solid Parts by which the Nerves are weakned and upon that Convulsions a Giddiness and other Affections of the Nerves do follow and at length the Muscular Parts being deprived of their Nutritious Juice do fall into an Atrophy or Consumption As it happened to Mr. Pettit's Son and to Mrs. Wells and very many others The Method of Cure The way of Curing this Consumption is by a long use of a Milk Diet Conserve of red Roses Bole Armenack Gum Arabick Gum Tragacanth c. by drinking the Bath or Islington Waters or any other Mineral Water that is Chalybeate for a long time But the Patient must abstain from Wine especially French Wine he must not Bleed nor use any Purging Medicines except Rhubarb Myrobalanes and other such like gentle things which have also some styptick and binding Particles of the Vertue of which in Curing this Distemper I shall presently give a very Remarkable History History 1. Mr. Pettit's Son upon a Diabetes which they had a long time neglected the Cure of was not only frequently troubled with Fits of the Falling-Sickness and a swimming in his Head but also in the Progress of the Distemper became very Consumptive But with the use of Tunbridge Waters a Milk Diet and Astringent Electuaries he was perfectly recovered and is now after Ten Years in perfect Health History 2. Mr. Pettit himself the Father of the Patient I just now mentioned living in Long-Lane being then about Seventy Years old who was brought by a Diabetes into a high Hectick Fever and to the utmost degree of a Marasmus and kept his Bed for three Weeks got well off his Diabetes and Fever and at length his Consumption too by the use of a Milk Diet which he very strictly observed and of Astringent Juleps and Electuaries and is now as far as I know after five Years still living History 3. Mr. Wheeler living in Prince's-Street though he has now three Girles living and well yet he lost all his Sons who were taken off in their first Infancy to wit as soon as they began to breed their Teeth with a Consumption from a Diabetes As for the Name of the Distemper that he was ignorant of but when he observed that he lost all his Sons in the same manner and that they were extreamly emaciated with a continual and unquenchable Thirst and a strange flooding of Urine he at length askt my Advice for his fourth who at that time was breeding of his Teeth And he began just like the three former that were dead to be very thirsty and to make Water at the same immoderate rate that they had done whereby his Flesh was become very lank and a Hectical heat began to arise So being confirmed in my Opinion by so demonstrative an Argument as the sweetness of his Urine being like Honey I pronounced it a Consumption from a Diebetes caused by the breeding of his Teeth which could not possibly admit of a perfect Cure till the Child had bred all his Teeth Within the space of a Month or two the poor Infant seemed to have a Hippocratical Face and to be reduced to that degree of a Consumption as to be come to the last Scene of his Tragedy for that he labour'd under a Colliquation as well by a Looseness as a Diabetes though he had no Cough nor any other Affection of his Lungs However for the present relief of the Symptoms I order'd a Milk Diet to be strictly observed and an Astringent Electuary and gave Orders that for his Thirst he tory ducts to no purpose is restored to Nature to make up the loss which the Mass of Blood sustains When a Consumptive disposition is to be expected from an Artificial Salivation How the Patient is to be managed in this case It is also as certainly true that every Salivation procured by Art that is raised with Mercurial Medicines if it continues long does bring a Hectical and Consumptive Disposition In which case the Salivation being ended the Patient must be put into a Milk Diet for a long time by which the sharpness of the Blood may be corrected and a Consumptive Disposition may be prevented After that he must be sent into an open and benign Air and be nourisht with the plentiful use of such Food as affords good Juice and besides all this if it be necessary he must drink the Chalybeate Waters An Observation of a Consumption from an Artificial Salivation I met with a very Remarkable Instance of this kind of Consumption in Mr. Daulton an Apothecary's Daughter who from a Salivation that was raised with Mercury to Cure the Kings-Evil fell as soon as ever the Salivation was ended into a fatal Consumption and by reason of the great expence of the Humours caused by her spitting she could never be restored either by the help of the Air or by a Milk Diet or any other Art but being gradually wasted away with a Consumption after a Month or two from the end of the Salivation she dyed without any sign of a Consumption of the Lungs CHAP. X. Of a Consumption proceeding from a Dropsie A Dropsie is caused by a Rupture of the Lympheducts or of the Chyliferous Vessels The cause of a Dropsie the breaking of the Lymphatick or Chyliferous Vessels whereby the Nutritious Juice which is Naturally conveyed by these Vessels as it were in certain continual Streams into the Mass of Blood in the form either of a Lympha or of Chyle in order to recruit it does now continually flow out of those Vessels and distills into the cavity of the Belly and Breast or into the Limbs themselves and Habit of the Body How it causes a Consumption By which means the Blood being deprived of its usual recruits of Chyle or Lympha or of both is very much impoverisht and thereupon grows sharp and hot upon which consideration no one has reason to think it strange that a Fever does arise with a Drought and other Symptoms of that kind as also a Consumption or Atrophy of the Parts with a great Weakness following upon it by reason of the want of fresh Nutritious Juice and finally a difficulty of Breathing by reason of the distention and fulness of the Muscles that serve for Respiration from the Dropsical Humour which is contained within them The most usual cause of the breaking of these Vessels The usual cause of their rupture is the swelling of the Glands of the Belly or of the Breast or Limbs through which or just by which these Vessels have their course and by which they are propt By which swellings those tender Vessels being streightned and comprest they cannot give a free passage either to the Lympha or the Chyle and thereupon these Vessels being distended beyond their Natural Tone by the continual flowing in of fresh Liquor that has its tendency to the parts of the Vessels that are comprest and does press on behind the Liquor which goes before it and stops at the
compressure are at length broken This Distemper is very hard to be cured neither indeed is there any possibility of doing it without healing and closing the Breaches in the Lympheducts or Lacteal Vessels and consequently taking down the swelling of the Glands which causes the rupture of the small Vessels by compressing them The Indications of Cure Therefore in this case the Indications of Cure are these which follow 1. To evacuate the extravasated Humours First to bring down and evacuate that load of the Nutritious Juice that is extravasated with Cathartick Medicines that purge off Water as Rosin of Jalap Gum Gottae and others of that sort which are more particularly to be specified in the Chapter of a Dropsie as also by Diureticks as Salt of Amber Wood-Lice c. 2. To open the Obstructions Secondly to open the Obstructions of the swell'd Glands and to dissolve their swellings which cause the Obstruction of the Chyle and upon that to restore and strengthen the Tone of the Parts that were swell'd by a long continued use of Chalybeates Which being done the Sick Person must be plentifully Nourisht with Food that affords good Juice and at length be sent into a free and benign Air and drink the Chalybeate Waters not only for the farther temperating of the heat and sharpness of the Blood but also in order to the perfect opening of the Obstructions of the Glands But in this case we must carefully abstain from a Milk Diet because it does stuff the Glands that are already obstructed more and consequently promote the cause which disposes the Patient to this Distemper A History The Son of Thomas Lechmere Esq being about two Years and breeding of his Teeth fell into an Inflammation of his Lungs upon taking of cold and was treated very ill by an Apothecary who had omitted Bleeding and other things that were very requisite to a true and skilful Method of Cure But at length I and my Famous Colleague Dr. Croen though we were called in late recovered him in some measure by taking away some Blood and the application of Blisters and Liniments that were convenient for his Breast as also by giving inwardly such Medicines as were proper for his Lungs But yet he continued sickly with a Cough and difficulty of Breathing for the space of a Twelve Month at least from which time the poor Child began to be seized with a Hectick Fever which intermitted every day which although it was several times taken off with the Peruvian Bark yet soon return'd again and indeed came upon him by uncertain intervals for a whole Year even to his dying day But at the very beginning of the Fever his Belly began to be distended with a Dropsical swelling which increased strangely every day his Cough and shortness of Breath at the same time growing worse All which Symptoms were at length accompanied with an Atrophy of the Parts even to the degree of a Marasmus But yet when his Body was a perfect Skeleton and the Dropsie at a high Tide which was very remarkable he had a brisk and healthful look and a lovely Countenance without the least Tincture of a Yellowness and a good or rather greedy Appetite and that to the very day he dyed From whence I did rightly conjecture and always told his Friends as my Opinion that his Dropsie was truly Chylous caused by the Chyle flowing into the cavity of the Belly by the Lacteal Vessels which were broke by some Accident and that the Consumption which accompanied it was not a true Consumption of the Lungs but such as proceeded merely from an inanition that is the draining of the due Nutritious Juice out of the Lacteal Vessels upon some rupture that had been made in them which appeared very plainly from the Event For in Tapping of the Child's Belly whilst he was yet alive we took out several Pints of Milky Chyle and very sweet such as is found in the Duct it self which conveys the Chyle But when we opened the Body after he was dead we found for all the difficulty of Breathing and long Cough he had had the Lungs themselves sound without any Distemper but only that in the hinder part near the Wind-Pipe there appeared a great many Glands and those pretty large and hard which made a hard and very considerable pressure upon the Chyle-duct it self almost in that Part where it arrives at the Subclavian Vein and they were of so great a weight and bulk that it seemed very difficult if not plainly impossible for the Chyle to pass into the Blood by reason of the pressure they had made upon the Duct which had straightned it as if it had been tied with a string And thereupon without doubt it came to pass that the tender and thin Lacteal Vessels which are in the Belly the Chyle continually pressing and not finding a free passage above by the Chyle-duct being distended beyond their Tone did at length break and so threw the Chyle which was design'd for the reparation of the Blood as it were in a continued stream into the cavity of the Belly From what I have now said it is plain almost to a demonstration first that these Tubercles or tumify'd Glands of the Lungs did at first proceed from the ill Method of Curing the Inflammation of his Lungs that is for want of timely Bleeding and Expectoration Secondly that as the troublesome and dry Cough was caused by the constriction of the Vessels of the Lungs which convey the Air by these swellings so the difficulty of Breathing proceeded from the pressure of the extravasated Chyle below the Midriff Thirdly that this Consumption was not a true Consumption of the Lungs because tho' there were Tubercles or Swellings in the Lungs yet they were not like Apostemes nor Ulcerated But this desperate Consumption did really proceed from that Chylous Dropsie upon which that Nutritious Juice which ought to have been employ'd for the reparation of the Blood and the Nutrition of the Parts was continually substracted and carried another way Fourthly that this Dropsie did proceed from a rupture of the small Lacteal Vessels that are in the Belly and lastly that this rupture of the small Lacteal Vessels was caused by that continual pressure which the swellings in the Lungs had made upon the upper part of the Chyle-duct CHAP. XI Of a Consumption caused by profuse Sweats Profuse and long sweats often turn Colliquative SUch Sweats as are profuse and last long do very often become colliquative that is they carry off a great quantity of the Nutritious Particles as if they were melted and more fluid than ordinary For by these Sweats not only the load of old dispirited and unprofitable Chyle but also a great quantity of that Chyle which is fresh and Oily is readily cast out by the pores of the Skin by reason the Blood cannot assimilate it from its own too great and Scorbutical sharpness which it had contracted by degrees From whence it comes
and Herbs with which the Beasts are fed are fresh Thirdly If common Milk will not agree we must use only Asse's Milk But if there be too Acid a Ferment in the Stomack that turns common Milk into a hard Curd and makes it uncapable of being concocted as it sometimes happens from whence their commonly follow Vomitings Gripes and a Looseness it is better to abstain from the use of common Milk and to endeavour to temper the Blood with Asse's Milk concerning the use of which these following things are also to be observed First The Rules to be observed in the use of Asse's Milk That the most convenient time to give the Asse's Milk is early â—n the Morning so that the Patient may sleep in his Bed afterwards and then again at five a Clock â—n the Afternoon Secondly That nothing else of a different Nature is to be taken into the Stomack either in the form of Food or of Medicine before the Milk is concocted Thirdly The Quantity or Dose of Milk for one time is from half a Pint to a Pint or there-abouts For â—he Stomack can neither receive nor digest a great quantity of this as neither of common Milk but uses presently to cast it out either by Vomiting or Stool and that to the great Prejudice of the Patient And therefore it is Prudently advised by Physicians that the Stomack be by little and little accustomed to this kind of Nourishment beginning at half a Pint and increasing the quantity every day till they rise to a Pint. Fourthly If the Patient by reason of the Acid Ferment of his Stomack be subject to a Looseness from the use of Asse's Milk which often happens the Milk must be sweetned with Sugar of Roses and milkt upon a sprig or two of Mint Yea if it be necessary and nothing contraindicates let the Patient every Night take a Grain of London Laudanum or a Dose of the Astringent Electuary which I have already mentioned Fifthly This Milk ought always to be given in its own Natural Heat as it comes from the Ass For if it has been once cold and is warmed again it is not only made less grateful to the taste and to the Stomack but also by losing its Spirituous part it loses some of its Vertue Sixthly During the use of the Asse's Milk they must abstain from all other Medicines which is a Rule ought to be prescrib'd as well in every Milk Diet excepting Opiates and Astringents if they should be necessary to prevent a Looseness or to quiet the violent Cough in the Night-time Seventhly But if a Looseness that is caused by the Milk should not be stopt with the use of Laudanum and Astringent Medicines or if a Vomiting or at least a continual Sickness and gravative Oppression of the Stomack succeed to the stopping of the Looseness which are certain signs that the milk curdles in the Stomack Or lastly if there are signs of a Schirrous and very obstructed Liver which is no rare thing in Scorbutical and Hypochondriacal Persons in a Chronical Consumption then they must carefully abstain from all sorts of milk For the use of milk is wont by increasing the Obstructions of the Liver to bring the Jaundice and a Dropsie upon the Consumption whereby the Original Distemper becomes plainly deplorable Fourthly If Asse's Milk disagrees with them too then we must use Shell-fish Testaceous Medicines c. Therefore in these cases it is better to alter the Blood and to correct the Acrimony of it with the plentiful use of Shell-fish and of Testaceous Medicines as also with Jelly Broths made of the Feet of Animals and drinking a good quantity of Compound Waters made with Milk of a Capon a Pig Snails and other things of that Nature The Phlegmatick Waters of Snails c. must not be used where there is an Obstruction of the Liver Although what I have already hinted concerning the use of milk is also true of these Phlegmatick Waters to wit that as often as the Liver happens to be before obstructed a Jaundies and Dropsie are wont to follow upon the plentiful drinking of them Therefore in this kind of Icterical and Hydropical Persons it is more convenient to endeavour to sweeten the Blood in the manner following Let them feed plentifully upon River and Sea Craw-fish Lobsters and in general all sorts of Shell-fish Which sort of Food being taken plentifully does very much temper the four state of the Blood and correct the Acid Ferment of the Stomack And of these Shell-fish may be made by Art very pleasant Broths which must be given in good quantities Take of Craw-fish an Hundred Prescripts for making of Broths beat them to pieces alive and then boyl them in two Quarts of spring-Spring-water adding when they are almost boyled enough two or three blades of Mace one Nutmeg sliced and half a pint of Malaga Wine Let the Broth be strained for use Amongst these may be reckoned Jellies and High Broths As for Example Take shavings of Harts-horn of Ivory of each four Ounces two blades of Mace the candied peel of an Orange sliced boyl them in two Quarts of Spring-water to a Quart or a Pint and half Strain it and let the Patient when he pleases take three or four spoonfuls by it self or with warm'd Broths These kind of Jellies may be made grateful to the Patient's Palate by adding at the time when they take it a little Syrup of Baum of Cloves of Rasberries Acids do not well agree with Jellies Oranges or Lemons Though it must be confest that Acid Syrups do not so well agree with Jellies because they do in some measure spoil their Vertue For an Example of a Jelly Broth take this which follows Take one Capon drawn and cut to pieces two pair of Sheeps-feet two pair of Calves-feet shavings of Ivory of Harts-horn of each half an Ounce two blades of Mace one Nutmeg sliced of yellow Saunders three Drams or half an Ounce Boyl them all gently in a Gallon of spring-Spring-water to two Quarts adding when they are almost boyled enough of right Malaga Wine a pint the Flowers of great Daisies Colts-foot Maiden-hair spotted Lungwort of each a handful of fat Dates eight pair of Jujubes twelve pair of Sebestens ten pair of Raisins of the Sun stoned three Ounces Strain it and let the Patient take a large Draught of this Broth two or three times a day For the farther tempering of the sharpness of the Blood it is also very good for this sort of Consumptive Persons that are troubled with Obstructions to use prepared Coral Wood-lice Pearl Crabs-eyes prepared the simple Pouder of Crabs-claws and other such-like Testaceous Medicines which must be taken in a good quantity and often in a day As for Example Take of the Cordial Milk-water Carduus-water or Black-Cherry-water a pint of small Cinnamon-water half a pint of prepared Pearl half an Ounce of Loaf-Sugar two Ounces mix them and make a Julep of which let
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
please her I substituted a Chalybeate Syrup in the room of it for the same intention And because she was not easie to work upon I ordered instead of the former the following Pills to be made up For the Syrup Take of the Chalybeate Wine a Quart Tincture of Saffron of Castor of each an Ounce of fine Sugar a sufficient quantity Boyl them to the consistence of a Syrup Let her take two spoonfuls of it in the Morning and at five a Clock in the Afternoon on those days she does not Purge by it self or diluted with Carduus-water For the Pills Take the Stomack-Pills with Gums Aloes Rosate of each fifteen Grains of Salt of Wormwood four Grains Elixir Proprietatis a sufficient quantity Mix them and make them into four Pills to be taken on the Morrow Night without any strict Confinement I likewise ordered the Tendons that were indurated and contracted by reason of their thickness so as to be painful to be anointed twice a day with Oyl of Amber and Compound Spirit of Lavender oâ— each equal quantities before a good Fire and to put a Flannel upon them Though the swelling of the Tendons seemed to be lessened and her stiff Joynts to be rendred something more fit for motion with the use of these things yet the System of the Nerves seemed now and then to be grievously affected from her Hysterical Fainting Fits often returning And therefore on the Ninth of June I ordered four or five Spoonfuls of the following Julep to be given her when she was faint Take the Waters of Bawm Black-Cherries of each three Ounces the Compound Waters of Bryony and Piony of each an Ounce of Tincture of Caster a Dram Spirit of Salt Armoniack half a Dram Compound Syrup of Piony ten Drams Mix them and make a Julep I repeated the Bag of Antiscorbutick Ingredients and ordered the Purging Pills to be taken every fourth Night The Nerves having been relieved three or four times with the use of the Julep that had been prescribed I observed besides her continual Hectick Heat sometimes also a Fit of a true Intermitting Fever seizing her first with a chilness and going off with profuse Sweats though 't was by uncertain intervals And thereupon I did not without reason suspect that her loss of Appetite her continual Hectick Fever and Universal Weakness did proceed from this Feverish Ferment lurking within which had never yet been thrown out of the Mass of Blood and which hitherto had so like a Proteus in various shapes deceived my sight And therefore now I go and encounter this Enemy with all the Power of the Peruvian Bark For I promised my self and my hopes were not frustrated as the Event did afterwards prove that when this Enemy was vanquisht the state of her Health would be very much restored upon it however Baths Fomentations and other things of that kind would be of great use to extirpate fully the Trophies of the Gout which were left in her knotted and weakned Joynts And therefore June 13. I ordered the following Draught to be given and to be repeated every four hours for seven or eight times Take Baum-water Black-Cherry-water of each an Ounce Epidemick-water Syrup of Clove-Gilly-flowers of each two Drams of the Peruvian Bark finely pouder'd a Dram mix them and make a Draught I ordered likewise the following Julep to be taken by spoonfuls when she was faint Take of Carduus-water six Ounces Barley-Cinnamon-water four Ounces strong Piony-water two Ounces prepared Pearl a Dram and half white Sugar five Drams Mix them and make a Julep June 15. Take of the Peruvian Bark finely pouder'd five Drams the Mucilage of Gum Tragacanth a sufficient quantity Make them up into Pills of a middle size to be gilt of which let her take six at four a Clock in the Afternoon and when she goes to Rest from day to day taking every Morning the Chalybeate Syrup before ordered Let the Bag of Antiscorbutick Ingredients be likewise renewed But though the Patient was perfectly freed from the Fever Fits yet still her sickness at her Stomack and want of Appetite continued together with her Weakness and the other Trophies of her inveterate Enemy And therefore though I changed the form of the Medicine yet I still pursued the Enemy that was now plainly upon its flight with the Bark in the manner following Take of the Ingredients of the Purging bitter Decoction a sufficient quantity Salt of Wormwood half a Dram the Peruvian Bark pouder'd half an Ounce Infuse them in a due manner and boyl them in a sufficient quantity of Spring-water to twelve Ounces Let her take four Ounces of the Liquor prest out hard from the Ingredients every Morning and repeat it for three days together continuing the use of the Chalybeate Syrup at Four a Clock in the Afternoon June 27. I ordered the following Bolus to be taken every six hours with four Ounces of the following Apozem for three days together Take of the Peruvian Bark finely pouder'd half a Dram Syrup of Mugwort a sufficient quantity mix them and make a Bolus Take of the Peruvian Bark pouder'd half an Ounce infuse and boyl it in carduus-Carduus-water and white-White-Wine of each a sufficient quantity to twelve Ounces Strain it out for use July 6. Because the Nervous Parts seemed still to be somewhat affected I ordered her three of the following Pills to be taken three times a day at Physical hours and to drink four Ounces of the Tincture of the Bark just before prescribed Take of the Pouder of the Peruvian Bark two Drams Troches of Myrrh a Dram Castor Ens Veneris of each two Scruples the Mucilage of Gum Tragacanth a sufficient quantity Mix them and make them into Pills of a middle size to be guilt With this plentiful use of the Bark though it was given in several forms my Patient was in a wonderful manner recover'd to a state of Health so as to be every way well and was perfectly freed from all the Symptoms of her Consumption and Rheumatism but only that the Tendons and Joynts especially those of her Hands continued stiff and likewise something swell'd and she did not yet gather Flesh enough And therefore when I had by way of Preparation taken care to Purge her with fifteen Grains of Extractum Rudii and a Scruple of the Fetid Pill I sent her down to the Bath to use those Waters both outwardly by bathing and inwardly by drinking them for six Weeks ordering the Tendons and Joynts that were swell'd at the end of every bathing to be embrocated for a good while and freely with the Waters of the King's Bath and the same Parts when she was laid in her Bed and disposed to sweat to be a good while anointed with the following Liniment Take Oyntment of Marsh-mallows Nerve Oyntment of each an Ounce Oyl of Scorpions of white Lillies of each half an Ounce of Chymical Oyl of Aniseeds three Drams Mix them and make a Liniment And for fear she should be
Medicines which by removing the Obstructions of the Liver and consequently by taking away the Procatartick cause of the Disease do likewise sufficiently provide for the Lungs which have not yet received so much Mischief but it may go off and vanish of its own accord after there is no more Fuel supplyed from a distempered Liver But this Consumption is never cured with Pectoral Medicines alone We must abstain from Incrassating Medicines Yet I never saw this kind of Consumption cured by Pulmonary Medicines alone but I have always observed that it has been very much and quickly confirmed even to a fatal degree with the plentiful use of Incrassating Medicines and of all those things which increase the Obstructions of the Liver And therefore as common Milk and all things made of it yea and Asse's Milk it self much more a strict Milk Diet is not convenient in the Cure of this Consumption So likewise for the same Reason it is best to abstain from all use of Laudanum and any sort of Opiates unless there is a great necessity to give them How the Patient is to govern himself The Patient must carefully avoid Sadness which does always promote the constriction of the parts of the Liver He must likewise live in a thin and open Air and there use moderate Exercise every day all which do very much help to remove the Obstructions of the Liver But above all things the long use of bitter and Chalybeate Medicines does promote this Cure and especially the Chalybeate Waters if the Obstructions are not come to that height as to hinder the passing off of the Waters by Urine But if it be so we must Religiously abstain from the use of them lest the Distemper be quickly rendred incurable by bringing a Dropsie sooner than it would otherwise have happened History 1. Mr. Dell about the Twentieth Year of his Age when he had for several Years before been troubled with a difficulty of Breathing an Asthmatick Cough together with other signs of a Chronical Consumption of the Lungs and had been affected with somewhat a yellowish Tincture in his Skin and had his Urine of the same colour with other signs of an obstructed Liver fell at length into an Inflammatory Fever accompanyed with dreadful pains of his Breast a Thirst want of Rest and likewise a little Tincture of Blood in what he spit and other signs of the Inflammation of the Tubercles of the Lungs and he desired my help Presently by looking on his Urine which was of a very red yellowish colour and likewise full of Contents like Mum as also from a light yellowness of his Skin though I had never seen the Young Man before this that I know of I rightly guest that the Peripneumonick Fever came by some Accident upon the Patient that was before in the state of an Icteritious or Hepatick Consumption And therefore the first day which was the 9th of Nov. 1688. I ordered Ten Ounces of Blood to be presently taken away from the right Arm and four Ounces of the following Apozeme to be given with a Spoonful of a Linctus very often Take Oyl of sweet Almonds Syrup of Hedge-Mustard of each two Ounces of white Sugar-candy two Drams mix them exactly and make a Linctus Take of the Pectoral Decoction depurated a Quart Ticture of Saffron the Syrup of the five opening Roots of each an Ounce and half mingle them and make an Apozeme To ease the pain of his Breast and Side I ordered the following Fomentation to be applyed hot to the Parts affected when the Pain was great being first put into an Oxe's Bladder so that the Bladder should be but half full Take Parsley-Roots Fennel-Roots Linseed Fenugreek-seeds of each two Ounces the Flowers of Camomile of Melilote of each two handfuls boyl them in a sufficient quantity of Spring-water for a Fomentation I took care that when the Bladder was removed a Flannel should be rub'd warm with the following Liniment and put upon the Parts affected 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 To comfort his Spirits I ordered the following Cordial Julep to be taken by Spoonfuls at any time Take Baum-water Black-Cherry-water of each three Ounces of Epidemick-water two Ounces of Syrup of Clove-gillyflowers ten Drams mix them and make a Julep Nov. 10. His Fever being yet very high and his Pain very violent I again ordered Eight Ounces of Blood to be taken from the same Arm at which he had been bled before and because of his great Thirst fifteen Grains of the finest Salt of Nitre and half a Dram of white Sugar mixt together to be dissolved in every draught of Beer that he took likewise a Clyster of Milk and Sugar with Camomile-flowers boyled in the Milk to be given if he had not a Stool of his own accord and if the Pain required it a Plaister of equal quantities of Paracelsus and De Minio Plaisters to be spread upon Leather and to be applyed to the Parts affected likewise when he was to go to Rest if his Pain were still very great fifteen Drops of Helmont's Liquid Laudanum to be given in a little Draught of the Julep and an Ounce of Stone-Horse dung to be infused cold in the Pectoral Apozeme With the use of which things he seemed to be something better his Fever being now very much abated but then having made a diligent inspection of his Urine Skin and Stools I was more certain of the Obstruction of his Liver And therefore in the stead of the former Apozeme I ordered that which follows with a Linctus to be taken to the quantity of four Ounces every four hours Take a sufficient quantity of the Ingredients of the Pectoral Decoction the Roots of Parsley Fennel Succory Grass of each two Ounces the Roots of Turmerick the inner Bark of the Barberry-tree of each an Ounce the shavings of Harts-horn of Ivory of each half an Ounce of Currans two Ounces of Saffron tyed up in a Cloth half a Dram boyl them in a sufficient quantity of spring-Spring-water to a Quart adding when they have done boyling half a Pint of the best white-White-wine To the Liquor when it is strained add of the Magisterial Water of Earth-worms three Ounces the Syrup of the five Opening Roots the Traumatick Decoction of each two Ounces mix them and make an Apozem I likewise ordered two Ounces and a half of Tinctura Sacra to be given when he went to Rest with which he had two Stools the next Morning with relief And therefore Nov. 11th I ordered the use of the Apozem to be continued the Tincture to be repeated when he went to Rest and two Quarts of the Purging Mineral Waters boyled to three Pints and turned with half a Pint of Milk to be given to drink the next Morning and in the room of the former Julep I substituted the following to be drank plentifully Take
colour of his Skin I understood well enough that the first Original of all this mischief was not in the Kidneys but had layn in his obstructed Liver and that neither the progress of his Consumption could be prevented nor that horrid Pain that moved up and down between his Back Sides and Belly could be removed unless we had a due respect first to this part And I did not make any matter that the pain was felt in the lower parts of the Belly just by the Region of the Kidneys and Bladder and a great way below the seat of the Liver because I had often observed this same thing before in those that had the Jaundies whom I had often heard complaining and crying out by reason of the violent pain which they felt in the lower parts of the Belly when in truth the cause was remote in the right Hypochondre Which appearance it is no hard matter to Account for to wit that as the substance of the Liver according to my Hypothesis and Observation by reason of its preternatural closeness and density is almost deprived of Sense so likewise for the same reason it affords a very difficult passage to the Blood Lympha and other Juices that passed through it so that the Vessels which tend hither from the lower parts of the Belly must necessarily be distended beyond their Natural Tone and be rendred varicous and thereupon suffer a great deal till at length with the use of Hepatick and Deobstruent Medicines the Substance of the Liver had recovered its loose and Natural Tone From this Hypothesis for three weeks I ordered two Ounces and a half of Tinctura Sacra to be given every Night when he went to Rest to which being forced I allowed Thirty Forty and at length Fifty Drops of Liquid Laudanum to be always added by reason of the violence of the pain I likewise ordered the Purging Apozem with the addition of an Ounce and half of Syrup of Buckthorn to be repeated every fourth Morning and four Ounces of the following Diuretick Apozem to be given every four hours on the days between Take the Roots of Succory Grass Parsley Fennel of each two Ounces the Roots of Turmerick the inner Bark of the Barbery-tree of each an Ounce shavings of Hartshorn of Ivory of each half an Ounce of Currans two Ounces of Saffron tyed up in a Linnen Cloth and often squeezed half a Scruple of Aniseeds half a Dram boyl them in a sufficient quantity of spring-Spring-water to a Quart adding when they are almost boyled enough half a Pint of white-White-wine Add to the Liquor when 't is strained of the Magisterial Water of Earth-worms three Ounces the Juice of two Lemons of the Syrup of the five opening Roots three Ounces Mix them and make an Apozem I advised him likewise to take an Ounce and half of the Steel Wine sweetned with a little brown Sugar every Morning After Eight or Ten days were now past as his Pain began to abate so he likewise began to go to Stool more easily And therefore first I left out the Syrup of Buckthorn from the Purging Apozem And at length Aug. 30. in the room of the Purging Apozem I substituted six Pints of the Purging Waters crude with which he now went to Stool well enough and therefore I took care they should be repeated every third Morning Sept. 6. Because of his Faintness caused by his frequent Purging from that time he began to have so many Stools I ordered the omission of the Purging Waters for the future and prescribed the following Cordial Julep to be given often Take of Dr. Stephens 's Water two Ounces of the Epidemick-water an Ounce of Black-Cherry-water four Ounces of Syrup of Clove-gillyslowers ten Drams Mix them and make a Julep Sept. 12. When now at length my Patient began plainly to loath the Tinctura Sacra by reason of the long use of it instead of that and the Laudanum mixt with it I substituted the Stomack-Pills with Gums Cynogloss-Pill of each twelve Grains to be made into three Pills which I ordered to be repeated every Night And because I now perceived by the plenty and less high colour of his Urine that the Obstructions of his Liver were in some measure opened I ordered four of the following Pills to be taken every Morning for the farther promoting of Urine Take of the Pouder of Wood-lice half a Dram of Salt of Amber very well cleared from the Oyl fifteen Grains of Syrup of Marsh-mallows a sufficient quantity mix them and make them into Pills of a middle size to be gilt Sept. 18. When by the Tincture of his Urine being brought almost to its Natural colour I rightly conjectured that the Liver was in a manner restored to its Natural Tone I advised my Patient that he should try to open the Obstructions that remained and to precipitate the Reliques of the Morbifick Matter by Urine with the use of Sadler's Chalybeate Waters at Islington But when after the tryal of a day or two I was well enough satisfied that the obstructed parts were not yet opened so much as to give the Waters liberty to pass freely by the Kidneys because the Serum of the Blood being held by the bilious Particles and too much saturated with them and as it were coagulated by reason of the preternatural viscousness contracted thereupon could not yet be readily strained through the Pores of the Glandules of the Kidneys I altered my mind and instead of the Waters I prescribed the following Julep to be drank often and plentifully and two Drams of the following Chalybeate Electuary to be given every Morning expecting from the former of them a more plentiful flux of Urine and from the latter a farther opening of the Obstructions whilst at the same time I persisted to make the Tone of his Stomack more firm and his Body more soluble by repeating the Tinctura Sacra every third Night Neither did the Event deceive my Expectation The Julep was this Take Parsley water Fennel-water of each a Pint the Magisterial Water of Earth-worms the Syrup of the five opening Roots of each six Ounces Mix them The Electuary was this Take of the filings of Steel prepared two Drams Saffron Mace of each a Scruple Conserve of Hipps of the Flowers of Succory of each an Ounce and half of Syrup of Citron-peel a sufficient quantity Mix them and make an Electuary With the use of these things my Patient plainly recovered being freed not only from his Pains and his disposition to Vomit but likewise from the stuffing of his Lungs which he used to have from his Cough and difficulty of Breathing as also from the yellowish Tincture of his Skin and from all the other signs both of the Obstructions of his Liver and the Distemper of his Lungs For he got a very good Appetite again with which he soon was freed from his Consumptive as well as his Jaundies state and continues hitherto well and strong However when I dismist him
use of the Parts affirms have no sense if they are cut or burnt or tyed hard with strings To which Opinion I very readily assent as being perswaded of the truth of it from the frequent Observation of Varices which I remember to have often happened in Cancrous Breasts and in the Legs of Women with Child All which seemed to be affected with a very obtuse or no pain from these Varices though they were grown never so big which pain too always seemed to me to proceed rather from a preternatural distention of the external Skin and a pressing upon the Muscular flesh under them caused by the larger Varices than from the sense of the Vessels themselves that were so varicous And it may be that dreadful pain in the lower part of the Belly which is wont to accompany an Icterical Consumption of which we are now speaking may be thought to be caused in the same manner For as soon as the substance of the Liver happens to be so constringed and thickned that being now deprived of its Natural laxity it does very difficultly if at all admit the passage of the Blood through it the Vena Portae and the branches of it which bring the Blood back to this part must necessarily at length be much swelled and rendred varicous by the continual drift of fresh Blood by reason of the stop that is here put to it Which being so though the Veins themselves according to Galen's Opinion are not affected with any dolorifick sense yet none ought to think it strange that from a distention and a Solutio continui made in the Membranes through which these varicous Vessels creep there proceeds this dreadful and spasmodick pain which can be removed only with the use of Chalybeate and Diuretick Medicines endued with subtle and penetrating parts and that a long and constant use of them which may be sufficient to open the Obstructions of the Liver Which Obstructions being once removed and thereupon the Varices going down of their own accord the Membranes through which they creep may by knitting together again be quickly freed from this Spasmodick Pain And in vain even for the abating of the pain are outward and warm applications made to wit of Fomentations and Anodyne Liniments which are wont to be of very great use in Pleuritick Colick and other Spasmodick Pains because the Blood contained in the Varices is more agitated and heated by external warmth whereupon a greater varication or preternatural distention of the Vessels with an increase of the pain must necessarily follow But I have observed that Oxycrate the Cerote of Saunders Oyntment of Roses and other such-like Styptick and cooling things and those applyed cold have much better answered the end But above all things Opium given inwardly as it is the last so it is likewise the only at least the greatest Relief and Refuge for this pain This too is given in vain if it be in a little quantity For no Dose will truly answer our end unless it be so great as may be able to cause some kind of numbness or insensibility in the distended Membranes as well as in the other parts of the Body Which I have often found in Mr. Maddox and other Patients in the like case whose Pains I could not so much as abate even with Laudanum it self till I began to prescribe three or four Grains every time 'T is true indeed the Original Disease and these Symptomatical Pains proceeding from it do afford different Indications For as much as these Pains are abated by Opiates so much the Obstruction or Constriction of the Substance of the Liver which gave the first occasion of the pain is increased and confirmed And indeed what is done by Chalybeates in the Day-time is in some measure undone by Opiates in the Night However forasmuch as the Vital Indication requires it oppressed and languishing Nature must be supported with necessary Opiates For they being now almost ready to expire with the continual Fatigue of these Spasms there cannot be room to use either Chalybeates or any other kind of convenient Medicines And therefore in this case though the use of Opium which is very necessary and which ought to be compensated with the more diligent and longer use of Deobstruent and Attenuating Medicines may be permitted at due intervals by a Prudent Physician yet we must not give even the least Grain of Laudanum without urgent necessity because the Original Distemper does plainly contraindicate the use of it History 4. The Wife of Mr. Prestbury that lived in Black-Fryars who was now some Months gone with Child really an honest Woman but somewhat anxious and thoughtful at length from Cares and various Passions of her Mind fell into the Jaundies from a deficient secretion of the Bile caused by as it were a kind of Schirrous hardness and closeness of the Substance of the Liver it self But from the long neglecting of her Jaundies she became not only tabid and emaciated by the long substraction of the Nutritious Juice but likewise began to want an Appetite to have a Thirst and something of a Hectick heat to be troubled with a difficulty of Breathing a Cough and other signs of an incipient Consumption of the Lungs insomuch that even I my self thought she would in a short time dye of a Consumption unless there could be some help given her to open the Obstructions of her Liver time enough And therefore when for fear of a Miscarriage I dare order neither Tinctura Sacra nor the Purging Mineral Waters nor any other Purging Medicine on the third day of May this present Year I ordered four Ounces of the Aperitive Apozem already described to be given her every sixth hour for ten days together adding likewise twice a day an Ounce of the Chalyheate Wine to the Draught But when by reason of some Natural Antipathy which she had against Saffron she could neither bear that not Turmerick-Roots nor it may be some other things that were Ingredients in these Medicines but as soon as they were taken she threw them up again and that not without signs of a sudden Miscarriage May 25. I set my self to answer the former Indications by some new Prescript made for the same intentions in the manner following Take the Pouder of Wood-lice Goose-dung of each two Drams of Salt of Steel a Scruple Syrup of the five Opening Roots a sufficient quantity Mix them and make them into Pills of a middle size to be gilt of which let her take three thrice a day at Physical hours and drink four Ounces of the following Apozeme after every Dose Take the Roots of Succory Grass Parsley Fennel Asparagus of each two Ounces of the inner Bark of the Barberry-tree an Ounce shavings of Hartshorn Ivory of each half an Ounce of Currans two Ounces boyl them in a sufficient quantity of spring-Spring-water to a Pint and half adding when they are almost boyled half a Pint of white-White-wine To the Liquor when it is
Tone of the Stomack so also the Assimilation the Fermentation and Volatilization of the Nutritious Juice are hindred in the whole Habit of the Body from the distemper'd state of the Brain and Nerves The Causes which dispose the Patient to this Disease I have for the most part observed to be violent Passions of the Mind the intemperate drinking of Spirituous Liquors and an unwholsom Air by which it is no wonder if the Tone of the Nerves and the Temper of the Spirits are destroy'd This Distemper as most other Nervous Diseases is Chronical but very hard to be cured The Prognosticks unless a Physician be called at the beginning of it At first it flatters and deceives the Patient for which reason it happens for the most part that the Physician is consulted too late And at last it terminates in an Hydropical and Oedematous swelling of the Body especially of the lower and depending Parts in which case there remain no hopes of the Patient's Life neither is there any thing more to be done for his Cure than giving him some ease whereby his Miserable Life may be lengthened for some days The Cure The business of Cure if it be so that the help of our Art is called in in due time consists in the convenient use of Stomack-Medicines and such as comfort and strengthen the Nerves such are Chalybeates Antiscorbutick Cephalick and bitter Medicines of all sorts As for Example let the Patient if his Body be costive take every third or fourth Morning four Ounces of the bitter Decoction with Senna or every fourth Night two Ounces of the Sacred Tincture or of our Sacred Cephalick Tincture made with Hiera Picra infused in rue-Rue-water Black cherry-Cherry-water and strong piony-Piony-water For his common Drink let him use Ale in which a Bag of Cephalick and Antiscorbutick Ingredients has been hung An hour before Dinner let him take xxx drops of Elixir Proprietatis in a draught of wormwood-white-Wormwood-White-wine To the Region of the Stomack let there be applyed the Magisterial Stomack-Plaister with some Drops of the Chymical Oyl of Cinnamon and Oyl of Wormwood Or let the Stomack be fomented every day with some Aromatick Bags made of the Leaves of Mint Wormwood Cinnamon Mace Zedoary Galingale Cyprus-roots Calamus Aromaticus boyl'd in Claret If it be in the Summer let him use the Chalybeate Waters But if it be the Winter time let him make use of a Chalybeate Syrup or our Chalybeate and Aromatick Wine made with the Filings of Steel quenched three or four times in strong White-Wine and with Zedoary-roots Galingale Nutmegs the best Cinnamon Mace Cubebs Cloves bruised and steeped in the same Wine But for Chalybeates I do prefer Mynsicht's Extract before any other which I order to be given for xx or xxx days in the form of a Bolus or Pills As for Example Take of Mynsicht's Extract half a Scruple Balm of Gilead which in this case is very proper and beneficial because it is not a little grateful to the Stomack and Nerves seven Drops Old Conserve of red Roses a Dram mix them and make them up into a Bolus to be repeated every day Or if the Patient chooses to take Pills let the Extract be made up into that form in the manner following Take of Mynsicht's Extract half a Scruple of Balm of Gielead seven Drops of Haly's Pouder six Grains of the compound Pouder of the Roots of Wake-Robin four Grains of Pouder of Liquorice so much as will make them into the due consistence of Pills and make the Mass into Pills of a middle size let them be gilded and repeated once every day Also Natural Balsam by it self as likewise Spirit of Hartshorn and Spirit of Sal Armoniack are of use in this case because they are good for the Nerves As for Example Let the Patient take viij or x. drops of Natural Balsam or Spirit of Hartshorn in a convenient quantity of Sugar-candy twice a day Rules for Exercise Diet c. Let the Patient endeavour to divert and make his Mind chearful by Exercise and the Conversation of his Friends For this Disease does almost always proceed from Sadness and anxious Cares Let him also enjoy the benefit of an open clear and very good Air which does very much relieve the Nerves and Spirits And because the Stomack in this Distemper is principally affected a delicious Diet will be convenient and the Stomack ought not to be too long accustomed to one sort of Food History 1. Mr. Duke's Daughter in St. Mary Axe in the Year 1684. and the Eighteenth Year of her Age in the Month of July fell into a total suppression of her Monthly Courses from a multitude of Cares and Passions of her Mind but without any Symptom of the Green-Sickness following upon it From which time her Appetite began to abate and her Digestion to be bad her Flesh also began to be flaccid and loose and her looks pale with other Symptoms usual in an Universal Consumption of the Habit of the Body and by the extream and memorable cold Weather which happened the Winter following this Consumption did seem to be not a little improved for that she was wont by her studying at Night and continual poring upon Books to expose her self both Day and Night to the injuries of the Air which was at that time extreamly cold not without some manifest Prejudice to the System of her Nerves The Spring following by the Prescription of some Emperick she took a Vomit and after that I know not what Steel Medicines but without any Advantage So from that time loathing all sorts of Medicaments she wholly neglected the care of her self for two full Years till at last being brought to the last degree of a Marasmus or Consumption and thereupon subject to frequent Fainting Fits she apply'd her self to me for Advice I do not remember that I did ever in all my Practice see one that was conversant with the Living so much wasted with the greatest degree of a Consumption like a Skeleton only clad with skin yet there was no Fever but on the contrary a coldness of the whole Body no Cough or difficulty of Breathing nor an appearance of any other Distemper of the Lungs or of any other Entrail No Loosness or any other sign of a Colliquation or Preternatural expence of the Nutritious Juices Only her Appetite was diminished and her Digestion uneasie with Fainting Fits which did frequently return upon her Which Symptoms I did endeavour to relieve by the outward application of Aromatick Bags made to the Region of the Stomack and by Stomack-Plaisters as also by the internal use of bitter Medicines Chalybeates and Juleps made of Cephalick and Antibysterick Waters sufficiently impregnated with Spirit of Salt Armoniack and Tincture of Castor and other things of that Nature Upon the use of which she seemed to be much better but being quickly tired with Medicines she beg'd that the whole Affair might be committed again to Nature whereupon consuming
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
a Dropsical and Oedematous swelling of his Legs After many things had been tryed in vain by other Physicians at length I was call'd and quenching the flame which was in his Blood and Spirits by the use of the Peruvian Bark I also brought his sweats within moderate bounds By which means the sick Person lying in Bed as he ought to do the swelling of his Legs also plainly vanisht though he still appears lean and Consumptive The APPENDIX THIS general Consumption proceeding from Evacuations does often depend upon other Distempers This Consumption from Evacuations often depends upon other Distempers as A Lientery and therefore it may justly be called a general Symptomatical Consumption As first upon a Lientery to wit when the Faculty of the Stomack which makes the Chyle is injured by a Preternatural disposition of the Spittle and the ill Temper of the Nervous Liquor Whereby it comes to pass that the Blood and Habit of the Body since the Food that is taken is carried down through the Guts and comes away as it went in without any alteration cannot receive any Recruits from the Food and from hence there necessarily follows an Atrophy caused by Inanition Many times this general Consumption proceeds from a Preternatural alteration The Celiack Passion or obstruction of the Gall and Pancreatick Juice or else of the Juice which is naturally and uses to be separated by the small Glands planted through the whole Pipe or Duct of the Intestines and which serves for the separation of the Excrementitious parts of the Food from those which are for Nourishment For from hence it comes to pass that the Chylous parts of the Food that goes down out of the Stomack slipping by the small mouths of the Milky Vessels are thrust out together with the dreggy Excrements by Siege and that either in white Stools and such as are plainly Chylous from the defect or preternatural disposition of the Choler which is the proper Liquor for separating the Chyle as it commonly happens in the Jaundice together with a great weakness of the Body and wasting of the Flesh Or else in yellow Stools as in the Celiack Passion which either is from an Obstruction of the Pancreatick Juice and that which is separated by the Glands of the Intestines or uses to happen from the depravation of the Nature of those Juices In the first case the Urine is much tinged with a Yellow or Jaundice colour but in the latter it is quite contrary In both of them the Chyle not being separated from the Excrementitious parts of the Food the Blood is depriv'd of its due recruits upon which I have often observed that an Atrophy or Consumption and that no lingring one has seized the sick Persons Scrophulous Glands in the Mesentery Finally this general Symptomatical Consumption is sometimes caused by many and large Scrophulous Kernels preternaturally situated in the Mesentery by which the Milky Veins being straightned as with a Thread or being comprest the passage of the Nutritious Liquor which is separated in the Intestines and taken in by the mouths of the Lacteal Veins into the Mass of Blood is either totally or in part hindred In which case the Stools are large and Chylous the Belly grows hard and is swell'd but the Urine flows in a very little quantity yet keeps its Natural colour Thereupon the Blood not being every day replenished with new Chyle the Muscular Parts are deprived of their due Nourishment and daily pine away and at length are wasted to the degree of a Marasmus though the Appetite at the same time be greedy and the Patient continues almost always free from any thing of a Fever an Instance of which kind I once met with in a Boy about four Years old the History of which because it was a very rare case I shall presently relate All these Symptomatical Consumptions are plainly incurable In the Cure of these Symptomatical Consumptions respect must be first had to the Original Diâ—â—â—se unless a particular respect be first had to the Distempers upon which they depend but if these are once remov'd by Art this kind of Consumption ceases of its own accord and therefore the Cure of this Consumption is to be sought for in another place to wit in the Cure of those Distempers which are the cause of it History 1. A certain Citizen's Son in the Street commonly called Wood-street being about four Years old seem'd without any Fever or Cough to be brought by degrees to the highest degree of a Marasmus but his Belly was unequally hard and swell'd his Urine very little in quantity yet of a good colour his Stools frequent large and plainly chylous Nevertheless his Appetite continued good or rather greedy all the time of his ilness whereupon I did easily conjecture that the passage of the Chyle through the Milky Veins was much hindred by the many and very large Glandulous Swellings plac'd up and down in his Belly and that his Consumption had its Origine from the Evacuation of the Chyle caused in this manner I ordered the Plaister Diasaponis to be apply'd to his whole Belly and the following Julep to be given him plentifully and frequently Take Parsly-water Fennel-water of each four Ounces the Magisterial Water of Earth-worms Syrup of the five opening Roots of each two Ounces of the purest Salt of Amber very well freed from the Oyl half a Dram mix them and make a Julep This Liquor he very greedily coveted beyond all expectation plainly refusing any other so that in the space of Four and Twenty Hours he drank up double the quantity of the Julep that was prescrib'd Upon which he made Water at a strange rate and had fewer and less chylous Stools the swelling of his Belly falling at the same time and in a short space with the frequent and plentiful use of this Julep and torrefied Rhubarb made up into the form of a Bolus with Diascordium the little Boy was freed from his Marasmus beyond the expectation of all his Friends History 2. Very lately which was just after I had wrote this Treatise I was called to go see Mr. Gouge's Son at the Sign of the Cornelian Ring in the Strand a Boy about six Years old and perfectly reduced to a Skeleton by a Marasmus As soon as I had made a diligent Enquiry into the cause of this Consumption I presently found his Belly which was very much and unequally tumifyed every where full of swellings which were disposed here and there in clusters which yet could not be discerned without pressing very hard with ones fingers His Stools also were frequent and chylous his Urine little but of a Natural colour he had no Cough breath'd freely enough but he had a very Melancholick and plainly dead Look and his Countenance was squalid and pale I ordered him the White Drink and a Bolus with Diascordium and torrefied Rhubarb of each half a Scruple to be taken once a Week the Plaister Diasaponis to be
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
to pass that the Blood retaining a Hectical heat the Lungs for a long time remain hotter than they ought to be and upon that there is a conflux of the Humours flowing into the Part affected or rather a plentiful separation of the new Chyle by the Glands of the Lungs From which there follow violent and dry Coughs Inflammations and at length when the Consumption comes to its height Exulcerations And therefore I never do take away so great a quantity of Blood from other Persons that have a Fever as from these sickly Consumptive People whenever they happen to be Feverish and this I have done with very good Success so that I do not remember that I ever yet repented of doing it If there be any Hectick heat with a Catarrh an Opiate must be given If the Catarrh has but the least degree of a Hectical heat joyn'd with it and the other Circumstances of the Patient allow it the frequent use of an Opiate is also very necessary in this case and that not only to quiet the Lungs which at this time are heated by the continual and violent motion of the Cough but also to temper and calm the whole Mass of Blood So that it is plainly convenient every Night or every other Night to give a Grain and half of London Laudanum in a little Conserve of Red Roses or an Ounce of the Syrup of Meconium with three Ounces of Milk-water and three Drams of old Epidomick Water or twenty Drops of Helmont's Liquid Laudanum in a spoonful of the Balsamick Syrup which I shall afterwards describe or half a Scruple of Hounds-tongue Pill or the Pill of Styrax Yea And in this case every Purge excepting the Mineral Waters should have an Opiate mixt with it and in this case no Purge except the Purging Mineral Waters ought to be prescrib'd without mixing an Opiate with it lest the Cough and Heat should happen to be increased by too great a Commotion of the Humours As for Example Take a Scruple or half a Dram of Aloes rosate half a Scruple or twelve Grains of Hounds-tongue Pill mix them and make them up into four Pills to be gilded and taken when the Patient is to go to sleep Or Take two Ounces and a half or three Ounces of the Sacred Tincture fifteen or twenty Drops of Helmont's Liquid Laudanum This kind of Purges may be ordered every third or fourth Night and two Quarts of the Purging Waters the following Mornings either cold or boyl'd according to the Season of the Year Those days the Patient does not Purge When the Patient does not Purge Diureticks and Diaphoreticks are to be taken the Physician must go another way to work and endeavour to carry off the Humours gently by the Pores of the Skin and by the Kidneys and do it with the use of such Diuretick and Diaphoretick Medicines as may rather abate than increase the Preternatural heat of the Blood For Example Let the Patient take three times a day Fifty Wood-lice bruised in small draught of Milk-water Parsley or Fennel-water sweetned to the Palate with the Syrup of the five opening Roots Or Take two Drams of Wood-lice prepar'd a Dram of Ceruss of Antimony so much Turpentine washt in Plantain-water as will make them into Pills mix them and make them into Pills of a middle size to be put up in Pouder of Liquorice of which let him take three three times a day at Medicinal hours and drink after them half a pint of the Decoction of Sarsa and China keeping himself from the open Air. The Chalybeate Waters are excellent in this case But for this purpose I generally prefer the Chalybeate Mineral Waters before all others it being what I have learnt from long Experience for that they are found by precipitating the serous Liquor out of the whole Habit of the Body by the Kidneys in a great quantity and tempering the Hectical heat of the Blood and Spirits likewise by opening Obstructions and restoring the due Tone of the Parts to perform every thing that is requisite to a preventive Cure even Reason it self being Judge Which I have also found by much Experience ever since this kind of Waters here near us that is at Islington have first come into Publick use with the Approbation of our Famous Colledge Many preserv'd and cured by them And by the help of these I have seen a great many preserved and indeed others miraclulously recover'd from a Consumption such as I had plainly thought could never be cured no not with all that vast stock of Medicines which are Sold either in the Apothecary's or Chymists Shops and the most approved Method of giving them at least that I knew unless I had had those Waters or at least some others like them ready for my purpose I shall afterwards at the end of this Treatise give a short Account of some few Histories out of many that are pertinent to this business Here also Issues made in the Arms Issues or between â—he Shoulders are serviceable for abating the â—uantity of the Serous Liquor of the Blood and â—onsequently for comforting the Brain and Nerves and tempering the Animal Spirits which doubtless contribute very much to the exâ—inguishing of the Hectical Flame and to the â—revention of a Consumption Shaving of the Head And perhaps â—ut little less benefit may be expected from the â—â—equent shaving of the Head When by this the â—assage of the Humours through that very thick â—kin of the Head is rendred more free the use â—f which thing in relieving obstinate Catarrhs 〈◊〉 approved almost by universal Experience But alas Physicians seldom consulted for the preventing of a Consumption Physicians have very seldom an ocâ—asion to give their Advice about preventing this Distemper when in the beginning perhaps it â—ay be cured as well as other Diseases although â—or the most part by neglect it proves fatal â—e sick Persons seldom imploring Aesculapius â—elp before the Distemper has run on so far as 〈◊〉 be a fatal case and then they in vain expect Miracles from the Art of Physick when it is â—ore convenient for them to have the good Counsel of a Minister about the future Salvaâ—â—on of their Souls and the Advice of a Lawyer â—bout making their last Will. Wherefore I â—â—all spare that labour which will be to so little â—urpose and without any farther delay proceed 〈◊〉 the Diagnostick and Pathognomonick Signs â—f this Distemper CHAP. III. Of the Diagnostick and Pathognomonick Signs of the beginning of a Pulmonary Consumption THE Diagnostick and Pathognomonick signs of a present Consumption The signs either shew the beginning or confirmation of a Consumption are either such as discover it when it is but begun or when it is once confirm'd and deplorable The Pathognomonick signs of the beginning of a Consumption of the Lungs are First a Cough which one may and that by very certain signs distinguish from a simple Catarrh how violent soever
feel somewhat like a Saw when one feels it with several Fingers together Though sometimes by reason of the violence of the Spasmodick pain caused by the Inflammation of the Tubercles it is no rare thing to observe a weak Pulse together with a coldness of the Extream Parts for a time which may employ the Sagacity of the most Skilful Physician to know whether he ought to prescribe Bleeding or no. For as the taking away of Blood does suddenly destroy Nature and ruin the Patient whenever the weakness of the Pulse and the coldness of the Extream Parts proceed from an habitual Weakness So Bleeding by abating the Inflammation makes the Pulse stronger and restores heat to the Extream Parts whenever this Weakness proceeds accidentally from a painful Spasm of the Lungs caused only by an Inflammation which is often immediately relieved by Bleeding When there is a Putrid Intermitting Fever But when in the progress of the Distemper a Putrid Intermitting Fever comes on from the gathering of Matter in the Lungs the Pulse is very uncertain to wit in the Morning before the Fit it is somewhat quick and weak quick from the Hectick Feverish disposition of the Blood but weak from the exhausted and impoverisht Habit of the Body at this time for want of the reparation which should be made by due and sufficient Nourishment But in the Fit it is quick and strong quick from the Hectick Fever strong from the present Orgasm or preternatural Commotion of the Blood But when the Sweat begins to come on both the preternatural quickness and the strength of the Pulse are by little and little abated until the strength of it is renewed by the next Fit 2. Observations of the Vrine Secondly the Urine when the Distemper first seizes the Patient is in some degree less than usual and somewhat high-coloured according to the degree of the Hectick Fever and being exposed to the Air turns thick with some settling at the bottom as abounding with more Chylous Particles than it should do But when the Tubercles begin once to be inflam'd it is very red and high-colour'd But as soon as the Putrid Fever from the Apostemes of those Tubercles succeeding the Inflammation of them comes to be one of the Symptoms it is high-colour'd as it uses to be in Intermitting Fevers and thick and at length being exposed to the external cold has a white settling like Meal and sometimes a little red for the Blood in this Colliquative state separates the Nutritious Juice by the Glands of the Kidneys as well as by other Glands Though it must be confest that Persons in a Consumption that are Scorbutical and Hypochondriacal but especially where the Nerves are affected or upon drinking of French Wine or other Diuretick Liquors do make a good quantity of Urine that is like Water thin and pale at some times after which there presently follows a high-colour'd and thick Urine Thirdly 3. Observations of the Matter that Consumptive Persons spit that which Persons in a Consumption spit at first that is when the stuffing of the Lungs gives the first occasion of it is plentiful sometimes crude sometimes concocted as it uses to be in a common Catarrh Or else it is thin and waterish because for the most part to wit whilst the Cough is dry it is thrown out of the Salivatory Glands from the extraordinary shaking of them by Coughing excepting some little quantity of viscid Phlegm which is wont to be hawk'd out of the Tonsils But in the progress of the Distemper especially when it is concocted by sleep or the use of Opiates it is of an ash-colour or yellow or greenish the like Concoction to which the Serum admits in the Glands of the Nose or Wind-pipe in the latter end of a Catarrh But after the Lungs are ulcerated if the purulent Matter not being contained in a proper Cystis be thrown into the branches of the Wind-pipe that which they spit is purulent and stinks and is sometimes also mixt with streaks of Blood like that which uses to run out of old and foul Ulcers But we must not make a Judgment of the spitting of purulent Matter We must not judge of purulent Matter by the yellow or greenish colour of it from the yellow or greenish colour of it For this kind of colour not only the Serum that comes from the Glands of the Lungs has but likewise that which is separated by the Glands of the Nose in the end of a Catarrh to wit as soon as it comes to be concocted Neither is that that Persons spit to be presently taken for purulent because it sinks or dissolves in warm water Nor by its sinking and dissolving in warm water For the spitting of Scorbutical Persons because it is much impregnated with Salt and thereupon glutinous and heavy is wont to dissolve and to subside in hot Water How true Pus may be known though the Lungs are sound But true Pus or Matter may be known by these three signs First it affects the Nose with a stinking smell Secondly though it be something thick yet it is not at all glutinous but fluid having no strings or ropiness Thirdly it is of several colours to wit yellow greenish c. but for the most part of an ash-colour and something black CHAP. V. Of the differences of an Original Consumption of the Lungs HEre I could easily make several Divisions of a Consumption of the Lungs and those such as are confirm'd by daily Experience but because they neither afford any light to the forming of a true Notion of this Distemper in general nor help us to a clearer or more distinct Understanding of the general Prognostick Signs and Indications of Cure I shall not so much as mention them at least in this place But yet there is one Division of a Consumption of the Lungs which is into an Acute The Division of a Consumption into Acute and Chronical and a Chronical Consumption without the knowledge of which a Physician must needs be very often mistaken as well in the making of his Prognosticks as in the discovery of the Indications of Cure And therefore no one ought to think it improper if I here add with what Brevity I can my Observations for a fuller explication of it For as I have seen some taken away by this Distemper within the space of one or at most of a few Months so I have observed a great many others that were far gone in a Consumption by due care and by making use of proper means who have lived though in a sickly and crazy state for many Years as for Example Mr. Haither who after the Cure of a spitting of Blood which he had been seized withal when he was a Youth is yet living in the fiftieth Year of his Age though in the whole course of this time he has been lean troubled with a Cough and often had touches of a Fever and been freed from several Putrid Fevers
are commonly called Pectorals and Expectorating the more neat forms of which I shall very willingly subjoyn Take Oyl of Sweet Almonds Syrup of Maiden-hair Jujubes Violets or of Marsh-mallows of each an Ounce and half of white Sugar-candy a Dram and half mix them very well for a Linctus of which let the Patient take a Spoonful every four hours and drink four Ounces of the following Apozeme warm after it Take of the Pectoral Decoction when 't is clear a pint and half Tincture of Saffron extracted with treacle-Treacle-water Syrup of Maiden-hair Scabious or Jujubes of each an Ounce mix them and make an Apozeme If you have a mind to incrassate more Take Oyl of sweet Almonds fresh drawn Syrup of Comfrey red Poppies or of dryed Roses of each an Ounce and half of Syrup of Meconium half an Ounce of Sugar of Roses a Dram and half mix them and make a Linctus But if you have a mind to lubricate more Take Linseed-Oyl fresh drawn without fire Syrup of Liquorice or Honey of Violets of each an Ounce and half of white Sugar-candy a Dram and half mix them exactly for a Linctus to be taken either by it self or dissolved in a Draught of the Apozeme above-mentioned If a Feverish Heat should forbid the use of Hyssop or of the Tincture of Saffron If there is a feverish heat hot things must be omitted let them be omitted in the Apozeme If there be a Looseness such things as will make them laxative must be omitted If a Looseness or any other Symptom forbid their use let the Pectoral Fruits be left out of the Apozeme and the Oyl out of the Linctus's or else instead of the Medicines just now mentioned let these be substituted which follow Take the Lohoch of Poppies Sanans of each an Ounce and half Syrup of Purslane of dryed Roses of each an Ounce the cold species of Gum Tragacanth Haly's Pouder of each a Dram Saccharum Penidiatum or Sugar of Roses three Drams Mix them and make a Linctus to be taken in a Spoon or with a Liquorice-stick every four hours or oftner if the Cough requires it swallowing it gently and drinking after it a quarter of a pint of the following Emulsion warm Take the four greater cold Seeds of each a Dram white Poppy-seeds Lettuce-seeds of each two Drams Pine-Kernels Fistick-Nuts of each three Drams with a pint of the Water of Red Poppies Red Rose-water Barley Cinnamon-water of each three Ounces Make an Emulsion according to Art to be sweetned with Saccharum Penidiatum Or Take the Lohochs of Foxes Lungs of Colts-foot of Purslane of each an Ounce the Syrups of Jujubes Maiden-hair of each an Ounce and half of Flower of Brimstone two Drams of the Tincture of Saffron half an Ounce the cold species of Tragacanth the could species of Pearl Haly's Pouder of each a Dram Saccharum Penidiatum half an Ounce Mix them and make a Linctus to be taken as before Take Tacamabac Balsam of Tolu of each a Dram a sufficient quantity of the Ingredients of the Pectoral Drink boyl them in a sufficient quantity of Spring-water to a pint and half with the Liquor strained and a Dram of each of the four greater cold Seeds two Drams of white Poppy seeds and as much Henbane seed seven sweet Almonds blanch'd Make an Emulsion according to Art to be sweetned to the Palate with Saccharum Penidiatum But if there be a greater difficulty of Breathing than ordinary from the toughness of the Phlegm let the following Linctus be prescribed Take the Lohochs of Raisins of Squills of each an Ounce and half the Syrups of Hedg-Mustard of Hyssop of Hore-hound of each an Ounce and half the species of Orrice of Calamint Flower of Brimstone of each a Dram and half of the Tincture of Saffron half an Ounce of white Sugar-candy six Drams Mix them and make a Linctus to be taken as before Yea if this Symptom be very urgent there may be added a Dram of Gum Ammoniack depurated and a Dram and a half of Flowers of Benjamin to the Linctus These Intentions to wit the speedy Concoction of that Mass which is lodg'd in the Lungs and the preventing of a new influx of it are likewise satisfied by Compositions made of Balsamick and Agglutinating Medicines As for Example Take the Pulp of Conserve of Red Roses of Wood-Sorrel of each an Ounce and half of Olibanum three Drams of Natural Balsam two Scruples mix them and make an Electuary of which let the Patient take the quantity of a Wallnut three times a day at Physical hours and drink after it a quarter of a Pint of the following Apozeme warm Take the Leaves of Yarrow Mouse-ear Burnet Dandelion spotted Lung-wort Jerusalem Oak Scabious of each a handful Flowers of St. John's wort Violets great Daisies red Poppies of each half a handful Jujubes Dates of each six pair of Saffron tyed up in a Cloath half a dram Anise-seeds Juniper-berries of each three drams steep them in a due manner and boyl them in a sufficient quantity of Spring-water to three pints In the Liquor when it is strained dissolve a quarter of a pound of the Conserve of Red Roses which being in this manner added to the Apozeme gives it a Balsamick and very grateful taste strain it again and then add Syrup of Corals of Jerusalem Oak of Maiden-hair of each an Ounce mix them and make an Apozeme for use Or instead of the former Electuary let this be prescribed which follows Take of the Pulp of the Conserve of Red Roses strained through a sieve two Ounces of the Conserve of the Fruit of the Dog-Rose an Ounce of Haly's Pouder a Dram of Leucatellus Balsam half an Ounce a sufficient quantity of the Balsamick Syrup mix them and make an Electuary to be taken as before Let the Patient likewise take often in a day a Spoonful or two of the Balsamick Syrup which is very grateful to the Stomack and a Scruple of Balsam of Tolu made up into little Pills with every Dose of the Syrup Every Night an Opiate must be given Also every Night when there are not some other Medicines to be taken if nothing forbids it it is convenient to give xv or xx Drops of Helmont's Liquid Laudanum in a Spoonful of the Balsamick Syrup For this end likewise 't will be well to prescribe a Dram of the Flower of Brimstone in a potch'd Egg or a sufficient quantity of Honey of Rosemary-flowers If a tickling Cough by reason of the Acrimony and thinness of the Humour separated by the Wind-pipe and the branches of it be very troublesome to the Patient so that 't is to be feared the Catarrhous Cough being irritated after the manner of Suction or drawing the Humour more into those parts will be increased let the following Lozenges be always at hand to be taken at pleasure and swallowed gently to quiet the Cough Take of the Pulp of Marsh-mallow-Roots prest through a sieve an Ounce
their proper Heads But now besides the altering Medicines already described which are given in a little quantity and at certain hours The altering Medicines we must do all we can to temper the Feverish Heat of the Blood and to eradicate the inexhausted stock of Humours lurking in the Habit of the Body together with the Colliquation arising from it by making the Patient take them plentifully and continually in the manner of a Diet. And therefore we must not only diligently make choice of such Food as affords good Juice and corrects the sharpness of the Humours as Partridges and Mountain-Birds potch'd Eggs Oysters the Feet of Animals together with Gelly-Broths and Gellies made of them also Craw-fish and other Testaceous Fishes with Broths artificially made of them some forms of which I shall afterwards subjoyn but also the Chalybeate Mineral Waters a Pectoral Mead a Milk Diet Asses Milk Milk-water Pig-water Snail-water and other Liquors that soften and take off the sharpness of the Blood must be ordered to be taken plentifully in the manner of Drink Likewise Issues shaving of the Head and the application of proper Plaisters are of great advantage Of the use of which and the Cautions that are to be taken in the use of them I shall briefly and particularly propose my own Observations If the Hectick heat is small we must use the Chalybeate Waters And first if the Hectical Heat be moderate and almost insensible from whence we may conjecture that those fixt Swellings of the Lungs are crude or at least scrophulous and of a cold Nature that they are stufft with a chalky fatty or any other such kind of Matter the Patient must by all means be put upon the use of the Chalybeate Mineral Waters in the Summer time And by this means I have relieved a great many of this kind of Consumptive Persons for many Years restoring their Appetite their Flesh and Strength abating their Hectick Heat and Cough and giving then a greater freedom of Breathing and that not only during the time of their drinking the Waters but also all the next Winter From whence we have reason to conclude that those Swellings if they are not perfectly eradicated by the use of the Waters at least are lessened and the Mass of Blood mightily temper'd by them And this palliative Cure if we cannot obtain a perfect one is of some moment For although the Patient prolongs his Life in a state somewhat sickly yet still he lives and by taking due care is able to do his usual Business and to have a moderate Enjoyment of the common Delights of Humane Life But I have seen some perfectly recovered from an evident Consumption by the use of these Waters and made sound again without a Relapse a History or two of whom I shall faithfully and briefly relate in the Chapter of a Hypochondriacal Consumption But for the use of the Chalybeate Waters I would recommend the following Rules strictly to be observed by all Consumptive Persons First in an Acute Consumption to wit Rules to be observed in the use of the Chalybeate Waters where the Lungs are evidently putrefied and where the Fever is advanced beyond the degree of a Hectick as also in an extream Chronical Consumption where the Patient is come to some degree of a Marasmus together with Colliquative Sweats a Looseness or Dropsie the Waters must be avoided which most certainly in this case are not only mischievous but also deadly Secondly those that are sick of a Consumption though they ought to spend a long time to wit the greatest part of the Summer in the use of the Waters that the Crasis of the Blood which is almost quite destroyed may by degrees be restored by the long use of them yet they must drink them sparingly every day and in a less quantity than others are wont to do that is four five or six Pints at a time lest by too great a distention of the tender Vessels of the Lungs there comes at length a spitting of Blood Thirdly during the use of the Waters they ought to take more care lest they get cold and commit any Errors in their Diet than many Persons that are sick of other Distempers commonly do Fourthly it is convenient for Consumptive People to repeat the use of the Waters for several Years in the Summer-time though after they have been used to them it is not necessary to drink them so long every Year as at first Fifthly neither are Consumptive Persons to be purged during the use of them as other Water-drinkers use to be But if they are subject to be more costive than they should be it is convenient before they fall upon the use of the Chalybeate Waters and after they have made an end of drinking them to give them the Purging Mineral Waters in a moderate quantity and to repeat them every three or four days till they have taken them three or four times Sixthly if the Waters do not pass off in a sufficient quantity by Urine much more if they cause a Looseness they must not persist any long time in the use of them unless we can by Art provide sufficiently against these Inconveniences To take off and prevent a Looseness I use to order the quantity of a Wallnut of the following Electuary every Night when they go to Bed Take the pulp of Old Conserve of Red Roses Marmalade of Quinces of each half an Ounce of Troches of Amber three Drams Bole Dragons-blood of each half a Dram of London Laudanum three Grains of Syrup of Myrtils enough to make an Electuary To promote the passing of the Waters by Urine they must dissolve a Scruple of the finest Salt of Amber very well cleared from the Oyl in the first draught of the Waters Seventhly it likewise does very well during the use of the Chalybeate Waters to order their ordinary Drink to be impregnated with a Bag of Pectoral Ingredients to which may also be added such as are proper for the Scurvy and the Kings-Evil that are mild if the Original Distemper requires it Secondly If the Hectick heat is great and the Consumption quick we must rather make use of a Milk Diet. The Rules that are to be observed in a Milk Diet. but if the Hectick Heat be considerable and thereupon the Consumption quick in its Progress it is better to temper the heat with a Milk Diet than with the Waters But about a Milk Diet we must observe these following Rules First In the use of this Diet nothing must be either allowed or taken for Meat and Drink but Milk and things made of Milk except Bread But they must take this Food in a good quantity and frequently for fear the parts should be deprived of their due Nourishment by reason of the thinness of it Secondly a Course of the Milk Diet ought to be continued a Month or two Thirdly the Spring is the most convenient time of all for this Diet that is when the Flowers
the Patient take a quarter of a Pint shaking the Bottle first three or four times a day adding if his Stomack should require it an Ounce or two of Epidemick-water Aqua Mirabilis Dr. Stephens's or some other Spirituous Water Or Take Wood-lice prepared Crabs-eyes prepared the simple Pouder of Crabs-claws red Coral of each a Dram of the Pouder of white Amber half a Dram. Mix them and divide them into nine Papers of which let him take one three times a day in a Spoonful of the Pearl Julep just now described or of some other such-like Julep drinking a Draught after it Fifthly If the Patient should seem to be plainly free from Obstructions of his Liver and so be neither in an Hydropical nor an Icterical state but yet the Milk Diet before described should not be very convenient by reason of a Looseness and the Acid Ferment of the Stomack besides the altering Medicines before described for the farther tempering of the sharpness of the Humours the plentiful use of a Compound distilled Milk-water Capon-water Snail-water Pig-water c. may be enjoyned with Advantage of which I shall in the next place give some Prescriptions A Milk-Water Take the Leaves of Maiden-hair Colts-foot spotted Lungwort Fluellin of each three handfuls Hyssop Goats-rue Minth Wormwood of each two handfuls Flowers of St. John's wort Scabious of each two handfuls of English Saffron a Dram three Nutmegs sliced Dates fat Figs of each a pound of Raisins of the Sun stoned a pound let them be all cut and steep'd in three Gallons of new Cow's-milk and three Quarts of Malaga Wine and distil them in an ordinary Still so that half of the Liquor may come over And let all that is distilled be mingled and reserved for Use If it be a Scorbutical Consumption let Pine-tops Brook-lime Water-Cresses Tun-hoof with others of the milder sort of Antiscorbuticks be added in the Distillation and instead of Malaga Wine put in Brunswick Mum. But if it be a Scrophulous Consumption put in three Pints of Wood-lice bruised with the Herbs and likewise other Ingredients that are proper for the Kings-Evil If you would make this Water not only Alterative such as may alter the Blood but likewise Restaurative you may add a Capon or a Pig in a second Distillation As for Example Take a Capon drawn or a Pig with the Bowels taken out and cut it to pieces of the Milk-water above described a Gallon and distill them so that three parts of the Liquor may come over A Snail-Water Take Three Hundred Garden Snails cleansed with Salt of common Milk or rather of the Milk-water before described three Gallons distil them in an ordinary Still with a gentle fire until an Acid Liquor begins to come off I think the following Magisterial Water of Snails likewise also which I use to make is not to be despised because it may be kept for Use a long time Take of New-Milk two Gallons distil it with Mint Roman Wormwood of each two handfuls to a Gallon Then Take of Garden Snails washed first in common Water and then in Small-beer half a Peck of Earth-Worms slit and wash'd a pint of Angelica a handful and half Agrimony Betony Rue of each a handful Put the Herbs in the bottom upon these lay the Snails and Earth-Worms and upon the top of all lay of shavings of Hartshorn half a pound of Cloves an Ounce of Saffron three Drams Infuse them in two Quarts of Syder and a Quart of the best Malaga Sack and then distil them in an ordinary Still These Liquors must be drank plentifully The Water of Snails c. where it is used must be drank freely and that even for ordinary Drink mixt with an equal quantity of Milk if the Stomack will bear it and it will quench the Patient's Thirst enough If you like the form of a Julep best it may be given in the following manner Take of the pig-Pig-water or Capon-water before described a pint of Loaf-Sugar a sufficient quantity Boyl them up into the form of a Syrup Take of the Milk-water or Snail-water a pint and half of the Magisterial Syrup just now described four Ounces Mingle them and make a Julep of which let the Patient drink freely whenever he pleases Or Take of the milk-Milk-water or Magisterial Snail-water a Quart of Sugar of Pearl ten Drams or an Ounce and half Mix them and make a Julep of which let him drink plentifully and frequently If there be a difficulty of Breathing rather than a Hectical Heat we must use a Pectoral Mead. But if it be not so much a Hectical Heat as a difficulty of Breathing that troubles the Patient as it often happens in those that have a Scorbutical Consumption a Pectoral Mead is more convenient for his ordinary Drink than distilled Waters that have a great deal of Phlegm Of which we have an Excellent Recept in Riverius in his Chapter of a Consumption and every where else amongst Authors And therefore I shall add no other Description of it in this place CHAP. X. Of the Cure of an Original Consumption of the Lungs in the third degree of it to wit when the Patient is reduc'd by the Inflammation the Apostemes and Exulceration of the Glandulous parts 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 WHEN he comes once to this Third Degree of a Consumption A Consumption in the third degree is very seldom cured the Patient unless the Ulcers are very small and benign very seldom is cured or lives long And therefore though a Prudent and Honest Physician when he is called to Consumptive Patients in this degree of the Distemper ought as much as it is in his Power to mitigate and relieve the Symptoms that afflict such poor Wretches and should make it his business likewise to prescribe such Antiphthisical Medicines as may best answer the present Indications and be most agreeable to the present state of the Patient yet he ought by no means Therefore a Physician must be very careful how he promises a Cure though there should be some hopes from the abatement of the Symptoms to flatter him to injure the Reputation of Physick and his own too by promising a Recovery of his Health to the Patient or to his Friends too confidently But what good soever he should with the greatest Commiseration and Diligence do the Patient yet he must always pronounce a Fatal Prognostick of his Life and not suffer himself to be deceived with the vain hopes of his Friends and those that are about him And by this means he will secure as well the Art of Physick as himself from Reflexions The Intentions of Cure The Intentions of Cure in this degree of the Distemper are these four
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
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
that is drank at a time must be made up by the length of the time that is every Year designed for the drinking of those Waters By which means likewise the Blood perhaps is more tempered and altered than by drinking a great quantity in a shorter space of time History 1. One of the Masters in the Hospital of Bridewell that had committed himself to my care a Year or two before when he was sick of a Pestilential Fever that went up and down attended with Swellings in the Groin and Carbuncles from which Venom perhaps his Blood had not yet sufficiently purged it self fell about the 35th Year of his Age and in the Year 1669. into a very great Haemoptoë by which he had lost a great deal of Blood before he sent for me But with Bleeding Ligatures Astringent Juleps and Electuaries a Milk Diet and a due Government in all things the Flux was perfectly stopt But yet he still continued Hectical and was troubled with an ugly Cough And therefore I ordered him to continue his Milk Diet and to take a Dose of an Opiate Electuary every Night And to prevent a Consumption that was like to follow I directed an Issue to be made in his Arm his Head to be shaved and the Cephalick Plaister to be laid upon it and that the Patient should be sent into the Country and into an open Air and that he should use there the Temperating Juices to wit of Plantain and Nettles at least twice a day with several other things which it is not necessary now to give a particular Account of But notwithstanding all this his Hectick Heat and his Cough continually troubled him and his spitting of Blood returned by uncertain periods at least twice a Month to wit about the Full and the New of the Moon from the heat and motion of the Blood being increased the Patient continually wasting more and more with the Fever that followed him till at length being brought into an universal Colliquative state with a Looseness Sweats a Dropsie c. and being troubled with a very great difficulty of Breathing he ended his Life For at that time I did not know the Vertue of the Peruvian Bark to take off this Hectick Fever from which that Fatal Colliquation did proceed The Body being opened I found the Lungs strangely swelled and every where in all the Lobes full of Tubercles some of which were crude others ulcerated History 2. Mr. Rookes in Cheapside being about Forty Years old from a multitude of Cares and hard Drinking seemed to be continually Hectical for Ten Years together being stufft in his Lungs troubled with a Cough and enclin'd to a Consumption And from extraordinary Exercise and excess in drinking of Spirituous Liquors he fell into a very great spitting of Blood accompanyed with a difficulty of Breathing and a pain in his Breast And the poor Man had it return'd upon him and that considerably every day or every other day for at least three Weeks and that notwithstanding frequent Phlebotomy the use of a Milk Diet of the Tempering Juices Astringent and Opiate Electuaries and Juleps and likewise of the Royal Styptick Water But at length when I had observed not only by the quickness of his Pulse and the high colour of his Urine but also from his very Temper that a remarkable Fever returning often by uncertain intervals always brought on his spitting of Blood I gave him a Dram of the Peruvian Bark in a convenient Draught every four hours To which I always took care there should be more or less Laudanum added according as he could bear it With the use of which I found his Fever taken off without any more to do and without any return of his spitting of Blood and that his Urine was come to its Natural colour I ordered the repeating of the Cortex again and again at due intervals and took care he should have Nourishment agreeable to his Appetite which now was better than it was before he spit Blood and that he should have the benefit of the Country Air. Whereupon which is strange to be told without any other help he came to have a more firm and strong Habit of Body his Lungs more free his Breathing more easie the heat of his Blood less and his Cough too more moderate now for a Year and half than he had found for several Years before his spitting of Blood his Friends admiring at it who expected he would certainly dye of a Consumption in a little time after his spitting of Blood Which was so much the more wonderful because he continued as careless in the management of himself in the six non-natural things as he used to be before his Haemoptoë which neglect he at last paid for with the loss of his Life For with the very great Errors he had lately committed he fell into a new Consumption and that a threatning and fatal one which at length carried him off His Body being opened after he was dead we found the substance of the Liver compact and close as if it had been parboyl'd all the Lobes of the Lungs most filthily ting'd with a black colour which perhaps was occasioned by his continual smoaking of Tobacco and every where full of a world of Tubercles of which some that were larger were full of purulent Matter others of a substance like Honey But the greatest part of the lesser ones which were disposed in Clusters and like Grape-stones through all the substance of the Lungs contained a Steatomatose Matter in them All the Glandules that were seated near the Wind-pipe were very black and had in them a Liquor of a black or dark colour such as I have usually observed Scorbutical and Hypochondriacal Persons that have been Consumptive to hawk up out of their Throats in a Morning especially those that have been used to smoak much Tobacco or have lived in an Air that has been filled with the smoak of Coals The Prescription for the Antipyretick Draught which I ordered for Mr. Rooks was this Take of the Waters of Tormentil of Plantain of each an Ounce Barley Cinnamon-water Syrup of Myrtils of each half an Ounce of distilled Vinegar half a Dram of the Jesuits Pouder a Dram. Mix them and make a Draught to be given every four hours till he has taken eight Draughts Once or twice a day I added a Grain of London Laudanum to the Draught In the same manner I cured Mrs. Martin an Old Woman almost Seventy Years old a Goldsmith in St. John's Mr. Bloomer's Daughter and a great many others of a considerable and to all appearance a fatal Haemoptoë All which continue well as yet without any return of their spitting of Blood or a Consumption following upon it and are able to go about their Business whose Histories perhaps it would be too long and tedious to give a particular Account of History 3. Mr. Luff the Son of that Reverend Divine which I have already mentioned living in Milk-street after he had married
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
of which let her take the quantity of a Nutmeg every six hours Take the Waters of Rue Black-Cherries of each four Ounces of Barley Cinnamon-water three Ounces the Compound Waters of Piony of Briony of each an Ounce and half of prepared Pearl a Dram and half of fine Sugar a sufficient quantity to sweeten them Mingle them and make a Julep of which let her take four or five Spoonfuls after every Dose of the Electuary and likewise at other times when she has a mind to it To help the pains and stiffness of her Joynts I ordered that same Night Blistering-Plaisters to be applyed to the inside of her Arms near the Arm-pits and I tryed a gentle Evacuation by Stool with two Ounces of Tinctura Sacra which she bore well I ordered the following Paregorick Draught to be taken when she was to go to Rest Take of Red Poppy-water three Ounces Barley-Cinnamon-water an Ounce of Compound Piony-water two Drams Salt of Wormwood six Grains Syrup of Meconium six Drams Mix them and make a Draught October 28. I gave her the following Vomit Take of the Infusion of Crocus Metallorum an Ounce Syrup of Violets two Drams Mix them and let them be given for a Vomit about five a Clock in the Afternoon with due care and management and if it be necessary let her take between her Vomiting a Scruple of Salt of Vitriol twice or thrice in a Draught of warm Posset-Ale I ordered also the following Paregorick Draught to be taken when the Vomit had done working Take of Mint-water half an Ounce Dr. Stephen's Water three Drams Barley-Cinnamon-water the Cordial Milk-water of each an Ounce of Meconium six Drams Mix them and make a Draught From the Vomit she found an Universal Relief and that not only from the Symptoms of her Consumption but also of her Rheumatism And therefore after three days I ordered the repetition of the Vomit and then I endeavoured to extinguish the Hectick flame which had been kindled in the Blood by the Rheumatism and thereby to take care of her Lungs which had been injured by it in the manner following Take a sufficient quantity of the Ingredients of the Pectoral Decoction of the Peruvian Bark an Ounce Balsam of Tolu a Dram boyl them in a sufficient quantity of Spring-water to a pint and half to the Liquor when it is strained add distilled Treacle-water the Balsamick Syrup of each an Ounce and half Mix them and make an Apozem of which let her take four Ounces three times a day for six days together taking always in the Night-draught fifteen drops of Helmont's Liquid Laudanum if any Gripes or Looseness or want of Rest should trouble her When she had done using the Apozeme I ordered the Emetick Potion to be repeated and afterwards sc Novemb. 13. I prescribed the following Pills Take of the Peruvian Bark finely pouder'd an Ounce Mucilage of Gum Tragacanth a sufficient quantity Mix them and make them into Pills of a middle size to be gilt of which let her take six Morning and Evening from day to day With the use of which she grew perfectly well being plainly freed not only from the pains and stiffness of her Limbs but likewise from her Cough difficulty of Breathing Oppression Fever and all the other Symptoms of a Pulmonary Consumption Her Appetite also returned and at length she likewise recovered her Strength and her Flesh and still enjoys very good Health without any return of her Rheumatism or Consumption History 2. Mrs. Covert a Virgin about the Eighteenth Year of her Age fell into a Continual Fever which at length was followed by another that was Intermittent which continued for the space of Eleven or Twelve Months But this went away of its own accord only a Humorose Rheumatism succeeded to it But the Fever and Rheumatism in process of time being I know not by what means in some measure overcome yet the poor Virgin remained continually Hectical Coughing Short breath'd very much Emaciated and pale as if she had no Blood in her presenting in a manner an Hippocratical Face Moreover the Tendons of her Muscles were almost universally stiff by reason of a preternatural thickness and hardness in them the Trophies of her former Rheumatism so that all her Joynts not only the lesser ones of her Feet and Hands but also the larger being plainly unable to do their Office or at least doing it with a great deal of difficulty and pain she continued almost always fixt to her Chair or Bed like an Image She was likewise many times seized with wandring and shifting spasmodick and dreadful pains up and down all about her Breast and troubled with Hysterical Faintings and Fits of a Fever often returning at uncertain times To all these Symptoms there were joyned a continual languishing Weakness a want of Appetite and a suppression of her Courses The universal Habit of her Body too seemed to me to be very Scorbutical A case verily if any is so very deplorable which yet with the Blessing of God I did help by our Art in the following manner Going to see this poor Virgin on the Thirtieth day of May 1683. to temper the Scorbutical sharpness of her Blood and to ease in some measure her wandring Pains which as they had continued a long time so they did not a little wear out oppressed Nature I ordered Calomelanos Diagrydium of each fourteen Grains Syrup of Succory with Rhubarb a sufficient quantity Mix them and make a Bolus to be taken in the Morning with due care I likewise ordered two Scruples of Wood-lice prepared and Crabs-eyes prepared mixt together to be given three times a day at Physical hours in a spoonful of the following Julep drinking three or four spoonfuls of it after them Take the Waters of Baum Black-Cherries the Cordial Milk-water of each four Ounces Barley Cinnamon-water Epidemick-water of each three Ounces of Sugar of Pearl six Drams Mix them and make a Julep I also ordered the following Bag to be hung in three Gallons of midling Ale for her ordinary Drink Take the Roots of sharp pointed Dock of Male-Piony of each two Ounces Garden and Sea Scurvy-grass of each three handfuls Brook-lime Water-cresses Tun-hoof Pine-tops of each two handfuls of Aniseeds an Ounce Mix them and make a Bag. On the Second of June because the form of a Pouder was not so grateful to her and that I might promote the opening of Obstructions instead of the Pouder I substituted the following Electuary Take the Conserves of Hipps and Red Roses of each half an Ounce of Wood-lice prepared a Dram and half Crabs-eyes prepared two Scruples Salt of Steel twelve Grains Syrup of Steel a sufficient quantity Mix them and make an Electuary of which let her take the quantity of a Nutmeg every six hours drinking a Draught of the Julep after it I ordered likewise a Scruple of the Stomack-Pills with Gums to be taken the Night following June 5th because the form of an Electuary did not
faint in the use of the Bath she had the following Cordial in readiness to be taken by spoonfuls at any time when she pleased Take the Epidemick-Water Dr. Stephens 's Water of each half a Pint of Syrup of Clove-Gillyflowers two Ounces Mix them and make a Cordial Julep In the Month of September my Patient returned from the use of the Bath having found a great deal of Benefit But especially her Tendons and Joynts that were affected were very much restored by it to promote the Cure of which yet farther I advised her to use one of our Bagnio's here at London twice or thrice a Week together with the following Medicines Sept. 4. 1683. Take of the best Sarsaparilla four Ounces China-Roots an Ounce and half shavings of Ivory of Hartshorn of each three Drams of Raisins of the Sun stoned two Ounces Liquorice sliced half an Ounce after a due Infusion boyl them in four quarts of Spring-water to two quarts Let her take half a Pint of the Liquor strained thrice a day at Physical hours Take Ceruss of Antimony Wood-lice prepared of each a Dram and half Mix them together for six Papers of which let her take one three times a day with every Draught of the Decoction before prescribed but especially when she goes into the Bagnio As soon as she had made an end of using the Bagnio I endeavoured to promote a gentle Diaphoresis every Night with the use of the following Draught Sept. 12. 1683. Take Carduus-water distilled Treacle-water of each an Ounce of Ceruss of Antimony a Scruple Syrup of Violets two Drams Mix them and make a Draught to be repeated for Ten Nights together With the use of which her Joynts and Tendons received a great deal of benefit But at length for fear the Patient's relapse into an Intermitting Fever at the end of the Year of which I had a great and reasonable Suspicion should frustrate the perfecting of her Cure I advised her to repeat the use of the Peruvian Bark for several days to be taken every fourth or fifth hour in the form of the following Apozem Sept. 20. 1683. Take of the Peruvian Bark pouder'd an Ounce boyl it in carduus-Carduus-water and white-White-wine of each an equal quantity to a pint and half and then let it be prest out very hard Lastly For the getting of her Flesh again and the farther tempering of her Hectick heat I advised her to go into a strict Milk Diet to be used for six Weeks in the Country Air. With the use of which she grew plump and recovered her perfect Health her Monthly Purgations then at length returning with a florid colour which before this had been quite stopt for four Years by reason of the emaciated and thin Habit of her Body But the next Year which was 1684 in the Month of June because of some stiffness which remained in the Tendons of her Wrists and of one Foot she went again to the Bath and afterwards repeated the Milk Diet. From which time to this present she has enjoyed perfect Health and likewise having been married has had Children With almost the same Method I happily cured Mr. Overton living without Newgate beyond the Expectation of all his Friends who with a long Rheumatism was at length brought plainly into a Tabid state with a difficulty of Breathing a violent and perpetual Cough a continual Hectick Fever a spitting of Matter like Pus and the other signs of a Fatal Consumption of the Lungs Whose Case I here forbear to recite for Brevity's sake History 3. Mrs. Lane a Barber's Wife whose Husband lived in Cow-Lane being about Five and Thirty Years old when she had lived in a Consumptive state Emaciated and Coughing for several Years past fell in the Month of April 1684. into a true Rheumatism with violent Pains and inflam'd Swellings which yet were moving suddenly from one Joynt to another with a Fever likewise that was evidently of a remitting kind accompanying of it which had the Type of a Tertian which I have very often observed to be the Nature especially peculiar to a Rheumatick Fever In which case whenever a new Fever-Fit seizes the Patient the Rheumatick Pain and Swelling which before were almost quieted are wont to be renewed in the Parts that were before affected or else by a Metastasis of the Matter as the Ancients love to speak to be translated to some other Joynts But the Fits were very long lasting for the space of Twelve or Sixteen hours and attended with a want of sleep light-headedness great tumbling and tossing heat and a very Feverish Pulse All which Symptoms used to be followed and go off with great Sweats But at the beginning of every Fit I observed that her Rheumatick Pains always grew more sharp in the Joynts affected or else seized some other Joynts that were free before So that a new Rheumatism seemed to come with every Fever-Fit Being called in the time of her Fit I endeavoured to satisfie the present Indications with Bleeding Blisters an Anodyne Draught Tincture of Roses a Pectoral Linctus and a Pearl Julep And indeed all the Symptoms going off at the end of the Fit when I came to see my Patient the next day I reckon'd the Distemper was overcome and removed with those things I had ordered till at length by the return of the Fever and Rheumatick Fit the next Night I plainly understood how vainly I had hitherto flattered my self And therefore according to the urgency of the Symptoms that indicated it I bled her again ordering the repetition of the Hypnotick Draught and likewise the application of an Anodyne Cataplasm to the Joynts that were affected with extream pain from the Rheumatism But after I found the Type of the Fever and Rheumatism for two or three times to be plainly a Tertian and that notwithstanding the Method I had before prescribed all things continually grew worse the very System of the Nerves being now at length seized with Spasms but especially in the time of the Fit and her Mouth being likewise ulcerated with a Thrush being led by a happy Conjecture I betook my self in this deplorable case to the use of the Peruvian Bark prescribing a Dram to be given every third or fourth hour when her Fit was off With the use of which in the space of Twenty Four hours she was freed both from her Rheumatism and Fever without any other Remedy and was well after her manner that is Consumptively but yet she was less opprest in her Lungs than she had been before she fell sick But as soon as she got rid of her Pain and Fever she wholly neglected her Chronical Consumption which likewise seemed to be helpt with the Bleedings the use of the Bark and the other Medicines before prescribed refusing all sorts of Medicines and thereupon after a Year or two she dyed of that Chronical Consumption of the Lungs CHAP. XII Of a Consumption proceeding from Fevers especially such as are from Surfeits Scarlate and Intermitting
parsley-Parsley-water Fennel-water of each four Ounces the Magisterial Water of Earth-worms Syrup of the five Opening Roots of each two Ounces Mix them and make a Julep Nov. 13. With this Method all the Symptoms began to be abated and he did not make such a Jaundies Urine as he did before And thereupon I ordered a continuation of the Apozeme Linctus and Julep which were last prescribed and the repetition of the Tinctura Sacra when he went to Rest and likewise for the farther opening of the Obstructions of the Liver three of the following Pills to be given every four hours in a Spoonful of the Linctus with a Draught of the Apozeme Take the Pouder of Wood-lice prepared Goose-dung of each a Dram of Saffron half a Scruple of the Syrup of the five Opening Roots a sufficient quantity Mix them and make them into Pills of a moderate size to be gilt Nov. 14. After I had taken this care for the relief of his obstructed Liver with good Success I began as the thing required to take more particular care of his Lungs which had suffered very much from the defect of this Entrail because his Chronical Cough as also his difficulty of Breathing proceeding from the toughness of the Phlegm with which the branches of the Wind-pipe were stufft did continually put me in mind of this part of my business but especially when both were now not a little increased by a Peripneumonick Affection he had so lately had And therefore besides the continuing of the use of the Abstersive Linctus and the Apozeme made of Pectorals Hepaticks and Diureticks and likewise of the Julep and the repeating of the Tinctura Sacra when he went to Rest I ordered three of the following Pills to be taken in a Spoonful of the Linctus three times a day with a Draught of the Apozeme Take of Wood-lice prepared three Drams of Gum Ammoniack depurated a Dram and half Flowers of Benjamin a Dram Extract of Saffron Balsam of Peru of each half a Scruple of Balsam of Sulphur Terebinthinate a sufficient quantity mix them and make them into Pills of a middle size to be gilt Nov. 15. I ordered him to insist upon the same things and after Midnight to repeat the Tinctura Sacra and the Purging Waters next Morning In which manner he proceeded by my Order to the Nineteeth day but only in the stead of the Tincture I substituted half a Dram of the Stomack-Pills with Gums because of the loathing of that Medicine which he began now to have from the long use of it Nov. 19. I ordered the repeating of the Stomack-Pills and the Purging Waters every third day for three times and that he should persist in the use of the Linctus Apozeme and Balsamick Pills for eight days Decemb. 10. He came to me into my Study strong fresh-colour'd and lusty and much more free from the unhealthful Symptoms of his Lungs and Liver than he had been for many Years past But that this Chronical Mischief might be perfectly eradicated I ordered a Pint of the Tinctura Sacra that he might take six or seven Spoonfuls every fourth Night and that he should take during the use of that four Ounces of the Pectoral and Hepatick Apozeme before described three times a day at Physical hours on the intermediate days Moreover I seriously advised him to use a Diet-drink made of Antiscorbutick Hepatick and Pectoral Ingredients steep'd in Beer and Sadler's Chalybeate Waters at Islington the Spring and Summer following History 2. Mr. Maddox a Man at least Fifty Years old Gouty and Hypochondriacal from long Cares and troublesome Passions of his Mind and from the hard drinking of Spirituous Liquors which he had used himself to fell by degrees into a want of Appetite a disposition to Vomiting a stuffing of his Lungs together with a Cough and likewise an Obstruction of his Liver and a Consumption of his whole Body But I being called on the third day of August in the Year 1688. found him labouring under a Costiveness of his Belly and a Spasmodick and very dreadful pain of his Back and Side for several days not without the manifest signs of a Fever and a Languor upon him which now were come to that height that they plainly despaired even of his very Life At first I thought the pain arose from a Stone-Colick and thereupon I ordered Ten Ounces of Blood to be taken from his Arm being induced to do it not only by the present Fever but likewise for fear of an Inflammation of the Intestines that might follow by reason of the violent pain I ordered the Parts affected to be anoynted warm with the Oyntment of Marsh-mallows Oyl of white Lillies and Oyl of Bricks mixt together and Pills of half a Dram of Extractum Rudii and a Grain and half of London Laudanum to be given him in his Bed that he might get some sleep likewise a temperate Cordial Julep to be given him often to drink to comfort him And I ordered that if there were occasion a Stool should be procured after eight hours with a Clyster of Milk and Sugar with Camomile-flowers boyled in the Milk but when the Purge had once done working they were to give him Twenty Drops of Liquid Laudanum in a small Draught of the Cordial at the time he should go to Rest But these things having no effect either to give him any Stools or the easing of his Pain on the 6th of August I prescribed a Mucilaginous and Lubricating Apozeme to be drank often and for three Nights together half a Dram of the Stomack-Pills with Gums and a Grain and a half of London Laudanum and the next Mornings two Quarts of the Purging Mineral Waters Aug. 17. I ordered the repetition of the Pills when he went to Rest and likewise of the Waters the next Morning and that he should drink the Waters boyled dissolving an Ounce and half of the choicest Manna in the last Draught But for all this the Spasmodick pain of his Back and his Costiveness continued And thereupon Aug. 18. I ordered four Spoonfuls of Elixir Salutis and Thirty Drops of Liquid Laudanum to be given when he went to Rest and that he should take three Ounces of the following Apozeme warm every three hours until he had had some good large Stools Take of Senna half an Ounce Coriander-seed prepared Salt of Tartar of each two Scruples boyl them in a Pint and half of the Purging Mineral Waters to a Pint dissolving in them when they are strained two Ounces of the best Manna With the use of which he at length began to have too many Stools that is more than he could bear but without any relief of his Pain which was so violent that it could hardly be quieted even with the use of Laudanum it self though by degrees I went as high as Forty Fifty Sixty Drops which yet I was forced to repeat every Night Aug. 21. Being called a second time to go see him by the little yellowish
strained add the Magisterial Water of Earth-worms Syrup of Hedg-Mustard of each three Ounces the Juice of one Lemon Mix them and make an Apozeme Take Parsley-water Fennel-water of each four Ounces the Magisterial Water of Earth-worms strong Piony-water of each an Ounce of the Syrup of the five Opening Roots an Ounce and half Mix them and make a Julep of which let her take four or five spoonfuls when she is faint With the long use of which the Country Air likewise contributing something she became plainly freed not only from her Jaundies but also from her Consumption and the Morbid Symptoms of her Lungs and that without one Grain of Pectoral Medicines and now at length having recovered her wonted Temper and Appetite she is very well CHAP. XIV Of a Consumption of the Lungs proceeding from Internal Vlcers of the Viscera and Membranous Parts I Have as well from Reason as Experience proved in the First Book that there is a Flame kindled in the solid Parts from the long and plentiful substraction of the Nutritious Juice caused by old and large Ulcers which are wont to discharge continually a great quantity of gleety Matter in what part soever of the Body they happen to be seated whether inward or outward and thereupon the Patient is rendred Tabid I have likewise sufficiently shewn in the 8th Chapter of this Book that a Consumption of the Lungs is very often occasioned from the healing of this kind of Ulcers but especially if they have been customary and of a long continuance or else Malignant or Fistulous A true Consumption of the Lungs often proceede from Internal Vlcers But because I have observed not only that Patients being brought into the state of an Universal Atrophy have at length been rendred Tabid but have likewise many times from thence been affected with a Consumption of the Lungs from the beginning by a long continuance of Ulcers bred in the Viscera and Internal Membranous Parts but especially in those that are reckoned the more Noble and of greater use such as the Liver Kidneys Testicles Ovaries the Womb and the Vagina Uteri the Urinary Bladder Stomack Intestines c. from long substraction of the Nutritious Juice as frequently as from the healing of them I shall think fit in this place to add also though briefly the Observations which my Practice has offered to me concerning the peculiar Nature of this kind of Consumption Neither has any one reason to think it strange This is not strange upon several Considerations that this kind of Ulcers especially if they have been Chronical can occasion a true Consumption of the Lungs I say no one has reason to think it strange that seriously considers with himself how great and continual an expence there is of the Nutritious Juice that is wont to be discharg'd by this kind of Ulcers and how great an impoverishment of the whole Mass of Blood together with an Acrimony following upon it from this substraction of the Chyle that is designed for the reparation of it and how great a wasting or Atrophy of the Parts proceeding from thence thereupon how great an excandescence or intestine motion of the Blood and Spirits and finally how great a Flame there is with a fixt heat in the whole Habit of the Body together with an Universal Colliquation of the Nutritious Juice from the Mass of Blood to which by reason of its preternatural Heat and Acrimony it could not be perfectly united made by every Avenue where it has the liberty of passing But to be Ingenious and to speak the whole truth I have been ready to wonder rather that in this Universal Flame and Colliquation the Lungs whose Substance is Naturally so Tender Vesiculous and Spongy and thereupon as it is apt to be very soon affected with a Hectical Heat so it is also ready to be as soon corrupted by the purulent Particles which are translated thither by the Circulation of the Blood and in every considerable Colliquation more susceptive of the Humours than any other part can ever be long free from a touch of a Consumption A Consumption from Vlcers in parts remote from the heart ends in an Vlcer of the Lungs And indeed to speak the truth of this case whenever these Ulcers happen to be bred in the Bladder Womb Vagina Uteri the Ovaries or Kidneys or other Entrails or Membranous Parts that are remote from the Heart and so of less note as I have always observed the Consumption that is caused by them to be more Chronical so I have observed that a little before Death it certainly terminates in a true Consumption of the Lungs proceeding by degrees from a stuffing of the Lungs to Tubercles and those such as at length become ripe and ulcerate together with a troublesom Cough a shortness of Breath an universal Colliquation and the other signs of this Fatal Disease In a Consumption from Vlcers in the Liver c. Death prevents this But yet in a more Acute and hasty Consumption proceeding from an Exulceration of the Liver Stomack and other Entrails or Membranous Parts seated nearer to the Heart it self I have found in the Bodies of such Persons that have been opened when they have been dead the Lungs not so much exulcerated as discolour'd stufft and sticking to the sides of the Cavity of the Breast and at length that is when they have been very ill affected full of crude Tubercles Because by reason they dyed quickly there was not time enough for the Lungs to receive any deep impressions from this Phthisical Malignity the Patient being taken off by a quick Death from the Original Consumption before the Tubercles of the Lungs could be ripen'd or the Consumption of the Lungs could be advanced beyond its first or second degree But in this very Acute Consumption I have found plainly the same if not more violent Symptoms than in a true Pulmonary Consumption that has been Mortal the same fierce and troublesome Cough the same difficulty of Breathing though they proceeded meerly from a stuffing of the Lungs and crude Tubercles bred in them but first an Inflammatory Fever and afterwards a Putrid and Intermitting Fever attended with an Universal Colliquation Light-headedness and other more direful and fatal Symptoms than in an Original Consumption of the Lungs I speak of those which arise from an Inflammation and Exulceration of the Viscera or Membranous Parts that are very Noble So that it is a very hard matter to distinguish this Consumption from an Original Consumption of the Lungs unless it be by the more intense degree of the Symptoms and by some Pathognomonick signs which discover the Part that is primarily affected Every Pulmonary Consumption of this sort is very hard to Cure These Consumptions are very hard to Cure because it springs from a certain Fountain that is for ever running For the Internal Ulcers which gave the first Occasion to this Consumption can very seldom be perfectly cured as lying