a Consumption pag. 250 The Cure pag. 251 An Observation pag. 252 From the Small Pox a Consumption pag. 294 The Cure pag. 295 The Prevention of a Consumption pag. 74 Prognosticks in an Original Consumption of the Lungs pag. 122 Pulmonary Medicines Vide Pectoral Medicines Of the Pulse in the Hectick Fever Observations pag. 113 In the Inflammatory Fever Ibid. In the Putrid Fever pag. 114 Purging proper in a Consumption pag. 128 The Purgers proper in a Pulmonary Consumption pag. 131 Purging-Waters when convenient in a Scorbutical Consumption pag. 205 Purging when not convenient pag. 158 The Putrid Fever in a Consumption of the Lungs described pag. 103. 179 The Cure pag. 179 R. A Raucedo presages a Consumption pag. 95 From a Rheumatism a Consumption pag. 276 The Cure pag. 276. 278 Observation 1. pag. 280 Observation 2. pag. 283 Observation 3. pag. 291 From a Chronical Rheumatism a Consumption incurable pag. 278 S. FRom a Salivation a Consumption pag. 45 The Cure pag. 46 An Observation Ibid. Salivation proper in a Consumption from the French Disease pag. 252 Salivation proper in a Consumption from Internal Ulcers pag. 346 A Salt Scurvy pag. 202 From Scarlate Fevers a Consumption pag. 294 The Cure pag. 295 A Scrophulous Consumption pag. 194 The Cure where there are hot swellings pag. 197 The Cure where they are of a middle nature pag. 199 The Cure where there is no Putrid Fever pag. 200 An Observation Ibid. From the Scurvy a Consumption pag. 202 The Signs pag. 203 The Cure pag. 204 An Observation pag. 207 Shaving of the Head good in a Consumption from Apostemes pag. 28 Shaving of the Head good in a Pulmonary Consumption pag. 81. 137 Shell-Fish when proper pag. 165 Shortness of Breath follows upon the Tubercles pag. 96 Signs of an Incipient Consumption pag. 82 The Skin how it shews a Consumptive disposition pag. 70 A Snail-Water pag. 168 From Spitting of Blood a Consumption pag. 225 The Cure pag. 230 Observation 1. pag. 232 Observation 2. pag. 233 Observation 3. pag. 236 Steel Medicines good in an Atrophy pag. 6 In a Consumption from Melancholy pag. 219 Steel Medicines good in a Scorbutical Consumption pag. 205 Stomachicks good in a Nervous Consumption pag. 6 From Stones in the Lungs a Consumption pag. 238 The Cure pag. 240 Observation 1. pag. 244 Observation 2. pag. 245 Observation 3. pag. 246 From Stones in the Kidneys and Bladder a Consumption pag. 243 The Cure Ibid. From giving of Suck a Consumption pag. 32 The Cure pag. 34 An Observation pag. 35 Giving of Suck sometimes Cures a Consumption pag. 32 The Suppression of Evacuations one cause of a Consumption pag. 70 From a Suppression of Womens Courses a Consumption pag. 258 The Cure pag. 259 From Surfeits a Consumption pag. 294 The Cure pag. 295 From Sweats a Consumption pag. 52 Observation 1. pag. 53 Observation 2. pag. 54 Observation 3. pag. 56 Colliquative Sweats in a Consumption pag. 107 The Colliquative Sweats how to moderate pag. 186 The Symptoms of a Consumption to be relieved pag. 182 Symptomatical Consumptions of the Lungs pag. 191 T. TAblets of the Peruvian Bark pag. 301 From breeding of Teeth a Diabetes and Consumption pag. 43 A Thirstiness attends a Consumption pag. 94 Much Thoughtfulness presages a Consumption pag. 70 Tobacco hurtful in a Scorbutical Consumption p. 206 A Thrush happens in the end of a Consumption p. 111 The Thrush how to be relieved p. 189 Tubercles in the second degree of a Consumption p. 156 An Account of the Tubercles in a Pulmonary Consumption p. 88 V. VEsicatories proper in an Original Consumption of the Lungs p. 145. 178 In a Consumption from the stopping of Ulcers c. p. 255 A Voice squeaking and shrill shews a Consumptive disposition p. 70 A disposition to Vomit when the Sign of a Consumption p. 94 A Vomiting in the end of a Consumption to relieve p. 188 Vomits good in an Original Consumption of the Lungs p. 132 In a Consumption from the Gout and Rheumatism p. 278 In a Consumption from Melancholy p. 219 Vomits to be given to help Expectoration p. 268 Observations of the Urine in a Consumption p. 114 From Iternal Ulcers a Consumption p. 340 Indications of Cure p. 345 Method of Cure p. 346 Observation 1. p. 348 Observation 2. p. 351 Observation 3. p. 353 Observation 4. p. 356 Observation 5. p. 357 From large Ulcers a Consumption p. 23 The Cure p. 24 W. WAsting of the Flesh a sign of a Consumption pag. 99 From the Whites a Consumption pag. 19 The Presaging Signs pag. 20 The Cure pag. 21 Wine hurtful in a Consumption from Bleeding pag. 16 In a Consumption from a Diabetes pag. 42 In a Consumption from a Gonorrhoea pag. 22 In a Pulmonary Consumption pag. 153 Y. IN Young Persons a Consumption is Acute and hard to Cure pag. 124 FINIS
by Spitting of Blood p. 225 Chap. 6. Of a Consumption caused by Stones bred in the Lungs and by things slipt down into them from without as also by the Stone in the Kidneys and Bladder p. 238 Chap. 7. Of a Consumption proceeding from the French-Pox p. 250 Chap 8. Of a Consumption proceeding from the Suppression of a virulent Gonorrhoea of the Running of Old Ulcers but especially Fistula's in the Fundament and Scrophulous Ulcers Issues and the Whites p. 254 Chap 9. Of a Consumption proceeding from the Green-Sickness and a Suppression of the Monthly Purgations in Women p 258 Chap. 10. Of a Consumption caused by a Peripneumony and a Picurisie p 263 Chap. 11. Of a Consumption proceeding from the Gout and from a Rheumatism p. 276 Chap. 12. Of a Consumption proceeding from Fevers especially such as are from Surfeits Scarlate and Intermitting Fevers as also from the Small-Pox and Measles p. 294 Chap. 13. Of an Icterical or Hepatick Consumption p. 307 Chap. 14. Of a Consumption of the Lungs proceeding from Internal Ulcers of the Viscera and Membranous Parts p. 340 A TREATISE OF Consumptions The First BOOK Of Consumptions in general and particularly of a Consumption proceeding from the whole Habit of the Body or an Atrophy both that which is Nervous and that which is caused by Evacuations THAT I may give such a Scheme of this whole Work as will lye under a single View and open a Prospect into my Design I shall here by way of Preface first give a Definition and make a Division of the Subject about which we are to treat whereby as by Ariadne's Thread we be easily and safely directed to and proceed through all the parts of the Work The Definition of a Consumption in general A Consumption in general is a wasting of the Muscular parts of the Body arising from the Substraction or Colliquation of the Humours and that either with or without a Fever and it is either Original or Symptomatical Of an Original Consumption An Original Consumption is that which arises purely from a Morbid Disposition of the Blood or Animal Spirits which reside in the System of the Nerves and Fibres and is not the effect of any other preceding Disease Of which there are two sorts to wit an Atrophy and a Consumption of the Lungs Of an Atrophy An Atrophy is an Universal Consumption proceeding from the whole Habit of the Body and not from any Distemper of the Lungs or of any other Entrail without any remarkable Fever and is either Nervous or the effect of Evacuations Of a Nervous Consumption A Nervous Atrophy or Consumption is that which ows its Original to an ill and morbid state of the Spirits and to the weakness or destruction of the Tone of the Nerves from whence as an imbecillity and an Universal Consumption in the whole Habit of the Body upon the want of a due assimulation of the Nutritious Juice do at length proceed so from the beginning of the Disease there is to be found a want of Appetite and a bad Digestion in the Stomack from an imperfect Fermentation and Volatilization of the Chyle Which sort of Atrophy may justly be reckoned one of the Fatal Symptoms of the Scurvy An Atrophy from Inanition or an Expense of the Humours Of an Atrophy from Evacuations is that which derives its Original from a preternatural Defect or Evacuation of the Nutritious Juice and that long and habitual which differs according to the variety of the passages formed in the Body either by Nature or Art by which this precious Liquor either has or may run off and be wasted A Consumption of the Lungs is an Universal wasting of the Parts of the Body Of an Original Consumption of the Lungs caused by some Distemper of the Lungs as a stuffing swellings inflammation and exulceration of them and thereupon it is attended with a Cough difficulty of Breathing and other Symptoms of the Breast and accompanied with a Fever which at first is slow and Hectical afterwards Inflammatory and at last Putrid and Intermitting A Symptomatical Consumption is that Of a Symptomatical Consumption which although it does immediately proceed from a Preternatural and ill state of the Blood and Spirits yet has a mediate dependance upon some other preceding Diseases which had given that ill Tincture to the Spirits and Humours And because it is necessary if we would be successful in the Cure of this kind of Consumption to have a respect to the Disease which the Patient first laboured under I shall in the end of this Treatise speak of all the several kinds of this Consumption which I have hitherto had an Opportunity to observe in my Practice but I shall begin and discourse first of an Original Consumption CHAP. I. Of a Nervous Consumption A Nervous Atrophy or Consumption is a wasting of the Body without any remarkable Fever Cough or shortness of Breath but it is attended with a want of Appetite and a bad Digestion upon which there follows a Languishing Weakness of Nature and a falling away of the Flesh every day more and more A Nervous Consumption that which Virginians are most incident to Which kind of Consumption I have sometimes observed in England but most frequently amongst those that have lived in Virginia after they have come over hither In the beginning of this Disease the state of the Body appears oedematous and blouted and as it were stufft with dispirited Chyle the Face is pale and squalid the Stomack loaths every thing but Liquids the strength of the Patient declines at that rate that before the fleshy Parts of the Body are evidently consum'd he is render'd plainly feeble and almost always confin'd to his Bed The Urine also keeps not constant to any colour though for the most part it be high-colour'd and but little in quantity Yet it is sometimes as it happens commonly to be in Nervous Distempers though seldom pale and plentiful But there is no considerable Fever to be discovered either by the Pulse or a Thirst or Heat how high-colour'd soever the Urine appears So that the Pathognomonick Signs or those which do evidently manifest the beginning of this Consumption are a decrease of the Patient's Strength and a loss of Appetite without any remarkable Fever Cough or shortness of Breath though in the Progress of the Distemper when a Consumption of the Flesh has gradually affected the whole Habit of the Body there is some difficulty and trouble in breathing to be observed as it uses to happen to all those who are under a great Weakness The immediate cause of this Distemper I apprehend to be in the System of the Nerves proceeding from a Preternatural state of the Animal Spirits The Causes and the destruction of the Tone of the Nerves whereupon I have used to call this a Consumption in the Habit of the Body For as the Appetite and Concoction are overthrown by the weak and infirm
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
First we must take care of the Lungs by the use of Pectoral and Antiphthisical Medicines and promote the Cure of the Ulcers if they are small benign and curable to wit so far as the present weak and low condition of the Patient can bear Secondly the Peripneumonick or Inflammatory Fever must be taken off as often as it happens together with the direful Symptoms of it Thirdly the Putrid Fever arising from the Purulent Matter in the Lungs must be relieved Fourthly and lastly we must help those troublesome Symptoms arising from the Putrid Fever by the Colliquation that the Patient if he does dye may at least obtain an easie passage out of this World What we must give with respect to the Lungs As for what concerns the first the Medicines proper in this degree of the Consumption are such as are Altering Expectorating and Balsamick or Healing not too hot because of the intense degree of the Fever but always Cordial because of the Patient's Weakness Such also must be made choice of as are most grateful and may be given in the least quantity because of the weakness of their Stomack and their aptitude to Vomit As for Example Take the old Conserve of Red Roses press'd through a Sieve of Wood-sorrel Leucatellus's Balsam of each an Ounce Mix them and make an Electuary of which let him take the quantity of a Nutmeg in Wafers Morning and Evening Or let him take three of the Balsamick Pills already described twice a day Take of the Cordial Milk-water or the Pectoral Milk-water already described eight Ounces Magisterial Water of Snails Barley Cinnamon-water of each three Ounces of Aqua Mirabilis an Ounce of prepared Pearl two Drams of the finest Chalk a Dram of white Sugar-candy an Ounce or ten Drams Mingle them and make a Julep of which let the Patient take four or five Spoonfuls after every Dose of the Electuary and of the Pills and likewise at any time when he pleases if he be faint Take of the Balsamick Syrup which is very grateful to the Stomack three Ounces of the Tincture of Saffron made with Treacle-water two Drams Mix them and let him take a Spoonful of it often In a Spoonful or two of this Mixture may likewise be given six or seven Drops of Opobalsam twice a day If the Cough Sometimes we must give Opiates and want of Rest be very urging let him also take sometimes when he should go to Rest Twelve Drops of Helmont's Liquid Laudanum But very cautiously But yet when the Patient is in this weak condition Opiam must be given very cautiously sparingly and at due intervals and indeed not at all unless there be a great Necessity lest a sudden and unexpected Death should follow and so bring a Scandal upon Physick Or Take of Syrup of Maiden-hair four Ounces of Aqua Mirabilis half an Ounce or six Drams Mix them and let him take some out of a Spoon or with a Liquorice-stick often but especially when his Cough is troublesome Here likewise Jellies and Jelly-Broths are to be prescribed and indeed in this deplorable state we must fetch our Remedies rather out of the Kitchen than out of the Apothecary's Shop An Account of the Peripneumonick Fever As for the Peripneumonick Fever that always proceeds from a great Inflammation of the Tubercles of the Lungs and therefore it is wont to return often and to be renewed to wit as often as any new Tubercle happens to be inflamed either of its own accord and from its own Nature or from taking of Cold or any other Error committed in their management So long as the Inflammation lasts this Fever constantly remains and many times puts a sudden and unexpected end to the Patient's Life being attended with the successions of a Chilness that comes at uncertain times and a great Burning with Watchings Restlessness Light-headedness Shortness of Breath a difficult Expectoration and with violent and wandring Pains of the Side Breast and Shoulders But as soon as the Inflammation begins to be changed into an Aposteme which if the Patient lives so long commonly happens about the seventh day of the Fever that continual Inflammatory Fever is succeeded by a Putrid Intermitting Fever a Quotidian or Tertian which is a certain sign that the Tubercles are turned into purulent Matter and without the healing of them it is impossible perfectly to eradicate that This Inflammatory Fever What is requisite in this Fever as all others of the same Nature requires a very thin Diet together with a due Government in their Beds that the Body be kept open Cordial and Temperate Juleps Pectoral Apozemes with Lubricating and Inciding Lambitives must be given plentifully to facilitate the Expectoration or raising of the Phlegm too much thickned by the Feverish heat to take off the painful compression of the Lungs and thereupon to quiet the insignificant and troublesome Cough Likewise Diaphoreticks that are a little Opiate must be exhibited at due intervals to promote the extrusion of the Feverish Matter by the Pores of the Skin Also Blistering-Plaisters must be laid on and external Applications made for the relief of the Brain and System of the Nerves which otherwise are wont in a short time to suffer much from this kind of Fevers Also Liniments and outward Fomentations that are Anodyne to relieve the painful and Spasmodick contraction of the Muscles and Membranes of the Breast Bleeding especially is necessary But above all Bleeding and that in due time to a good quantity and if there be occasion repeated according to the strength of the Patient and the present Effervescence of the Blood which it may be a Consumptive state requires more than that which is Robust And by this means I have seen Mr. Tibs Dr. Owen and our Famous Colleague Dr. Staines and several others even in their very Old Age recovered from several of this kind of Fevers returning sometimes twice or thrice a Year though it has been only to their former sickly state and that as easily and as quickly as if they had not been at all Consumptive When on the contrary it is as well known how dangerous this kind of Peripneumonick Fevers very often are to the strongest Men let them have never so good a Habit where due Bleeding and any other part of a right management has been omitted The Peripneumonick Fever may be as easily cured as an ordinary Peripneumony Therefore though a Physician must make a Fatal Prognostick of the Consumption it self which without doubt is much promoted by every Fever of this Nature yet he may set himself about the Cure of the Peripneumony with as much hopes if he be but sent for in time as if the Patient were not at all Consumptive and that in the manner following Let him be ordered a Diet of Water-gruel Ptisans roasted Apples Posset-Ale with Raisins of the Sun stoned and Liquorice boyled in it midling Beer warm'd with a Toast and such-like But in
at least by prudent Counsel if he cannot by Medicines Therefore first let the Patient be ordered to take though often but a very little quantity of Food at a time Secondly let him be indulg'd the use of Food that is most grateful to his Stomack so it be such as affords good Juice and is of easie digestion Thirdly let him as much as ever he can keep from Coughing and deep hawking up of Phlegm that lyes low and let him likewise forbear sleeping and lying down presently after he has eaten But Medicines can scarce do any good in this deplorable state Of relieving a Thrush a pain in the Throat and Hiccough in the end of a Consumption After the flame of the Putrid Fever is kindled but especially when the exclusion of the colliquated Matter by the Bowels and other Doors is hindred by Art it sometimes happens that Nature endeavours though in vain the extrusion of her Enemy by the Salivatory Ducts and Glandulous Membrane of the Mouth and Gullet From whence a continual troublesome spitting for many Weeks arises Secondly by reason of the sharpness of the Humour separated by these parts there follows an Inflammation of the Membrane not only of the Mouth but also of the Gullet and Stomack Thirdly from the Inflammation there follows an Exulceration and thereupon little Ulcers commonly call'd a Thrush attended with a very troublesome pain in the Throat as I observed in Mrs. Wells and some other Consumptive Persons who were wont to complain of this Symptom more than of the Original Distemper it self Fourthly and lastly a very troublesome Hiccough arising from the Inflammation and Exulceration of the Stomack And these Symptoms A Thrush and Hiccough are always fatal as they are wont to be very troublesome so sometimes also of a long continuance but always fatal and such as presage the Patient's Death neither indeed do they admit of any Cure For that the cause from which they proceed is incurable However that may be yet an honest Physician ought here also as much as it is in his power to give a helping hand with the use of Gargles to be squirted into the Mouth and Throat with a Syringe which must be made of Cleansing Soft Astringent and Mucilaginous Ingredients Such as we have often occasion to use in our Practice the forms of which we meet with every where in Authors under the Head of a Fever But yet for the easing of this kind of pain in the Throats of Consumptive Persons the keeping the backward Glands seated in the Throat continually Night and Day defended from the external Air with a covering of Flannel doubled does a great deal of good from whence there may be more relief expected than from Gargles or Mucilages A TREATISE OF Consumptions The Third BOOK Of a Symptomatical Consumption of the Lungs I Call that a Symptomatical Consumption of the Lungs which is caused by What a Symptomatical Consumption is and depends upon some other preceding Diseases For it often happens so that from Distempers and those not only Chronical but also Acute and that whether they are perfectly cured or not the Mass of Blood is so altered by the preternatural Ferment preceding that there remain and lurk in the Blood some indelible Impressions and the Seeds of a Consumption that will afterwards follow which by degrees shews it self by a Cough and other usual Signs until at length the miserable Patient being on every side environed with the Fatal Symptoms of the Disease is forced to submit to the stroke of Death Yea sometimes also it is not only the Distemper but likewise the Physician himself that uses to be the occasion of this Consumption to wit when being greedy of Gain and a little present Fame he does in a perfunctory manner and without a due Method and necessary Evacuations rather suppress than root out the Ferment of the preceding Disease whereupon the Patient not being so much cured as translated from one Distemper to another after some space of time spent in a sickly state falls into an Acute and Deplorable Consumption This is the most common Consumption And indeed this kind of Consumption as far as I have been able to observe is the most common of all others and where we see one Original Consumption of the Lungs which depends meerly upon an alteration of the Blood predisposing the Patient to it there are five and it may be ten to be found which proceed from Crapulous and Intermitting Fevers from the Small-Pox Measles Scarlet Fevers a Pleurisie Peripneumony Melancholy and Hysterick Affections from the Kings-Evil Scurvy Green-Sickness Asthma Spitting of Blood Stones in the Lungs and sometimes also in the Kidneys and Bladder from the French-Pox Gout stoppage of the Monthly Purgations of Issues a Gonorrhoea and of Old Ulcers especially such as are Fistulous and Scrophulous These Consumptions have a peculiar disposition Which Symptomatical Consumptions besides the general Nature of a Consumption use to have likewise a proper and peculiar Genius or Disposition of their own and thereupon they are to be distinguisht amongst themselves as by particular Marks and Pathognomonick Signs And there is some variation to be made in the Cure proportionate to the different Nature of the Distemper And a Physician can scarcely in the Cure of a Symptomatical Consumption of the Lungs rationally satisfie all the Indications of Cure by the general Method already described so as to obtain a happy and desired event of things Therefore in the Cure of them a respect must be had to the Original Distemper unless he has in the whole course of his Cure as well a peculiar respect to the Original Distemper by mixing Specificks with his other Medicines as to the Symptoms in the Lungs which are the effects of it by Medicines that are proper for a Consumption of the Lungs which we have already described Therefore taking it for granted that the Description and Cure of an Original Consumption the Lungs already delivered belong likewise to of these Consumptions that I may not draw out the Thread of this Discourse to too tedious a length by Tautologies I thought it worth my while briefly to add under their proper Heads those things which may shew the various Nature of these Consumptions their Causes Differences Pathognomonick Signs and Indications of Cure by which a Physician with his Judgment and Sagacity may alter the general Method of Cure so as to be able to accommodate his Remedies to the peculiar Nature of the Disease and to answer the Indications that arise from it CHAP. I. Of a Scrophulous Consumption This Consumption is very fr quent I Shall speak of this kind of Consumption in the first place because it occurs most frequently in our Practice For I remember more of this kind of Consumptive Patients that I have cured or at least have seen cured by others than of any other sort For in a Scrophulous Consumption the Blood by reason of its preternatural
Salt Ferment of their Stomacks and generally speaking is wont to disagree as well with Scorbutical as Hypochondriacal Persons The use of Tobacco is to be much suspected Eighthly The taking of much Tobacco is likewise to be much suspected in this Consumption because not only it increases the Ill and Salt Ferment of the Stomack by reason of the abundance of Salt that is contained in it whereby the Colliquation that is caused by a Saltness is increased but also because that Saline Smoak by irritating the Salivatory Ducts does promote a more plentiful excretion of the Spittle and that not only by the Glandulous Coat of the Mouth but also by the Tonsils and the whole Trunk of the Wind-pipe even to the very Lungs from whence it comes to pass that as the troublesome hawking up of Phlegm from the Tonsils so also the Cough of the Lungs is wont to be promoted Finally the shaving of the Head and many Issues are here very advantageous because they conduce very much to the lessening of the quantity of the Serous Liquor that abounds in this Distemper the one by promoting a Perspiration the other by deriving that Liquor to themselves A History Mr. Hunt a Citizen of London that had been a Scorbutical and Hypochondriacal Man lived almost from his Youth to the Seventieth Year of his Age in a Consumptive state doing his Business well enough by taking care and rightly managing himself without the help of Physick till he was above Sixty Years old from which time being very much emaciated he was very often subject to a Catarrhous Cough that was also something Asthmatical to a want of Appetite especially in the Winter and likewise to a light Peripneumonical Fever from a slow Inflammation of the Tubercles of his Lungs From which he was easily freed by the Advice of a Physician He also had three Sons all which though they were Scorbutical and Hypochondriacal by Inheritance yet they seemed strong and lusty even to the Thirtieth Year of their Age. About which time they were all one after another seized by the same Right of Inheritance with a Consumption occasioned by Passions of the Mind and the drinking of Spirituous Liquors from whence it came to pass that by reason of their neglect of a due Government this Distemper which was so Chronical in the Father was Acute enough in his Sons and if I well remember carried them all off before the emaciated Old Man dyed One of these Sons to wit the Eldest after he had continued his Hectical Heat for some Years by Cares and Drinking falling into a want of Appetite Thirstiness a dry Cough and heavy Oppression in his Breast committed himself to my care After Bleeding gentle Purges and the plentiful use of Pectoral and Balsamick Medicines he seemed to be something better But yet his Hectical Heat Cough and weakness of Appetite still continuing I sent him to drink Tunbridge Waters in the open Country Air the time of the Year favouring that Advice I expected more from the due use of the Waters than from the most pompous Apparatus of Medicines For although he did not stay so long as he ought to drink the Waters nor fortified himself by a due Government yet he came back after a Month recovered in his Flesh his Looks and Appetite and almost perfectly freed from his Cough and Hectical Heat too till the next Winter entangling himself with Cares and much Business and falling to his usual drinking of Wine he felt a return of all the former Symptoms of which he could not be relieved by any Prescriptions of the most able Physicians and so about the next June he dyed at Ebisham where he had lived for some time for the benefit of the Air. His Widdow as well from her grief for the Death of her Husband as from other causes as from taking of Cold in often Watching with him and perhaps by Infection too because she lay with him to his dying day but especially because she seemed predisposed to a Consumption from a Salt and Scorbutical Habit of Body after a Month began to have a dry Cough a very great Hectical Heat an extream Thirst and almost a total want of Appetite together with a squalid Look an emaciated Habit of Body a continual Oppression of her Lungs a Weakness and all the Symptoms of a very Acute Consumption So that if I must speak ingenuously I did expect that she would within a Month or two follow the lamentable Fate of her Husband let her be never so diligent in the use of the best Medicines of the Shops that I had any knowledge of unless the extraordinary heat of the Blood and Lungs could be extinguisht by a great plenty of some diluting and temperating Liquor which would obtund the sharp Salts of her Blood and open the Obstructions of the Nerves at the same time And therefore after a light Ventilation by taking away a little Blood I ordered her because her Body had been costive Ebisham Waters made into Posset-drink by way of Preparative and afterwards that she should drink Sadler's Waters at Islington the extraordinary Vertue of which to extinguish a Hectical Heat I had that very Year with great Success found in my self as well as in several others I ordered likewise a Pearl Julep her Faintness and the heat of her Blood and Spirits requiring it But by reason of the sickness and weakness of her Stomack she could not take any Linctuses or Pectoral Apozemes much less Balsamick Medicines And because of her great difficulty of Breathing I was very doubtful of the use of Opiates And thus for the present I left her The Purging Mineral Waters she took once or twice which put her into a Looseness that held her for three Weeks and I knew nothing of it her Fever still flaming and her Thirst Cough difficulty of Breathing Consumption Atrophy Weakness and other Symptoms increasing But she wholly abstain'd from and was plainly afraid of using the Islington Waters because that was the first Year they were found out and there were a great many Reports spread abroad of their Mischievous Nature But one time when I was not sent for going to visit her in her Chamber to know certainly what Effects the Chalybeate Waters had had because I had heard nothing either from her or from her Brother the Apothecary I found her in a worse condition than ever before and her Fever Cough and Atrophy with all the other ill Symptoms before mentioned so much increased by a Looseness that was come upon her and had now continued so long that she could hardly rise out of her Bed But at last being prevailed upon by the Reasons and the Experience that I urged I had lately had of them she consented to try the Vertue of Islington Waters And in order thereunto I ordered a Dose of my Astringent and Opiate Electuary to be given every Night for her present Looseness when it was necessary and the next Morning always
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
Fevers as also from the Small-Pox and Measles A Consumption often proceeds from these Acute Diseases I Have very often seen a Consumption of the Lungs take its Original from these Acute Diseases Neither indeed have we any reason to think it strange that a heat kindled in the Humours by a Putrid Fever is wont to degenerate so easily into a Hectick or Habitual heat seated in the Spirits and solid Parts of the Body For when the Spirits and Humours in the Habit of the Body have been a long time fed or nourisht by the Blood too much inflamed and heated they do not easily shake off that Preternatural Heat And what wonder is it if from this Hectical and fixt Flame a Colliquation and Consumption are apt to follow Especially from the Small-Pox c. And this is wont to happen especially in the Small-Pox Measles and in Scarlate and Crapulous Fevers Because in these Diseases there is so great a Colliquation of the Humours follows caused by that sharp heat that attends them that it can hardly be stopt afterwards whereupon the new Chyle afterwards cannot be united or assimilated to the Solid Parts And from hence it comes to pass that the Preternatural Heat of the Parts is not always quite extinguisht by the critical eruption made in the former Diseases but there still remains a Hectick heat in the Solid Parts together with a dry Cough with other signs of the Serous and Colliquative state of the Blood after the other Distempers are cured which even presages a Consumption that is to follow The most usual fore-runner of this Consumption is a light Peripneumonick Affection What is the usual fore-runner of this Consumption or Scrophulous Tubercles bred in the Lungs themselves which are always wont to arise first in the declension of the former Diseases From whence it comes to pass that not only a Feverish Heat is kindled again but it likewise returns attended with a Cough difficulty of Breathing want of Rest a Thirst want of Appetite yea and sometimes with a pain in the Breast and other signs of an incipient Consumption This Consumption for the most part is Acute For this Consumption for the most part is quick and Acute because it comes upon Nature when she is already weakned by the former Distemper neither can it be prevented Bleeding is necessary as well to prevent as to Cure it or cured any way without timely and repeated Bleedings though the state of the Patient seems never so weak And indeed the neglect of Bleeding or doing of it too late or too sparingly in the declension of the preceding or Original Disease uses for the most part to be the occasion of this Consumption But when we have bled the Patient as often After which Expectorating and Balsamick Medicines must be used and as much as we ought to do the rest of the Cure is to be performed with the diligent use of Expectorating and Balsamick Medicines already described in the General Method as also of a Milk Diet and Temperate Juleps What I have said of a Consumption coming after the Measles Small-Pox as also Scarlate and Crapulous Fevers all which Diseases are of one and the same kind to wit of a Serose and Colliquative Nature the same may likewise be affirmed with the same Reason of all Scorbutical and Chronical Fevers as also generally speaking of any kind of Fevers that have terminated without a fair and due Crisis For the Feverish Ferment being in this manner rather deprest by force than overcome there succeeds a mild Hectical Heat to the former Putrid Flame which will afterwards introduce a Consumption after it And therefore even in the declension of these Fevers In the declension of some Fevers we must bleed what sort soever they are of we ought to bleed and then finish the rest of the Cure in the manner as I have hinted in this Paragraph Malignant Fevers may bring a Consumption And I do not doubt but that even Malignant and Pestilential Fevers which are wont to have a Critical termination by Apostemes and Ulcers may likewise bring a Consumption by throwing the Feverish Matter by the way of a Crisis upon the tender Substance of the Lungs from whence Swellings and ill-natur'd Ulcers arising are apt to bring a very Acute Consumption But the Cure of it must be performed with the timely and diligent use of Expectorating Absterging and Balsamick Medicines before described by which means we may as soon as is possible clear the Lungs Observations concerning a Consumption from Intermitting Fevers But here I have a mind to add some few things particularly of the Original of a Consumption proceeding from Intermitting Fevers Scil. Observ 1 First That I have observed a Consumption to have its Original from no other Fever more frequently than from an Intermitting one Which to me seems to happen for two Reasons First because this Fever either from its own peculiar Nature because it has an inexhausted Source in the Habit of the Body or from the neglect of giving Efficacious Medicines in time and in a good quantity is very Chronical and many times though it is driven away returns again and from thence it comes to pass that at length a Hectical and continual heat is brought upon the Spirits and Solid Parts by this Putrid Heat prevailing for a long time and thereupon there must necessarily follow a Serous Colliquation of the Humours together with a Cough and the other Symptoms that accompany a Consumption Secondly because this sort of Patients having no suspicion that this kind of Distemper will be Mortal as they commonly make slight of it so they are wont to neglect themselves not only endeavouring to Cure themselves with I know not what Receipts of Old Women from whence it comes to pass that under the pretence of Curing the Fever they many times procure an Inflammatory and Venomous disposition to the Blood and Humours but likewise very often exposing themselves carelesly to the cold Air even in the time of the Fit and getting one Cold after another they at length suffer for their carelesness and ignorance by a Consumption caused by the often taking of Cold and the neglecting of it too in this distemper'd state of the Humours Which Consumption is wont to go by the less infamous Name of a Catarrh with these poor Patients till at length through their Negligence it becomes incurable And therefore I would give this Advice to all Persons that they do not from a false Opinion of the Innocent Nature of this Disease trust to the Receipts of Quacks and Old Women but that they would immediately make it their business to Cure it perfectly and in due time with the plentiful use of the Peruvian Bark the only mighty Antidote of this Distemper and to prevent the return of the Fever by repeating the use of it For a frequent relapse into this kind of Fever does threaten a Consumption as well
THE Blood as soon as it has here and there in its Circulation distributed the new Chylous Parts and those that are fit for Nourishment becomes plainly sharp as if it were imbued with a Ferment from the Saline and Acrious Particles which by the Law of Nature it still contains in it self to the end that from thence the Bile and other necessary Ferments of the Body may be supplyed and every day renewed And therefore by the same Sagacity of Nature there is Provision made that after she has in this manner done what is sufficient for the necessary Ferments the Acrious and superfluous remainders should as Excrements be forthwith thrust and thrown out by the pores of the Skin by the Kidneys the Glandules of the great Guts and the other Avenues or Emunctories of the Body lest the Mass of Blood it self being burdened and opprest with this kind of Particles and thereupon brought into a distemper'd state should not be able to perform its Natural Office From what I have now said it is evident to Reason how many ways a Jaundies is wont to occasion a Consumption How a Jaundies causes a Consumption For whether it be Accidental as when it proceeds from an Obstruction of the Natural course of the Bile from the Gall-Bladder into the Cavity of the Duodenum caused by a Stone or the glutinousness of the parts of the Bile or whether it be more Habitual coming from a defective separation of the Bilious parts in the Liver caused by a Schirrous hardness or an Exulceration of that part there are two things which must necessarily be the Effects of it to wit a want of Bile in the Intestines and too great a congestion of it in the Blood By the first of these Nature for want of a due Menstruum in the Volatilization of the Chyle is hindred from the convenient separation of the Excrementious from the Chylous parts From whence it comes to pass that the Excrements of the Guts containing in them both parts are voided of a white colour together with a manifest faintness and weakness of the Patient even from the very beginning of the Distemper Because by this continual Substraction of the new Chyle there is caused by degrees an Universal Atrophy which I have already hinted in the Appendix to the First Book But by the latter the Mass of Blood itself is altered and distempered as being too much saturated with Bilious Particles that are sharp and pungent Which discovers itself not only by an Universal Itching excited in the Habit of the Body but also by a yellow Tincture coming upon all the Skin and by the very red and yellowish colour of the Urine From this Collection of sharp and bilious Particles in the blood at least when it happens to be long and Habitual no Body must think it strange if even the very Mass of Blood is vitiated and contracts a Hectical Heat and any one may as easily observe how soon the Lungs being from thence affected with a Hectical Heat are apt to be stufft to swell to be inflamed and putrefie So that the Jaundies whenever it is Chronical and Habitual by gradually spoyling the Crasis of the Blood is wont likewise to bring a Chronical Consumption of the Lungs Which also is not a little promoted by the Oppression of the Hypochondres This Consumption is promoted by an Oppression of the Hâ—pochondres which continually creates a weight in them caused by the preternatural thickness and compactness of the Liver to wit whenever the Jaundies is Chronical and likewise from the Colick of the Stomack or those dreadful Spasmodick Pains which are wont to return often from the Obstruction of the Gall-duct by a Stone or the Glutinousness Viscidity of the Bile or else from an Inflammation and Exulceration of the Liver itself to wit whenever this Distemper is Accidental and more Acute For as it is impossible but the Lungs must be much injured by the consent they have with the Liver that lyes so near to them and must likewise necessarily partake with it of the Spasmodick Contraction in the manner of Hysterical Suffocations whereupon their tender Substance must needs be very much injured and changed from their Natural Tone by that frequent Constriction to wit in an Accidental Jaundies So likewise whenever it is Habitual the Hypochondriacal Melancholy which is wont always to accompany the Gravative Oppression caused by the Obstruction of the Liver does dispose Persons to a Consumption of the Lungs it may be more than any other Passions of the Mind A Consumption is seldom caused by an Accidental Jaundies 'T is true indeed that I have very seldom met with a Consumption of the Lungs proceeding from an Accidental Jaundies whether this Disease has had its Original from the Obstruction of the Bile-duct or from an Inflammation and Exulceration of the Liver it self For by reason of the violent Colick or Spasmodick Pain and the Acute Inflammatory Fever which are wont for the most part to accompany this Jaundice the Patient very seldom happens to live so long that the Blood can undergo so great an alteration from the Bilious Particles preternaturally heaped up in it as to be disposed to form a Consumption of so Chronical a Nature But before it is possible for the Blood to undergo such an alteration as is able to produce so great an Effect either the Distemper is taken off from the Patient by Art or the Patient is killed by the Distemper But no Disease comes more frequently upon a Chronical Jaundies But there is no Disease does come more frequently than a Consumption upon a Chronical and Habitual Jaundies proceeding from a Schirrousness or too great a Compactness and hardness of the Substance of the Liver which Consumption for the most part is wont to terminate in a Fatal Dropsie For as this is a Disease of several Years because it is attended with no very great Symptom so the Bile which is thereupon preternaturally heaped up in the Blood though it is not in so great a quantity as in an Accidental Jaundies yet by its long stay in and frequent cohobations with it if I may speak it does more effectually alter the whole Mass and disorder it and it is no wonder if the tender Substance of the Lungs does at length get some fatal Mischief from it The Evident or Procatarctick Causes of this Consumption The Procatarctick causes of this Consumption are commonly frequent and long Debauches and the more grievous Passions of the Mind succeeding alternately one another By the first the Substance of the Liver and perhaps the Lungs too happens almost always to be too much heated and stuffâ— with superfluous Juice and by the latter it happens to be spasmodically girt or comprest By both together the Liver and it may be the Lungs too is rendred too close or compact in its substance if it does not also become Schirrous or inflam'd and ulcerated And from hence there must
beyond the Sphere of Surgery And not to be cured without healing the Original Vlcer And indeed to Cure this Consumption perfectly without healing of the Ulcers from from which it takes its Original is the same thing as to take away an Effect whilst the Cause of that Effect remains It is true indeed that so often as these Ulcers happen to be small and benign and are likewise placed in the Kidneys Bladder Testicles Ovaries the Vagina Uteri or in other Membranous Parts and Entrails that are more remote from the Heart as the Ulcers themselves which here assume the Nature of a Cause do sometimes admit of a perfect Cure so likewise the Pulmonary Consumption it self which depends upon them may as well be cured But this Consumption whether it be capable of a Cure or not does nevertheless almost always assume the Nature of a Chronical Disease in some measure And from hence I have found some of this sort of Patients for several Months When this Consumption is Chronical yea and sometimâ— several Years languishing with a Consumption pining away by degrees and dissolv'd by Colliquations but especially when the source of the Disease has been in one of the Kidneys the Bladder or Vagina Uteri that have been ulcerated A Consumption proceeding from an Ulcer of the Ovaries in Women or the Testicles in Men I have observed to have been of a middle Nature but for the most part to carry off the Patient within the space of a Year But that which arises from an Exulceration of the Womb it self When Acute the Stomack Liver or other Entrails or Membranous Parts of the greatest note I have observed to put an end to the Patient's Life in the space of a very few Months or even Weeks after the manner of a very Acute Consumption because it has been immediately attended first with an extraordinary Inflammatory Fever and after that with a Putrid Intermitting Fever and an universal Colliquation together with a want of Rest Light-headedness Spasms and other direful Symptoms of the Nerves But yet by reason of the sudden Destruction brought on from the Nature of the Original Disease I have found by inspecting into Bodies after they have been dead that the Lungs have not been so much affected as they used to be in other Consumptions that are more Chronical to wit where by reason that the Original Distemper has suffered the Patient to live long enough the Lungs have happen'd not only to be stufft but likewise to have Tubercles bred in them and those Tubercles at length have happen'd to turn to Apostems But generally speaking The more Acute it is the harder to Cure as every Consumption of this kind is very hard to Cure so it is so much the harder as it is more Acute because it has its Original from more considerable Ulcers Neither indeed does it ever admit of a perfect Cure without the healing of the Ulcers whatever they are and in whatsoever Entrail or Membranous Part those Ulcers are bred which gave the first occasion to this Disease From what I have now said it is plain enough even to Reason what are the Indications of Cure in this kind of Consumptions which likewise the happy Success of our Practice is wont daily to present to our very sight that is whenever the Distemper does in its own Nature admit of a Cure The Indications of Cure And they must respect the Original Disease as well as the Lungs themselves first by promoting as much as we can the healing of the Ulcers in what part soever of the Body they have been bred with the plentiful use of Balsamick and Vulnerary Medicines which indeed ought to be of the milder sort lest by increasing the Feverish Flame that is already kindled in the Blood they should do more hurt than good Secondly by taking timely care of the Lungs with the use of Pulmonary Remedies to wit Opiate and Expectorating Medicines given alternately by which the mischief which they have got may be taken off or at least as little as may be promoted by the Original Distemper Thirdly by mixing always with the Pectoral and Balsamick Medicines those things which may restore and confirm the Tone of the Part which was first of all affected and which have a particular respect to it as Uterines Hepaticks Diureticks and other such-like Medicines as the case may require Fourthly by tempering the Hectick heat which is already kindled in the Blood and Spirits with a strict Milk Diet the Chalybeate Mineral Waters Vulnerary Decoctions of Sarsa Lime-water and other things of the like Nature so far as the present state of the Patient can bear them as also by taking off the Putrid Intermitting Fever with the plentiful use of the Peruvian Bark and with repeating of it often enough at due intervals And lastly by relieving with the most diligent application the most urgent Symptoms and those which weaken the Patient most whether they arise from the Original Ulcer or from the Lungs As for Example The Method of Cure If the Original Ulcer is so benign and small that there appear any hopes of a perfect Cure and it has not continued so long that the Patient is brought very weak with it and if it is not seated in so Noble a Part as to make us fear the sudden destruction of the Person from an Acute Consumption it is plainly convenient in the very beginning of the Cure to endeavour the healing of the Original Ulcer by giving Calomelanos plentifully and that not only mixt with Purges and therefore at due intervals but likewise by it self in Doses repeated quickly one after the other with a design to raise a Salivation by which if the Patient has strength enough to bear so great an Evacuation and it be convenient in other respects we shall take much better Measures as for the healing of the Ulcer so likewise for the preventing of the Consumption which is like to follow than by any other Apparatus of Medicines But if that be contraindicated by the Patient's Weakness the intense degree of the Fever and the very Acute Nature of the Consumption at least as Antimonial so Mercurial Medicines may be so disposed at due intervals in the Method of Cure that they may successfully exert their extraordinary Healing Vertue without any expensive Evacuation excited thereby As for Example Let the Patient take every Night xv or xx Grains of Antimonium Diaphoreticum in a little bit of Old Conserve of Red Roses mixt with Leucatellus's Balsam And every third or fourth Morning a Scruple or half a Dram of Mercurius Dulcis in a spoonful of Milk Let him also drink a Vulnerary Decoction of Sarsa described in another place for his ordinary Drink adding always at the time when he takes it of the Balsamick Syrup so much as will serve to make a Draught of it grateful to the Patient's Palate My Balsamick Pills are likewise very good in this case being ordered so
PHTHISIOLOGIA OR A TREATISE OF Consumptions WHEREIN The Difference Nature Causes Signs and Cure of all sorts of CONSUMPTIONS are Explained Containing Three BOOKS I. Of Original Consumptions from the whole Habit of the Body II. Of an Original Consumption of the Lungs III. Of Symptomatical Consumptions or such as are the Effects of some other Distempers Illustrated by particular Cases and Observations added to every Book With a Compleat TABLE of the most Remarkable Things By RICHARD MORTON M. D. And Fellow of the Colledge of Physicians Translated from the Original LONDON Printed for Sam. Smith and Benj. Walford at the Prince's Arms in St. Paul's Church-yard 1694. TO THE High and Invincible Monarch William III d. By the Grace of God King of Great Britain France and Ireland Defender of the Faith c. Dread Soveraign NOW that you have with the greatest Difficulty and Danger happily expended so many and such vast Labours for the sake of Religion and the Common-wealth now that you have had so many Remarkable and Eminent Rewards conferred upon Your Majesty as we must think by the Hands of Heaven with the Suffrage and Applause of all Good Men for your Vertue and Piety both towards God and Mankind which every way imitate and equal what has been always found in the Family of NASSAW permit me who not by my own Merits but by Your Favour alone was some time since advanced to the Doctor 's Chair to Present to your Majesty these First Fruits of my Studies how mean soever they be as an Expression of my most Humble Gratitude and to lodge them securely under the Protection of Your Most Mighty Patronage From which if any thing shall redound to the Publick Good I shall have Reason abundantly to Congratulate my own Felicity And may it please Almighty God that his free and infinite Goodness towards Mankind may especially at this time be manifested to all the World to bestow upon Your Majesty and upon the Most Illustrious Consort of Your Bed and Throne MARY Queen of Great Britain perpetual and unshaken Health a Long and Prosperous Reign and an Heir in every thing like his Parents and at length a late arrival to the Regions of Immortal Bliss This all Good Men particularly Pray for this they passionately desire In the mean time go on Most Renowned Monarch to Compose the disordered state of Religion and the Common-wealth to Succour the Christian Part of Europe that is just ready to perish to give Peace to the World and finally to take off every Unjust and Tyrannical Yoak that in after-ages you may for ever be stiled under God the only Deliverer and Saviour both of Your Country and of Mankind which is the most ardent desire of Your MAJESTY'S Most Humble and Devoted Subject RICH. MORTON TO THE READER THIS Book had remained concealed from Vulgar Eyes in the Learned Language in which it was writ by the Author had we not been certainly informed that the Translation of it was intended and attempted by other Hands And having also fresh Experience how by such means two late Treatises of Dr. Harris and Dr. Sydenham whose Copies were our Proprieties were surreptitiously invaded and by false and unintelligible Translations the worthy Authors themselves much defamed and injured we thought in Justice to our selves as well as the learned Author to anticipate such an ill Design by procuring and putting forth this Exact Traduction wherein not only the Sense but also the Life and Elegancy of the Author's Style is fully set forth And we do here at once declare to the World our Intentions to frustrate the Designs of any whoever they be who for the future shall go about to Translate and Publish any Copy of Ours S. Smith B. Walford The CONTENTS BOOK I. OF Consumptions in General and particularly of a Consumption proceeding from the whole Habit of the Body or an Atrophy both that which is Nervous and that which is caused by Evacuations pag. 1. Chap. 1. Of a Nervous Consumption pag. 4. Chap. 2. Of a Consumption proceeding from some Evacuation p. 11 Chap. 3. Of a Consumption from Bleeding p. 14. Chap. 4. Of a Consumption from a Gonorrhoea and the Whites p. 19 Chap. 5. Of a Consumption proceeding from Apostemes and large Ulcers p. 23. Chap. 6. Of a Consumption happening to Nurses from the giving of Suck beyond what their strength will allow p. 32 Chap. 7. Of a Consumption from a Bloody-Flux and from a Looseness p. 37 Chap. 8. Of a Consumption from a Diabetes or too great a Flux of Urine p. 41. Chap. 9. Of a Consumption caused by Salivation or Spitting p. 45 Chap. 10. Of a Consumption proceeding from a Dropsie p. 47 Chap. 11. Of a Consumption caused by profuse Sweats p. 52 The Appendix p. 57 BOOK II. OF an Original Consumption of the Lungs pag. 62 Chap. 1. Of the Causes of an Original Consumption of the Lungs p. 64 Chap. 2. Of the Degrees of an Original Consumption of the Lungs and the Signs which give us warning of it together with the Preservatory Indications or what we are directed to do in order to prevent it p. 69 Chap. 3. Of the Diagnostick and Pathognomonick Signs of the beginning of a Pulmonary Consumption p. 82 Chap. 4. Of the Pathognomonick Signs of a Confirmed Consumption of the Lungs p. 100 Chap. 5. Of the Differences of an Original Consumption of the Lungs p. 117 Chap. 6. Of the Prognostick Signs of an Original Consumption of the Lungs p. 122 Chap. 7. Of the Indications of Cure in an Original Consumption of the Lungs p. 127 Chap. 8 Of the Method of Cure in an Original Consumption of the Lungs p. 138 Chap. 9. Of the Cure of a Consumption in the Second Degree of it to wit when from the want of a due Expectoration and from the Matter that was lodged in the Lungs thereupon staying long in them some crude Tubercles arising from the knotty Swelling of the Glands of the Lungs happen to come upon a long Cough p. 155 Chap. 10. Of the Cure of an Original Consumption of the Lungs in the Third Degree of it to wit when the Patient is reduced by the Inflammation the Apostems and Exulceration of the Glandulous part of the Lungs to the state of a Marasmus together with an extraordinary Weakness a Consumption of his Flesh an increase of his Hectick Fever and likewise the addition of a Peripneumonick and Putrid Fever and the other direful Symptoms which are wont to accompany the Fatal state of a Consumption p. 171 Chap. 11. Of the Relief of the Symptoms of a Consumption in the Third Degree of it p. 182 BOOK III. OF a Symptomatical Consumption of the Lungs pag. 191 Chap. 1. Of a Scrophulous Consumption p. 194 Chap. 2. Of a Scorbutical Consumtion p. 202 Chap. 3. Of an Asthmatical Consumption p. 212 Chap. 4. Of a Consumption proceeding from Melancholy as also from an Hysterical and Hypochondriacal Affection p. 217 Chap. 5. Of a Consumption caused
Medicines such as the Balsamick Syrup Leucatella's Balsam c. As for Example Let the Patient take every Night Leucatella's Balsam Conserve of red Roses of each half a Dram or two Scruples with three or four drops of Balsam of Peru. Or a spoonful of the Balsamick Syrup truly made twice or thrice a day either by it self or dissolv'd in a draught of Sarsa Drink Or half a Dram of Balsam of Tolu made up into Pills at Physical Hours drinking a draught of the Sarsa Drink after it Or if there be no Feverish Heat let him take twice a day eight or ten drops of Natural Balsam mixt with a little Sugar-candy But when the Ulcer comes to heal Care must be taken that a Consumption of the Lungs does not follow upon healing of the Vlcers there must be a great deal of care taken lest a true Consumption of the Lungs follows in the room of a common Consumption from the substraction and loss of the Chyle which indeed does very often happen For this passage by which the Nutritious Juice uses to run off being now stopt by the Surgeons and Physicians Art if the Blood still remains dispirited and does not recover its former Balsamick and Oily Nature it is wont to grow more hot and sharp and thereupon that sharp and hot Nutritious Juice which was used before to be thrown out by the Ulcer it usually comes now to cast off upon the substance of the Lungs as being spungy and apt to receive the Humours Whereupon follows not only a stuffing of the Lungs and upon that a difficulty of Breathing but also a considerable swelling of the Glands which do often enough happen in these parts and upon that a dry and troublesome Cough yea a Heat and Inflammation and thereupon a Fever not only a Hectical one but also a Putrid or rather Inflammatory Fever and at length an Apostem and Ulcers with a Thirst and want of Appetite all which do at last end in a fatal and confirm'd Consumption of the Lungs The Signs which threaten it must be attended to And therefore as soon as ever these external and remote Ulcers begin to heal the Physician ought to make what Observation he can to find whether the least degree of a difficulty of Breathing or any other sign of an Affection of the Lungs comes upon it Yea if the Appetite continues weak or if but the least degree of a Preternatural Heat in the Habit of the Body does appear If they appear what is to be done which may give us the least occasion to suspect a Consumption of the Lungs the first Attack and Progress of it ought to be prevented with all the Physician 's Power in the manner following Let several Issues be made the Head shaved the use of the Balsamick Remedies before mentioned and the Sarsa Drink with the aforesaid Vulnerary Herbs be continued or for the farther temperating and altering of the Blood let the Patient be put into a Milk Diet and kept strictly to it For the same reason the Chalybeate Mineral Waters are here also of great use Also the Physician must make all the hast he can and disburden the Lungs that are stufft by Pectoral and Pulmonary Apozems expectorating Linctuses and other Medicines of that Nature which we shall afterwards describe in the Book of a Consumption of the Lungs before the Tone of the Parts is injured and a Feverish heat is brought on by the continual stagnation of hot and sharp Juices Let the Patient also have a very great care to preserve himself from Passions of his Mind Passions of the Mind Cold and violent Excercise are to be avoided and Cold and use no violent Exercises let him also abstain from the use of Wine and Spirituous Liquors which may make the motion of the Blood to and through the Lungs quicker than it ought to be and kindle a Preternatural heat in the Blood But if there be no suspicion of the Lungs What is to be done after the Vlcers are healed when there is no suspicion of the Lungs when the Ulcer comes to be healed let the Patient be enjoyn'd to be chearful let him be plac'd in a benign and open Air and eat plentifully of such Food as affords a good Juice but yet is mild and free from a sharpness and lastly let him use moderate Exercise by the use of all which the Blood may as soon as is possible recover its former Balsamick Temperate and Oily Nature and the Appetite of the Stomack may be increased By which Method we may not only prevent a Consumption that is coming but also cure one that is begun when it proceeds from external Ulcers as I have before discours'd more largely in the former Chapters of other Original Consumptions caused by the loss and want of the Nutritious Juice An History Mr. Wheatley's Wife near St. Sepulchres in London about Fifty Years old having been tormented for the space of two Years with an intolerable pain of her Loins first from an Inflammation and then an Aposteme of the Muscles of the Loins following upon the Inflammation was in progress of time by the uninterrupted pain racking her both Night and Day and by the continual loss of the Nutritious Juice discharging it self daily and plentifully into this Common-shore put into a Fever and at length brought into a Consumption and that even to the degree of a Marasmus with an intolerable Thirst a continual Weakness want of Appetite and want of Rest yet without any sign of a Consumption of the Lungs so that the poor Woman being always confin'd to her Bed lingred a long time crying out dreadfully as if she were ready to expire presently By reason of her mean Circumstances she did not ask the Advice of a Physician but thinking her Distemper to be the Stone in the Kidneys she miserably tormented her self every day with I know not what Medicines to break and dissolve the Stone such as every sorry Woman that came to see her did with assurance warrant should do her good But I being at length desired by the most Ingenious Dr. Tyson to go and see her and together with him observing the parts of the Loins to be swell'd and to resist a Pressure and perceiving the fluctuation of purulent Matter under our fingers when we prest it though it lay somewhat deep by reason of the thickness of the Muscles and of the Skin with the consent of my most worthy Colleague I ordered that after the application of a Caustick the Tumour should be opened in a convenient place Which was no sooner done but a great quantity first of clear then purulent Matter and a great Number of little Bags filled with a very clear Water at least Five Hundred gusht out with a great force We brought away for three Weeks or more taking out the Tent every day a great deal of Matter and small Bags filled with Water From the first opening of the Apostem her pains were
very much abated and by the moderate use of Syrup of Meconium she got convenient Rest and by the help of Surgery outwardly administred and the continual use of a Decoction of Sarsa given inwardly for her ordinary Drink the Ulcer within the space of a Year and half which we did designedly keep open so long with a Silver Tent that was hollow quite thorough was at length perfectly healed her Hectick Fever and Thirst went off her Strength increased her Appetite returned and she was plainly freed from the state of a Marasmus and being sent into the Country Air such as was open and benign and put into a Milk Diet she grew fleshy within six Weeks and recovered without any sign of a Consumption and being yet alive after Eight Years which are since past enjoys her Health very well Several Histories of this Nature I do designedly omit for Brevity's sake CHAP. VI. Of a Consumption happening to Nurses from the giving of Suck beyond what their Strength will allow What the Milk is MILK is nothing but the Nutritious Juice continually separated from the Mass of Blood by the Glandules of the Breasts And therefore if by reason of the want of an Appetite there be more Nutritious Juice suckt out of the Blood through the Breasts for a long time than is supplyed to the Mass of Blood by the new Chyle from the Lacteal Vessels When and how the giving of Suck does cause a Consumption it is in possible but an impoverishment of the Blood should follow and thereupon an Atrophy of the Body seeing it is depriv'd of due Nourishment and consequently an Hectical heat in the Blood Spirits and Habit of the Body which is another kind of Original Consumption proceeding from the substraction of the Nutritious Juice of which we shall now treat Yet a Consumptive disposition is sometimes cured by giving of Suck Yet I must ingeniously declare that I have sometimes observed a Consumptive Disposition cured by giving of Suck and that not only in my most dear Wife but also in very many other Women As for Example My Neighbour Mrs. Wilson who at other times is Consumptive and goes up and down like a Ghost does always grow fat all the time she gives Suck Yea Mrs. Thompson upon Snow-Hill did manifestly fall into a fatal Consumption in the Habit of her Body and upon that into a Consumption of her Lungs from the sudden weaning of her Child But at the same time it is as obvious to our Observation that all such Nurses as grow fat in this manner from giving of Suck But such Nurses have always a good Stomack have a good Stomack yea that during the time of their giving of Suck their Appetite is very much increased and from thence it is very easie to give an Account for this appearance to wit that the Appetite being increased by the continual drawing off of the Nutritious Juice by the Child's Sucking there is room made for a greater quantity of new and oily Chyle by which the Blood is every day enrich'd which does conduce more to the Cure of a Consumptive Disposition than all the Medicines in the World But if the Appetite during the time of giving Suck grows languid and thereupon by reason of the little Food that is taken in a less quantity of new Juice is supplyed to the Blood than is carried off by the Breasts a Hectical Disposition in the Blood and Spirits must inevitably follow and an Atrophy or Consumption in the Habit of the Body and that for the Reasons which we have just now given The first thing that presages the coming of this Consumption is a want of Appetite The presaging signs of this Consumption and therefore I give this Caution to all Nurses that when they find their Appetite to abate for some time they forthwith wean their Children The second sign is a weakness and faintness of the Spirits proceeding from a dispirited and impoverisht state of the Blood A third sign is an Hypochondriacal Oppression and frequent Fits of the Mother and Choakings Which appearance does not proceed from the sucking of the Child drawing the Vapours upward as is commonly thought but a too plentiful substraction and too great an expence of the Nutritious Juice By which means the Spirits themselves become in the same manner as the Blood poor and windy by reason they have lost their Natural and Original Vigour whereupon there follows an Obstruction and this inordinate and ungovernable motion of the Spirits in the Nerves and Fibres of the Muscles and upon that Oppressions and Suffocative and Convulsive Contractions of some Parts commonly called Hypochendriacal and Hysterical This Consumption often terminates in a Consumptions of the Lungs These presaging Symptoms in the Progress of the Distemper have an Atrophy and a Hectical heat following them which is not strange and do often terminate in a Consumption of the Lungs together with a Cough shortness of Breath c. Nevertheless this Consumption is Originally in the Habit of the Body and that from too great an expence of the Nutritious Juice And is then fatal This Consumption when it once comes to the degree of a Marasmus and to terminate in a Consumption of the Lungs proves plainly fatal and incurable The Method of Cure But in the beginning it is easily cured first by the speedy weaning of the Child whereby the cause which dispos'd the Person to it is removed Secondly by giving the Patient plentiful Nourishment of such Food as affords a good Juice Thirdly by exciting and restoring the Appetite by chearfulness of Mind the enjoyment of a benign and open Air by moderate Exercise c. Yea and lastly if her Hectical Disposition requires it the Sick Woman must be put upon the use of a Milk Diet A Caution or of the Chalybeate Waters But let her abstain from Wine and all Evacuations but what are necessary as we have already hinted in the Cure of a Consumption proceeding from other Evacuations A History The Wife of Mr. Bird my very good Friend who lives in Fetter-Lane being about three and thirty Years old gave Suck to a lusty Boy for the space of a Year or more But after she had given Suck for four Months she lost her Stomack and took very little Nourishment at any time and thereupon her Strength declin'd and she was troubled with Choakings or Hysterical Passions but without an Atrophy or Cough or any other Distemper Being sufficiently directed by these things I going at that time by chance to see her advised her to wean her Child without any delay lest she should fall into a Consumption But she however persisting in the giving of her Child Suck when she had lost her Stomack did at length fall into a Consumption or Atrophy of her Body but without a Cough or any remarkable Fever But yet she very much and almost continually complain'd of a dryness and very troublesom heat about the
to pass by reason of the continual impoverishment of the Blood And from hence a Consumption arises that not only the Mass of that becomes sharp and grows hot with a Feverish and Hectick flame but also the solid Parts of the Body being at the same time deprived by this means of their requisite Nourishment do by degrees fall into an Atrophy and perfectly wast Colliquative Sweats attend every Consumption when deplorable This Colliquative Sweat as it accompanies every Consumption of the Lungs in the deplorable state and highest degrees of it that is when it is now hastening to a fatal period so it is found in the lamentable state of every Distemper and the sudden ruin of Nature always follows it And therefore these Dews or Colliquative and Oily Sweats are commonly called clammy Death-sweats Sometimes also though seldom Iâ— the Scurvy Collâ—quâ—tive Sweats the Original of an Atrophy I have observed in a Scorbutical Disposition that this kind of Colliquative Sweat has the place of an Original Distemper by the excess of which I have seen the whole Body brought into a Hectick and Consumptive state in a few Weeks Which comes to pass because the Mass of Blood is by these profuse Sweats continuing long reduced to an impoverisht state and rendred unfit for Nourishment Upon which there necessarily follows a Hectick heat and an Atrophy of the Parts with a great Weakness and other usual Symptoms of a Consumption in the Habit of the Body I have a mind to add here to the end of this Chapter an Instance or two of this Nature by the relating of which the cure of this Consumption will be shewn so far as I have observed and am able to give an Account of it History 1. Mr. Luffe a Presbyter being about Sixty Years Old who was also the Father of Dr. Luffe a Famous Professor of Physick at Oxford a Man that had for many Years past been Scorbutical and Melancholick was frequently subject to a Giddiness Palpitation of the Heart and many other Affections of his Brain and Nerves But above all he was wont to complain of Colliquative Sweats that followed him continually both Night and Day and that as well in the Winter as the Summer time From whence it came to pass that not only he was very subject to take cold upon which he always felt great pains in his Nervous Parts but also his whole Body wasted so that he was justly to be reckoned in the number of those that were in a Consumption However with Issues made between his Shoulders and the use of a Diet-drink made with Antiscorbutick Ingredients steep'd in Ale for his ordinary Drink and especially the long use of the Mineral Waters both the Chalybeate and Purging which he took as well in the Winter as the Summer he was perfectly freed not only from those other Distempers which affected his Nerves but also from these Colliquative Sweats By which means it came to pass that he lived several Years in the latter end of his Old Age with a strong Habit of Body an uninterrupted Health a chearful Mind a fresh and brisk Look as if he began to grow Young again History 2. The Wife of one Mr. Clapton who lived in Lothbury being about Forty Years old a Woman that had been for many Years very Scorbutical and Asthmatical a Month after a Lying in fell in the Spring-time into most violent pains a little above the Groin To whom besides the outward application of an Anodyne Liniment I gave a Draught that might put her into a breathing sweat Of Carduus-water Treacle-water Venice-Treacle and the Syrup of Meconium upon which it happen'd that she fell and dissolv'd into most profuse and very stinking Sweats which though they took some of the Bed-cloaths off from her by degrees did nevertheless continue for a fortnight or more with an extraordinary decay of her Strength and a pining Consumtion of her Body Which when I observed I forthwith prescrib'd such Electuaries and temperate Juleps as were binding and proper to stop the pores of the Skin and other things of that Nature whereupon her Sweats presently decreas'd but although the pores of the Skin were then stopt by Art yet the new Chyle which by reason of the Acrimony that remain'd in the Blood was not so well assimilated and united to that Mass which remain'd being mixt with it the fresh Nutritious Juice attempted to find out a new way and to discharge it self by Stool and so in the room of her Colliquative Sweats there succeeded a Looseness that was as Colliquative as they were together with griping pains the Habit of her Body every day running farther into a Consumption But this Door being in like manner barricadoed with the use of Opiates and Emplastick Medicines the Nutritious Juice found out another by the Kidneys whereupon the poor Woman fell into a Diabetes which still promoted her Consumption almost to the degree of a Marasmus But when the Diabetes was overcome with the use of Gum Arabick Astringent Electuaries c. at length her profuse and colliquative Sweats return'd again And therefore I resolv'd to send this Miserable and Consumptive Woman into the fresh and open Air at Hampstead the time of the Year encouraging me it being the Spring by which change of Air the pores of the Skin being now suddenly stopt the Distemper was turn'd into an extraordinary Spitting for Twenty days or more her Consumptive Disposition still remaining or rather increasing but with the plentiful use of a Milk Diet and the benefit of the open Air the Mass of Blood being softned by little and little and its Acrimony corrected the colliquation also of the Nutritious Juice was by degrees overcome and thereupon being freed not only from her Spitting but also from the Consumptive disposition it self she improv'd every day in her Flesh and Appetite till she had perfectly recovered them A large Apostem at length gathering upon her Groin where the pain first seized her which was opened and cured by a Surgeon And by this means the Woman lived and was well for Ten Years or more though she afterwards dyed of an Asthma History 3. Mr. Fortescue a Man about Sixty Years old who had been Scorbutical for many Years before and something Asthmatical was for three or four Summers troubled with a continual heat and burning of his Loins and Limbs Whereby it came to pass that he was plainly exhausted and brought almost into the state of a Marasmus by profuse and colliquative Sweats which followed him more especially when he was in Bed But in the Winter time he was well being in a manner freed as well from his Heat as from his Sweats tho' he never mended his very thin Hippocratical look But this Summer 1688 the burning in his Loins and his profuse Sweats grew so much upon him that he could not lie in his Bed to sleep from whence at length it came to pass that having lost his Appetite he fell into
apply'd to his Belly and the Julep I just now mentioned in the last History which was made very strong of the Salt of Amber to be drank as often as he would take it What I have been telling of the former Patient the same thing did happily fall out here in this For the Boy refusing all other Liquors did covet the Julep Day and Night so that he drank almost four and twenty Ounces every day By which means it came to pass that in the space of a fortnight or less his Stools were brought to a Natural consistence colour and quantity His Urine also flow'd plentifully The swelling of his Belly went down to a Miracle Neither could I any more perceive any Swellings that lay conceal'd within it though I strictly examin'd with my fingers His Appetite and desire of Drink were Natural and as they ought to be His Flesh likewise seem'd gradually to increase every day And now his Melancholy and Weariness being overcome the Boy seems to recover not only the wonted vigour and activity of his Body but also a good Look and a fresh Colour in some measure so that I am not at all sollicitous about what remains to compleat the Cure A TREATISE OF Consumptions The Second BOOK Of an Original Consumption of the Lungs What a Consumption of the Lungs is A Consumption of the Lungs is a Consumption of the whole Body with a Fever proceeding first from an ill Affection and at length an Exulceration of the Lungs Which indeed is the most Famous Consumption and that which is called so by way of Eminence and of which Authors use to treat as if there were no other kind of Consumption and therefore I shall now speak more largely of it It is either Original or Symptomatical This Consumption of the Lungs is either Original which from the very beginning depends upon an ill disposition and an Exulceration of the Lungs Or Secundary and Symptomatical when ever the Lungs receive any great Injury from preceding Distempers But seeing that we ought always in the Cure of a Symptomatical Consumption of the Lungs to have a particular regard to the Primary Distemper from which this Consumption has its Origine and the Cure of it does require a variation in some things according to the Nature of that Distemper I shall make it my business in the last Book of this Treatise to treat of the Cure of this kind of Consumptions having first given in this Second Book so far as I have been able to observe a general Account of the Nature Causes Differences Diagnostick and Prognostick Signs Indications of Cure and the Method of Curing an Original Consumption of the Lungs CHAP. I. Of the Causes of an Original Consumption of the Lungs The general cause of a Consumption THE cause of a Consumption of the Lungs in general is a vitiated disposition of the Mass of Blood and of the Spirits in the Nerves contracted gradually from several Procatartick or predisposing causes in which the sharp or Malignant Serum or Water of the Blood being separated by the soft and Glandulous substance of the Lungs does stuff inflame and at length also exulcerate the Lungs themselves which is the immediate cause of this Distemper The Procatarctick causes of a Consumption First the stopping of Evacuations The Procatartick causes or those which give the first occasion to this Disease are First the stopping of some usual and necessary Evacuations as the Monthly Courses Child-bed Purgations Old Sores and especially Fistula's Issues Sweating in the soles of the Feet or any other parts of the Body a Gonorrhoea the Whites and other Evacuations of that kind when they are stopt without correcting or removing the causes upon which they depend From whence it comes to pass that even the Blood it self is polluted and distemper'd by those Humours which are condemned by Nature to be thrown off or banisht but by some Bars and Impediments lying in their way are stopt and retain'd in the Mass of Blood longer than is convenient 2. Passions of the Mind Secondly troublesome Passions of the Mind but especially Fear Grief Anger too much Thinking and Sollicitude as also unseasonable and too long Studies with other things of this Nature which contribute very much to this Distemper not only by vitiating the Animal Spirits and thereupon hindring the Natural Fermentation of the Blood but also by fixing almost a continual Spasmodick Contraction or Convulsion upon the soft substance of the Lungs Thirdly 3. Intemperance in eating and drinking a too plentiful and an unseasonable gorging of Meat and Drink and also an imprudent choice of such Meats and Liquors as abound with Excrementitious parts and are not very easie to be digested but especially the drinking too much Wine and Liquors that are very Spirituous Which when it is joyn'd with Cares and Grief and other such-like Passions of the Mind so far as I have been able to observe is commonly the cause of a Consumption of the Lungs For the Habit of the Body being from hence filled with a load of dispirited and unprofitable Humours as it is when it is Oedematous the whole Mass of Blood is polluted and rendred waterish and sharp and at length is disposed to a Hectical heat Fourthly the neglect of due Exercise 4. Want of due Exercise for want of which the Excrements which ought by the usual Law of Nature to be thrown out by the Skin being detained in the Blood are wont by degrees to destroy the Crosis or mixture of it For want of this the Humours also are wont to stagnate in the Habit of the Body and various Obstructions to arise here and there in the small Fibres themselves which contribute very much to the corrupting of the Blood and the weakning of the Spirits Fifthly Night-studies 5. Night Studies and long Watchings and long Watchings which not only weaken the Animal Spirits which are necessary for the Fermentation of the Blood but also keep within the Body those Excrementitious parts which are wont to be thrown out in the Bed by Sweat or Perspiration and who will think it strange that the whole Mass is by degrees vitiated by this means Sleeping in the day To this we may also add sleeping in the Day and sleeping much but especially presently after eating which as it dispirits the Mass of Blood and fills it with useless Chyle by hindring the Digestion of the Food from which cause frequent and troublesome Coughs are wont to proceed So by putting the Animal Spirits to sleep at an unseasonable time and thereupon hindring the Fermentation and Volatilization of the new Chyle it makes the whole Mass of Blood too waterish and sharp 6. An ill Air. Sixthly also a foggy and thick Air and that which is filled with the smoak of Coals does extreamly promote a Consumption by vitiating the Animal Spirits which are so necessary to the Natural Fermentation of the Blood and also by stuffing
Anxiety Sadness and an unusual proneness to Anger especially if they be without any evident cause Eighthly the stopping of customary Evacuations by Issues or old Sores so likewise of Child-bed Purgations the Whites and all others of this Nature Ninthly spitting of Blood though it be accidental Tenthly the hawking of black and tough Phlegm constantly in a Morning for a long time For that it proceeds from those Glands being filled with a black Humour which are placed in the Lungs near the Wind-pipe Which Symptom as it is a common thing with those that have the Scurvy or Kings-Evil so it does in progress of time afford us a Prospect of an Asthmatical Consumption that is like to follow Eleventhly 11. A sharp and salt tast of the Phlegm a salt tast of the Phlegm that is hawk'd up which discovers a saltness and sharpness to be in all the Serum or Water of the Blood Which when a great deal of it passes through the soft substance of the Lungs and is separated there upon the getting of a great Cold is apt to inflame and ulcerate them in a strange manner Twelfthly 12. A proneness to spit much A proneness to have a great flux of Spittle by the glandulous Coat of the Tongue and by the Salivatory Ducts and Tonsils and that whether it be with or without any evident cause Which Symptom is a thing that is very common with those that have the Scurvy and such as are Hypochondriacal and shews a Colliquative disposition of the Blood That is that it cannot by reason of its too great and preternatural sharpness perfectly assimilate to it self the new Nutritious Juice nor make it duly mix with it self and therefore throws it off upon these Glandulous Parts and consequently does in progress of time oblige the soft substance of the Lungs to receive it from whence a Consumption commonly has its Original 13ly 13. A want of Appetite that lasts long A want of Appetite that continues long and still grows worse without any other Distemper accompanying of it so that the sick Person unless he uses much Exercise and abstains from eating a great while and pleases his own Fancy in the choice of such Food as is very grateful cannot make a full Meal as he used to do without the turning of his Stomack and making him sick Neither indeed can he digest or distribute the Food which he takes be sure if he eats much without an Oppression at his Stomack and a gravative weariness in his Limbs Which is the very Symptom that opens the way to a Consumption For it proceeds from too great a fulness of the Vessels and the whole Habit of the Body caused by stale and dispirited Nutritious Juice by which means there is not room to receive new Chyle and therefore Nature does not desire it Which want of Appetite does yet grow worse if it happens so that a flame is kindled in the whole Mass of Blood by the present Catarrh from the continual and violent motion of the Lungs and by reason of the serous and colliquative state of the Blood In which case as the Thirst increases so the desire of Food grows less Or else there follows an universal want of Appetite from too great a fulness of the Vessels so that the sick Person plainly refuses Drink as well as Food 14. A Chronical heat 14ly A troublesome and Chronical heat at least in the soles of the Feet and the palms of the Hands especially after eating together with a Pulse somewhat quicker than it ought to be For this Symptom shews an Inflammatory and Hectical state of the Spirits and consequently a sharp serous and colliquative disposition of the Blood from which causes a Consumption of the Lungs does commonly proceed 15. A streightness of the Breast and shortness of breath 15ly A straightness and oppression of the Breast with some difficulty and shortness of Breath almost always joyn'd therewith Which Symptome is very common not only with such as have the Kings-Evil by reason of the swelling of the Glands of the Lungs but also with those that are Scorbutical and Hypochondriacal by reason of the constriction of the Lungs the Diaphragm and other Muscles that serve for Breathing which is from a light degree of a Convulsive Affection of the Nerves that are assign'd for their motion 16ly 16. A disposition to Catarrhs A disposition to Catarrhs that is when the sick Person is frequently subject to a Cough even upon every little occasion yea and sometimes without any evident cause For this Symptom shews a sharpness and colliquative state of the Blood From whence it comes to pass that the sharp Serum or Water of the Blood supply'd from the load of Humours lurking in the Habit of the Body uses to be almost continually separated and thrown out by the glandulous Coat of the Wind-pipe and by the soft substance of the Lungs Which is a very evident sign that a Consumption of the Lungs is then just at hand which will most certainly seize the Patient whenever the serous part of the Blood has contracted so great a sharpness as is sufficient to inflame or exulcerate the Lungs either from the liberal drinking of Spirituous Liquors or from taking of great Cold or any other cause 17ly 17. Any of those Distempers preceding which are apt to dispose to it All those Distempers before mentioned as the Scurvy Kings-Evil a Chronical Green-sickness an Inflammation of the Lungs spitting of Blood Pleurisy Rheumatism Asthma c. which are wont to occasion a Consumption of the Lungs For the Body being in this manner as it were habitually predisposed a Consumption of the Lungs and that many times an incurable one does very frequently seize upon the Patient upon the next great Cold he gets And indeed almost every Catarrh when it afflicts the Patient does at the same time threaten a Consumption that is like to follow To prevent a Consumption the great business to be careful in the six non-natural things Therefore in the preventing of a Consumption which is much easier than the Cure of it the great business whilst the Patients remain in this sickly condition is to take all possible care that no Error be committed in those six things which we call not Natural For in this so slippery a state of Health they are wont upon every little occasion of this Nature to fall headlong into a Fatal Consumption As for Example First 1. In eating and drinking they ought to be Prudent in the choosing of their Meat and Drink that the Chylous Liquor may be made to abound with good Juice and that the Nourishment may create very little trouble to Nature in digesting and dispensing of it Let them also take heed they do not eat too much Food though it be such as affords a good Juice as also that they do not drink too much Wine and strong Liquors 2. Sleep Secondly let them sleep the fore-part of
the Night But let them avoid sleeping in the day-time yea and sleeping too long in the Morning because such sleep is wont to retain and heap up a great load of Humours in the Habit of the Body 3. Exercise Thirdly let them every day use moderate Exercise and rubbing for a good while together to fetch out the dispirited Humours from the Habit of the Body by the pores of the Skin 4. Evacuations Fourthly let them strictly avoid all strong Purges forasmuch as they not only weaken Nature but also by putting the Blood into too great a motion with their sharp Particles they make it grow acrious and hot and bring it into a more Serous and Colliquative state upon which a Catarrh and a Consumption of the Lungs are wont to follow Fifthly 5. Passions of the Mind let the Patient by all Lawful ways industriously lay aside Care Melancholy and all poring of his Thoughts as much as ever he can and endeavour to be chearful For I have very often observed that a Consumption of the Lungs has had its Origine from long and grievous Passions of the Mind Sixthly 6. The Air. let the Patient enjoy an open fresh kindly Air and such as is free from the smoak of Coals which may not only cherish the Animal Spirits and comfort the Nervous Parts and consequently restore the weak Appetite but likewise procure quiet at least in some measure to the Lungs But there must be great care taken that he does not get new cold For the Body being in such a manner filled with a load of Humours every new Catarrh or Cold tends to a Consumption and from hence come all our Sorrows And here I shall earnestly beg Pardon for being too quick with my Pen if any one can resent it as preposterous whilst I offer something more in this Chapter though briefly concerning the Indications for preventing this Distemper and that before the Methodical Thread of my Discourse brings me to the more copious subject of the Indications of Cure The general Indications for preventing a Consumption in this sickly state are chiefly three The Indications of Cure The carrying off by some way of Evacuation the dispirited Chyle that lurks in the Habit of the Body The tempering of the Preternatural and Hectical heat in the Blood and Spirits newly caused by the stagnation of the Humours And lastly the strengthening of the Tone of the Parts and consequently freeing them from their Obstructions which being neglected there is all the reason to fear an ill Habit of Body and a return of the Preternatural Heat Gentle Purges to evacuate the Humors For this end though strong Purges as I have before hinted are in this case to be condemned yet it is very convenient to carry off the load of Humours by Stool gently and by degrees with kindly and Stomatick Purges until the Body is freed from its bloutiness and Obstructions and reduc'd to its first and Natural state The Purges of this Nature are the Stomack Pills with Gums Aloephangin Pills Aloes prepared with juice of Roses Mastick Pills Pill Ruffi the bitter Draught with Senna c. But I prefer the Tinctura Sacra and the Purging Mineral Waters before any other sort of Purge which as they carry off the vappid Humours by little and little with ease and without putting them into too great a motion so they also rather temper the Heat than kindle a new flame in the Spirits and Blood which is often the effect of other Purges and strengthen the Tone of the Stomack which in this case is weak and relaxt and withal increase the Appetite Diureticks and Diaphoreticks for the same end For the same purpose likewise such Medicines as provoke Urine and Sweat are of great use in order to the more effectual carrying off of the nasty Serum of the Blood But a Physician must be very prudent in the choice of these Medicines But in choosing of these Medicines a Physician ought always to be very cautious and prudent preferring those which communicate the least heat and sharpness to the Blood before others For Diureticks I prefer before any others Wood-Lice raw or prepar'd Turpentine Leucatellus Balsam Balsam of Sulphur and other Preparations made of Turpentine but especially the Chalybeate Mineral Waters Amongst the Diureticks the Chalybeate Waters are the best and amongst them Sadler's Waters at Islington the Vertue of which I have had the Experience of now for five Years not only in many others but also in my self with very good Success because that they are impregnated with more of a Mineral Spirit than any others that I have ever yet try'd in several Parts of England by which they penetrating like Lightning the farthest corners of the Body open Obstructions and provoke Urine very plentifully and yet they do not affect those that drink them so as to make them giddy and as it were fuddled to oppress the Stomack or to cause a great heat in the Hands and Feet at the end of their passing off so much as other Chalybeate Waters use to do Among those Medicines that are Diaphoretick a Decoction of Sarsa deserves the preference Amongst the Diaphoreticks a Decoction of Sarsa which not only causes a gentle breathing by the pores of the Skin but also tempers and softens the Mass of Blood As also Ceruss of Antimony Diaphoretick Antimony c. which Antimonial Medicines provoke Urine as well as sweat If the Blood seems but in the least degree to grow preternaturally hot If the Blood be at all preternaturally hot some must be taken away it is convenient in the very beginning to take away a moderate quantity of it in order to cool it and to abate the fulness of the Vessels For although Bleeding is condemn'd in a Consumption when it is once confirm'd because the use of it at that time not only affords no benefit but also procures the sudden destruction of Nature Yet nothing does conduce more to the preventing or extinguishing of that Hectical Flame which is in the Blood if it be administred time enough By which means other necessary Medicines being also given in a due Method the Inflammation and Swelling and consequently the Exulceration of the Lungs themselves yea and the Consumption it self together with a Cough difficulty of Breathing and the rest of the train of direful Symptoms may be happily prevented And indeed from what I have learnt by a great deal of Experience I do not doubt but many fall into fatal Consumptions from an Inflammation of the Lungs Many fall into Consumptions for want of due Bleeding a Pleurisie ordinary Catarrhs and other Distempers of that kind because through the carelessness of the Physician or the Patient's fear and the timorousness of his Friends that are about him there was not Blood taken away in due time or so often as there should be or in a sufficient quantity by opening a Vein From whence it comes
that is plentifully supplyed from the Glandulous Coat of the Wind-pipe Neither indeed can the Patient when the Distemper comes to be a Fatal Case be ever freed from this Cough by any Art till Death effectually stops it But let no one admire how those Tubercles or Swellings that are placed in the Lobes of the Lungs far from the top of the Wind-pipe can provoke this dry Cough together with a tickling in the upper part thereof when he may every day observe the same kind of Chronical dry Cough caused and continued a long time by chalky stones generated in the substance of the Lungs Yea and once I observed the same Symptom to happen from three Nails that slipt by chance as the Person was laughing through the Wind-pipe down into the Lungs and to continue for a whole Year the sick Person all that while being in other respects very well How the Tubercles which are remove from the top of the Wind-pipe do affect that part And indeed the thing it self shews it for the Wind-pipe is every where divided through all the Lobes of the Lungs into many branches which are a great way distant from one another so that the very fine and small Pipes of those branches are propagated to the very extremities of the Lungs by the continuity of those Membranes which had their Original from the beginning or upper part of the very Wind-pipe From whence it necessarily follows that as those Tubercles in what part soever of the substance of the Lungs they happen to be bred cannot but make a troublesome compression upon some of these small Pipes and straighten them So that troublesome sense by reason of the continuity of the Membranes does affect the upper extremity or beginning of the very Wind-pipe by a consent of parts as we commonly say whereby it provokes the Wind-pipe to cast out its Enemy by a vain and dry Cough Just as we see every day in a Strangury or difficulty in making Water from a stone pressing uneasily upon the Ureter yea if it be the very Kidney a great pain felt in the extremity of the Yard it self from the continuity of the Membrane For in Nature's endeavouring to expel the Stone there arises a Spasmodick Contraction of the whole Urinary passage from the very Kidneys which yet does very much affect the extremity of the Yard with a kind of heat of Urine The Nature of this Cough shews it to be from the Tubercles And even the Nature of this Consumptive Cough does likewise favour much this Opinion whilst it yet continues to be dry as being caused only by Tubercles and before a disposition to a Catarrh does in progress of time come upon it For as it is dry and without any expectoration so it is not great nor the Fits long and is rather made of its own accord to relieve the Oppression of the Lungs then excited by a violent tickling or accompanied with that great straining which usually accompanies a Catarrhous and fierce Cough that is caused by the continual excretion of a Waterish Humour by the Wind-pipe and the branches of it But if any one should be inquisitive about the Original of the Tubercles in the Lungs A general Account of the Original of the Tubercles in the Lungs which are the first occasion of this dry and truly Consumptive Cough I shall give this general Answer That the substance of the Lungs not only seems more obnoxious to a flux of Humours as the Ancients love to Phrase it than any other parts of the Body from the continual motion of these parts caused in respiration but also by reason of its spungy softness because it consists wholly of small Bladders and Vessels is wont to suck in and retain the Humours And therefore when all the internal and external Parts as well those that are Muscular as those that are Glandulous are very often affected with several sorts of such Swellings why should it be strange if they are frequently found here also as they are in other parts of the Body Yea when I consider with my self how often in one Year there is cause enough ministred for producing these Swellings even to those that are wont to observe the strictest Rules of Living I cannot sufficiently admire that any one at least after he comes to the Flower of his Youth can dye without a touch of a Consumption And without doubt the breeding of these Swellings is so frequent and common The breeding of these swellings is very common that a Consumption of the Lungs would necessarily be the common Plague of Mankind if those Swellings did not vanish or were not removed by Art as easily as they are bred at first And indeed I have been used to think not without Reason that as the more Benign Tubercles are wont to go off of their own accord and that quickly so none of them lay the Foundation of this great Disease And when they are Malignant they occasion a Consumption of which I am now treating but only those which are in some degree Malignant and ill-natur'd and that are wont to putrefie sooner or later from some peculiar quality in their Nature from what part soever of the Body they have their Original But that I may more particularly say something of the beginning and rise of these Tubercles A particular Account of the beginning of them As far as I have been able hitherto to learn either from the inspection of the dead Bodies of such as have had a Consumption or by Reasoning a crude Tubercle or Swelling is bred from the Obstruction of some Glandulous part of the Lungs to wit when a greater quantity of Serum or Water is separated from the Blood than is thrown out by the Duct of the Glandule From whence it comes to pass that as the Part affected being too much distended by the Humour that is imprisoned in it is deprived of its Natural Tone and thereupon is no longer able to spew or throw out the Serum or Water that flows into it or is separated so likewise the Humour that is so shut up not being any more renewed by an influx of fresh Humor does by degrees grow dry and hard from the Natural heat of the Part From whence arises a hardness that resists a pressure or a Tubercle of which we are now speaking which in progress of time after the Natural Tone of the Part is in this manner destroyed is wont to be inflam'd and to turn to an Apostem sooner or later according to the Nature of the Lympha or included Humor and of the Blood from which it is separated which indeed is the whole immediate cause of a Consumption of the Lungs and of the dry Cough which attends it The causes of that Obstruction which produces the Tubercles There remains yet some Enquiry to be made from what cause this Obstruction or Stagnation of the Humour in the Glandulous parts of the Lungs does proceed And this is
and in a certain Merchant in Philpot-Lane that this Peripneumonick Fever has return'd several times in a Year to wit as often as any new Tubercle happened to be inflam'd whether it were from some evident cause or from the Natural disposition of the Tubercle it self to ripen Some Apostemes ripen sooner than others and become an Aposteme For all the swell'd Glands are not disposed to an Inflammation at the same instant of time as it was evidently apparent to me in the Body of Mr. Davison who dyed of a Fatal though a Chronical Consumption when we came to open it For in the Lungs of the dead Body we found at the same time some Tubercles that were turned to Apostemes and others that were inflam'd and lastly some that were crude and unripe But for the most part such Consumptive Persons dye of a Peripneumonick Fever proceeding from a new Inflammation of some Tubercle which the Patient has not strength enough to overcome having been weaken'd by grapling with his Distemper before The degree and daâ—ger of the Fever answers to the degree of the Inflammation As the duration of this Fever so the degree and danger of it is to be calculated from the Inflammation of the Tubercle upon which it depends For as soon as the Inflammation goes off whether it be of its own accord or by the help of Physick this Fever likewise ceases tho' as often as the Part that is inflam'd happens to be turned to an Apostem there forthwith comes in the room of it a Putrid Intermitting Fever arising from the collection of Matter And generally speaking according to the Nature of the Swelling and its disposition sooner or later to ripen into purulent Matter the Peripneumonick Fever it self which proceeds from it is sooner or later cured and according to the Malignity of the Humour and the bigness and number of the Swellings that are inflamed it is more or less Acute and Fatal Whereupon tho' this Fever does for the most part come to a period within the compass of seven days for in that space of time inflamed Swellings begin to turn to Apostemes yet Scrophulous Tubercles This Fever generally terminates in seven days as they ripen very slowly Where the Consumption is Scropholous the time is uncertain so they bring an Inflammatory Fever which though it be almost insensible and less dangerous yet is Chronical and ends in no certain number of days But by how much the Fever is more Acute so much the shorter it is and by how much the more moderate so much the longer it lasts I come Secondly to speak of the Putrid Intermitting Fever of Persons in a Consumption As soon as these inflamed Swellings of the Lungs begin to be Apostems whether it be for want of Bleeding in time A Description of the Putrid Fever in a Consumption or a sufficient quantity or from the Natural disposition of the Swellings to putrifie this Inflammatory Fever is changed into a Putrid Intermitting Fever Whose Fits for the most part observe no certain Order at first but the cold and shivering Fits return often the same day as it uses to be when purulent Matter is breeding But when the Matter is once perfectly made this Fever imitates the Type of a Quotidian and sometimes though seldom of a Tertian and that at a certain time of the day beginning with a chilness and coldness proceeding with a great heat and so at last ending in profuse and colliquative Night-sweats During the time of the chilness and hot Fit the Cough and shortness of Breath with the other troublesom Symptoms are increased But during the time of the Sweat and the abatement of the Fever the Cough and other Symptoms being mitigated the Patient sleeps quietly recruits his Strength and flatters himself with the hopes he is then ready to have of his Recovery And this Putrid Intermitting Fever I always reckon one of the most certain Pathognomonick signs of a confirm'd Consumption because as it proceeds from purulent Matter bred in the Lungs so it is an Infallible Evidence of corrupted Lungs And from thence it comes to pass that this Putrid Intermitting Fever uses to accompany a Consumption whenever this Distemper happens to be Fatal to the Patient's dying day Whose Fits and the Colliquations proceeding from them are greater or lesser longer or shorter according to the greatness and number of the Tubercles that are ripened into Apostemes This Fever not to be cured without the Cure of the Vlcer Neither indeed can this Fever be perfectly cured with the Peruvian Bark Poterius's Antihectick or any other Specifick Medicine having often tryed what they could do in this case nor by any other Method that I know of unless the Ulcer be so benign that that can be healed by the help of Balsamick Medicines given inwardly and the Mass of Blood it self where the fuel of the Distemper lyes can be brought to a good state by the plentiful use of temperating and altering Medicines Or of the Distemper upon which the Consumption depends when it is Symptomatical The colliquation of the Nutritious Juice is another sign of a Consumption or at least unless the Consumption be Symptomatical and depends upon some other Distemper which may admit of a perfect Cure with the use of Specificks The Second Pathognomonick sign of a confirm'd Consumption or that plainly discovers it to be such is a great and continual colliquation or melting of the Nutritious Juice and a continual and plentiful separation and running off of it from the Mass of Blood by all the ways of Evacuation that Nature affords from whence it comes to pass that a sudden sinking of strength and a Marasmus with a Hippocratick Face follows in a short time though it comes gradually This Colliquation is proportionate to the degree of the Hectick Fever Indeed I must confess a Consumption has from the beginning always something of a Colliquation joyned with it proportionable to the degrees of the Hectick Fever from which it proceeds which discovers it self by Night-sweats a Looseness or some other way Which Colliquation though it be very hard to be cured because it depends upon a Hectick Fever that is incurable yet is always moderate and brings but a very slow and less sensible Consumption till first a Peripneumonick Fever from the Inflammation of the Swellings of the Lungs and then a Putrid Intermitting Fever from the Exulceration of them comes upon and is joyned to the Hectick And then indeed as the Fever so the Colliquation which proceeds from it is increased For the Blood being then continually foul'd by purulent Particles communicated to it as it circulates through the Lungs by the Swellings that are ripened Nature when she is so much loaded and opprest with such Heterogeneous Particles that she cannot bear them any longer rises up against them and begins a Fight or Feverish Fit in order to thrust them out and this Combate she renews every day
In the beginning of this Conflict she is too much opprest and therefore is affected with a chilness and coldness but as soon as she rallies her Force and begins to get the better there is so great an ebullition and commotion made in the whole Mass of Blood that the fresh Nutritious Juice which is then carried into the Blood-Vessels can no longer unite it self to the Blood but is thrust forth and thrown out in a large quantity together with the purulent Particles by any of the parts of the Body that are open and passable as if they were melted not without a great loss of Strength nor without a wasting of the Body that is by this means continually deprived of its Food which should restore and nourish it And the greater the Ulcers are in magnitude and the more they are in number the greater quantity of Heterogeneous Particles are mixed with the Blood as a Preternatural Ferment and the more severe is the Feverish Fit the Colliquation likewise is so much the greater and the Consumption makes so much the quicker dispatch This colliquated matter runs off first by the Glands of the Wind-pipe and the Bronchia 1. This separation of the colliquated Matter is first made by the Wind-pipe and the branches of it by which the Cough that at first was dry is now turned to such a one as is attended with a great Catarrh especially when the Feverish Fit is going off At which time a great quantity not only of a crude thin Matter but likewise of concocted Phlegm either purulent or like Pus or Matter and of several colours is thrown out of the Lungs by Coughing until the Mass of Blood having thrown out that heterogeneous and purulent Ferment or Leaven does by degrees cool and come to be quiet And this Calm lasts no longer than till this deceitful and uncertain Truce happens to be broke by a new Fit Secondly Then by the Pores of the Skin this separation of the colliquated Humours is made likewise by the pores of the Skin in large and colliquative Sweats For these Sweats differ in their degree to wit according to the different degree of the Colliquation of the Blood and of the Fever Fit which precedes and is the cause of it For the Sweats always come on when the Putrid Fever is going off to wit after Midnight For this Fever whether it be a Tertian or Quotidian comes like other Intermitting Fevers at a certain hour which is about Noon or a little after with a manifest chilness but then proceeding for some hours with a burning Heat Drought Restlesness Vomiting shortness of Breath a continual fierce and violent Cough want of Sleep yea sometimes also Light-headedness and a very red colour in the Cheeks proceeding from the Oppression of the Lungs and those parts that are seated under the short Ribs But at length to wit about Midnight it ends in vast and colliquative Sweats At which time the Patient sleeps quietly breaths not so short as before and plentifully coughs up concocted Phlegm without any difficulty or pains having the Symptoms of the Fever all gone off altogether of their own accord For at this time the stream of the colliquated Humour is turned from the Lungs and carried to the Pores of the Skin And by that means the Patient seems all the Morning to be free from a Fever his Heat is moderate and his Pulse low until at length another new Fit seizes him and breaks the Treacherous Peace And from these remissions of their Fits it often happens that these kind of Consumptive People even when they are lookt upon as deplorable by others flatter themselves extreamly with the hopes of their Recovery so that the same Persons that at Night use to think themselves irrecoverable and tell those about them they should certainly dye yet the next Morning they always pluck up their Courage and in vain entertain the hopes of living long The stopping of these Sweats does no ways relieve the Patient but thereupon the Matter runs off from the Blood some other way 'T is true indeed these Colliquative Sweats causing a great expence of the Nutritious Juice do commonly spur on the Patient's Consumption and quickly make him a Skeleton And yet he must not expect any relief or benefit from the violent stopping of them either by the change of Air or rising out of Bed in the Night which I have often seen prov'd true by Experience For the Blood thereupon growing hot does not melt or dissolve ere the less but when this passage of the colliquated Humour is once stopt by Art Nature presently opens some new Sluces to carry that troublesome Load another way though it may be more inconvenient as either into the cavity of the Breast As into the cavity of the Breast or Belly c. from whence there follows a Dropsie of the Breast with an increase of their Cough and an intolerable difficulty of Breathing or into the cavity of the Belly and into the Legs and Thighs in the Nature of a Dropsie in those parts or else by the Glandules of the Guts whereupon there arises a violent Looseness that is no less Colliquative than the Sweats themselves Yea and sometimes even a Bloody-flux if the colliquated Humour be very sharp attended with dreadful Convulsions and Torments of the Bowels which bids defiance to all the Medicines that are used to cure a Dysentery as I found in the deplorable case of Mr. Lechmere and likewise some other Persons that have been in a Consumption who being by that Symptom thrown into the last degree of a Consumption with a Hippocratick Face dyed as quickly as they did miserably But this Thread of my Discourse has unexpectedly brought me to the other Diagnostick signs of a confirm'd Consumption of which I must likewise say something briefly Thirdly The colliquated Matter when the Consumption is confirm'd is exern'd by the Guts This Colliquation as soon as the Consumption comes once to be confirmed is often made by the Glands of the Guts in the Nature of a thin and waterish Looseness or else of a Bloody-Flux For the Blood when it cannot in this colliquative state assimilate the fresh Nutritious Juice to it self nor unite it to the solid Parts by reason of its own Preternatural Heat and Sharpness does frequently endeavour to drive it down and throw it out as an unprofitable Burden by these Glandules likewise But Nature does not use to endeavour the expulsion of her Enemy this way unless it be either for want of Care or designedly that the High-way by the Pores of the Skin is stopt or at least when this way alone is not sufficient to serve her purpose by reason of the greatness of the Colliquation And therefore a Looseness is justly to be reckoned for the most part one of the last and fatal Diagnostick signs of a confirm'd Consumption For excepting only the case of such Persons as have the Scurvy with their
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
of this Distemper does plainly appear in the several Stages or Degrees of it as well to our very Reason as to Experience from what I have already said and therefore I shall not propose my Prognosticks though found out by much Practice and Experience after the usual manner that is like a Dictator and Magisteriously any further than as they are confirmed by Reason and proved the Nature of the thing it self As for instance Every Consumption of the Lungs is Chronical First Every Original Consumption of the Lungs strictly speaking is Chronical though when we compare them one Consumption may be more quick than another and in that respect may be said to be Acute But let it be whither it will it is always very hard to Cure because it depends upon a load of Humours and a stock of them heaped together in the Habit of the Body which cannot be emptied or drawn out by any sudden Crisis like a Fever and other Distempers that are properly called Acute A Consumption in the beginning is curable Secondly But yet in the beginning when the Lungs are only stufft yea in the Second degree of this Distemper when the Tubercles are already bred from a long stuffing and whilst they remain crude and not so subject to be inflam'd and ulcerated a Consumption does admit of a Cure as well as other Distempers but especially in the Spring-time which is wont mightily to conduce to this Cure whilst the Sun is advancing towards us It admits of a Cure I say either true or at least palliative according to the Nature of the Swelling and the present state of the Blood from which there arises a Swelling more or less Malignant and apt to be inflam'd and ulcerated To wit a true Cure as often as these Swellings being but few and benign happen to be dissolved by the Art of Physick And a palliative Cure so long as those Swellings can but be kept from an Inflammation and Exulceration Though the Cure is sometimes only palliative by the help of Balsamick and other such-like Medicines By which means it comes to pass that the Patient though he is sickly and subject to Fevers even upon every little occasion yet is able to do his ordinary business and many times lives to grow Old The Reasons why it is thought incurable And this Distemper comes to be reckoned such a stubborn and incurable Disease either because the Patient being deceived by the flattering Nature of the Distemper or through carelesness and the fear of Charges who commonly sets a lower Price upon himself than any thing else comes to desire the Physician 's Advice too late which very often happens or else lastly through the Ignorance of the Physician who not having a true Understanding of this Distemper in the several degrees of it knows not therefore how to treat it in a due Method Thirdly but a confirm'd Consumption A confirm'd Consumption rarely cured together with the Putrid Fever that is added to it caused by an Inflammation or Exulceration of the Lungs does very rarely admit of a perfect Cure But yet if it be but a small part of the Lungs that is ulcerated and the Matter be benign and contained in a proper Bag the Life of the Patient may be preserved many Years by the careful management of himself and the use of proper Medicines but he will be always sickly and subject to a Putrid Fever even upon the least occasion The more Acute the harder to Cure Fourthly A confirm'd Consumption by how much the more Acute it is by so much the more difficult it is to cure because it depends upon more Malignant Tubercles and is accompanyed with a greater Colliquation and likewise a quicker decay and loss of strength An hereditary c. Consumption generally Mortal Fifthly If a Consumption be Hereditary or proceeds from an ill conformation or make of the Breast for the most part it is Mortal because the cause which produces it lyes beyond the reach and power of our Art Very hard to Cure when 't is got by Infection Sixthly A Consumption that is got by Infection but especially whenever that Infection is derived from one that has an Acute and Malignant Consumption is when all other Circumstances are alike more difficult to cure and for the most part more Acute and Fatal than other Consumptions A Consumption in young Persons is very hard to Cure Seventhly A Consumption in Young Persons by reason it is more Acute and apt to bring a Putrid Fever sooner is harder to cure than when it falls upon one that is of a greater Age where the Blood as it is less disposed to be hot so it threatens a slower Fever and not so sudden a destruction as in the flower of their Age where all the Essays of Nature are made with strength and violence It cannot be owed in the Autumn or Winter Eigthly A Consumption in the Autumn or Winter though it may be relieved by a careful management and the convenient use of Medicines yet it can never be perfectly cured without the benefit of the Spring and of the approaching Sun For as the vesiculous substance of the Lungs is almost continually penetrated by the Air and by the Decree of Nature is blown up in the farthest corners of it by the continual succession of new Air that is driven in and out by Respiration so the present state of the Air must necessarily be of very great moment seeing it may either hinder or promote the Cure of this Distemper as it is found to be wholsomly dry and warm or unwholsom by being cold and cloudy So that the due constitution of the Air contributes not only to the Preservation of the Lungs when they are out of Order but also to their Cure more than the most pompous heap of Medicines which cannot be conveyed into the Blood and the Part affected so continually or in the same quantity as the Air is And therefore 't is usually in vain to expect the Cure of a Consumption in the Winter-time and in Autumn to wit whilst the state of the Air being cold thick and moist and consequently unwholsom does continually promote the Distemper more than a store even of the most proper Medicines can stop and check it when the edge of the most Powerful Remedies is taken off and their Efficacy weakned in this manner by the extreamly incommodious state of the Air. Ninthly Every Putrid Fever Every Putrid Fever promotes a Consumption though it proceeds meerly from an accidental Catarrh or taking of Cold does by heating the Lungs mightily promote a Consumption but especially if Bleeding be omitted in the beginning Tenthly An Original Consumption is harder to cure than one that is Symptomatical An Original Consumption of the Lungs is for the most part harder to cure than a Symptomatical Consumption because this last seems to arise not so much from the Habit of the Body as by
Pectoral Decoction the Decoction of Sarsa and China Pectoral and Antiscorbutick Ingredients in their ordinary Drink Emulsions of the four cold Seeds made with Barley-water a Milk Diet but especially Asses Milk things made with Barley the Chalybeate Waters Oysters Snails and Medicines made of these These that are lubricating and inciding Secondly Lubricating and cutting Medicines which promote the Expectoration of the Humours that stick in the Lungs as Liquorice Honey Mead common Oyl Oyl of Sweet Almonds but especially Linseed-Oyl fresh drawn without fire Turpentine Natural Balsam fresh and sweet Butter Almonds Figs Raisins of the Sun Dates Sebestens Jujubes Juice of Liquorice Gum Ammoniack Benjamin Balsam of Tolu Lohoch Sanum expertum Lohoch of Foxes Lungs of Coltsfoot Sugar-candy or Loaf-Sugar with several Linctuses and other Medicines in which that is an Ingredient such as the Syrups of Hedg-Mustard Maiden-hair Colts-foot simple Syrup of Horehound Syrup of the Flowers of St. John's wort of the five opening Roots the Balsamick Syrup Syrup of Jerusalem Oak of Liquorice Hyssop Horehound Marsh-mallows Jujubes Violets as also Honey of Violets the Compound Pouder of Orrice Haly's Pouder Trochisci Bechici or Cough-Lozenges both white and black Those that are Carminative Thirdly Carminatives which by comforting the Nerves and freeing them from Obstructions do remove the Convulsie Constriction of the Lungs upon which there follows a freer Respiration and consequently a more easie Expectoration as Aqua Mirabilis Spirit of Hartshorn of Salt Armoniack the Compound Waters of Briony and Piony Aniseeds Fennel-seeds Elecampane and Orrice-Roots Orange-flowers Rosemary-flowers the Leaves of Hyssop Sun-dew with the Waters and Syrups made of them Orange and Citron Pills candied Bay-berries Juniper-berries Honey Civet Gum Ammoniack Benjamin Cinnamon Nutmeg Mace Balsam of Peru Natural Balsam Syrup of Hedg-Mustard of Hyssop the Compound Pouders of Orrice of Calamint Treacle Mithridate Laudanum and others of that kind which yet must be used very cautiously and sparingly and not without urgent Necessity if there be any considerable Fever Fourthly Those that are Incrassating and agglutinating Incrassating and Agglutinating Medicines which conduce very much to the speedy Concoction and consequently the Expectoration of the Serum that flows into the Lungs as Comfrey Alehoof Yarrow Dandelyon Mouse-ear Plantain Self-heal Sanicle Scabious and in general all Vulnerary Herbs the Flowers of Red Roses of Red Poppies English Saffron Liquorice Saunders yellow and red Pectoral Fruits as Raisins of the Sun Figs Dates Jujubes Sebestens Sweet Prunes Pine-Kernels Fistick-Nuts white Poppy-seeds the four greater cold Seeds Seed of Henbane with the Emulsions and Syrups made of them Sugar penidate Sugar of Roses old Conserve of Red Roses Juice of Liquorice Starch Honey Olibanum Gum Arabick Tragacanth Syrups of Comfrey Marsh mallows dryed Roses and of Liquorice Lohoch of Fleawort-seed of Coleworts Poppies Purslane of Pines Sanum expertum and of Raisins Jelly Broths made of Calves-feet c. Jellies of Hartshorn and Ivory the species Diatragacanthi frigidae Haly's Pouder the black Lozenges for a Cough Mithridate Diascordium Venice-Treacle Syrup of white Poppy-heads and in general all Opiates as Laudanum both solid and liquid Hounds-tongue-pill Styrax Pill Philonium Persicum and Romanum c. Which by stopping the present influx of the Humours into the Lungs as the Ancients love to speak do likewise contribute very much to the Concoction of the Humours which had been lodg'd in the Lungs before And therefore without the cautious and prudent use of them there is no great matter to be done in the Cure of a Consumption And lastly Deobstruents Fifthly Such Medicines as open Obstructions which by freeing the stufft Glands from their stoppages do lessen them As the Roots of Orice Sarsa China Sassafras-wood Saunders Bay-berries Juniper-berries Gum Ammoniack Benjamin Balsam of Tolu of Sulphur of Peru Opobalsam Steel either of Nature's Preparation in the Mineral Waters or prepared by Art in the form of a Syrup or Electuary or of Pills c. Wood-lice with many other Antiscorbutick and Antiscrophulous Medicines From this Treasure of Simple and Compound Medicines a Prudent Physician ought with the Direction of his Judgment and Experience to compose and prescribe divers Medicines in the several degrees of the Distemper and according to the Exigence of the Symptoms as there shall be occasion in that form which shall be most grateful to the Patient that he may be always able to answer the present Indications in the whole course of the Distemper and not insist like a Quack upon one single Medicine as a Charm for the Disease The Method of which Rational Cure in the various state and Symptoms of this Distemper as it proceeds I shall immediately propose The Chirurgical Remedies in this Distemper are Issues Blisters Shaving of the Head What are the Chirurgical Remedies the application of the Head-Plaister Betony-Plaister or any other of the like Nature as also Bleeding of the Use and Reason of which I shall Discourse more largely in the following Method of Cure CHAP. VIII Of the Method of Cure in an Original Consumption of the Lungs In the Cure of a Consumption in the beginning the influx of Rheum into the Lungs must be stopt IN the beginning of this Distemper to wit when the Lungs the Wind-pipe and Glandules that are dispersed through all that Pipe and the branches of it are at first only stufft by the constant spewing out of the Serum that is separated from the Mass of Blood and they are troubled with a continual Cough especially in the Night proceeding from thence the new influx of Catarrhous Rheum into these parts is to be stopt by all proper means and the Humours that are already lodg'd there must be concocted as soon as may be And therefore First Some Blood must be taken away First There must be some Blood taken from the Arm especially if the Patient has a fulness of Blood and has before been accustomed to Bleed to the quantity of Six Seven Eight or Ten Ounces not only to abate the Effervescence and consequently the Colliquation of the Blood but likewise to prevent the Swelling and Inflammation of the Lungs themselves and to take away the Feverish Heat which is usually caused by the continual agitation of the parts of the Breast by the Cough and by the want of Rest This must sometimes be done more than once which follows upon it This opening of a Vein where the Indications require it is to be done once twice or thrice at due intervals especially where there is a flux of colliquated Serum in the form of a suffocative Catarrh together with a plentiful Expectoration of crude Phlegm that comes near to the Nature of a Rheum or where there is a very Asthmatical difficulty of Breathing a pain of the Side or any signs of a Rheumatick Pleuritick or Peripneumonick disposition or lastly where a Surfeit or a too plentiful drinking of Wine or other Spirituous Liquors have preceded
those times the Patient is free from his Fever but likewise to mix them with the Bark it self whenever you have a mind to repeat it in the manner following Take of the Peruvian Bark beat into a very fine Pouder half a Dram of the Balsamick Syrup a sufficient quantity mix them up into a Bolus and let the Patient take it in the Morning and repeat it every six hours for three days one after another drinking three or four Ounces of the following Apozeme after it Take of the Peruvian Bark grosly pouder'd three Ounces of Balsam of Tolu two Drams English Saffron Cochinel of each a Scruple boyl them in a pint of the clear Pectoral Decoction to six Ounces Then strain it and pour on another pint of the same Decoction so repeating the Operation thus for three times And then mix all the strained Liquors together and add Malaga Wine the Balsamick Syrup of each four Ounces Mix them and make an Apozeme Let the use of this Febrifuge be repeated in the manner just now prescribed twice a month The Bark must be repeated Balsamick and Pectoral Medicines must be given in the intervals or oftner if it shall seem necessary But in the intervals the diligent use of Balsamick and Pectoral Medicines ought to be enjoyn'd which must be varied according to the Temperament of the Patient and the Nature of the Disease under the care of a Judicious Physician If the Belly should be too loose a Grain of Laudanum may be added to every Night Bolus or instead of the Boluses a Physician may make use of Pills made of Diascordium and the Pouder of the Peruvian Bark so that every Dose may contain half a Dram of the Pouder And in this manner I saw Mr. Houghton an Apothecary's Wife that was emaciated with a deplorable Consumption preserved a Year or two and very often recovered from a Putrid Fever caused by her Consumption by the care of my Famous Colleague Dr. Tyson as also the Wife of Mr. Walker a Merchant of London and Mr. Blakey the Minister's Son restored from a Putrid Consumptive Fever almost to a perfect Health by my care recovering their Strength and Appetite and so several others whose Histories it would be too tedious to give an Account of in this place Yet I will ingenuously confess The Bark does not answer so well here as in Agues that I have not observed the Bark to answer its end so certainly and constantly in a Consumptive Intermitting Fever as in a plain Ague proceeding meerly from a morbid disposition of the Blood But where I have found it to do little or no good I have always suspected that the Brain and System of the Nerves have been injured and that the Patient has been more apt to be light-headed and more subject to Spasms than he had been before CHAP. XI Of the Relief of the Symptoms of a Consumption in the Third Degree of it AS Nature is wont to be irritated by the mixture of purulent and heterogeneous Particles with the Blood to wit as soon as the Tubercles of the Lungs happen once to ripen and to become Apostemes and to endeavour the extrusion of them in the Periodick Fits of an Intermitting Fever by the Bowels the Cutaneous Glands Salivatory Ducts Stomack Wind-pipe c. by what passage soever there is a vent opened according to the Nature of the Humours and the tendency of Nature together with an extraordinary Colliquation and a sudden sinking of their Strength Nature to her violent efforts makes 〈◊〉 Symptoms So it often happens that Nature being then spurr'd on too far by that irritation does in expelling the colliquated and sharp Serum in a greater quantity than is convenient form some new Distempers or at least some new Symptoms that are more sharp and more dreadful than the Original Disease it self such as a Looseness and Bloody-flux with violent Torture in the Bowels a Cough and pertinacious Watchings profuse and colliquative Sweats almost perpetual Vomitings Hiccough Thrush c. For the Relief of which Symptoms the Art of Physick may do something though it should be unable to gratifie the Patient with a perfect Cure But by what means and by what Rules a Physician ought to help these kind of Symptoms I shall endeavour particularly to shew in what follows And first Of the manner of Relieving a Looseness Bloody-flux and Racking Pains of the Belly All the time this Necessity continues Opiate Medicines must be given not only frequently In case of a Looseness Opiates must be given but likewise in a good quantity For as these dreadful Symptoms cannot be relieved by any other Medicine so likewise as long as these Symptoms last as the Cough is commonly more moderate so their Breath is more free and easie as I sometime since observed in Mr. Lechmere Mr. Chadwel and several others the Matter which used to irritate and load the Lungs being then translated to other parts for a time and thereupon the use of Opiates is not contraindicated or forbidden by any present Symptom In this case the Patients will bear them from whence it comes to pass that they can bear a convenient Dose of Opium without any prejudice or danger As long as these Symptoms last the Patient must abstain from the use of all sorts of Beer and content himself with the white Drink and Milk boyled with Water instead of it Let him also take every four hours if it be needful the quantity of a Wallnut of my Astringent Electuary already described when we spoke of the use of Asse's Milk or let him take Twelve Drops of Helmont's liquid Laudanum in a draught of the Pearl Julep To Correct also the sharpness of the irritating Humâ—â—r that is wont to be thrown out by the Glandulous Coat of the thick Guts and to restore the Tone of the Parts that are weaken'd by it let there be a Clyster given every day as a Fomentation to the Parts of Chicken-broth or the Broth of a Sheeps-Head boyled in Water with the Wool upon it or else this which follows Take of Milk wherein Steel has been quenched several times and in which some Red Roses have been boyled six Ounces of Diascordium half an Ounce mix them and make a Clyster When the Looseness is moderate we must give but little Opium But where the Looseness is moderate and where the Pains are not great but especially if there be a difficulty of Breathing Opium must be ordered seldom and not much in any form Because for the most part upon the giving of it as the Breast uses to be loaded so also their breathing and expectoration become more difficult and their Stomack is apt to be sick with it And therefore in this case it is better to keep the Looseness moderate by the use of an Opiate every third or fourth Night rather than to stop it quite After an Opiate we must use Expectorating Medicines plentifully for fear a greater mischief
Aposteme Specificks then do no good at all but such kind of Consumptive Patients must be treated in the same manner as other Consumptive Persons to wit according to the degree and progress of the Disease If the Swellings are of a middle Nature the Consumption is so too But if these Swellings be of a middle Nature so that though they are apt to be inflam'd yet 't is but slowly as they concoct the Matter contained in them into the form of Chalk into the Nature of a Suet or a substance like Honey there follows thereupon a Consumption partaking likewise of a middle Nature to wit a Chronical one that runs on for many Years and is attended with a gentle and moderate degree of Symptoms to wit with a continual Cough at all Seasons of the Year which yet is moderate and not very dry But in the Winter and when the Air is thick it is more troublesome a very mild and almost insensible Fever plainly of a Hectick Nature accompanied rather with a lankness than an evident Consumption of the Flesh as also with a delicate Stomack rather than a want of Appetite Which indeed is the most common Consumption of Old Persons and often occurs in Practice These Consumptive Patients with due care rub on a great while I have observed that this sort of Consumptive People have not only lived a great many Years though they have been crazy but also with due government and care in those six things we call non-natural have followed their ordinary Business But upon committing of the least Error either in the quantity or quality of their Food or in the time of Eating and Drinking much more upon a Debauch and the liberal drinking of Spirituous Liquors or upon the getting of Cold they are very subject to Putrid Fevers and so long as they last the Patient's Life is in danger and the Lungs being heated suffer more Injury from thence in a Week than otherwise they would do in a Year For the Fever that seizes this kind of Consumptive Persons contrary to the proper Nature of the Tubercles is Acute But though in the beginning that or even the Cough and other Symptoms of the Lungs seem to be mild and though the Habit of the Body be never so much emaciated we must bleed them moderately and if there be occasion we must repeat it at the first Invasion of the Fever and with all the Medicines we use for the Fever we must mix such Pectoral and Antiscrophulous Ingredients as are proper by which means I have with the Blessing of God recovered one and the same Consumptive Person as Mr. Andrews and a certain Merchant in Philpot-Lane with many others from several Putrid Fevers that have returned the same Year and that without any great mischief occasioned to the Lungs by them But the oftner these Fevers return so much the sooner does the Consumption quicken its pace towards a fatal end and the nearer the Consumptive Person is to this Fatal Day the oftner are these Putrid Fevers apt to return arising from the least occasion The Inflammation of any new Tubercle as it seems to me always giving the occasion of this kind of Putrid Fever The Cure of this Consumption where there is no Putrid Inflammatory Fever But when there is nothing of this Fever the Cure of this Consumption may be very well performed by observing those necessary Rules which concern the six non-natural things and that perpetually By a long use of the Mineral Waters in the Summer-time unless there be some great Obstruction of the Liver and a Dropsie proceeding from it In the Winter-time by a frequent and long use of my Balsamick Pills as also of the Gums and other Balsamick Medicines but in the Spring and the Autumn with a Diet-drink made with Wood-lice Antiscrophulous and Pulmonary Ingredients steeped in Beer which must be prescribed for their ordinary Drink And by these means I have recovered even some that have been old but a great many others as Mr. Tibbs Mr. Herbert c. I have brought to a better state of Health than they could enjoy for a great many Years before Expectorating and other Pulmonary Medicines are useful to this kind of Consumptive Patients as well as to others except Opium which must very seldom be given in this case and that not without urgent Necessity because of its fixing and stopping Nature But these Pectoral Medicines though they do some good and give some present relief yet they do not much promote the Cure of the Original Distemper without Antiscrophulous Medicines and the other things I have now mentioned A History The only Son of Mr. Davison an Eminent Citizen and Merchant of London that had been troubled from his Cradle even to his Youth with a Purulent Scab scattered up and down his whole Body and often returning upon him proceeding from a Scrophulous Habit being quite tired and uneasie with it in his Youth when he was a Lad got rid of it with I know not what Repercussive Plaisters and Oyntments that he made use of by the Advice of some Old Women Whereupon presently which was about the Year 1678. he was troubled with a dry Cough all the Summer from Tubercles in his Lungs occasioned by driving in of his Scab which nevertheless he wholly neglected for a Month or two until with a light Inflammation and Exulceration of the Swellings in the beginning of the Autumn he fell into a Putrid Intermitting Fever with a loss of Appetite a Thirst and other Symptoms of that kind at which time he desired my Advice and with the help of the Peruvian Bark of Balsamick and Pectoral Medicines given in the Country Air he seemed to be freed from his Fever and in some measure from his Cough too But through Impatience and his aversness to Medicines taking no further care of himself he had a Fatal Relapse into his Fever and likewise his Consumptive Cough by which together with a Looseness profuse Sweats a Dropsie and other Symptoms of an Invincible Colliquation he was carried off in the middle of the Winter following In the Body when 't was opened we found all the Lobes of the Lungs here and there bespatter'd with Tubercles of a various magnitude some that were small and newly bred others that were pretty large though they were crude but some that were inflam'd and exulcerated containing in them a purulent Matter that was of the consistence of Honey This I took to be a Scrophulous Consumption of the Second sort that is Hot and Acute CHAP. II. Of a Scorbutical Consumption There is a Colliquative Ferment in all Scurvies IN all Scurvies but especially that which is Saline the Blood always has in it a Ferment which causes a great Colliquation and likewise Secretion of the Chylous Lympha in the Glands but especially in those that are seated about the Mouth Jaws and Lungs and from hence it comes to pass that this kind of Patients as they are subject
often because it takes off the Spasmodick contraction of the Lungs by its Carminative Power and by its Abstersive Faculty it cuts and brings up the Phlegm But yet we must bleed them sparingly according to the Patient's strength and we must not give that Mixture of Riverius unless there is an absolute Necessity A History Mrs. Sherwin a Virgin that had been for many Years past troubled with an Asthma especially in the Winter and when she lived in London with the help of a due Government of the Country Air c. she seemed to do her Business well enough till she was Forty Years old or there-abouts From which time she began to be somewhat Consumptive with an increase of her Cough and her difficulty of Breathing growing worse and worse every day her Appetite likewise being spoiled from her Feverish Hectick Heat which then began to seize her But with using the Chalybeate Waters my Stomack-Pills my Balsamick Pills and other Pectoral Medicines the Country Air likewise contributing very much for two or three Years she seemed much relieved and almost perfectly recovered But at length upon a Peripneumony arising from an Inflammation of the Tubercles of the Lungs she fell into a Colliquative Fever together with a Looseness Dropsie Vomiting profuse Sweats and the other Symptoms of a Fatal Consumption and dyed almost in the Flower of her Age of this Consumption which I call a Consumption of Old Age and if you had seen her before she dyed you would have taken her for an Old Woman When the Body was opened we found the Lungs every where knotted and in many places inflamed yea maturated and ulcerated The same I observed in Mr. Baxter an eminent Citizen of London who from a Chronical Asthma fell at last into a fatal Consumption of which he was much and a long time relieved with the use of Spirit of Salt Armoniack and Pectoral Medicines but especially Balsamicks but after a Year or two his difficulty of Breathing being very much increased and having a Looseness come upon it together with the Gripes a Dropsie and other Symptoms of a fatal Consumption he was carried off But the Asthmatick Fits which used to return often I always took off with the use of Riverius's Mixture when he once grew too weak to bleed with very good Success and with great Relief to the Patient even to his dying day Mr. Rand a noted Apothecary of London rub'd on many Years in the state of an Asthmatick Consumption though he was emaciated and weak with the plentiful use of Spirit of Harts-horn of Pectoral Chalybeate and Balsamick Medicines and a due management of himself in those six things which we call not Natural And although he was often in a Year subject to a light Peripneumonical Fever from a new Inflammation of the Tubercles of his Lungs yet with Bleeding and a due management and the use of Pectoral Medicines he as easily escaped But the extraordinary benefit of Emetick Medicines I often found in him whenever he seemed to be in very great danger from the increase of his Asthma and from his loss of Appetite and great Weakness following upon it CHAP. IV. Of a Consumption proceeding from Melancholy as also from an Hysterical and Hypochondriacal Affection ANY one that has been but a little concerned in the Practice of Physick Hypochondriacal and Hysterical Persons are often Consumptive for a long time and at last dye of it The Reason why it is so may easily observe that those that are Hypochondriacal and Hysterical do often live a long time in a Consumptive state and at length being seized with those Symptoms of a Consumption of the Lungs that accompany the last and fatal degree of it they dye The reason of which thing may be easily gathered from the Principles which I have already mentioned For in an Hypochondriacal and Hysterical Affection the Brain and the whole System of the Nerves are always distempered and thereupon not only the Animal Spirits do degenerate into a Windy and unquiet Nature but also the whole Mass of Blood which ought to be duly actuated and invigorated by those Spirits is turned into a crude and cachectical load And indeed we have reason to wonder that a Consumption does not always follow where there is such a destruction of the Tone of the Nerves and from such a disposition of the Spirits and Blood Moreover every one knows that some troublesome Passions of the Mind do for the most part precede or at least accompany an Hysterical and an Hypochondriacal Affection From which as I have already observed in the beginning of this Discourse a Consumption is wont oftner to take its Original than from Cold or any other Occasion Besides those that are Hysterical and Hypochondriacal from Fear and Anxious Thoughts are very often subject to continual Suffocations and Oppressions of their Breast which are nothing but Spasmodick contractions of the Muscles of the Breast and Larynx and of the tender Substance of the Lungs whereupon their Tone being once weakned and destroyed no Body can think it strange if there often follows a Consumption This Consumption is for the most part Chronical yet fatal But this Consumption for the most part is Chronical because it depends upon a morbid disposition of the Spirits and Humours contracted by degrees But yet for the most part it is Mortal not only because they are seldom frighted at it by reason of the insensible Progress of it until the Patient that had been a long time sickly falls at last into a deep Consumption but also because the stock of Humours upon which this kind of Consumption depends is plainly not to be exhausted How it is distinguisht from other Consumptions This Consumption may be distinguisht from other Consumptions especially by an Oppression of the Breast and an unusual Sadness of the Mind as also by frequent Hysterical Choakings Faintings and other Nervous Symptoms The Cure is almost the same as the general Method But the Volatile Spirits and Cephalicks must be given more plentifully in this Consumption The Cure is not to be altered much from the General Method Yet I will subjoyn some Observations concerning it First In this Consumption because the great Weakness and Obstruction of the Nerves require it we must allow if not even enjoyn a more liberal use of Spirit of Harts-horn Spirit of Salt Armoniack Tincture of Castor Hysterical Water and Compound Piony-water and other things of that Nature than we use to do in other Consumptions the extraordinary Efficacy of which in relieving the Symptoms of this kind of Consumptive Persons I have very often found by Experience and indeed without these neither their Faintness nor Choakings which are Symptoms that are wont very frequently to affect these Patients nor indeed the Cough it self which in this Consumption does for the most part proceed from the Genus Nervosum can be mitigated Secondly The Chalybeate Waters are very useful Likewise the Mineral Waters
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
a Virgin that was Consumptive and as I remember dyed within a Year after she was married with an universal Colliquation and the other Symptoms of a fatal Consumption of the Lungs a few Months after her Death fell into a Consumption as I judg'd by Contagion To which fatal Disease an Haemoptoë prepared the way with which he was suddenly taken at Exeter and that in the Winter-time and he lost a great deal of Blood But as soon as his spitting of Blood was stopt by Phlebotomy a Milk Diet and Incrassating Medicines and he had recovered his strength in some measure being dismist by his Country Physician within a Fortnight which was much sooner than was fit he came back to London on Horse-back and presently sent for me But alas how much was he changed from what he was before I found the poor Patient very Feverish and always Coughing and extreamly wasted with a Colliquation that was now begun and troubled with a streightness and pains in his Breast I found it to be a mixt Fever partly Peripneumonick from a new Inflammation of some of the Tubercles partly Putrid from the purulency of other Glandules which had begun so soon to be ulcerated I judged the Distemper to be a very Acute Consumption of the Lungs from a spitting of Blood which as it was contracted by Infection so it was rendred more hasty and violent by his ill Government in his Journey and his return into our Air that is filled with the smoak of Coals The violence of the Pain and Fever requiting it I presently ordered a Vein to be opened but I took away but a little Blood because of the Consumption and Colliquation that was upon him Then I endeavoured at least to stave off this hasty Ruin for some time with temperate Juleps and Opiates and all sorts of convenient Pectoral Medicines Blisters and a due management in all things But all these things were to no purpose for within three or four Weeks he departed this Life with all the Symptoms of a very Acute Consumption of the Lungs CHAP. VI. Of a Consumption caused by Stones bred in the Lungs and by things slipt down into them from without as also by the Stone in the Kidneys and Bladder Chalky stones are often bred in the Lungs I Have often observed Chalky Stones bred in the Lungs which when they have been Angular and disturbed with the shaking of the Lungs are wont to tear the tender substance of those parts from whence have arisen a violent and dry Cough and a horrible pain in the Breast like that in a Pleurisy and Peripneumony sometimes also an Haemoptoë with a considerable Flux of Blood and from thence Ulcers with the usual Signs of a Consumption of the Lungs Therefore when these horrid Pains happen with an Haemoptoë about the beginning of a Consumption When we may judge a Consumption to be from them we may justly suspect it to be a Consumption from Stones in the Lungs Although we cannot pronounce any thing certain of this thing till a Stone or two have been cough'd up For it often happens that these Stones passing by degrees through the Lungs do at length get into the branches of the Wind-pipe by which they are cough'd up and that seldom without a great flux of Blood But if these Stones are smooth and not such as may break or tear the substance of the Lungs they do not dispose the Patient much to a Consumption at least an Acute one nor indeed do they occasion any great mischief more than a dry Cough that is somewhat troublesome and something of an oppressing weight in the Breast as I have observed in several long ago in whose Lungs after they have been dead I have found many of these smooth Chalky Stones and some of them pretty large without the least Tubercle or Ulcer occasioned by them Where these Stones are sharp they cause a Consumption But where these Stones have been Angular and sharp and apt to break and tear the Lungs they have caused a Pain a spitting of Blood Ulcers and a Consumption it self as I have already hinted In which case as a pain does precede to and accompany the spitting of Blood so a spitting of Blood goes before and accompanies the Ulcers and Consumption What I have now said of Stones The same is true of Nails c. is likewise true of Nails Pins and other things that slip down into the Lungs as People laugh For unless they are quickly cough'd up again they prick the Lungs and cause a lancinating pain from whence a spitting of Blood Ulcers and a Consumption are wont to proceed Of which I shall add a remarkable History presently at the end of this Chapter These Ulcers as also the Consumption The Vlcers they cause cannot be cured before they are brought away which is the effect of them which we may likewise observe of Ulcers in the Kidneys and Bladder can never be cured without fetching away the Stone or Nail or Pin or whatever else it is of that Nature that breeds the Ulcers But these things which causing a continual pricking in the ulcerated part did by that means render the Cure of it impossible before being once come away though it be as it usually is with a great Haemorrhage yet the Ulcer and Consumption of the Lungs that proceed from them do oftentimes admit of an easie and perfect Cure because they have not their Original so much from a predisposed Habit of the Body as from a meer accidental Distemper of one single part Of which I shall relate one or two remarkable Histories at the end of this Chapter The Cure of this Consumption In the Cure of this kind of Ulcers Opiate and Balsamick Medicines with a Milk Diet are of very great use Opiates to obtund the sense of the torn and stimulated parts and to keep them as quiet as is possible whilst the Balsamicks exert their Healing Power And with the continual use of Milk the Hectick heat of the Blood contracted in this Consumptive state is to be allayed But although these sharp Stones can neither be made to lye quiet in that part of the Lungs which they occupy with the plentiful use of Laudanum nor brought away with the use of Lubricating Medicines but cause an Incurable Consumption and spitting of Blood and that such a one as returns by uncertain Intervals with a lancinating pain Yet this Consumption is in its own Nature slow and very Chronical as a Consumption from the Stone in the Kidneys and Bladder uses to be and generally speaking every Consumption that depends meerly upon an indisposition or Ulcer of some particular part without an habitual disposition of the Blood contracted either by propagation from the Parents or a long abuse of the six things called non-natural But whenever a heap or stock of predisposed Humours does conspire with some such fatal Cause the Consumption which proceeds from thence is not only fatal from
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
all over them and the very Membrane which covers the outside of the Lungs corroded by the sharpness of the Matter whereupon there came to be a continual dropping or distillation of the purulent Phlegm into the cavity of the Breast out of which to the best of my remembrance I took out at least six-Pints of this purulent Liquor Which when I saw I no longer wondred at the obstinateness of the Pain and the difficulty of his Expectoration which accompanyed that Peripneumony Nor did it seem strange that a Peripneumony caused in this manner should terminate in a Fatal and such an Acute Consumption CHAP. VII Of a Consumption proceeding from the French Pox. The French Disease often brings on Atrophy 'T IS certain every French Pox if it be Chronical accompanyed with a virulent Gonorrhoea or many and large Ulcers is always apt to bring the Patient by degrees into a Consumptive state by the continual substraction of the Nutritious Juice from the Habit of the Body of which sort of Consumption I have before discoursed in the First Book And likewise a Consumption of the Lungs It is also as true and I have often observed in my Practice that a true Consumption of the Lungs has had its Original meerly from the alteration of the Blood and Humours caused by the French Pox. And it is no wonder when the whole Mass of Humours is so manifestly altered and brought into a colliquative state by the Ferment of this Distemper which is evident enough from the Malignant Swellings Gonorrhoea's and Ulcers that commonly accompany this Disease if these kind of Venereal Swellings and Ulcers happen sometimes also in the spongy and soft Substance of the Lungs whereupon a true Pulmonary Consumption must necessarily follow Indeed I have rather wondred that we ever meet with the French Disease especially if it has been of a long standing or ill cured without an Ulcer in the Lungs and a Consumption proceeding from it But to speak the truth I very seldom if ever observed a Consumption of the Lungs from the French Pox Which is rare unless the Lungs were obstructed before or from ill management unless it has been where the Lungs were obstructed and disposed to a Consumption before or at least where there has been a bad management and ill-natur'd Medicines have been given by some Quacks and the often taking of Cold in a Sweating Course or in a Salivation has been joyn'd with the French Pox. This Consumption if it be treated in due time and in a due manner is as easily cured as any other This Consumption is of an Asthmatick Nature For as far as I have observed it is of an Asthmatick Nature and is wont to be attended with tough Phlegm and a difficulty of Breathing rather than a violent Cough and therefore it is Chronical and ascends slowly and by degrees to its highest degree from whence it comes to pass that I have sometimes observed some of these kind of Patients to live several Years in a Sickly and Consumptive state Which perhaps may be partly from the continual use of the Decoction of Sarsa and other things of that Nature by which the Malignant Venom of the Humour though it is not perfectly eradicated is in some measure obtunded For I do not doubt but the peculiar Nature of the French Pox is so Venomous that unless the Malignity of the Humour happened to be corrected by the use of Calomelanos a Decoction of the Woods and other Medicines prepared by Art or Nature every Consumption from a French Pox in its own proper Nature would be Acute From a frequent Experience I do affirm This Consumption is not to be cured without Antivenereal Medicines mixt with the Pectoral that all Pectoral and Pulmonary Medicines that are meerly such without mixing Antivenereal Medicines with them will do nothing towards the perfect Cure of this Consumption And therefore there is no better Method can be thought of than to endeavour the healing of the Ulcers of the Lungs and the restoring of the Crasis of the Blood The best thing is a Salivation which has been destroyed by the Venereal Ferment by a Mercurial Salivation before the Patient has been weakned by a long protraction of the Distemper and so is unable to bear such a continual and profuse Evacuation What is to be done if the Patient cannot bear that But if the Patient by reason of the extenuated Habit of his Body does not seem to have strength enough for this Method of Cure all the hope that remains must be from the use of a Restorative Milk Diet and then from a strict and long use of a Decoction of Sarsa and of my Balsamick Pills giving likewise Purges with a moderate Dose of Calomelanos mixt with them Of a Cure of this Nature I shall not think much here to give an extraordinary Instance A History A Young Girle about Twelve Years old was perswaded by the Enticements of a Lascivious and Wicked Dancing Master that was infected with the French Pox to let him lye with her Whereupon she likewise by Contagion was so pepper'd with the Venereal Venom that notwithstanding one or two Salivations which had been raised by some Empericks and other Methods of Cure that had been tryed in the space of four Years after her Uvula was eaten away and after other marks of the French Pox yet remaining she fell into a Consumption of her Lungs with a Hectick Fever an Emaciation of her whole Body a continual Cough and a very great shortness of Breath by reason of the toughness of the Phlegm stuffing her Pipes Being called to her by Mr. Simons a skilful and noted Surgeon of London I ordered a Dose of Calomelanos with Diagrydium to be repeated once a Week and on those days she did not Purge to have three of my Balsamick Pills given her three times a day and the following Decoction for her ordinary Drink With the use of which continued for the space of six or eight Weeks in the Spring-time she was perfectly and without any relapse freed from her Consumption as well as from the Relicks of the Pox. Take of the best Sarsaparilla six Ounces of China-Roots two Ounces Sassafras-Chips red Saunders shavings of Harts-horn of Ivory of each half an Ounce of Raisins of the Sun stoned two Ounces Jujubes Sebestens of each an Ounce and half of Liquorice sliced half an Ounce After a due Infusion boyl them in six Quarts of Spring-water to three Quarts adding when they are almost boyled enough Colts-foot Maiden-hair spotted Lungwort Sanicle Ladies-Mantle the Flowers of the great Daisie of each two handfuls then strain out the Liquor and add three Ounces of the Balsamick Syrup Mingle them and make an Apozeme CHAP. VIII Of a Consumption proceeding from the Suppression of a virulent Gonorrhoea of the Running of Old Vlcers but especially Fistula's in the Fundament and Scrophulous Vlcers Issues and the Whites How this Consump ion
is caused I Have also observed in my Practice these kind of Consumptions which are not caused as it is commonly thought by the translation of the Purulent Matter into the Lungs which to me seems impossible but by the Pollution of the whole Mass of Blood by the violent keeping in of the Excrementitious Juice which used to be continually thrown out by these Ulcers From whence it comes to pass that the Blood being in this manner foul'd does make it its business to cast off this extraneous and excrementitious Ferment and to lodge it in the soft substance of the Lungs as it circulates through them which many times according the Nature of the Matter is disposed to a speedy Putrefaction And hereupon that Consumption of the Lungs which I make it my business to treat of in this Chapter though it be sometimes of a middle Nature This Consumption is Acute yet for the most part it is Acute yea many times according to the Nature and Disposition of the Ulcer of the Lungs And most commonly Mortal which causes it very Acute and almost always Incurable and Mortal because it depends upon an inexhaustible stock of Matter lurking in the Habit of the Body In the Cure of this kind of Consumption The Cure besides the General Method before prescribed I shall add these few things particularly to be observed First The former and accustomed Ulcers must as far as it is possible be revived whereby the Humour may be diverted from the Lungs and be evacuated by the usual and less dangerous vents though it may seem troublesome Secondly But if this cannot be obtained which indeed is very seldom done then frequent Issues yea and Vesicatories but especially applyed near the place which Nature first assign'd for the separation of this Humour ought to supply this defect by which we may make some compensation to oppressed Nature and particularly derive the Matter from the Lungs Thirdly In the beginning of this Consumption to wit when the Glands of the Lungs begin to swell which we may guess at by the Cough difficulty of Breathing and Feverish Heat we must use Bleeding and also repeat it if it be necessary By which the stagnation of the Blood which arises from the first reception of the Matter into the Lungs and so the swelling of the part may be prevented or at least abated Fourthly Amongst the more general Pectoral Medicines already described I would commend the use of a Milk Diet of Asse's Milk the Chalybeate Mineral Waters if they are drank in time of a Pulmonary Decoction of Sarsa for ordinary Drink of the Gums Balsams and Wood-lice but especially my Balsamick Pills Fifthly But we must always add to the Pectoral Medicines also those things which have a respect to the peculiar Nature of the Ulcer or Original Distemper A History Mr. Simons the Famous Surgeon before mentioned had as he told me himself a Fistula in his Fundament continually weeping for the space of Twenty Years which he did industriously preserve instead of an Issue whilst he cured very many in other Persons because it did seem neither very troublesome to him nor at all dangerous But by chance this accustomed Ulcer at length drying up of its own accord about the Sixtieth Year of his Age he presently began to be affected with an Oppression at the Breast and a dry and troublesome Cough Which Symptoms for several Months he never minded till being rouz'd from this stupid Neglect by a manifest falling away in his Flesh as well as a Hectick Fever also by a frequent want of Appetite Sickness Weakness and other Signs of a present and confirm'd Consumption he desired my Advice but too late when the poor Man had for some Weeks and that in the Spring too laboured under a great Colliquation both by a Looseness and Sweats brought upon him by a Putrid Intermitting Fever and was confin'd to his Bed in a weak condition I did endeavour at least to alleviate the Fever by the use of the Peruvian Bark to abate his Looseness with Astringents and Opiates to remove the cause of the Consumption with the White Drink a Pulmonary Decoction of Sarsa and Lime-water with all other sorts of Pectoral and Specifick Medicines given in the form of Linctuses Electuaries c. as also with a Milk Diet and so far as the Looseness would give me leave to temper the heat of the Blood and Spirits with Asse's Milk and to comfort and refresh his Spirits with Pearl Juleps Jelly-Broths and Jellies But all was in vain for this Excellent Person being brought into the state of a Marasmus by this Colliquative Fever yielded to Fate in the space of two or three Months CHAP. IX Of a Consumption proceeding from the Green-Sickness and a Suppression of the Monthly Purgations in Women THIS is most commonly the Original of Women's Consumptions Ab Obstruction of the Menses is commonly the Original of Consumptions in Women and I have very seldom seen any Woman that was capable of the Monthly Purgations either Virgin married Woman or Widdow who ever fell into a Consumption without an Obstruction of these Purgations coming upon it either in the beginning or at least in the progress of the Distemper Sometimes 't is the effect of a Consumption 'T is true indeed this Obstruction may arise in the progress of a Consumption from the impoverisht state of the Blood by reason of the want of new Nutritious Juice and therefore is to be accounted an Effect rather than the Cause of this Disease But many times the occasion of it But many times it is the occasion of a Consumption and that not only in Virgins and Widdows but even in married Women For when there is an Obstruction of these Purgations caused by Passions of the Mind taking of Cold or using such Food as breeds a bad Juice the Mass of Blood is apt to be foul'd and to be rendred cachectick by those Excrements which used to be thrown out but are now detained in it By which Mass of Humours now gathered in the Blood the Lungs are wont to be stufft and thereupon a Cough difficulty of Breathing and the other ordinary Symptoms of a Consumption are wont to arise From which being a long time neglected a Consumption of a peculiar Nature attended with prickings and dreadful pains in the Sides does many times arise In the beginning of this Distemper Bleeding What is to be done in the beginning of this Consumption and moderate Purging with the Sacred Tincture and other things of that Nature and the use of Chalybeate Medicines but especially my Chalybeate Electuary which I may afterwards mention in the Chapter of a Chlorosis c. are convenient to provoke the Menses and to correct the Cachectical state of the Blood But if through the neglect of the timely use of these things the Patient is already brought into a Consumptive state it is not only in vain to try any of these things
because we cannot expect those Purgations in this impoverisht state of the Blood but also very prejudicial to the Patient to give them For it is to no purpose to diminish the stock of Blood by opening a Vein and with the use of Chalybeates it is more exagitated and grows hot Therefore in this case the Patient must be put into the General Method of Cure used in a Consumption of the Lungs and already described and the Pains of the Sides must be eased with warm Liniments and Fomentations mentioned in another place But the Consumption being once cured and the Body grown lusty again the Uterine Vessels being replenish'd with Blood and Nutritious Juice are wont to be opened of their own accord in a thin Country Air. But we must relieve this defect of Nature if she is still deficient after the Patient is recovered with the help of Art For if the Obstruction still continues the Patient will quickly grow Cachectical again from whence we may justly expect a return of the Consumption Therefore in this case let the Patient be kept in a thin Air and shake off all Sadness and troublesome Cares let her use Exercise and due Frictions as also bitter Antiscorbutick and Chalybeate Medicines but especially the Vitriolick Mineral Waters if it be a proper time of the Year for them This Consumption because it proceeds from a Cachexy is for the most part Chronical and not presently Mortal But if it is not cured in the beginning it is very difficult if ever to be cured and indeed the Green-Sickness of Virgins has very often this Fatal Event because the Symptoms of a Consumption and a Green-Sickness are so much alike that the Common People seldom perceive when one comes to be joyned to the other till the Consumption is come almost to its Third and Fatal Degree And from hence it is that I am wont always to suspect a Chronical Cough that attends a Chlorosis A History Mrs. Anderton Madam Davison's Maid a pretty Beautiful Young Woman about the Seventeenth Year of her Age from the Suppression of her Menses a long time neglected fell into the Green-Sickness with the usual Symptoms of it a pale Look Head-ach shortness of Breath Weakness Lassitude a slow Fever c. But at length when the Maid had advanced from an Oedematous to a Consumptive state and the stuffing of her Lungs was turned to a troublesome though dry Cough it gave me occasion to suspect that a true Pulmonary Consumption had been the Product of the Chlorosis And I was very much confirmed in this Opinion by those dreadful Pains in her left Side with which the poor Creature had been almost continually rackt to the highest degree for several days which I could not ease so much by Bleeding as by outward Fomentations and Liniments and the internal use of Laudanum Which sort of painful Spasms in the Sides I have observed almost always to have accompanyed or at least to have been the fore-runners of a Consumption of the Lungs whenever this Distemper has happened to have its Original from a Green Sickness or a Melancholick and Thoughtful Mind A long time before her Spasms first seized her she was confined to her Bed looking as if she had almost no Blood and emaciated almost to the degree of a Marasmus troubled with a Hectick Fever continually languishing and without any Appetite And therefore though the violence of the Spasms at that time did Indicate it yet her extenuated Habit and the little stock of Blood which she had as also her want of Strength and the weakness of her Pulse did forbid Bleeding However we bled her sparingly again and again and then those painful Spasms being taken off with the diligent use of Pectoral Remedies mixt with Antispasmodicks but especially with repeated Doses of Laudanum added to Antihystericks and with the outward application of Anodyne Liniments and Fomentations I applyed my self to the Cure of the Pulmonary Consumption with the General Method of Diet and Medicines too already described with very good Success and not without the great Applause of those that were about her But the whole Cure was compleated and finished by the Restitution of her Monthly Purgations with the long use of Chalybeate Medicines in the form of an Electuary Pills Wine Syrup c. which I always ordered to be mixt with her Pectoral Medicines For after she began to be freed from her Consumptive state and the Habit of her Body began to be restored and the Vessels to be filled with good Blood it was an easie thing to open their Obstructions with those very Medicines which are wont to be tryed without any Success yea with Prejudice to the Patient when she is in a Consumptive and emaciated state And so the whole business being crowned by gaining of this Point without any Relapse into a Consumption my Patient has continued fresh and lusty for Fifteen Years or more to this very day almost always enjoying her perfect Health having been in that time a Virgin a Wife and a Widdow CHAP. X. Of a Consumption caused by a Peripneumony and a Pleurisy IT is well enough known to all those that have but a little Skill in Physick A Consumption often proceeds from a Peripneumony and Pleurisy that a Consumption is wont to arise likewise from these Distempers very often And this happens sometimes from the Ignorance or Neglect of the Physician sometimes from the perverseness and peculiar Nature of the Original Distemper or a previous disposition in the Patient to a Consumption Many times too the Patient himself and his Friends that are about him are to be blamed who not observing the proper Directions of the Physician in Bleeding so often as is necessary in the seasonable and plentiful administration and taking of Pectoral Medicines and in the other parts of a due management do many times lay the Foundation of a Consumption that follows afterwards For a Consumption follows after a Peripneumony and a Pleurisy for the Reasons following First The first Reason why it does so When the Blood is left in a Colliquative state by these Distempers which is wont to happen likewise for two causes to wit First when the Patient has been Habitually predisposed to a Consumption by a propagation from the Parents or by a long abuse of the six non-naturals in which case the Blood and Lungs being heated and inflamed are very difficultly brought to a due temper for the Peripneumony and Pleurisy being once conquered the putrid heat of the Blood degenerates into a Hectical or Habitual heat so that afterwards the Chyle can neither be perfectly united nor amicably mixt with the Mass of Blood And from this Colliquative state of the Blood a Consumption of the Lungs must necessarily follow Secondly and it may be this more frequently happens from the perverseness of the Patient and the timorousness of his Friends and those that are about him and perhaps too from the Ignorance or at least the
to be Acute for this Reason because it proceeds from a Colliquation of the Humours in an Acute Fit of a Humorose Rheumatism And therefore because it partakes of the Nature of an ordinary Consumption And must be treated with the general Method it ought to be treated wholly in the General Method that is with the use of Lubricating Incrassating Opiate and other Pectoral Medicines And indeed it has been my Practice and that with very good Success to prescribe in every Rheumatick Fit the plentiful use of Pectoral Lubricating and Incrassating Apozemes and Linctuses though there be no urgent Cough nor difficulty of Breathing not only to temper and soften the Blood but likewise to prevent a Consumption which uses often to be the effect of a Rheumatism But whenever this Consumption proceeds from an old Gout or a Rheumatism When it comes from an old Gout c. 't is Chronical that has returned frequently it is plainly Chronical and does gradually in several Years create trouble to the Lungs and the Parts that serve for Respiration And indeed it is of an Asthmatick kind And of an Asthmatick kind attended rather with a difficulty of Breathing from the toughness of the Phlegm than a pertinacious Cough Because it seems to arise rather from a Stupor of the Nerves than from a Colliquation of the Humours But yet this Asthmatical Consumption to me seems to be of a peculiar Nature But of a peculiar Nature because it is not at all relieved by the choice of a good Air. For I have observed that this kind of Consumptive Persons though they be likewise Asthmatical breath as well in a foggy and smoaky Air as in that which is thin and open And from thence also it comes to pass that Lubricating and Expectorating Medicines do no good in this case though Incrassating and Opiate Medicines are fatally Mischievous But there is more Relief to be expected from the frequent and plentiful giving of Spirit of Hartshorn of Salt Armoniack and Chymical Oyl of Juniper and other things of that Nature that excite the Spirits and comfort the Nerves than from any Opiates or Pectoral Medicines As the Consumption proceeds the Pains abate The more this Asthmatical Consumption grows upon the Patient the more the Rheumatick Pains and Swellings are wont to abate And a true and genuine Humorose Rheumatism long before it becomes Mortal degenerates into a Nervous Rheumatism attended with pains running up and down but with no evident Swelling When a Rheumatick Consumption is incurable This Rheumatick Consumption proceeding from a Chronical Rheumatism and happening to those that are Old so far as I understand is plainly incurable For it is a sign that Nature absolutely sinks and is now overcome in the last Scene of a Rheumatism Gentle Vomits are good Gentle Vomits repeated at due intervals especially if the Patient bears them well and they are not given when 't is too late do much towards the promoting of the Cure of this Consumption because they open the Obstructions of the Brain and Nerves and abate the Rheumatick pains by taking off the stiffness and Stupor of the Nervous parts from whence it comes to pass that a great part of the Procatartick Cause or that which feeds the Distemper is taken away Bleeding does good in the beginning Likewise Bleeding in the beginning of this Consumption before the Habit of the Body is too much extenuated does a great deal of good not only by abating the Hectick heat and the Rheumatick pains but also by relieving the difficulty of Breathing When the Distemper is improved it is hurtful But in the progress of the Distemper when a great Emaciation has before seized the whole Habit of the Body as I have often observed Nature to be more weakned so their Respiration to be rendred more difficult with Bleeding And indeed I do not at all doubt but this Asthmatical Consumption does often proceed from Bleeding profusely and the often repeating of it in the Fits of a Rheumatism the Crasis of the Blood being thereby destroy'd and the whole Mass of it impoverisht as it uses to happen in all immoderate Haemorrhages I have likewise very often by Experience found the extraordinary Vertue of the Peruvian Bark in extinguishing the Colliquative Hectick Flame which has been kindled in the Blood The Peruvian Bark does well and is left there by its Rheumatick state which Flame unless it is taken away either by some Art or by Nature does most certainly prepare the way to this Pulmonary Consumption I have observed likewise that Chalybeate Medicines do for the same Reason conduce very much in the beginning of this Distemper So Chalybeate Medicines at least to the gaining of some respite if not to a perfect Cure but especially the Chalybeate Waters if it be not too late when they are drank if they pass plentifully enough by Urine The use also of Natural and Artificial Baths And Baths if they are used before the Habit of the Body is too much extenuated is wont to promote the Cure of this Consumption very much at the beginning by opening the Obstructions of the Nervous parts every where A Milk Diet is likewise very beneficial at the first Invasion of this Distemper And a Milk Diet at the beginning by lessening the flame that is kindled in the Blood and correcting the preternatural Acrimony of it Though it must be confest it does not so well agree with these Patients in the progress of the Distemper when once there comes to be a difficulty of Breathing because it uses to cause a greater toughness of the Phlegm that is lodged in the branches of the Wind-pipe And it may be this Conjecture is grounded upon very good Reason to wit that the using of Milk too much in a Rheumatism does very much dispose the Patient to this Asthmatical Consumption History 1. Mrs. Laurence about the Five and Thirtieth Year of her Age at which time too she was big with Child fell into an Universal Rheumatism and committed her self to the care of a certain Apothecary for several Months till at length with a Cough difficulty of Breathing Hectick Fever Emaciation and other Symptoms of this kind which she then had upon her it was uncertain whether she would dye of a Rheumatism or of a Consumption the Rheumatism which before was a genuine one being degenerated into a Nervous Rheumatism attended with a rigidity and a wandring pain in the Limbs but with no Swelling At which time being the 25th of October 1686. I being sent for ordered an Electuary with the following Julep to temper the Rheumatick and Hectick heat of the Blood and Spirits and to allay the Hysterical Affections arising from thence Take the Old Conserve of Red Roses of Hipps strained through a Sieve of each an Ounce Lavender-flowers pouder'd Magistery of Coral of each a Dram of Syrup of Corals a sufficient quantity Mix them and make an Electuary
as if it were plainly continual I likewise advise these Patients out of the same good will to have a great care of taking of Cold so long as the Distemper continues but especially in the time of the Fit Observ 2 Secondly This Consumption is for the most part Chronical and continues for the space of a Year or more before it comes to its helght partaking in this respect of the Nature of the Original Disease upon which it depends Observ 3 Thirdly The Pathognomonick Sign of this Consumption is that from the first beginning of the Disease there is a Feverish Paroxysm every day or each day or every third day according to the peculiar Nature of the Original Distemper always joyned with the Hectick Fever together with a Cough difficulty of Breathing and the other ordinary signs of a Pulmonary Consumption Observ 4 Fourthly In the Cure of this Consumption the Peruvian Bark ought always to be mixt in good quantities with the Pectoral Medicines For though I have freed several from a deplorable Consumption of this kind in three Weeks or a Month in the Spring-time with an Ounce or two of the Peruvian Bark without any Pulmonary Medicine and without a relapse of a Cure of which kind I shall not think much to add an Instance or two by and by Yet I never my self cured any one of this sort of Consumptive Patients nor do I remember one cured by any other even with the most diligent use of Antiphthisical Medicines without mixing the Bark with them History 1. Mr. Thompson a Painter living in St. Nicholas Lane near Lumbard-street about the Year 1674. in the beginning of the Month of October at Midnight after the eating too freely of Salmon and his Wife at the same hour were taken in their Beds with a Quotidian Ague or as I think a Treble Quartane The Wife was ill treated by an Apothecary with I know not what Medicines so long that though she seemed freed from the stated Fits of the Fever before January yet by reason of her Weakness she kept her Bed and lay as if she were just ready to dye For her Pulse was very weak and quick she was troubled with frequent Swoonings pertinacious Watchings almost a continual Sickness and Vomitings had large and Colliquative Sweats a great Thirst a plentiful Spitting a continual Restlesness and extraordinary Affections of her Nerves like Hysterical and no Stomack The poor sick Woman that now expected to dye every moment earnestly wish'd for the return of her former Fever so she were upon that Condition freed from her present Miseries Having given her the bitter Decoction with Senna twice for that purpose as I would have it I brought her former Fever again with its true Periodick Fits And then in the time between the Fits I ordered the Peruvian Bark in several forms to a good quantity to wit an Ounce and half With the compleat use of which she perfectly recovered without the least return of her Distemper or the Symptoms of it Neither did I order her any thing more besides Hysterick Juleps and Opiates as the Symptoms required But the Husband because he was of a strong Habit of Body and engaged in much Business but especially because he observed his Wife to grow every day worse with the Medicines which were unskilfully given her by the Apothecary look'd out for no help for himself either from a Physician or the Apothecary expecting that the Spring being now approaching his Distemper would go away of it self And every day after his Fit was off he did his Business both at home and abroad his Fever in the mean time keeping its simple form with one and the same tenour in its stated Fits and Intermissions all this while But at length after his Wife was well when he found himself every day to grow weaker and weaker with his Distemper he was about to desire my help but both the approaching of the Spring-time and a hurry of great Business diverted him from this Prudent Resolution 'T is true indeed according to the Opinion he had before about the beginning of the next Spring his Fever in its simple form left him of its own accord but still he had no Stomack his Strength was gone the Habit of his Body lean and pale his Pulse always quick and weak he had a great Thirst a shortness of Breath a dry Cough that troubled him continually both Day and Night with all the other Symptoms of an Incipient Consumption At length he comes to me both he and his Wife imploring my help and much lamenting his delay Presently I well enough thought I had sufficient reason to believe that this Incipient Consumption was the true Off-spring of his former Proteus-like Disease and therefore I ordered almost nothing of common Antiphthisical or Pectoral Medicines with the help of which I thought it almost impossible that the Patient who was now almost brought into the state of a Marasmus should be restored to his former Health But I concluded that the whole Cure was to be performed with the use of the Peruvian Bark by which means the Fever being once perfectly conquered I rightly judged that the other Symptoms would go away of their own accord as the Event it self did happily prove And therefore I made it my business only to make the form of the Medicine as grateful as I could lest I should have the Fancy of the Patient to strive with as well as his Disease And therefore I ordered the Pouder of the Peruvian Bark in the form of Tablets in the manner following Take of the Pouder of the Peruvian Bark an Ounce and half Sugar-candy dissolved in eight Ounces of Wormwood-water thickned with the Mucilage of Gum Tragacanth Mix them and make them into Tablets so that every one may weigh two Drams let him eat one four times a day drinking four Ounces of the clear Pectoral Decoction after it When he had taken all the Tablets presently that Hectick Fever which as it was the Genuine Off-spring of the Intermitting Fever so it still partook of the Nature of its Parent plainly went away together with his Cough difficulty of Breathing and the other Company of Fatal Symptoms of a Consumption but only that his Appetite was not yet perfectly restored neither had he got his Flesh by reason of the shortness of the time And therefore the time of the Year enclining me to it I sent him presently into the Country Air out of which after the space of two or three Weeks he returned strong and plump having got a good Colour and a great Stomack and enjoys very good Health to this very day History 2. A certain Norway Merchant that lived at Newington on the other side of the Thames that Year when Mr. Talbor was very Famous for the liberal use of the Peruvian Bark in the Cure of Intermitting Fevers and likewise that same Month wherein I had recovered the same Merchant's Wife beyond the expectation of all those that
the Art of Surgery Whereupon at last the ulcerated part being gangren'd after he had lain six Months he was reduced to a very Skeleton and carryed off not only with an Universal Consumption but also a true Consumption of the Lungs though it was a Symptomatical one History 4. Mr. Nye the Son of Philip Nye the Famous Nonconformist Minister as they are called when he had now about the Thirtieth Year of his Age been troubled almost continually for the space of a Year with a Swelling that grew in his Stomack a Cardialgia and Vomiting from which Symptoms he could not be freed neither by the frequent use of Calomelanos the Purging Mineral Waters Chalybeates Wood-lice the Decoctions of Sarsa prepared Coral Pearl Crabs-eyes prepared nor of other Medicines of all sorts ordered even by the most learned and skilful Physicians at length the Swellings beginning to be inflamed and ulcerated he being presently taken with an Inflammatory Fever which was afterwards succeeded by a Putrid Intermitting Fever he not only ran apace into a Consumptive state with an Universal Colliquation but also being troubled with a pertinacious Cough a difficulty of Breathing and all the other Symptoms of a very Acute Consumption of the Lungs at length he sent for me though 't was to no purpose For I found him Sick in Bed in the last degree of a Symptomatical Consumption of the Lungs which as it was in its own Nature fatal so likewise very quick And therefore when I had once given him my helping Hand as much as I could for the Relief of the urgent Symptoms I presently took my leave of him having first made a Prognostick of his Death Neither indeed did this miserable Patient continue many days But not having the liberty of opening the Body after he was dead though there were all the Symptoms of a Pulmonary Consumption yet as it did not appear to me as an Eye-witness so I cannot confidently affirm how much the Lungs themselves had happened to be affected and injured thereby History 5. A certain Old Gentlewoman a Lawyer 's Wife that lived in Shoe-Lane when as she told me she had for the space of Twenty Years been hardly able to sleep half an hour at a time by reason of a violent and continual pain in making of Water with which and with other direful Symptoms accompanying of it she having been very much and continually weakned and that notwithstanding she had taken the Advice of the most able Physicians and thereupon being brought at length into a plain Consumptive and Hectick state and being continually confin'd to her Bed by reason of her Weakness she sent for me not long before she dyed now when by reason of the loss of her Appetite she had for a long time abhorred Food as well as Physick When I came I found her really an extraordinary Woman that adorn'd her Old Age with Fortitude and Prudence beyond what is common to that Sex but yet as I guest even at the first sight by her extream Emaciation Cough Fever and difficulty of Breathing I found her lying very miserably in the last degree of a Consumption Because she was obliged almost perpetually to conflict not only with the usual Symptoms of a Pulmonary Consumption and a Hectick Fever but also with a frequent and dreadful Spasmodick Colick of her Stomack from the motion of some Stones out of the Gall-Bladder as likewise with a continual pain in making of Water caused by a Stone and an Ulcer of the Kidneys From whence it came to pass that her Urine when 't was first made was whitish and afterwards had a very great a fetid and truly purulent Sediment But upon looking on the Urine I presently found there was a pretty large Ulcer caused by a Stone in the Kidney affected and I did think that a Pulmonary Consumption had been brought on Symptomatically by that Ulcer Nature having been now for some time weakned opprest and sinking under so many and such great Evils it happened likewise that her Brain and the whole Genus Nervosum were so remarkably and continually affected that laying aside all her other Complaints of her Consumption Ulcer and Stone she desired only this that I would do something to help her against her Swoonings and Faintness which often returned as also against delirousness and the cold and hot Vapours as she called them which did continually both Night and Day alternately succeed each other which seemed to be more troublesome to her than all the other miserable Symptoms Presently I did all I could to relieve those troublesome Symptoms with the use of Spirit of Hartshorn of Salt Armoniack Tincture of Castor Antihysterick Juleps and other things of that Nature Neither indeed did I plainly neglect her distempered Lungs and her ulcerated Kidneys where the first Original of this Distemper lay but I took care of these too with the use of Emulsions Balsamick and Pectoral Medicies that is so far as the extenuated Habit of her Body and of her bad Stomack would bear But yet all these things were now ordered to no purpose For as the Ulcer of her Kidney was now for a long time become plainly incurable so likewise the Secundary Affections of the Lungs and Genus Nervosum which were the Effects of it seemed to be rather the Trophies of conquer'd and yielding Nature than either accidental Oppressions or any accidental Diseases that Art could overcome But a little before she dyed when Death seemed to be near at hand this Virago desired me very earnestly and indeed made me promise that I would take care that her Body should be opened after she was dead that for the good of the Living she might when she was dead be serviceable to that Art of Physick from which she received no Benefit whilst she lived The Husband having given leave though with much ado that the Body should be examined after she was dead she was opened very Solemnly several Eminent Physicians being present The first thing that was Remarkable was that though all the Limbs and the Face of this Tabid Woman were emaciated yet the Adipose Membrane of the Belly was strangely thick with Fat as it commonly happens to Calculous Persons it may be from a slower motion of the Blood through the Neighbouring Parts and a smaller secretion of the Serum by the Kidneys than there ought to be but we found the outward Membrane of the left Kidney sticking firmly to it as being something swelled from its Distemper But the Substance of it being opened it looked like a Honey-Comb being every where full of Stones and Cavities or certain little Cells out of which some Stones had been formerly extruded but without the least Exulceration But the right Kidney we found like a Purse not only full of Stones and Matter but likewise very much distended the whole Substance also which had been contained within the investing Membranes having been before by degrees corrupted and consumed and likewise the Membranes themselves being filled
Glutinous Medicines of which we are to speak more fully in the Chapter of Spitting of Blood As for Example The manner how this is to be done Let strong Ligatures be made upon the Arms and Thighs yea if it be necessary and the strength of the Patient will bear it let a Vein be opened with a Lancet and Blood taken away frequently but in a small quantity to divert the present Flux of Blood and to prevent the return of it If the Part where the Blood breaks out will admit of it let Galen's Styptick Plaister the Royal Styptick cold Oxycrate Ink the ashes of Humane Hair lightly burnt in a Retort and made into the form of a Pultise with Vinegar true Bole Dragon's Blood and other things of that Nature be in a convenient manner presently applyed and often renewed Inwardly let the Patient take three or four times a day xx or xxx drops or more of the Royal Styptick in a draught of Milk-water Also v. or vj. spoonfuls of the clarified Juices of Plantain and Nettles or let him frequently take the following Linctus out of a Spoon Take of Syrup of Purslane three Ounces true Bole Dragons-Blood Troches of burnt Ivory sealed Earth of each two Scruples Japan Earth a Dram of Gum Tragacanth dissolved in Plantain-water a sufficient quantity mix them up into a Linctus Or let him take the quantity of a Nutmeg of the following Electuary Take of the Conserve of red Roses an Ounce Troches of Amber three Drams true Bole Dragons-blood of each half a Dram Syrup of Myrtles a sufficient quantity mix them up into an Electuary Let him likewise take every Night v. or vj. Spoonfuls of the following Julep shaking the Bottle Take of Plantain-water six Ounces small Cinnamon-water three Ounces distill'd Vinegar half an Ounce true Bole Dragons-blood of each half a Dram London Laudanum three Grains Syrup of Myrtles an Ounce and half mingle them and make a Julep After the bleeding is stopt the blood must be supplyed with new Chyle The Flux of Blood being thus sufficiently stopt and cur'd we are to use our most diligent Endeavours that the Blood may be quickly replenished with such new Chyle as abounds with sweet and Nutritious Juice and that the Feverish heat if there be any may be extinguisht to prevent a Consumption And therefore the Patient is to be nourished with the frequent taking of Jelly-Broaths poached Eggs and variety of Food that affords good Juices and is both easie to be digested and most grateful to the Stomack Nevertheless he is to abstain from Wine and from things that are salt or have Spice in them lest they increase the heat of the Blood which was before too hot from the defect of its Nutritious Juice And because this sort of Patients as all that are upon the Confines of a Consumption are subject to Anger to Sadness Hypochondriacal Oppressions Hysterick Fits and to a want of Appetite whereupon they can neither take nor digest much Food and consequently uncapable of making up the loss of that Blood which has been spent therefore the sick Person ought to be diverted and humour'd by his Friends and to be sent as soon as may be into an open and wholesome Air The Patient must be diverâ—ed and sent into the Country Air. which in truth I have being taught from a great deal of Experience observed to conduce more than any thing of Medicines to the comforting and fortifying of the Nerves and Spirits to the recovery of an Appetite and a chearful Mind and consequently to the preventing of an approaching Consumption But if the Patient seems either through his own neglect When there is a Hectical heat it must be taken off with the Bark or the sudden advances of the Distemper to be affected with a Hectical Heat and some degree of a Consumption from his bleeding then let the Physician make it his whole business perfectly to put out this flame as soon as ever he can with the help of the Peruvian Bark given in a large quantity the efficacy of which I have often found to be wonderful in this case Afterwards What is afterwards to be done if it be necessary let the Patient be put into a Milk Diet or upon the use of the Chalybeat Waters But he must forbear the use of all Purging Medicines And some benefit may be reasonably expected from the giving of Crabs-Eyes Coral Pearl and other such kind of altering and sweetning Medicines A History Mr. Hotchkins a Merchant of London a Man that was Scorbutical and Hypochondriacal was subject to a frequent bleeding at the Nose from the twentieth almost to the thirtieth Year of his Age so that he sustain'd a great loss of Blood from the heat of his Feverish Blood at least once or twice a Month though it did not observe any certain periods till at length the Blood that was let out with a Lancet or that which he bled at his Nose did appear just like the Water that Flesh has been wash'd in From the return of which bleeding I could not then free that Excellent Person and my very worthy Friend either with Phlebotomy or the temperating Juices Opiate and Incrassating Medicines a Milk Diet Antiscorbutick and Chalybeate Remedies or any other manner of Medicines From which he first fell into the state of an Atrophy and at length into a true Consumption of the Lungs together with a very great difficulty of Breathing and thereupon falling into an universal colliquative state he suffered a little before he dyed an exulceration of the Salivatory Glands after an extraordinary swelling of them By the opening of which on the out-side there flow'd out so great and such a continual stream of the Salivatory Juice as very much hastened the Death of that worthy Man that was before brought almost to the state of a Marasmus by the Consumption of his Lungs which was caused by his Bleeding But I was extreamly troubled that I did not at that time know the Efficacy of the Peruvian Bark in suppressing this effervessence of the Blood upon which that Bleeding which return'd frequently did certainly depend for from the use of this Medicine we may justly expect more Service in the preventing of a Haemorrhage proceeding from the effervessence of the Blood than from a Milk Diet or any other manner of Medicines CHAP. IV. Of a Consumption from a Gonorrhoea and the Whites THIS Consumption seems to have been known even to the Ancients This Consumption was not unknown to the Ancients under the name of a Consumption of the Back when it proceeds from a Gonorrhoea Galen also notes the Story of the Wife of Boethius a certain Nobleman of Rome who fell into a Consumptive Dropsie from the Empirical suppression of the Whites that had flow'd in too great a quantity and a long time 'T is very true indeed that a Gonorrhoea A Venereal Gonorrhoea and Whites often end in a Consumption of the Lungs and the
Whites that are of an ill Nature and Venereal when the Impurity proceeding from that Venom has once infected the Humors do often terminate in a Consumption of the Lungs unless they are timely and perfectly cur'd But of this kind of Consumption and of the Causes Degrees and Cure of it I shall Discourse more fully in its proper place to wit in the latter part of this Treatise when I shall professedly speak of a Symptomatical Consumption of the Lungs But for the present I do from a long Experience and Observation affirm that a Consumption does often arise from a simple or benign Gonorrhoea and Whites A Consumption sometimes proceed from a simple Gonorrhoea c. and therefore this sort arising from the continual substraction of the Nutritious Juice by the Seminal Glands must be reckoned under the Head of an Originary Consumption For in a Gonorrhoea and the Whites sometimes the Flux is so extraordinary and continues so long that the Mass is thereby plainly dispirited and rendred unfit for Nourishment whereupon the Blood being loaded with Heterogeneous and disagreeable Particles grows hot and at length a Hectick Disposition is by degrees brought upon the solid Parts and the Habit of the Body which is the same sort of Consumption that we are now treating of The presaging signs of this Consumption The Symptoms which presage this Consumption I have for the most part observed to be these to wit an Hypochondriacal Oppression Melancholy and too much Thoughtfulness with a decay of Strength and loss of Appetite in Men that are affected with a plentiful Running of the Reins but in Women that have been long afflicted with the Whites flowing in a great quantity a soft and blouted Habit of the Body a squalid and pale Countenance together with Hysterical Fits a remarkable Weariness and decay of Strength all which Symptoms proceed from the same cause to wit from the poor dispirited Nature of the Blood caused by a want of new Chyle whereby not only the Spirits are weakned and opprest but also the Habit of the Body is rendred Oedematous from the waterish disposition of the Blood as it is full of old and dispirited Chyle And therefore the Signs which presage this Consumption are as I said before Hypochondriacal Oppressions Hysterical Affections a decay and want of Strength a blouted habit of the Body and a want of Appetite Which Symptoms in progress of time that is when the Distemper comes to be confirm'd are followed also by some others as a Thirst a Hectical disposition Atrophy and wasting of the Flesh till at length the Body is plainly brought to the highest degree of a Consumption and that very often without any Cough or any other remarkable sign of a Consumption of the Lungs This Distemper is easily cured if the antecedent cause of it can be removed that is if the Gonorrhoea and Whites can be cured When confiâ—med it is incurable But when it comes once to be confirmed it is plainly incurable And therefore a Prudent and Honest Physician that is carefully concern'd for his own Reputation will not do well to undertake the Cure of it but ought rather to take his leave and walk off from such a Patient after he has made a Prognostick of his Death and so he will be just to his Art and may satisfie his Conscience though he loses some Fees and defrauds his own Pocket But if the Physician be sent for in time What a Physician is to do in the Cure of it when he is sent for in time he ought to do all he can by all proper means and a convenient Method to stop the Gonorrhoea or Whites which are the cause of this Consumption Which thing we shall speak of at some other time and shew how it is to be done in the Chapters of a Gonorrhoea and of the Whites This efflux of the Nutritious Juice being once stopt by Art we must endeavour with all our Power to replenish the dispirited and impoverisht Blood as soon as may be with new oily and benign Chyle And therefore as we hinted in the former Chapter such Food as is delicious and affords a good Juice and is most grateful to the Patient's Palate and Stomack must be given often in a day though in a little quantity at a time And that his Appetite may be the more excited let him be advised to be chearful For there is nothing that destroys the Appetite and confirms a Consumption more than Grief and Sadness Let him also enjoy the advantage of an open and benign Air which is very beneficial to the Nerves and consequently to the Appetite and Stomack Let him likewise use Exercise every day and rubbing of his Body even to the procuring of moderate Sweats if his strength will bear it that the load of old dispirited and unprofitable Chyle with which the Blood-Vessels and Habit of the Body are stufft may be sweated out to make more room for new and useful Chyle and consequently for the improvement of the Appetite in the Stomack But he must Religiously abstain from the liberal use of Wine Spirituous Liquors are to be avoided and Spirituous Liquors which are wont to put the Blood which is before become too hot No considerable Evacuations are to be made into a greater flame Let the Physician also take heed he does not prescribe any Purges or any Medicines whatsoever to procure any other considerable Evacuation which may create farther Expences to Nature when she is already weak But if a Hectical heat even in the least degree be kindled in the solid Parts he must presently endeavour with all his Industry to quench this flame by the use of Asses Milk a Milk Diet and of such Mineral Waters as are Chalybeate CHAP. V. Of a Consumption proceeding from Apostemes and large Vlcers I Have always observed that Apostemes Large Vlcers in any part may cause a Consumption and large Ulcers let them happen to any part whatsoever of the Body whether external or internal if they continue long and throw out much Serum or waterish Matter have at length rendred the Body of the Patient Consumptive and that even to the degree of a Fatal Consumption and I can say I have taken notice that these kind of Ulcers do bring on a Consumption as well when they are in the Muscles of the Back and in the Testicles yea in the Knee and the Foot as when they are in the Kidneys or Liver or in the Lungs themselves Besides that I have often observed that a Consumption of the Lungs has come upon these large and old Ulcers The cause of this Consumption without all question is the long and plentiful substraction of the Nutritious Juice continually flowing out of the Mass of Blood by the Ulcers The reason of this Consumption whereby the Blood which remains in the Vessels being deprived of its Oily Nutritious Juice does grow sour and contracts a Preternatural heat and is
the first declension of the Fever let it be of Chicken-Broth potch'd Eggs c. He must likewise if there is occasion presently have a Stool procured with a Clyster made of Milk in which Camomile-flowers have been boyled sweetned with brown Sugar which as often as it shall be necessary must be repeated Then let Eight or Ten Ounces of Blood be taken from the Arm of that side where the pain is which Bleeding must be boldly repeated every day or every other day according to the Effervescence of the Blood and the violence of the pain in the Side and the difficulty of Breathing so far as the strength of the Patient will bear it that the progress of the Inflammation to a ripening and an Aposteme if it be possible may be prevented In the mean time all along the course of the Disease let a Spoonful of the following Linctus be given dissolved in four Ounces of the Pectoral Decoction warm'd every third All the time of this Fever we must use Pectoral Medicines or at least every fourth hour Take Oyl of sweet Almonds new drawn Syrup of Maiden-hair of each an Ounce and half of white Sugar-candy a Dram and half Mix them very well and make a Linctus Yea if the toughness of the Phlegm the difficulty of Breathing and the increase of the Pain arising thereupon require it and there be no Looseness to forbid it let new Linseed-Oyl fresh drawn without any Fire be put in the stead of the Oyl of sweet Almonds and Syrup of Hedg-Mustard or of the five opening Roots in the room of the Syrup of Maiden-hair Moreover let two or three Ounces of Linseed-Oyl be likewise ordered to be taken by itself every four hours because it is wonderfully endowed not only with a Lubricating but likewise an Anodyne Quality Take of the clear Pectoral Drink a Pint and half Tincture of Saffron made with Treacle-water and Syrup of Maiden-hair of each an Ounce Mix them and make an Apozeme for the Use before mentioned For refreshing their Spirits Something must be done to comfort them and tempering the heat of the Blood let four or five Spoonfuls of the following Julep be ordered to be taken Take of the Cordial Milk-water eight Ounces Barley Cinnamon-water Epidemick Water of each two Ounces of Pearl prepared a Dram and half of Loaf-Sugar six Drams mix them for a Julep At the time they should go to Rest let the following Anodyne and Diaphoretick Bolus be ordered to be taken with a draught of the Pearl Julep but especially if their Body be too loose which often happens in this state of the Distemper Take of Venice-Treacle half a Dram of Gascoin Pouder a Scruple of Syrup of Clove-gilly-flowers a sufficient quantity mix them and make a Bolus Something to preserve the Brain For the security of the Brain and the System of the Nerves presently after Bleeding let Blistering-Plaisters be applyed to the hinder part of the Neck to the inside of the Arms and Legs and the Cephalick Plaister with Euphorbium to the soles of the Feet What is to be done when there is a pain in the Side For the relieving of the pain in the side caused by the Spasms of the Muscles and Membranes of the Breast let the following Fomentation and Liniment be alternately applyed to the Parts affected Take the Roots of Parsley of Fennel Linseed Foenugreek-seed of each two Ounces Camomile flowers Melilot-flowers of each two handfuls mix them together and boyl them in a sufficient quantity of Spring-water let the Liquor being strained be put into a new Ox's Bladder till it is half full and let it be applyed hot to the Parts affected when the pain is violent When the Bladder is removed lay on a warm Flannel with some of the following Liniment Take of the Oyntment of Marsh-mallows half an Ounce Oyl of white Lillies Oyl of Bricks of each three Drams mix them and make a Liniment for use For the farther tempering of the Effervescence of the Blood and the heat of the Lungs the following Pouder may be ordered with Advantage Take of the finest Salt-Petre two Drams of white Sugar-candy half an Ounce mix them and then divide them into Eight Papers and let one of them be dissolved in every draught of Beer the Patient drinks As for the other things they must be left to the Judgment of the Physician that is with him to be prescribed as there shall be occasion As for what concerns the Putrid Fever of Consumptive Patients we must take notice A Description of the Putrid Fever that although they being treated in the foregoing Method do not dye of a Peripneumony yet the Inflammation of the Tubercles of the Lungs at this time turning to an Ulcer which very often happens at the end of the Inflammatory Fever there presently arises a Putrid Intermitting Fever which returns at certain periods every day or every other day with a Chilness a hot Fit and then Sweats succeeding one another for the Blood in its Circulation passing now through these purulent Parts is filled and opprest with Heterogeneous and disagreeable Particles by which Nature being irritated is rouzed and forms a Feverish Fit every day or every other day to expel her Enemy Vnless we can heal the Vlcers Pectoral Medicines will not Cure this Fever The Peruvian Bark will many times do great Service Which Fever so far as I understand it is impossible perfectly to eradicate with the help of Pectoral and Balsamick Medicines without healing as often as they are small and benign the Ulcers from which that Fever proceeds Yet I have very often found with very good Success the efficacy of the Peruvian Bark in taking off these Fever Fits at least for a time being frequently repeated and at due intervals So that I have seen the Lives of some Consumptive Persons that have been lookt upon as deplorable by the frequent use of it prolonged not only some months but likewise some years who though they were never perfectly recovered from a sickly state yet being once freed from their Fever by the use of the Bark could do their ordinary business well enough Wherefore I look upon this as the only Febrifuge in this case that has hitherto been found out For although by this means there is only a Treacherous and uncertain Truce obtained because the Fever is wont to return of its own accord or upon the least occasion yet by this temporary suppression of the Fever the Patient is not only immediately freed from many troublesome and grievous Symptoms for a time but likewise recovers his lost Strength in some measure and moreover gains some Opportunity for the use of Balsamick and Pectoral Medicines which by healing the ulcerated Tubercles may work a perfect and eradicative Cure of the Fever We must mix Balsami ke with the Bark And therefore it is very convenient not only to insist diligently upon the use of this kind of Balsamick Medicines at
short time provoked to Vomit he brought up not only crude Chyle out of his Stomack but also near a Pint of Pus plainly fetid out of his Lungs and thereupon with the use of a Cordial Julep both his Spasms and his Strangulation went off the heat of the Extream Parts too and his Pulse came again and at length after three hours he began to mutter some incoherent words and after some quiet sleeps he came to himself And so within 24 hours he was hungry and asked for something to eat to the great Amazement of his Friends and those that were about him But nevertheless he was not only weak and confined to his Bed but also emaciated and Hectical and lay continually Coughing and fetching his Breath very short from the weight of that Matter in the Cavity of his Breast which prest upon his Diaphragm as if he would in a short time dye of a Consumption By reason of the Acute Consumption which was upon him and his Weakness I dare not try to evacuate the Matter by Catharticks nor to let it out by a Paracentesis because as they that were about him were against it so indeed there appeared no protuberance in the Hypochondres to shew the right place where the aperture should be made And therefore for the present I resolved to bring the business about by a long and slow Method by ordering a Milk Diet to temper his Blood and the frequent use of the following Apozeme partly Pectoral and partly Diuretick with which if it were possible I might bring away the Matter by the Urinary passages without any loss of his strength The form of the Apozeme was this which follows Take the Seeds of Mallows of Marsh-mallows of each three Drams the four greater cold Seeds of each a Dram of red Cicers an Ounce of Winter-Cherries two Drams the Leaves of Colts-foot Maiden-hair of each a handful seven Figgs fifteen Sebestens Liquorice sliced an Ounce boyl them in two Quarts of Spring-water to a Quart To the Liquor when it is strained add of Syrup of Marsh-mallows an Ounce Mingle them and make an Apozeme With this Management and the addition of a Pearl Julep and a Pectoral Linctus his strength seemed to be much mended But upon that there arose an Universal Dropsie which increased so much that the poor Patient seemed every day ready to dye for want of Breath But with the plentiful use of Salt of Amber gentle Purges and Chalybeate Electuaries Balsamick and Pectoral Medicines being always mixt with them he grew perfectly well of his Consumption and Dropsie both with the help of the Spring and Country Air and is yet living in health strong and lusty following his Business of Merchandize History 2. Mr. Gifford's Daughter in Fleet-Lane about the Eighth Year of her Age was taken with an Inflammatory Fever a Pain in her Side and a troublesome and dry Cough I being called after the Second or Third day of the Disease judging by the Diagnostick Signs that the Patient had a Pleurisy ordered a Vein to be opened once and again Liniments and Fomentations to be applyed externally and likewise Expectorating Medicines to be given her plentifully which she took too sparingly I ordered likewise Blisters as it was necessary upon the account of her Fever and the Affection of her Nerves and Pearl Juleps made of Cephalick and Cordial Waters After the use of these things the Inflammatory Fever turned to a Hectick and the Convulsive Pain of her Side into a Gravative Pain and thereupon all the Symptoms appeared more mild But because no Phlegm could by any Art be brought out of the Lungs by Coughing I did much suspect that the Putrid Phlegm which had been concocted in the Lungs had found some other way through the very substance of them into the Cavity of the Breast and that my poor Patient would at last dye of an Empyical Consumption caused by the Pleurisy for want of Expectoration And indeed I was not much out in my Conjecture For after the poor Girle had lain languishing for Twenty days after the end of the true Pleurisy every day pining away with a continual Hectick Fever a redness in her Cheeks often returning the palms of her Hands very dry with a dry and troublesome Cough pertinacious Watchings shortness of Breath and other expensive Symptoms at last she began to complain of a gravative pain of her Side about the left Hypochondre which increased so one day after another that at last she could not be moved nor set upright without crying out But after the Thirtieth day of the Disease looking upon the Part affected I found it swelled and rising a little with a point But yet I stay'd till the fortieth day and then Mr. Hollier a very Skilful Surgeon being called in we took out by degrees the putrid Phlegm by a Paracentesis made a little above the Diaphragm in the space of a Month For by reason of the emaciated state of her Body she could not bear the taking away of much at a time But for a Year or two the Wound was designedly kept open in the same part like as an Issue In the mean time making use of a Milk Diet Balsamick Medicines Wood-lice and drinking freely and a long time a Vulnerary Decoction of Sarsa c. with the help of the Country Air interposing likewise at due intervals and according to the strength of the Patient Purges made of Calomelanos and Diagrydium at length she recovered out of her Consumptive state having got a good Colour and Flesh and so she continued for several Years without the least Symptom of her former Distemper but only that she was somewhat drawn in with a crookedness on the Side that had been affected to her dying day when she was taken off by a Malignant Fever CHAP. XI Of a Consumption proceeding from the Gout and from a Rheumatism There is a Colliquation in a Gout and Rheumatism IN a Gout and Rheumatism especially that which is true and Humorose which is caused by a sharp Ferment supplyed from the Nerves there is such an evident Colliquation in the whole Mass of Blood that no Body can reasonably think it strange that a Consumption should arise from these Distempers but especially when they are stubborn and Chronical and return often And hereupon it is an easie matter to observe that a Rheumatick Pain In Rheumatick Pains there is a Cough coming from the taking of Cold seldom if ever is wont to seize upon the Joynts without a Pulmonary Cough And as I have seen that great Man the Lord Bridgman Mr. Philips and Mr. Tibs and many others after frequent and long Fits of the Gout and Rheumatism dye at last of a Consumption or Asthma so I have likewise observed that sometimes an Acute and Fatal Consumption has followed upon the first Fit of a Rheumatism This Consumption it sometimes Acute This Consumption when it seizes them from the first Invasion of a Rheumatism happens sometimes
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