that as in this quick kind of Consumption arising from Tubercles of this Nature there is no room for this second degree of the Disease so I shall not here say any thing more of it For whatever relates to the Cure of it is to be spoken of in the third degree of this Distemper to wit when I shall particularly make it my business to treat of the Peripneumonick and putrid Colliquative Fevers of Consumptive persons But for the most part these Tubercles are Glandulous Tumours of a Chronical and cold Nature For the most part they are Chronical and of a cold Nature and somewhat like Kings-Evil Swellings having their Original from the glutinousness of the Humour or from an Obstruction of the pore or duct of the Glandules from whence it comes to pass that the Humour stagnating within them is gradually concocted by the Natural heat of the part into the form of Chalk or into a substance like Suet or like Honey and yet is always contained in its proper Bag and thereupon arises immediately that hard Swelling which I call a crude Tubercle which although in progress of time it may grow to a considerable bigness yet is not presently inflam'd and turn'd to Corruption until from the Acrimony contracted by the Humour in its Bag or from the Tone of the part being too much distended there comes on from some Accident an Inflammation and upon that an Aposteme So long as this crude state of the Tubercles of the Lungs lasts the Consumption remains in its second degree The Diagnostick signs of Tubercles in the Lungs are 1. An increase of the Hectick Fever The Diagnostick signs whereof are especially to be taken First from the remarkable increase of the Hectick Fever which at this time does often begin in some measure to imitate a Putrid Intermitting Fever by reason of the Acrimony that is at length procured to the Matter contained in the Bags 2. A remarkable wasting of the Muscular parts 3. A dry Cough Secondly from the notable increase of the wasting or Consumption of the Muscular Flesh which now at least begins to grow lank Thirdly from the dryness of the Cough which how frequent and troublesome soever it is yet is not accompanied with a Catarrh and such a frequent spitting as before Fourthly from the heavy weight and oppression which are always felt in the Breast To which also for the most part there use to be joyned a difficulty shortness and trouble in Breathing Purges Vomits and Diaphoreticks are hurtful at this time In this degree of the Distemper all Evacuations by Stool by Vomit or by Sweat are mischievous because they promote the Fever and quicken the pace of the Consumption Neither is Bleeding convenient unless for some particular Reasons Neither indeed is it convenient at this time to bleed unless it be to prevent an Inflammation of the Lungs that is as often as a Pleuritick pain the liberal drinking of Spirituous Liquors the taking of new Cold and other such-like Occasions give a Sagacious Physician ground to suspect that such an Inflammation is at hand And then too by reason of the present Consumption and Weakness the Blood must rather be cooled by drawing it off with a sparing Hand than taken away in a large quantity But yet he must diligently persist in the use of those Altering and Pectoral Medicines which have been already described so far as the Stomack can bear them But the chiefest benefit is to be expected from the long use of Balsamick Medicines as of my Balsamick Pills before prescribed But Balsamicks are especially proper and of other things of the like kind so there be no considerable Fever And by this means I have with the Blessing of God recovered a great many Consumptive Persons whose Tubercles seemed to be of a cold Nature and crude and so the Consumption slow and Chronical to a former state of Health and the Lives of some I have preserved several Years though they have continued sickly In a Scorbutical and Hypochondriacal disposition it is proper also to mix Mynsycht's Extract or some other Chalybeates and mild Antiscorbuticks with these Balsamick Medicines as likewise Remedies against the Kings-Evil in a Scrophulous disposition Of which I shall speak more afterwards under
to great Sweating and to make much Urine so likewise to a continual spitting by the Salivatory Ducts to a hawking up of tough Phlegm from the Tonsils and to a frequent Cough proceeding from a continual spewing out of a Serous Liquor by the Glandulous Coat of the Wind-pipe But this Scorbutical Lympha that is excern'd by the Tonsils and the other Glands though it admits of some Concoction yet as it abounds with a fixt Salt and is in its own proper Nature glutinous it has always some toughness The Cough in a Scorbutical Consumption is not violent and hereupon the Cough of this kind of Consumptive Persons though it be continual yet is not so violent and dry as it uses to be in others where the Serum that is thrown out by the Glandules is thinner whereupon there arises a fierce and troublesome Cough from the continual spewing out of that Serum by the Wind-pipe or at least a perpetual tickling molests them from the swelling of its Glandulous Coat whenever the Lympha does not find a convenient passage out of the Glandules and from hence for the most part there arises a violent and dry Cough From whence it comes to pass that in a Scorbutical Consumption by reason of the viscousness of the Matter that is separated by which the Coat of the Wind-pipe and of the branches of it is rather troublesomly besmeared than irritated the Patient is not so much provoked to Cough as he makes a Cough of his own accord to bring up the Phlegm that sticks and is troublesome to him But Asthmatical and hereupon this kind of Cough comes near to the Nature of an Asthmatical Cough and is attended with a greater Wheesing difficulty of Breathing Constriction and weight of the Lungs than we use to observe in other Consumptions This Consumption is very Chronical And from hence also a Scorbutical Consumption proves very Chronical and never threatens a sudden Fatality without a spitting of Blood or some other great Symptom coming upon it This kind of Consumptive Patients Every little Error makes these Patients Feverish though they spin out their Life to some length without any Medicines only by a due government and care in those six things called non-natural yet they live sickly and upon committing the least Error in their Diet or taking of Cold they are wont to be Feverish and to lose their Stomack The Signs that presage this Consumption The signs of this Consumption are especially two to wit a frequent eruption of Spots scattered up and down upon the whole Skin like the Miliary Shingles and a perpetual hawking up but especially in a Morning of Phlegm that is salt and troublesome thrown out by the Tonsils which is many times accompanied with an Exulceration and wasting of the Gums The manner how it is to be cured But in what manner the Cure of this Consumption is to be altered from the General Method I have already described I shall here briefly observe to wit Opium is hurtful First Opium is always mischievous unless it be upon the taking of new cold and then only it must be given to mitigate the Symptoms that arise from it because it makes the Phlegm more tough and hard to be expectorated Inciding Medicines are besâ— of Pectoraâ—s in this case Secondly Amongst the Pectoral Medicines those that are cutting and cleansing are alway to be preferred for helping and making the Expectoration easie or at least they must be mixt with others as Honey Mead Oxymel Gums and Balsams Wood-lice Syrup of Hedg-Mustard of the five Opening Roots the Balsamick Syrup But above all I commend my Balsamick Pills which I have already described the Use and Efficacy of which in a Scorbutical Consumption I have often had Experience of Antiscorbuticks must be mixt with the Pectoral Medicines Thirdly Antiscorbuticks must always be mixt with the Pectoral Medicines that at the same time when the flux of colliquated Matter is expectorated with the help of the Pectoral Medicines the Ferment that causes this Colliquation may be destroyed or at least abated by the Vertue of Antiscorbuticks Otherwise so long as the Cause is not taken away the Distemper it self cannot admit of a perfect Cure But we must make choice of the milder sort of Antiscorbuticks such as may cause the least heat and disorder in the Blood as Water-cresses Brook-lime Pine-tops the Leaves of Tun-hoof red Dock-roots Male Piony-roots c. of which a Bag may be made to be hung in Ale for ordinary Drink By which means the Volatile Salt of the Simples in which the Energy of the Medicine consists is better preserved than in Apozemes and so the Vertue of the Medicine is more freely communicated to the Blood and the Appetite is less injured by them Fourthly Steel is useful Also Steel is very useful in the Cure of this Consumption unless it runs hastily on to its Fatal Period If it be an Acid Scurvy then Salt of Steel will be proper a Grain or two of which may be mixt with every Dose of the Balsamick Pills If it be a Salt Scurvy Mynsicht's Extract which we have already taught how to give in the form of Pills Especially the Chalybeate Mineral Waters But in all Scorbutical Consumptions the Chalybeate Mineral Waters are to be preferred before any Artificial Preparation of Steel in the Summer-time if it be so the Consumption has not reached to the third degree because they are endued with an extraordinary power not only to open the Obstructions of the Nerves and to penetrate and dissolve the Tubercles but likewise to temper the Hectical Heat in the Blood and Spirits to quench the Drought restore the Appetite and to procure a Briskness and Chearfulness of Mind the Efficacy of which in curing this kind of Consumptions above any other Method of using Pectoral Medicines I have very often experienced with great Success And therefore I shall add at the end of this Chapter a History or two of their extraordinary Vertue in the curing of a Scorbutical Consumption But the use of them ought to be repeated every Year because this Chronical Distemper does not use to be overcome with one blow Fifthly If the Patient is costive What is to be done if the Patient is Costive the Purging Mineral Waters are here also very useful as also any Stomack-Pills before described by the help of which being repeated once or twice a Month my dear Father did happily prolong his Life in a Scorbutical Consumption for many Years Diversion and Chearfulness necessary for these Patients Sixthly The Patient must recreate his Mind and all Lawful means must be used to make him chearful For as this Distemper for the most part takes its Original so likewise its fatal Increase from Grief and disturbance of the Mind A Milk Diet seldom agrees with them Seventhly A Milk Diet seldom â—…ees with this kind of Consumptive Persons by â—eason of the Acid or
if the Hectick Flame remaining within does at length throw the Patient into a Consumption yet whenever the present Orgasm of the Blood is so overcome by repeated bleeding the use of the Temperate Juices of Astringent and Opiate Juleps and Electuaries and other things of that Nature which are to be found in another place in the Chapter of a Haemoptoë or spitting of Blood that we have an Opportunity to give the Bark totally to extinguish the Feverish flame and to open the Obstructions which otherwise might occasion a new Effervescence we commonly make not only for the present a palliative but a truly eradicative and perfect Cure without the least danger of the return of the spitting of Blood or of a Consumption following upon it For the flame being in this manner perfectly extinguisht the Blood is reduced to its Natural Motion and Crasis whereupon the Appetite presently returns the Lungs recover their Natural Motion and Temperament and the loss of the Blood is by degrees repaired until at length the Patient obtains though by little and little his former strong and lusty state and it may be a better than he had before without the least degree of a Hectick Heat or the danger of a Consumption following upon his Bleeding In this Consumption there are Tubercles in the Lungs But if either through the Physicians neglect or from the peculiar Constitution of the Patient or from any other cause it so happens that a Consumption of the Lungs succeeds to a spitting of Blood the whole Lungs or at least one of the Lobes being stufft with hard Glandules scattered every where up and down in the form of Tubercles is much swelled And these Tubercles are wont sooner or later to turn to Apostems and to be ulcerated and from thence this Consumption has its Original and Progress too But according to the Magnitude and Number of these Tubercles The Nature of which makes the Consumption various and their disposition to a more quick or slower putrefaction this Consumption is very various sometimes slow and Chronical sometimes quick and Acute yea very Acute For as I have seen some Persons that have been in a Consumption who have been subject to a frequent spitting of Blood from the least occasion live several Years with due care and management doing likewise their business though they have been sickly with a Cough and some degree of a difficulty of Breathing to wit whenever the Tubercles of the Lungs happen to be few small and not apt to putrefie or whenever the spitting of Blood proceeds rather from Stones that are bred in the Lungs or from some external Accident than from an Intestine Hectical motion of a hot Fermenting Blood So I have observed others that have been carried off with a quick Death within the space of a few Weeks and that has been when great Haemorrhages have often returned upon the Patient from the Commotion of the Blood boyling vehemently or when the Tubercles have partaked of some malignant Nature and so have been quickly putrified But whatever this Haemoptoïcal Consumption has been whether Acute or Chronical This Consumption is one of the most fatal it has from the common Observation of Physicians been always reckoned amongst the number of the most Fatal and Incurable Consumptions But the more Acute it is the more dangerous it is wont to be For as the spitting of Blood is the first occasion of this Consumption so likewise it is very apt in the Progress of the Distemper to return often either from the taking of the least Cold or the committing any Error in their Diet from Passions of the Mind c. And every new spitting of Blood pushes on the Consumption to a Fatal end So that I have often seen this kind of Consumptive Persons in the very Haemoptoë when it has returned upon them spit out their very Lives in that stream of Blood which has come from them And therefore in the Cure of this Consumption Inciding and Lubricating Medicines are not good in the Cure Cleansing Inciding and Lubricating Remedies must be avoided or at least used very cautiously as also hot and penetrating Liniments and Plaisters that are outwardly applyed to the Breast to promote Expectoration But Incrassatin c. But we must at least in the beginning of this Disease and after every new spitting of Blood rather insist upon the use of Alterative Incrassating Agglutinating and Opiate Medicines as also a Milk Diet Solid or Liquid Laudanum Syrup of Meconium Syrup of Purslane of Marsh-Mallows of Ground-Ivy the plentiful use of which in a Consumption from spitting of Blood I would recommend above all other things Bole-Armenack Coral Dragons-Blood Lapis Haematites Gordonius Troches Troches of Amber Of which Electuaries may be made and Compound Medicines in other forms for the Patient to take Of which it will be proper to speak more largely in the Chapter of an Haemoptoë But in the Progress of the Disease when once there is not so much fear that the spitting of Blood will return we may more safely answer the Indications of the Disease with the cautious use of Lubricating and Expectorating Medicines Likewise Balsamick Medicines are here of great use as the Balsamick Syrup Balsam of Tolu Capivi of Peru Leucatellus Balsam or Opobalsam Balsam of Sulphur Terebinthinate and Anisate my Balsamick Pills and other forms compounded of these Medicines the manner of giving of which is to be learnt from what has been already said in the General Method of Cure Also Issues and shaving of the Head are very Advantageous in this Consumption But above all I must The best thing in the Cure of this Consumption is the Peruvian Bark from the long Experience I have had of it commend in this Acute and Dangerous Consumption from a spitting of Blood the use of the Peruvian Bark to be given in that form which is most grateful to the Patient By the frequent and sufficient repetition of which we may expect to temper the Feverish Heat and to suppress the Intestine motion of the Blood and so consequently to prevent the return of the Haemoptoë and the Progress of the Consumption more than with a Milk Diet with Asse's Milk or a Magazine of Pectoral Medicines But in a Chronical and slow Consumption In this Consumption when 't is slow the Chalybeate Waters are proper or rather a Consumptive state from a spitting of Blood where the heat of the Blood from the Intestine motion of it does not use to be so great the Chalybeate Mineral Waters are of great use if they are drank every day for a long time but yet in a small quantity They must be order'd to be taken thus in a little quantity and to be drank leisurely every day lest a too great and sudden distention of the tender Vessels of the Lungs caused by drinking a great quantity of Water at a time should bring a fresh spitting of Blood But the small quantity of Water
the Humours contracted by his irregular way of living And the Fatal Day which concluded his Life was not a little hastened by reason he would not though he took Medicines submit to any Government during the use of them Whereupon in this Consumptive state there being some new Stones moved three or four times in his Lungs with hard Riding Drinking and often taking of Cold he found again and again a return of his dreadful Spasms and a long and profuse spitting of Blood Which continuing upon him though he cough'd up several Angular Stones yet he was so much weakned by the Spasms and lost so much Blood by his Haemoptoë that he very quickly to wit in the space of a Year or thereabouts ran the whole course of this Distemper even to the fatal period of it as if his Consumtion had been in its own Nature plainly Acute History 2. Mr. Foster an Apothecary of London who setting aside a hesking and dry Cough he had which yet was not very troublesome enjoyed his Health very well for several Years was suddenly taken when he was about Thirty Years old with Spasms in his Lungs and dreadful pains caused thereby as also a spitting of Blood from the disturbance and motion of some sharp Stones in the substance of his Lungs For the relieving of which Symptoms we did very little good with Bleeding external Liniments and Pectoral Medicines given inwardly so that with the loss of his Strength and Blood caused by his spitting of Blood and his pains returning almost every day and by his want of Rest and Fever that attended them a continual Cough c. he was brought so low and so much wasted as if he would in a short time dye of a Consumption But with the long and plentiful use of Opium in the open Air at Highgate whither he was now gone for the Recovery of his Health he was at the same time freed from his spitting of Blood and from his Pains and so he continued recovering his Strength thereupon every day and being more and more freed from his Fever and Consumption till at length he seemed as florid in his Looks and as plump in his Flesh as he was before he spit Blood and now for four or five Years past he has followed his business and is in all things just as he was before his Distemper but only having some degree of a difficulty of Breathing and a dry Cough he cannot bear the smoaky Air of London so well as he used to do before by reason of the stuffing of his Lungs caused by the Stones that are fixed there and his using a great deal of Laudanum History 3. Almost the same thing happened to Mr. Smyth an Apothecary in Aldermanbury who from the moving of some Stones in the substance of his Lungs several of which he had cough'd up fell into a spitting of Blood which often returned together with Spasmodick Pains and from thence he seemed to be enclined to a Consumption of his Lungs Which nevertheless after the voiding of the Stones he was very easily freed from with the use of a Milk Diet Opiates and Balsamick Medicines and now having had his Health very well for several Years he goes about his business as he used to do History 4. A Young Man living near Cripple-Gate that was strong and every way sound in his Entrails as he was doing something at his Trade of Whiting by which he got a convenient Livelyhood by chance with laughing heartily let three Nails which he held in his Mouth for his use go down through his Wind-pipe into his Lungs Whereupon being seized with a most violent Cough and continual tickling he fell into a very great spitting of Blood From which Symptoms I know not by what means he got himself free But this is most certain that though those Nails never came up again either of their own accord or with the help of Art yet the Young Man was very well for the space of several Months following his Employment as before Neither did he as he told me find himself any thing worse but only from that time he used to be troubled with a dry and hesking Cough and likewise with some Oppression He was so well that he thought himself fit for a Wife and he did Marry one But upon his Wedding-day whether from his more liberal drinking of Wine or from his dancing too much with which the Nails that before lay unmov'd and as it were buried in the substance of the Lungs were stirred again the poor Bridegroom in the Evening was taken with dreadful Spasms and a most Acute pain in his Breast and Side and withal a difficulty of Breathing and a dry but very troublesome Cough so that he could scarcely lye in his Bed or get the least sleep Whereupon he began to be very Feverish though his extream Parts seemed to be cold from the violence of the Spasmodick pain When they had tryed all the Old Women's and Apothecary's little Receipts in vain and without any benefit at length I being very earnestly entreated went about the third day of his illness to see him I presently apprehended the Distemper to be plainly Peripneumonick and therefore I ordered plentiful Bleeding Fomentations and Liniments externally likewise Linctuses and Pectoral Apozemes and temperate Juleps of Antispasmodick Waters to be given inwardly But these things doing no good I ordered again and again some more Blood to be taken from him And indeed I was forced for many days continually to insist upon the use of several internal and external Remedies before the poor Patient found the least ease of his pain But at length when his pain was somewhat mitigated yet I could hardly with my Skill promote any Expectoration of Phlegm nor wholly remove the Fever though it seemed changed from the Nature of an Acute and Peripneumonick into a lingring and Hectick Fever So that the Patient being now freed from the violence of the Symptoms though he was always Feverish yet he could sleep and eat his Food better than before But yet he grew every day weaker and at length from an Universal Colliquation he dyed plainly of a Consumption within the space of a Month or five Weeks Indeed I wonder'd very much at the obstinateness of the Pain and the difficulty of his Expectoration and therefore being directed by Hippocrates's Aphorism I did fore-tell that a Consumption from an Empyema would follow But I never did so much as dream of the Original cause to wit the Nails which were slipt down into his Lungs before the Patient's Life was past all hopes Otherwise I should have given him good quantities of Laudanum from the first and it may be with better Success The Body being opened after he was dead we found those three fatal Nails as it were buried together in one bed of Matter a little below the divarication of the branches of the Wind-pipe and the Tone of the Lungs universally impaired by the Matter which by degrees had crept
were about her of a Remitting Fever accompanied with very direful Symptoms with the use of the Peruvian Bark amongst other Remedies when he himself was taken with a true and benign Tertian Ague Leaving his Friend and his known and familiar ordinary Physician he went with the Croud to Mr. Talbor and having paid five Guinea's he had an Ounce of the Bark for a great Secret which when he had taken he presently was well recovered But there being no care taken by that Emperick to prevent the return of the Fever after two or at most three Weeks the Distemper at length returned of which he was freed again and again with repeating the use of the Bark but not without giving in hand the former extravagant Price every time it returned The Gentleman being saving chose rather to pass the remaining part of the Winter under the miserable Symptoms of this Fever than to be always draining his Pocket in this manner hoping in the mean time that his Distemper would at least leave him the next Spring of its own accord But with the long continued course of this Fever which perhaps the frequent taking of Cold in the time of the Fit and the Old Women's and Quacks Receipts that were none of the wholsomest all which he was wont to use very greedily and without distinction did promote I say with the long continuance of this Ague there seemed at the beginning of the Spring to be kindled a continual Hectick Heat in the intervals of the Fits of the Putrid Fever attended with a great Cough difficulty of Breathing Colliquative Sweats a continual Thirst Nauseating and other Symptoms of this kind Whereupon before the end of June at which time he desired my help thinking he should soon dye of a Consumption he was so weak and emaciated that he had perfectly a Hippocratical Face and when I first saw him I should plainly have thought him past Cure if this Consumption had proceeded from any other cause than an Intermitting Fever But yet I did rightly judge a Consumption arising in this manner though to all outward appearance deplorable to be curable because it was in my Power at least at this time of the Year to give that great Antidote the Peruvian Bark in that manner as not only to take off the Intermitting Fever but also to prevent the return of it Whereupon I did not at all doubt but when the Fuel was once taken away the Hectical Flame would soon be extinguisht of its own accord together with the whole Company of Pulmonary Symptoms depending thereon Which Conjecture of mine was very quickly proved to be true by the happy Event For the Fits of the Intermitting Fever being once taken away by giving an Ounce of the Peruvian Bark in the form of Pills in the space of four or five days the Hectick Fever also vanisht of its own accord likewise the Cough with the other Pulmonary Symptoms was much lessened and his Appetite much increased But when the return of the Original Distemper was prevented by repeating the use of the same Bark all the Symptoms of the Consumption vanisht within the space of a Month even without a Grain of Pectoral Medicines And my Patient as far as I know to this very day looks well and is lusty History 3. Mr. Lane a Vintner at the Sign of the Queen's Head in Southwark a Man that was truly robust and tall about the middle of his Age in the beginning of the Autumn in the Year 1668. was seized with a violent Quartan Ague he presently committed himself to the care of a Skilful Physician who treated him with the usual Remedies and in the old Method to wit with Bleeding Vomiting frequent Purging Febrifuge Juleps and tedious Deobstruent and Altering Apozems But yet he grew every day worse at length his Ague was doubled yea trebled so that he was no day free from his Fever and about the end of December his Fits were so long that almost presently after one was off another came on He was so weak too that he could scarcely rise out of his Bed and his Stomack was so weak that he hardly could eat so much as Water-gruel He was continually and extreamly Thirsty because he never seemed to be free from his Original Fever or the Hectick which was come upon it and therefore being restless he was continually tossing himself up and down in his Bed And moreover there appeared Purple Scorbutical Spots and those very large every where almost all over his Body but especially in his Breast and Limbs His Legs and Thighs as also his Belly and Breast were very much swelled like those that have the Dropsie His Cough was troublesome and continual and his breathing difficult and very unequal So that the Patient at the first sight seemed to me to have not only an Intermittent Fever but also a continual Hectick arising from the former and upon that to have fallen into a Pulmonary Consumption and an Universal Dropsie When it was so that they plainly had no hopes of the Patient's Life I was at last sent for by his Friends not so much to Cure his Fever which they judged to be incurable before the Spring Weather came as to give him some help against his Consumption Dropsie and Scurvy Distempers that raged so violently that they seemed to threaten almost immediate Death But the Patient himself loathing even Food it self though the most delicious much more Medicines with the great quantity of which his Stomack had been long burdened did with a great deal of difficulty consent that I should attempt his Cure with any kind of Medicines But at length his Friends with much entreaty obtained this of him that he would for three or four days take my Specifick Pills made of the Peruvian Bark only for a Tryal In which time having taken six Drams of the Pouder he presently escaped the next Fit The next day when I came to see my Patient I found him plainly Triumphing over his Enemy eating a potch'd Egg and ready to ride out in a Coach which was now at the Door in order to follow his necessary Occasions But which seemed much more wonderful to me as all the Spots were disappeared so likewise that Dropsical Swelling went away without even any sensible Evacuation Also his difficulty of Breathing and Cough with the other Symptoms of an incipient Consumption seemed to be very much abated and they decreased every day till at last the Patient had by little and little recovered his former state of Health 'T is true indeed this Fever after a Month returned in the form of a simple Quartan and continued till he had had almost four Fits But yet it went quite away without the use of any Remedies or the former Symptoms following upon it from which time the Patient enjoyed his Health very well till at length after one Year and some part of another he dyed of a Bleeding at the Nose CHAP. XIII Of an Icterical or Hepatick Consumption
necessarily follow too great a Collection of Bile in the Blood and thereupon a Morbid alteration of it an Oppression of the Hypochondres a Melancholy with the other signs just now mentioned which tend to a Consumption of the Lungs And hereupon I use to call this a Crapulous Consumption For it is well known even to any one that has had but a little Experience in the Practice of Physick how from anxious Care and other troublesom Passions of the Mind and much and accustomed drinking alternately succeeding one another some happen often to pay dear for their ill-spent Life by an untimely and miserable loss of it caused by this kind of Consumption to which an Ascites and sometimes an Anasarca is wont to be joyned not long before they dye The Diagnostick Signs of this Consumption are to be taken from three Heads to wit The Diagnostick Signs of this Consumption are taken 1. From the Vrine from the Urine the Skin and the Hypochondres First for the Urine that is very little in quantity very full of contents and of a very red and yellowish colour like Mum. 'T is true indeed the Urine of all Persons in a Consumption by reason of the Fever is high colour'd and but little in quantity and likewise by reason of the present Colliquation full of Contents and in this manner it is wont to appear in Putrid Intermitting Fevers But in an Hepatick or Icteritious Consumption all those appearances are always found in a much greater degree and by how much the more the Substance of the Liver is obstructed and the greater the Collection of the Bile in the Blood thereupon is by so much the more intense they always are For by the mixture of the Bile the Serous or Urinary part of the Blood as it uses to be imbued with a very deep red and yellowish Tincture so it is apt to be coagulated and to preâ—ipitate its heterogeneous parts from whence we may deduce the reason why the Urine of this sort of Consumptive Persons uses to be so little in quantity and so full of Contents as well as red and yellowish also the colour of the Skin is yellowish I do confess indeed that the Skin of all Persons that are in a Consumption growing thick from the contraction of the Parts so far as the Emaciation has prevailed loses its wonted lustre but in this Consumption besides the paleness and that squalidness of the Countenance there is a different and uncertain yellowness more manifest one day than another 2. From the Skin but especially about the Neck Back and some other parts of the Body that are covered with a thicker Skin though it is not so deep as it uses to be in an Accidental Jaundies where there is a much greater quantity of Bile heaped up in the Blood by the total Obstruction of the Bile-duct than where it is only imperfectly separated from the Blood by reason of the Obstruction of the Glands of the Liver 3. From the Hypochondres Thirdly there is always the sense of a gravative Oppression in the Hypochondres joyn'd with a Melancholy proceeding from the Obstruction of the Liver and the bulk of it being enlarged thereupon which very often grows so hard and is so much increased in its Magnitude that from thence not only the right Hypochondre happens to be much distended and elevated but likewise a Swelling as it were hard and renitent may be perceived in it even by the external touch This Consumption is always Chronical This Consumption is always Chronical and of several Years because it proceeds from a slow and lingring cause That which the Persons in this Consumption spit is likewise more viscid and plentiful as it uses to be in every slow Consumption As this Consumption begins with a want of Appetite and a loathing of Food It ends in an Ascites so it almost always ends in a slow and painful Ascites to wit as soon as the Liver is grown so hard from the progress of the Disease that the Lymphatick Vessels which creep upon it happen from their Constriction to be broken to which also a frequent Bleeding at the Nose proceeding from the circulation being hindred in other parts by the same Obstructions uses almost always to be joyned And though this Consumption may be curable when a Skilful Physician is sent for in time by a Patient that will be Obedient to Rules yet there is no Consumption more Fatal than this is when once there comes a Dropsie upon it from the Rupture of the Lympheducts caused by the hardness of the Liver Nor indeed can the miserable Patient have so much as an easie Death by reason of the dreadful and continual Pains his shortness of Breath and the other Symptoms that are wont to accompany this lingring Dropsie The General Indications of Cure are only two to wit the restitution of the Lungs The Indications of Cure that are distempered to a sound state and the taking away of the cause by which the Lungs happened to be ill affected The first Indication we may satisfie with the use of Pulmonary Remedies already mentioned in the Second Book in the General Method But we must answer the second Indication with the help of Hepaticks Diureticks Chalybeates and other such-like Medicines which by removing the Obstructions of the Liver may restore the due and free secretion of the bilious Particles from the Mass of Blood and promote the Excretion of the Bile into the Intestines by the Bile-duct by which means the cause of the Atrophy and likewise of this Symptomatical Consumption of the Lungs may be perfectly removed But in what manner the General Method of the Cure of a Consumption is to be altered by the mixing of Hepaticks with Pulmonary Medicines that we may satifie both Indications I had rather shew by some Examples than by the description of a new Method least I should seem to spin out this Discourse to too tedious a length And therefore I will presently give a History or two relating particularly to this business only premising first this general Observation The Pectoral Medicines we use must be always Inciding Abstersive and Carminative which it is convenient to have in our Eye through the whole Method of Cure in this Consumption and that is that for Pectoral Medicines we must always make choice of those that are Inciding Abstersive and Carminative plainly avoid Incrassating things and use Mucilaginous Medicines mixed with other altering Medicines moderately being directed thus to do not only by the toughness of the Phlegm which this kind of Consumptive Patients with all that they can do can hardly expectorate or hawk up but also by the obstructed state of the Liver it self where indeed in this case the first Seeds of this Consumption are lurking And from thence it comes to pass that though this Consumption when it is but beginning may sometimes admit of a perfect Cure only with the use of Inciding and Chalybeate
at length wholly given over the vain hopes of being with Child I was sent for though too late to visit this miserable Patient Whom I found in a Tabid state and afflicted every day with a Putrid Intermitting Fever which moreover was accompanyed with the Gripes vast Colliquative Sweats a Dropsical Swelling of the Legs as well as of the Belly a perpetual Catarrhous Cough a shortness of Breath and the other usual Symptoms of a Fatal Consumption of the Lungs With which the Patient being at length brought into the state of a Marasmus in the space of six Weeks or somewhat more notwithstanding the plentiful use of Pulmonary and Uterine Medicines of the Peruvian Bark Laudanum Pearl Juleps Vesicatories and other Remedies respecting the Original Disease as well as the various Symptoms proceeding from it and she wasting away by degrees went off plainly in the same manner as those use to do who dye of a Consumption of the Lungs The Body being opened after she was dead we found the Lungs contrary to our Expectation not very much affected with the Stigmes of a Consumption For though we found them stufft adhering to the Ribs and ting'd with several Colours yet so far as I remember there were no Tubercles either crude or ripe found in them But the Substance of one Ovary was plainly eaten away and consumed by an Exulceration and the outward Membrane in a wonderful manner distended with a Dropsical Humour so that we took out of it which now took up the greatest part of the Belly several Pints of Water somewhat purulent together with a great quantity of little Bones and small Fibres or as I judg'd threads which had made up the Glandulous Substance that look'd like yellow Hair From whence it seemed plain to me that that Mortal Fever accompanyed with the fatal Colliquation though this Consumption was Pulmonary only Secondarily and Symptomatically and the Cough and in some measure the difficulty of Breathing too had their rise from the stuffing and adhesion of the Lungs had its Original from the Inflammation and Exulceration of the Ovary it self By which Colliquative Fever as also by the substraction of the Nutritious Juice by the large Dropsical Swelling of the Ovary such a quick Consumption and so grievous a difficulty of Breathing were caused that her Life being thereby brought all of a sudden into extream danger there was not time enough given for that Consumption which was imprest upon the Lungs to be advanced beyond the first degree of a Pulmonary Consumption though there seemed to be all the usual Symptoms of a Fatal Consumption of the Lungs History 3. A certain Merchant of London before the Fortieth Year of his Age when he had now lived almost two Years somewhat sickly and with little and uncertain Appetite which perhaps he procured to himself by his immoderate use of Wine and Women at length asked my Advice about a Swelling and a painful Inflammation arising from thence with which the right Testicle had been now affected for almost the space of three Months and that as he told me occasioned by some Contusion he had got in Riding Indeed that Swelling to me seemed to be a kind of Sarcocele The Testicle swell'd to the bigness of ones fist There was likewise no small Inflammation upon the Scrotum it self as well as upon the Testicle But with repeated Bleedings the application of Cataplasms made of Barley-meal and Oxycrate the Parts affected being likewise kept up with a Truss to prevent the flux of Humours into the place frequent Purging with Calomelanos and Confectio Hamech and also drinking plentifully of Emulsions of the four greater cold Seeds made with Barley-water and of a Decoction of Sarsa and China ordered for his common Drink the painful Inflammation plainly vanish'd But the Swelling still continued though without any pain and the bigness of it was uncertain being sometimes greater sometimes less and easily yielding to a pressure of ones fingers so that at length the Judgment of two very skilful Surgeons being taken and that Swelling being supposed to be a Hydrocele it was justly thought fit to open it But when it was solemnly opened with an Incision-Knife there came out scarce any Water and no Matter Also the whole Substance of the Testicle seemed to have been eaten away and perish'd for some time but the Investing Coats were hard and incrassated so that the Testicle being once opened look'd like an empty Egg-shell or rather a Pomegranate-shell when the Meat or that which was contained in it is taken out From the Fistulous state of this Swelling it came to pass that the Surgeons being deceived and taking it because it yielded to the pressure of their Fingers for a Hydrocele opened it by Incision though indeed after they had once opened it it soon appeared to be in truth a Venereal Fistula proceeding from some virulent and old Gonorrhoea that had been ill cured But from that Wound there arose a large Ulcer which every day ran a great quantity of Ichorous or gleety Matter Which though many times it deluded us for several times with the vain hopes of Curing it having ordered the Sarsa Drink now again for his ordinary Drink when at the same time he was purged with the bitter Decoction repeated at due intervals that is so often as there was occasion and every Night he had a Paregorick Draught given him with Syrup of Diacodium But yet from an unexpected flux of the Humours which as I always told the Surgeons it was impossible to prevent without castration or cutting out of the Fistulous Testicle the Ulcer very often broke out again so that the Patient being quickly brought into a Tabid and Hectick state by the contiual and plentiful substraction of the Nutritious Juice through the Wound and the expences arising from it which Nature was not able to bear as he began to have a great Thirst so likewise to lose his Stomack and at length to be afflicted with a troublesome Cough a shortness of Breath and the other usual Symptoms of the Lungs when they are distemper'd continually wasting away more and more with the sudden Ruin of Nature which was much promoted by the Fits of a Putrid Intermitting Fever coming upon all which returned every day at a stated hour with a Chilness Heat and Sweats succeeding one another till at length the Patient being brought to the utmost degree of a Marasmus was forced to yield to Fate With the repeated use of the Peruvian Bark I very often took off his Putrid Fever which nevertheless the cause of it still remaining in the Wound returned as often after the interval of a Week or two Likewise the Hectick heat which was kindled in his Blood was much mitigated with the use of a Milk Diet of Asses Milk and by the benefit of the open Country Air though it could never be perfectly extinguished because the Procatartick Cause of it to wit the Malignant and Incurable Ulcer was plainly too much for
the very beginning but also quick and very Acute so that it carries off the Patient within a few Months and it may be Weeks I shall add these few things concerning the variation of Cure in this kind of Consumption First Lubricating Medicines must be taken plentifully in the beginning of this Distemper yea and gentle Vomits by which means we may endeavour to bring away the Stone or any other things that have slipt down into the Lungs before they are quite fixt there by their lodging long in the part and before the Tone of the Lungs is much injured by them Secondly But if great and spasmodick pains are excited by the tearing of the Lungs caused from the motion of these sharp bodies we must expect a great spitting of Blood and therefore instead of Lubricating Medicines we must give Laudanum and that in good quantities and often whereby we may hinder the motion of the Stone for the present abate the pain and prevent the spitting of Blood For in this case letting of Blood outward Fomentations and Liniments do no good as they use to do in Pleuritick and Peripneumonick pains and this I found by Experience in one Mr. Foster and in many others 'T is true indeed that a lingring and slow Consumption attended with a difficulty of Breathing and other such-like Symptoms will follow from a Stone lying in this manner in the Lungs which I have often observed in my Practice But yet a lingring and uncertain Consumption is better than an Acute one accompanied with horrid pains that certainly and quickly terminates in Death For if this kind of Consumptive People take such care of their Health as to live always in an open and Country Air to keep from taking of Cold from Drinking and too much Exercise and any other thing that may disturb the Stones again that are fixt and lye quiet they may live to a great Age and do their Business well enough Sometimes the Bleeding must be permitted a while Thirdly But if there follows a spitting of Blood from the tearing of the Lungs it ought to be let alone for a while For in this Flux the Stones or any other things that have slipt down into the Lungs may be voided But if the Haemoptoë is great and dangerous we must open a Vein and if it be necessary repeat it and we must give not only Opiate Medicines but also Astringents in the form of Linctuses Juleps c. the Lapis Haematites the Royal Styptick Water we must use a Milk Diet and other things briefly mentioned before in the former Chapter which I shall hereafter give a larger Account of in another Book if I have an Opportunity to treat of an Haemoptoë Balsamicks must be plentifully used Fourthly But if the Lungs happen to be torn and to be ulcerated from the motion of the Stone whether it be voided or not we must make choice of Balsamick Medicines and give them plentifully of which I have given several forms in the General Method of Cure A Milk Diet is not convenient where there are Stones in the Lungs Fifthly we must not Order a Milk Diet in a Consumption proceeding from Stones in the Lungs unless there is a great necessity because it is apt to breed some new Chalky Stones Whereby it comes to pass that the Cure of one Consumption is wont to lay the Foundation of another The Chalybeate Waters must be drank in little quantities Sixthly Likewise the Chalybeate Waters though they may be good in this Consumption must be drank in a little quantity at a time for fear the Stone should be stir'd again by the too great distention of the Vessels of the Lungs Whereby it comes to pass that the return of the pain and of the spitting of Blood does often follow upon it Seventhly Sometimes there are several Stones Sometimes there are several of these Stones in the Lungs so that after one or two or it may be a third has been voided yet the Lungs are ulcerated by those which remain behind and from thence there follows a Consumption As I remember it happened to Mr. Plucknet and some others But a Consumption of the Lungs is wont to proceed not only from a Stone in the Lungs The Stone and Vlcers of the Kidneys and Bladder do often cause a Consumption and an Ulcer there following upon it but likewise very often from Ulcers and a Calculous disposition of the Kidneys and Bladder so that I have very often observed those that have had the Stone to dye of a Consumption But this Consumption is alwas lingring and Chronical and is to be cured in the same manner as an ordinary Consumption How this Consumption is to be cured only we must avoid those Medicines that irritate the pains of the Stone as my Balsamick Pills c. But the Chalybeate Waters which ease those pains must be often used For I am apt to think that those who have the Stone do not fall into a Consumption so often from the long and tormenting pain as from a want of the due secretion of the Serum and an alteration of the Ferment which separates it in the Kidneys following upon it And therefore in the Cure of this kind of Consumption we must have a regard not only to the Consumption by using the Pectoral Medicines I have before mentioned but also to the Disease which is the cause of this Consumption to wit the Stone of the Kidneys and Bladder by using such Medicines as may lubricate the Urinary Passages and expel the Stone or at least mitigate the pain History 1. Mr. Plucknet being Forty Years old or thereabouts a strong and lusty Man but one that had for many Years lived irregularly in almost all the six non-natural things yet found no other mischief from it besides a hesky and dry Cough which he had now been used to for a long time without any great trouble at length upon hard Riding and taking of Cold by being very wet with the Rain he fell into dreadful pains of his Breast that were like the pains in a Pleurisy upon which there came a great and long spitting of Blood with a Fever and a Cough almost continually troubling him I could do no good with External Liniments and Expectorating Medicines until I came at length to the use of Opiates With which though he got a little respite and a treacherous Truce yet he could get no perfect Cure For as his Cough so the Hectick Fever still continued with which he every day by degrees pined away and that notwithstanding the plentiful use of Balsamick and Pectoral Medicines of Asse's Milk c. till at last in the space of a Year he appeared in a deplorable Consumptive state with an universal Colliquation made by the Skin by Stool by his Lungs c. Which Consumption that in its own proper Nature was lingring and Chronical without doubt came to be so quick and hasty from a long predisposition of