THE Colick takes its Name from the part affected, which is the Colon, a long and winding Gut, appointed to receive the Excrements of almost the whole Body; and if those Excrements are re­tained too long, they are wont to occasion Pains of this kind, the Excrementitious Mat­ter occasioning a Dissolution of the continuity either by distending, or pricking, or corro­ding; and this Matter is either Wind or Hu­mour.

[Page 2] Wind proceeding from Crudities, or from a cold intemperies of the Stomach or Guts, if it be stop'd by reason the Excrements are grown hard, or because something else ob­structs the Intestines (a great quantity of it remaining in the great Guts, especially in the Colon) occasions violent Pain.

Gross cold and phlegmatick Humours dri­ven into the Tunicles of the Intestines, may occasion such Pain, either by gnawing, if they are Acrimonious or Briney, or by chilling the part which is consequently bound up thereby, and much disordered, (as Galen says, when he was grievously afflicted with the Colick, he evacuated a Glassy sort of Phlegm actually cold,) or by emitting Wind, which is easily elevated by a small Heat from the gross viscid and clammy Humour.

Lastly, Cholerick and Acrid Humours, and also Melancholy and Acid by pricking and twiching the Intestines, cause such Pains. But it may be ask'd how it comes to pass, that in the action of these causes, the Colick should have its exacerbations and remissions, the same Matter remaining in the Intestines, which as 'tis present, should continually gnaw and distend. To which I answer, that sometimes that Matter remains quiet, and so at that time occasions little or no pain; but that at other times 'tis moved and excited by various Fer­mentations, which happen in the Humours, as is usual in an Epilepsie, Hysterick Fits, and the accession of Fevers.

[Page 3] But we must take notice that the Wind or Humours don't only reside in the Cavity of the Intestines, for then they would be easily ex­cluded, by evacuating deterging and carmina­tive Medicines; but for the most part insi­nuate themselves into the Coats of the Inte­stines, and for that reason they are difficultly removed; and so the Disease lasts longer, and can't be easily eradicated by the foresaid Re­medies. The gross and phlegmatick and me­lancholy Humours flow by little and little through the Veins of the Intestines, into their substance, and so don't presently cause Pain, 'till there is a quantity sufficient to irritate Na­ture for their expulsion; and then being mov'd and exagitated, cause Pain. Or Wind, occa­sion'd by them, and included in the Coats of the Intestines, distends and twitches them, and not easily getting out, occasions a lasting Pain. Also Choler after the same manner pour'd through the Veins of the Intestines upon their Coats, and imbib'd by them, causes violent Pains, which are wont to be long and obsti­nate, because 'tis difficultly removed from their Substance.

There is another Species of a Bilious Colick which degenerates into a Palsie, scarce known to the Ancients, which proceeds from a bilious Humour, not pour'd as the former upon the Colon, but of a sudden upon the Membranes of the Abdomen, which is transferr'd thither, ei­ther from the Gaul-Bladder, or from the Me­sentery in the Crisis of long Fevers, or by rea­son of violent Anger, or some other external [Page 4] cause, when because of Obstructions, it can't be carried to the common passages, but by a preposterous motion is put off suddenly upon the foresaid Membranes of the Abdomen. And hence great pain arises like the Colick, which yields neither to Clysters nor to any other Remedy, but continues for many Months, by which the Body Wasts, and the Sick is vex'd with a sort of intermittent Fe­ver, and often with a slow continual Fever; at length the pain remitting, a Palsie succeeds, that Humour leasurely creeping through the Membranes of the Abdomen, to the Spine of the Back. But this Palsie chiefly possesses the upper parts; yet there is most commonly a Pain in the Thighs and Legs, and in some few the use of them is wholly taken away; the Choler by reason of its Levity moving chiefly upwards; and sometimes it breaks in upon the Brain, and causes Epileptick Fits, from whence Death generally follows.

There are other causes of the Colick, but less frequent, viz. Stones growing in the Guts, Worms wound up in a bottom, and Obstru­cting the Intestines, a compression of the Guts, by a tumour of the Neighbouring Parts, and the narrowness of them by reason of an In­flamation, and other tumours of the Guts, or a twisting of them, occasion'd by Wind, which is next to an Iliac Passion; and sometimes the Matter which causes a Colick is venomous and malignant, and so 'tis a Pestilential Colick. As Paulus Aegineta relates, that a Pestilential Co­lick arising in Italy, was very troublesom to [Page 5] many of the Roman Provinces. Lastly, all hard Bodies by obstructing the Guts, or di­stending them, may occasion a Colick, as Stones generated in the Guts, a great quanti­ty of Cherry Stones, hard Cheese, and the like. As Platerus relates of a certain Gover­nour a long while troubl'd with the Colick and Convulsions, who after the use of Clysters, e­vacuated a great quantity of hard Cheese by Stool, which had remain'd a long time in his Guts; for before he was Sick, he eat of it immoderately.

The external causes, are a cold constitution of the Air pressing and hardening the Belly, or a hot Constitution which does likewise harden the Excrements, for all their Moisture is dry'd up by heat: The use of Meat and Drink un­fit for the Mans Constitution, of crude and harsh Fruits, and of gross Meats of hard Di­gestion, too much Rest, immoderate Sleep, un­seasonable Exercise, immoderate Venery, and other external Causes which may injure the Concoction of the Stomach. The Diagnosticks in this Disease are plain, for first the Pain is violent; for if it be small, it ought not to be called the Colick; and then the pain is wan­dering, sometimes it grievously afficts this part, sometimes that, so that sometimes it pos­sesseth the Region of the Spleen, sometimes of the Stomach or Liver, or of the Reins, some­times 'tis above, sometimes below the Navel, and oftentimes 'tis most violent in the left side, because in that part there is a narrowness first observ'd by Bauhinus. For when the Excre­ments [Page 6] in the upper and capacious part of the Colon being hardened into great Clods, agree­able to the capacity of it, are violently driven by the Wind towards that narrow part, they can't pass through without great pain; by reason of which Symptom the Colick is often taken for Splenetick or Nephritick Pains; neither are they easily distinguish'd when the Signs of each are compared one with another. But sometimes the pain is more fixed and setled in one place, and like the boring of an Auger. The Patient often Vomits, the Stomach being affected by consent of Parts, and Phlegm is sometimes cast up, and sometimes Choler, green as a Leek, and like Verdegrease: The pain is increas'd after Eating, because the Sto­mach being full, presses the Guts. The Belly is most commonly so bound, that the Sick can evacuate nothing that way, not so much as Wind; but if any thing be evacuated natu­rally or by art, 'tis chiefly windy, and like Cow-Dung, and Swims upon the Water, be­ing for the most part Phlegmatick; for Phlegm voided by Stool, is wont to swim upon Water and serous Excrements: But sometimes the Belly is so much bound when the pain is vio­lent, that strong Purging Medicines will not work at all.

The Signs of the Causes are distinguish'd af­ter this manner.

If the pain proceed from Phlegm, 'tis not so violent, unless it be accompained with Wind, which can't break out of the Places 'tis con­tain'd in, for then the pain is violent, and [Page 7] sometimes remains in one part, and seems to bore as with an Auger, and sometimes 'tis in many Parts, when the Wind wanders about. The Sick is eased by hot things, but is injur'd by cold things. A course of Diet went be­fore, apt to increase Phlegm. The Urine is crude and sometimes whitish, but not always which is wont to impose upon young and un­skilful Physicians, for sometimes in a Phleg­matic and Windy Colick, the Urine is yellow and red dish, by reason of the Pain which inslames the Humours contain'd in the Veins and Arteries. Which Avicen has wisely observ'd, He says, no one should deceive himself, by judging the Disease is hot, from drouth, inflamation, and redness of the Water, for 'that's common to all.

If the Colick is occasion'd by Wind, there is a stretching Pain, and certain inflation of the Belly: The Sick perceive a great deal of Wind, and a rumbling of the Belly, they are much eased by breaking Wind. A course of Diet fit to breed Wind went before, as unseasona­ble Drinking of cold Water, the frequent use of Pulse, Turneps, Chesnuts, Herbs and Fruits, and the like. And if the Wind be contain'd in the cavity of the Intestines, the Pain is wandering, and not fix'd to one Place, and is renew'd by Intervals; but if it be kept in within the coats of the Guts, the Pain is fix'd, because the Wind can't change its place, and is continual and obstinate, because it can't find vent.

[Page 8] If the Colick proceeds from an Acrid and Cholerick Humour, 'tis most sharp; there's a twiching and pricking Heat, Drouth, and for the most part a Fever, and the Urine is very Cholerick, and the Disease is increas'd by hot Medicines and Diet, and is mitigated by cold, and likewise by the excretion of Cholerick Matter, and a course of Diet fit to breed Cho­ler went before. The pains of the other parts contain'd in the lower Belly, are easily distin­guish'd from the Colick by their proper signs, except the Nephritick pain, whose signs are so like those of the Colick, that oftentimes the most skilful Physician can't distinguish them, as Galen confesses of himself, being af­flicted with the Colick Pain, he thought 'twas Nephritick, by reason of a Stone driven into one of the Ureters, 'till the Humour being evacuated by Stool, and so the pain ceasing, he found 'twas the Colick. But by the fol­lowing Signs, these two Diseases may be plainly distinguish'd, if they are accurately ex­amin'd.

First, The Nephritick pain is fix'd in the Kid­ny, and stretches it self from that to the Te­stis, according to the length of the Ureter; but the Colick is wandering, and painfuly girds the lower Belly.

Secondly, The Colick increases after Eating, by reason of the pressure upon the Gut by a full Stomach; but the Nephritick pain is not at all increas'd after Eating, but rather lessen'd, because some of the nutricious Juice is carried [Page 9] to the Reins, which somewhat asswages the Pain.

Thirdly, In the Colick, Vomiting is more severe, and the Belly is more bound, because the Colon lies near the bottom of the Sto­mach, and the Intestines being full or violent­ly provok'd, contract themselves, that they may expel the Enemy; but either of the Symp­toms is common to either of the Diseases: So that the intension or remission of them, has a difficult diagnostick; for the Nephritick pain being intense, may occasion greater Vo­miting, and bind the Belly more than a remiss Colick.

Fourthly, In the Colick, the Patient is more eas'd by Vomiting and going to Stool, than in Nephritick Pains.

Fifthly, In the Nephritick pain, the Urine is first clear and thin, afterwards something settles to the bottom, and at length Sand or Gravel is evacuated: But in the Colick the Urine is thicker, from the beginning.

As to the Prognosticks, the Colick most com­monly, if it be gentle and remiss, and not very lasting, and not fix'd in one part, and inter­mits, and does not wholly stop the Belly, is curable and without danger. But if the pain be violent and fix'd to one part, and does not intermit, and if nothing be evacuated by Stool, and if the Patient can't Sleep; and lastly, if Vomiting, Hickocks, Delirium, Coldness of the Extream Parts, and cold Sweats follow, the Disease is Deadly.

[Page 10] An obstinate Colick from Acrid Matter, es­pecially occasion'd by Choleric Matter, often degenerates into other most dreadful Diseases, as to the Gout or Epilepsie, but oftner to the Palsie.

A contagious Pestilential and Epidemick Co­lick is most commonly deadly.

The Cure of this Disease must be varied according to the variety of the Causes.

And First, There is the same way of Cure for a windy and Phlegmatick Colick: You must begin with an emollient Clyster, and af­terwards you must give a carminative and discutient Clyster, which must be repeated twice, thrice, or four times in a Day, till the Pain be gone. But if after the use of one or two Clysters, the Sick does not go to Stool, as sometimes it happens, the Belly must be irritated by a sharp Suppository; but 'tis convenient to add to one of the Clysters ℥iiij of the Aq. Benedicta, or ʒij, or ʒiij of Colo­quintida may be boil'd in an emollient and carminative Clyster.

If Clysters don't give ease, you must not obstinately persist in the use of them; but 'tis better to use some gentle Medicine. It has been observ'd, that when a Sick Person has taken without any success Thirty Clysters, another Physician having given only ℥iss of Manna, with ℥ij of Oyl of Almonds in Fat Hen Broth, has cur'd the Patient: But in that pain which proceeds from thick Flegm, stronger Medicines must be given.

[Page 11] Afterwards Fomentations, Ointments, Baths, Plasters, and other Remedies, are useful; to which must be added some Specificks very pro­per in this Disease.

Wash the Guts of a Wolf in White-wine, and afterwards dry them in a Furnace, in an Earthen Vessel, till they may be powder'd, let the Sick take ʒi of this Powder in White-wine, it presently eases pain. Boil Simple Water, and when 'tis Boiling Hot, add a Fourth part of common Oyl, and some Grains of Pepper grosly beaten; let the Sick take Three or Four Spoonfuls as hot as he can bear it, the pain will be gone as 'twere in a moment.

Take of the best Aloes ʒi, of Laudanum Opia­tum, gr. iv, of Diagridium, gr. vi, Mingle them, make Six Pills, guild them. Let the Sick take them at a convenient time, they give ease in an Hours time, and afterwards purge off the noxious Humours. Instead of the Pills, a Potion may be taken, made of ℥ss of Diaph [...]enicon, and ℈ij of Philonium Romanum, in the Water or Decoction of Chamomil.

Hypocrates proposes a Purge made of Wild Purslain and Meconium. Six ℥ of Fresh Oyl of sweet or bitter Almonds taken, asswage the Pain, and carry the marter sticking to the Guts down­wards, and mixt with the following things, it does a great deal of good.

[Page 12] Take of the Oyl of Almonds, or of some other Oyl for Poor People ℥iiij, of Generous Wine ℥i, of Syrup of Poppies ℥i, mingle them, make a Potion.

Oyl of Sweet Almonds also taken with Manna in fat Broth, asswages the pain, and evacuates the Peccant Matter.

The Seed of Ammi powder'd, and ʒi of it given in Wine, soon takes off the pain, and being given a Second time, it most commonly cures the Disease; a Cataplasm of ℥iij of Turpentine being apply'd with Stupes at the same time, to which must be added of the Sinapisatum Piperis, and of Dragons Blood, each ʒi.

Paracelsus's Galbanetum is proper to discuss the Humour, if the whole Belly be anointed with it: This Description of it is propos'd by Crato.

Take of Gum Eleme, of Ivy, of Galbanum, of Oyl of Lawrel, each equal parts, distil them in a Retort in Sand; keep what comes over apart, first the Water, then the clear Oyl, af­terwards the thick Oyl like Hony, which must be used first.

Take of Calamus Aromaticus ℥i, of Galangal ʒiij, of the Yellow of the outward Peel of O­ranges ℥iiij, of choice Cinamon, of Anise and Fennel Seeds each ʒiij, of Cummin Seed ʒvi, of fresh Juniper Berries ℥ss, of Lawrel Berries ʒiij, let them be finely Powder'd and [Page 13] infus'd in vi th of Malago Sack, let them stand in a warm place for vi days, afterwards distill them in B. M. the Dose is ℥i evacua­tions going before.

Gum Caragna and Tacamahaca may be con­veniently apply'd to the Belly, and before they are put on, a Cupping-Glass may be apply'd t [...] [...]he Navel.

And tho the foresaid Plaisters are not ap­ply'd, yet the Cupping-Glass ought to be ap­ply'd to the Navel, which Galen says, does like a Charm, remove the pain occasion'd by Wind.

If the Disease is lasting, it may be success­fully treated with the Decoction of Guaiacum continued for many days, purging now and then, and injecting Clysters frequently; but if the Colick proceed from glassy Phlegm, boil the Guaiacum with Wine, as Amatus Lucitanus us'd it with good success.

The pain being quieted, an Apozem evacua­ting Phlegm is to be prescrib'd, by which the Reliques of the Disease may be carried off, or instead of that, a decoction of an old Cock, compounded of such things as purge and atte­nuate.

A bilious Colick is cur'd by emollient Clysters, and with such things as attemperate the Acri­mony of the humours.

Let the Belly be fomented with an emollient and anodyne Decoction, or which is better, let a Semicupium be prepar'd of the same Deco­ction.

[Page 14] A Cataplasm will also be convenient, pre­par'd with Barly-meal, and Flax-seed boil'd in Oyl of Camomel, and apply'd to the bottom of the Belly.

Also a cooling Epithem compounded after this manner, to be apply'd to the region of the Liver, will be proper:

Take of the Juice of Endive, of Cichory, each thss. of the Juice of Lettice and Rose-Vinegar each ℥ij, mingle them, make an Epithem.

Give Juleps of the water of erratic Poppy, of Lettice and Sorrel, with the Syrups of Vio­lets, of Apples, and of Lemons.

If the pain is very violent we must use Nar­coticks. The pain being somewhat mitigated, an infusion of Rubarb in Cichory-water is to be given, with Syrup of Roses, and to be repeat­ed often, till the stock of matter is evacuated. If gentle purging be not sufficient to eradicate the Disease, we must use Mercurius dulcis, which being given sometimes with Purging Medicines, that have Diagridium in them, perfects the Cure. They that dislike Diagridium may give Mercu­rius dulcis alone, made into Pills with Conserve of Roses, drinking upon them an infusion of Rubarb and Senna, with Manna and Syrup of Roses added to it.

Afterwards 'twill be convenient to use Tun­bridge, or such like Water.

When the pain is violent, we must fly to Baths and Laudanum, with which Catharticks may be sometimes given, but in a large Dose, [Page 15] because the quality is much blunted by Lau­danun.

Paracelsus's Galbanetum, tho 'tis hot, is pro­per to discuss the humour, if the whole Belly is anointed with it; the description of it is above.

Bleeding is sometimes proper in this sort of Colick, when there is danger, lest the violence of the heat should occasion a Fever; but if there be a Fever already, 'tis presently to be us'd.

When there's a great drouth, Cold water must be given, according to Galen's instructi­on; and Amalus Lusitanus says, he wonderfully Cur'd of a sudden, such a pain by the use of it; and Septalius declares in two Observations, that he us'd it inwardly and outwardly with great success.

For the Cure of a Colick that degenerates into a Palsie, put the Patient into a warm Bath, made of a Decoction of emollient things, the Belly being loosen'd with various Clysters, and the first passages open'd by Catharticks. The Patient must be bath'd twice, thrice, or four or five times in a day, that the Acrimony of the Humours may be attemperated, and that the Pores of the Membranes may be open'd. The next day let the Humour be purg'd with some proper Cathartick, and then the Bath must be repeated; and so you must do every other day, if the Patient be able to bear it, till the humours being purg'd off, and the pain quieted, he is recover'd.

[Page 16] In the mean while, you must continue the use of Clysters; but those made of Milk are best to asswage the pain; to which you may add Cassia, Oyl of Violets, and Oyl of Lillies.

Let the Belly be frequently anointed with Oyl of Chamomel, of Dill, sweet Almonds, Lillies, and with Butter.

Lastly, Use Whey and Tunbridge-waters, or the like: And if the Disease continue a long while, those things may be used which are pro­per to Cure Hypocondrical Melancholy.

And Bleeding is to be us'd at the beginning of the Disease, and before Purging, and to be often repeated, if the Bloud seem to be bad, or if something of a Rheumatism seem to be join'd with it.

Lastly, All those Remedies which are pro­pos'd for the Cure of the Bilious Colick, may be used in this case; and if these things do no good, some Physicians prescribe the following Potion, which though it be loathsom, and won't go down with the delicate, yet they say it presently mitigates the pain.

Take of Horse-Dung ℥ i, crumble it into small pieces, and infuse it in lbi of Erratic Poppy water, to which add viij or x Drops of Spirit of Wine; stram it gently, and divide it into Three Doses, to be taken at the times in which the Pain is most violent.

But if the Disease degenerate into a Palsie, you must use to the Spine of the Back, and the Paralitick Parts, some resolvent Balsom, and [Page 17] such a one as strengthens the Nerves if there be a Fever. But if there be no Fever, you may apply Wool dipt in Oyl or Ointment to the Paralitick parts, taking great care that the Patient does not catch cold, for by that means the Humour will be more fix'd upon the part, and the perspiration of it will be hinder'd. Paracelsus's Galbanetum is very use­ful in this case, if it be apply'd to the fore­said parts, and also to the Navel.

IN all these Years the Blood was much in­clin'd to put off upon the Bowels Hot and Cholerick Humours, upon which account this Colick was more frequent than is usual: The same Febrile Symptoms preceeded this Disease as us'd to go before the Dysentery that reign'd in those times; and sometimes this Disease follow'd the Dysentery, when it had a long while afflicted the Patient, and was just about to leave him. But when it did not follow a long Dysentery, it generally took its rise from a Fever, which after some Hours was wont to end in this Disease. It chiefly siez'd young People of a Hot and Cholerick Constitution, [Page 18] especially in the Summer. The pain of the Bowels was extreamly violent, and more in­tollerable than any other that afflicts poor Mortals. It sometimes binds as it were the Guts, and sometimes being contracted to a point, it bores like an Auger. The pain now and then remits, and presently the Fit ap­proaches again, which as soon as the Patient perceives, he looks sadly, and bemoans him­self as if 'twere actually upon him. At the beginning of this Disease, the pain is not so certainly determin'd to one point, as in the progress of it; neither is the Vomiting so fre­quent, neither does the Belly so obstinately resist Catharticks; but the more the pain is increas'd, the more pertinaciously is it fix'd in a point, the Vomiting is more frequent, and the Belly more bound, till at length by the dreadful force of these Symptoms, a total in­version of the Peristaltick motion of the Guts, (if the Patient be not soon relieved,) and by con­sequence an Iliac Passion is procur'd; in which Disease all Purging Medicines become present­ly Emetick, and Clysters that are injected, are vomited up with the Excrements. The Mat­ter that is cast up after this Manner, if it be sincere and without mixture, is sometimes green, and sometimes yellow, and sometimes of an unusual colour.

Now seeing every Phaenômenon of this Di­sease shews plainly that it proceeds from some Acrid Humour, or Vapour put off by the Blood upon the Intestines; this in my Opinion is the chief curative Indication, namely, that [Page 19] the said Humour should be evacuated, as well that which is antecedently in the Veins, as that which is contain'd in the Guts; and the next to this is, that the force of the Humours tending thither▪ should be restrained by the use of Anodines▪ and that the violent pain should be mitigated by them.

Therefore I order that Blood should be freely taken from the Arm, if no Blood has been taken away before; and af­ter The Cure. Two or Three Hours, I give an Anodine. The next day I prescribe some gentle Purge, and to be repeated the next day save one, and sometimes thrice, according as the Relicks of the Humour are more or less.

But we must take notice, that if this Disease proceed from Eating too much Fruit, or from any Meat of hard Digestion, upon which ac­count ill and corrupted Juices are first trans­mitted to the Blood, and afterwards to the Bowels, I say in this case the Stomach must be wash'd with large Draughts of Posset-Drink, which must be Vomited up again; which be­ing done, an Anodine is to be given, and the next day a Vein must be open'd; and as to o­ther things, you must proceed according to the Directions above-mention'd. But when the violence of the Pain, and the Vomiting (by reason of which the Guts are as it were in­verted) do resist the operation of the Cathar­ticks, they must be made stronger; for 'tis in vain to give a gentle Cathartick, unless the Patient is easily Purg'd, which must be care­fully enquir'd into; for such a Medicine be­ing [Page 20] not strong enough to make its way through the Intestines, the Patient is more injur'd thereby; for by its ineffectual agitation, the Vomiting and the Pain is increased. A Le­nitive Cathartick Potion, of the infusion of Tamarinds, of the Leaves of Senna and Rubarb, in which may be dissolved Manna, and Syrup of Roses, is to be preferr'd before other Ca­tharticks, for it least exagitates and moves the Humours. But if the Sick can't retain a Li­quid Medicine, by reason of an aversion, or because of the Vomiting, you must necessa­rily use Pills, among which the Pill Cochia pleases me best, for they pass best through the Body in this and in most other cases. But when the weakness of the Stomach, or the Vo­miting is so great, that the Pills can't be re­tain'd, then I first order an Anodine, and a few Hours after a Purge; but there must be so much space betwixt them, that the Ca­thartick be not quell'd by the Narcotick, and so render'd ineffectual; but that it may con­tinue so long in the Stomach, as is necessary for its imparting its Purgative▪ quality to it, that it may operate when the virtue of the Narcotick is spent; though the Purge if it could be conveniently done, is best given a long while after the Anodine; for Twelve Hours after taking it, the Patient is difficultly Purg'd.

But because in this as well as in most other Diseases, in which Narcoticks are indicated, a Purge always increases the Pain (at least when it has done working, for while 'tis in [Page 21] operation, the Patient is not so ill,) therefore I usually give an Anodine as soon as the Purge has done working, which I order to be taken Morning and Evening Daily, viz. In the middle spaces betwixt the Purges, that I may the more certainly appease the Pain till the Patient has been sufficiently Purg'd.

The Purging of the Humours being over, I endeavour to bridle the fury of the Disease, (which now only remains to be done,) by gi­ving an Anodine constantly Morning and E­vening, which must be sometimes repeated oftner; nor cou'd I ever take off violent pains, without a larger Dose than is usual, and that repeated too; for that which is sufficient to vanquish another Disease, will be altogether insufficient in this case, the violence of the Disease subduing the force of the Medicine: And 'tis indeed safe to repeat Narcoticks, while such a pain as this continues violent, but not when 'tis gone off. Wherefore I repeat the Anodine according to the degree of the pain, till it ceases, or till it be very much lessen'd; yet there must be such a space of time between them, that I may find what may be hop'd for from the former Dose, before I give another: But for the most part, unless the pain be very violent, a Paregorick given Morning and Evening may be sufficient. Li­quid Laudanum is the Anodine I chiefly use, of which I give Sixteen Drops in some Cordial Water, or the Dose may be increas'd accord­ing to the violence of the Pain.

[Page 22] This plain Method by which first the Pec­cant Matter is evacuated by Bleeding and Purging, and then ease procur'd by the help of Narcoticks, succeeded better in my practice, than any other I ever knew; whereas Carmi­native Clysters, injected in order to Extermi­nate the Acrid Humours, do only stir the Coals, and render the Disease more lasting, by the tumult they raise in the Humours. But here I must admonish you, that though I have said Bleeding and Purging must necessarily precede this quieting Method, yet sometimes upon oc­casion both being omitted, you must begin with Anodines. For instance, when by reason of some preceding Sickness, large Evacuations have been us'd not long before the coming of the Colick, (for many times they who have recover'd of another Disease, have fell sud­denly into this, by reason of a weakness of the Bowels, especially if there be a great degree of Heat, occasion'd by drinking of Wine, or some other Spirituous Liquor immoderately,) I say in this case, 'tis not only unnecessary, but I think 'tis injurious to give Catharticks again, for by them new Tumults will be rais'd. More­over the Guts are most commonly sufficiently cleans'd by Clysters, frequently us'd before the Physician is advis'd with; so that partly for this cause, and partly by reason of the long continuance of the Disease, Narcoticks seem in a manner to be only useful.

In August, 1671, the Noble Baron Annesly being afflicted with the Bilious Colick, with intolerable Pain, and frequent Vomiting [Page 23] for some Days, sent for me to the Castle of Belvoir; he had try'd all sorts of Clysters and other Remedies, by the prescription of Learn'd and Experienc'd Physicians living thereabout. I advis'd without any more adoe, the repeated use of Narcoticks, according to the Method just deliver'd, by which he recover'd in a few Days, and came to Town well with me.

But because this pain of its own nature is wont to return more than any other, all occasions of its Relapse must be prevented, by giving an Anodine twice a Day for some Days: But if as often as the Narcotick is intermitted, the pain now and then returns, as it sometimes happens, I don't know any thing that will so cer­tainly perfect the Cure, as Riding on Horse-back, or in a Coach, with which the Patient must take long Journies▪ and in the mean while an Anodine must be given constantly Morning and Evening; for by this kind of Exercises, the Matter causing the Disease, is remov'd to the habit of the Body, and the Blood being broke into small parts by perpetual agitation, is as it were depurated again, and at length the Intestines are much strengthen'd and refresh'd by this way of stirring up the natural Heat. Nor am I asham'd to confess, that by the help of this Exercise, I have more than once per­fectly cur'd this Disease, when I was not able to cure it any other way; but this must not be us'd before the Patient has been well Purg'd, and then he must continue the use of it for ma­ny Days.

[Page 24] One of my poor Neighbours who is now Living, was afflicted in these Years with a most violent Bilious Colick, who a long time endea­vour'd, but in vain, to conquer the Disease by Catharticks, Clysters, and Leaden Bullets swal­low'd down; I order'd him to use Narco­ticks frequently, which he did with good success, for as often as he us'd them, he found himself very easie; but seeing the Disease was only palliated with these things and not extir­pated (for it return'd assoon as the vertue of the Narcotick was spent,) I took pity upon the Man, being grievously afflicted with this Di­sease, and also with Poverty, and lent him one of my Horses, that he might go a Journy as above directed, and having travelled a few Days, the Bowels grew so strong, as to be a­ble to shake off the Relicks of the Disease, and so he perfectly recover'd, without the help of Anodines.

And to speak the truth, I have known this kind of Exercise has been always us'd with admirable success in most other Chronical Di­seases, if the Patient continued it resolutely. For if we consider with our selves, that the lower Belly in which are plac'd the Organs of Secretion, are much shaken by this Exercise, perhaps some Thousands of times in a Day, we shall easily believe that they are able by the help of the foresaid Exercise, to shake off any Excrementitious Juice that is impacted there; and (which is of greater Moment yet,) that they are so corroborated by that power­ful excitation of the native Heat, that they [Page 25] may duly perform that office of purifying the Blood which Nature has appointed them.

If the Patient be Young, and of a Hot Con­stitution, I order a cooling and thickening Diet, suppose Pulp of Barly, Panada, and the like, and every third day if the Stomach is craving, a Chick, or a Whiting boyl'd. I allow no other Drink than Small-beer, or Milk-water: And this is all I order, unless Riding necessary to reco­ver the Health, requires more nourishing Food, and more generous Liquor, by which the Spi­rits exhausted by Exercise may be repair'd.

But when the Disease being unskilfully treat­ed has a long while afflicted the Patient, so that the Bowels become weak and infirm, and he is in a manner quite wasted, I say in this case we find by experience, that the free use of Epide­mick Water, or of Aq. Mirabilis, or of any o­ther the Patient likes best, relieves him at this time beyond expectation; for by this means the small Relicks of the Native Heat and the Spirits will be excited, and the preternatural ferment sticking to the Bowels, and now and then occa­sioning new Fits, will be extinguish'd by Spiri­tuous Liquors.

Moreover as in the cure of the Disease, so when 'tis over, the thin Diet we have mention'd must be observ'd for some time; for this Di­sease being more apt to return than any other, and seating it self upon the principle parts for Concoction (I mean the Bowels already weaken'd by it) the least error of this kind will present­ly occasion much pain. Wherefore in this and all other Diseases of the Bowels, Meats of hard [Page 26] Digestion are carefully to be avoided, and things of easie Digestion must be taken only in such a quantity as will suffice to sustain Life.

A certain kind of Hysterical Disease afflicts some Women, very like the Bilious The Hyste­rick Colick. Colick, both as to the sharpness and situation of the Pain, and also upon the account of the Humours ejected by Vomit, of a Yellow and Green Co­lour: I will treat of it by the by, lest any one should take it for the bilious Colick just now mention'd.

Those Women that are of a laxe and crude habit of Body, are chiefly afflicted with this Di­sease, and they that have lately labour'd under some other Hysterick indisposition, (or which is very often) those that have scarce evaded a diffi­cult and hard Labour, in bringing forth a large Child, whereby the Mothers Nature and Strength has been almost spent. A pain as violent almost as that of the Colick or Iliack Passion, seizes the region of the Stomach; and sometimes it comes a little lower, and then violent Vomitings fol­low, and the Matter which is cast up, is some­times Yellow, and sometimes Green; and more­over (which I have often observ'd,) there's a greater dejection of Spirit and desperation than in any other Disease whatever. After a Day or Two the pain goes off, and returns again a few Weeks after as violent as 'twas before. Some­times 'tis accompanied with the Jaundice, which is very visible, and which goes off of its own accord in a few Days. When all the Symptoms are gone off, and when the Patient seems very [Page 27] well, the smallest disorder of the Mind, whether it be occasion'd by Anger or Sorrow (to both which in this case Women are very prone,) al­most recalls the pain, which may be said of Walking or any other Exercise us'd too soon; for by these means Vapours are elevated in a laxe and weak habit of Body. When according to the vulgar Opinion, I say, Vapours, whether they be so or no, or whether they are convulsions of particular parts, the Phaenomena may be solved either way. These Vapours or Convulsions when they invade this or that region of the Body, produce Symptoms agreeable to the part they invade; and though they are one and the same Disease every where, yet they cunningly resemble most of the Diseases Mankind is expos'd to, which is manifest from this Symptom, which when it seizes upon the parts near the Colon, imitates exactly the Bilious Colick, which is also as apparent in many other parts of the Body af­flicted with this Disease. For instance, Some­times it seizes one of the Kidneys with a vio­lent pain, from whence arises violent Vomiting, and being oftentimes convey'd by the passage of the Ureter, it resembles the Stone; and be­ing exasperated by Clysters and other Lithon­triptick Medicines design'd to force away the Stone, it afflicts the Patient in the same manner a long while, and sometimes (contrary to its nature, for left to it self, 'tis no way dangerous) kills the Patient. I have seen moreover Symp­toms occasion'd by it, exactly resembling the Stone in the Bladder. Not long agoe I was call'd up in the Night to visit a Countess, my [Page 28] Neighbour, seiz'd suddenly with a violent pain in the region of the Bladder, and with a sup­pression of Urine; and having known that she was subject to various Hysterick Indispositions, I suppos'd the Disease was not that they imagin'd, and therefore I would not suffer a Clyster that her Maid had prepared to be injected, lest the Disease should be increas'd thereby; and instead of this and Emollients, namely Syrup of Marsh Mallows and the like, which the Apothecary had brought, I order'd a Narcotick, which soon took off that Symptom. And indeed there is not one part of the Body wholly secur'd from the assaults of this Disease, whether they are internal or external, as the Jaws, Hips and Legs; in all which it excites violent pain, and when it goes off, leaves a tenderness behind, which will not bear touching, just as if the Flesh was bruis'd with violent Strokes.

But now seeing I have deliver'd some things by the by, appertaining to the History of the Hysterick Colick, lest it should be mistaken for the Bilious Colick, I will transiently▪touch upon some things relating to the cure of the Symptom of pain which accompanies it. For the perfect Cure which takes off the Disease, by removing the cause, comes under another Speculation, and belongs to another place.

Bleeding and Purging repeated, which are plainly indicated at the beginning of a Bilious Colick, are not to be used here, unless in the case to be mention'd by and by; for experience teaches, that the pain is exasperated, and that all the Symptoms increase by reason of the tu­mult [Page 29] which those things occasion; and I have more than once observ'd, that the repetition of the gentlest Clysters have brought on a long se­ries of Symptoms. And reason as well as expe­rience dictates, that this Disease is rather pro­duced by an inordinate motion of the Spirits, than by vicious Humours, if we consider what things most commonly occasion it; and they are such as these, large and unnecessary profusions of Blood, violent motions of the Mind and Body, and such like: All which forbid those Remedies by which a greater disturbance of the Spirits may be occasion'd; and instead of them Anodines are to be us'd, though the green and ill colour of the Matter vomited up may seem to indicate the contrary; for the speculation of colours is too nice to authorize those Evacuations, which we find ipso facto injurious. And I don't at all doubt that this Disease (which though it occa­sion violent pain, is no way Mortal,) has prov'd deadly by reason of Errors committed upon the belief of such Speculations. Moreover if any one should give the strongest Vomit to Day, to eject that which he supposes to be the occasion of the Disease, yet the next Day the Patient would vomit up Matter quite as green or of some other ill colour, as was the for­mer.

But we must take notice, that there is some­times so great a quantity of Blood and Humours which so resists the operation of the Narcotick, that though it be often repeated, it can't quell the tumult, till the Patient is Blooded and Purg'd, which I have observ'd in Women of a [Page 30] very Sanguine Constitution, and in Virago's. If the case is so, Bleeding or Purging, or perchance both, must make way for the Anodine; for ei­ther of these being us'd, a moderate Dose of the Narcotick will perform the business, which otherwise would signifie nothing, though the largest Dose was given: But this seldom hap­pens, and then these Remedies must not be re­peated; and when they are us'd when there is need of them, you must proceed in giving Ano­dines in that Method which I have propos'd in the Bilious Colick, and they must be taken often or seldom, according to the degrees of pain. Which Method indeed respects only the Symp­tom of violent pain; for I don't now undertake to treat of that Method which takes off the cause. But for as much as this Disease in Hy­pocondriacal as well as Hysterical People, (for the reason is the same in both, as is said in another place,) often ends in the Jaundice, and as this comes on, so that goes off; we must take notice, that in curing this kind of Jaundice, all Catharticks are either wholly to be omitted, or if they are given, you must use only▪ Rubarb or some other gentle Purge▪ for there's danger lest by Purging, new Tumults should arise, and so all the Symptoms return. And therefore in this case, nothing must be done presently, see­ing the Jaundice taking its rise on this account, generally lessens of its own accord, and wholly vanishes in a short time; but if it continues a long while, and seems to go off difficulty, Re­medies must be taken for it: I use the follow­ing.

[Page 31] Take of the Roots of Madder, of Curcuma, each ℥i, of all the greater Celandine, and of the tops of the lesser Centauris, each M i; boil them in equal parts of Rhenish Wine, and of Fountain Water, to lb ij, in the straining Dis­solve ℥ij of the Syrup de quinq. Radicibus, mingle them, make an Apozem; let the Patient take lbss Morning and Evening, till he's well.

But if the Jaundice comes of it self, the Co­lick not going before, 'tis necessary besides the alteratives just mentioned, to give Cholagoges, that is, such things as purge Choler by Stool, namely once or twice before the Patient enters upon the Apozem prescrib'd, and afterwards once a Week as long as he takes it.

As take of the Electuary of the Juice of Roses ʒij, of Rubarb finely Powder'd ʒss, of Cream of Tartar ℈i, make a Bolus with a sufficient quantity of Syrup of Rubarb, with Cichory; give it early in the Morning, and let the Pa­tient drink upon it a small Draught of Rhenish Wine.

But if notwithstanding the constant taking of these things a long while, the Disease continues obstinate, the Patient must drink Tunbridge Wa­ter or such like, from the Fountain every Morn­ing 'till he recovers.

THIS Disease if I calculate right, is the most frequent of all Chronical Diseases, and as Fevers with those Diseases that appertain to them, if they are compar'd with Chronical taken all together make two Thirds, so Hysterical Diseases (at least those that go under that Name,) are half the remaining Third; that is, Chronical Diseases are half Hysterick, for very few Wo­men (which Sex contains the half of grown Peo­ple) are wholly free from all kinds of Hysterick Diseases, if you except those who being ac­customed to labour, live hardly. Yea, many of those Men that live sedentary Lives, and are wont to Study hard, are afflicted with the same Disease. And though heretofore Hysterical Symp­toms were always reckon'd to proceed from a vitious Womb, yet if we compare Hypocondriacal Symptoms which we are supposed to proceed from obstructions of the Spleen or Bowels, or from some other I know not what Obstructions, with Womens Hysterick Symptoms, an Egg is scarce more like an Egg, than these Symptoms are one another in all respects. But it must be confess'd that Women, are much more subject to this kind of Disease than Men, not for that the Womb is more faulty than any other region of the Body, but for causes to be shewn by and by.

[Page 33] Nor is this Disease only frequent, but so won­derfully various, that it resembles almost all the Diseases poor Mortals are subject to, for what­ever part it seats it self in, it presently pro­duces such Symptoms as appertain to it; and unless the Physician is very sagacious and very skilful, he will be mistaken, and suppose that those Symptoms proceed from some essential Di­sease of this or that part, and not from an Hy­sterical Distemper.

Sometimes for instance, it possesses the Head, and occasions an Apoplexy, which also ends in an Hemiplegy, and is exactly like that Apoplexy by which Corpulent and Antient People are de­stroy'd, and which happens by reason the passages of the Animal Spirits are stopt, the Cortex of the Brain being stuffed by a great deal of Phlegm, from which cause the Apoplexy that happens to Hysterical Women, does no way seem to arise, for it seizes such very often presently after de­livery, a great quantity of Blood being at the same time evacuated, or it's occasion'd by hard Labour, or some violent commotion of the Mind.

Sometimes it produces violent Convulsions, ve­ry like an Epilepsie, the Belly and Bowels swel­ling towards the Throat, the Patient strugling so violently, that though at other times her strength is but ordinary, she now can scarce be held by all the strength of the by Standers, ut­tering some odd and inarticulate sounds, and striking her Breast. Women who are accu­stom'd to this Disease, commonly call'd Mother Fits, are generally extraordinary Sanguine, and [Page 34] have an habit of Body almost like that of a Vi­rago.

Sometimes it possesses the outward part of the Head betwixt the Pericranium and Skull, causing violent pain continually fix'd in one part, which may be cover'd with the top of your Thumb; and violent Vomiting accompanies this pain. I call this Species, Clavus Hystericus, chiefly afflict­ing those that have a Chlorosis.

Sometimes falling upon the Vital parts, it oc­casions so great a palpitation of the Heart, that the Women who are afflicted with it may verily believe that the by Standers may hear the sound of the heart thumping upon the Ribs; this kind chiefly afflicts those that are of a thin habit of Body, and of a weak Constitution, and who look almost tabid; and also Young Maids that have the Green Sickness.

Sometimes it seizes the Lungs, and the Pa­tient coughs almost without intermission, but ex­pectorates nothing; and though this sort of Cough don't shake the Breast so violently as that which is Convulsive, yet the Explosions are much more frequent: But this kind of Hysterick Cough is very rare, and chiefly invades Women that a­bound with Phlegm.

Sometimes rushing violently upon the Colon, and the region under the Scrobiculum Cordis, it occasions violent Pain, much like the Iliac Passion, and the Woman Vomits exceedingly, ejecting a certain green Matter, somewhat like that they call Porraceous Bile, and sometimes of an unu­sual colour. And often after the Sick has been almost destroy'd by the said Pain, (which would [Page 35] tire a Stoical Apathy,) and reachings to Vomit for many Days, at length the Fit is carried off by the Jaundice, tincturing the Superficies of the Body like Saffron. Moreover the Sick is oppres­sed by an anguish of Mind, and wholly despairs of Recovery, with dejection of Mind, and as it were a certain Desparation which as certainly accom­panies (as I have observ'd) this kind of Hyste­rick Diseases, as the Pain and Vomiting above mention'd. This kind chiefly invades those that are of a Laxe and Crude habit of Body, and those that have suffer'd much in bringing forth great Children. When this Disease falls upon one of the Kidneys, it plainly represents by the pain it causes there, a Nephritick Paroxism, and not only by that sort of Pain, and by the place it rages in, but also by violent Vomitings, which accompany it, and also for that sometimes the pain extends it self through the passage of the Ureter; so that 'tis very difficult to know whe­ther these Symptoms proceed from the Stone, or from some Hysterick Disease, unless perchance some unlucky accident disturbing the Womans Mind a little before she was taken ill, or the Vomiting of green Matter, shews that the Symp­toms rather proceed from an Hysterick Disease, than from the Stone. Neither is the Bladder free from this false Symptom, for it does not only cause Pain there, but it also stops the U­rine, just as if there were a Stone, whereas there is none. But this last kind seizing the Bladder, happens very seldom; but that which resembles the Stone in the Kidnies is not so rare: Both us'd to invade those Women who are much [Page 36] weaken'd by Hysterick Fits coming frequently▪ and whose health of Body is much impair'd.

Sometimes falling upon the Stomach, it causes continual Vomiting, and sometimes a Diarrhaea, when 'tis setled upon the Guts; but no pain ac­companies either of those Symptoms, tho of­tentimes in both, that green Humour appears: Both these kinds are familiar with those that are much weaken'd by Hysterick Fits coming fre­quently.

And as this Disease afflicts almost all the in­wards parts, so sometimes it also seizes the out­ward parts, and the Musculous Flesh, occasion­ing pain, and sometimes a tumour in the Jaws, Shoulders, Hands, Thighs and Legs, in which kind that tumour which swells the Legs is more conspicuous than the rest; but whereas in Hydro­pical Tumours these Two things may be always taken notice of, namely, that the Swelling is most in the Evening, and that the Finger press'd upon it, leaves a Pit. In this tumour the Swel­ling is most in the Morning, neither does it yield to the Finger, or leave any Mark behind it; and for the most part it only swells one of the Legs. As to other things, if you mind the largeness of it, or its superficies, 'tis so very like Hydro­pical Swellings, that the Patient can scarce be brought to believe 'tis any other Disease. Nei­ther can the Teeth free themselves from the assaults of this Disease, though they are not hollow, and though there's no apparent defluxion that may occasion the pain, yet is it no whit gentler, nor shorter, nor easier cured. But those pains and tumours which afflict the outward parts, [Page 37] chiefly seize those Women that are in a manner quite destroy'd by a long series of Hysterick Pa­roxisms, and by the force of them.

But among all the torments of this Disease, there's none so common as a pain in the Back, which most certainly all feel, how little soever they are afflicted with this Disease. Moreover this is common to the foresaid Pains, that the place on which they were, will not bear touch­ing after they are gone, but is tender, and akes, just as if 'twere soundly beaten; but this tender­ness goes off by degrees.

And this is worth observing, that often a no­table cold of the External parts, makes way for these Symptoms, which for the most part does not go off till the Fit ends; which Cold I have observ'd is almost like that by which a Carkas grows stiff, yet the Pulse are good.

And moreover, almost all Hysterick Women which I have hitherto taken care of, complain of a dejection and sinking of the Spirits; and when they wou'd shew the place where this con­traction or sinking of the Spirits is, they point to the region of the Lungs.

Lastly, Every one knows that Hysterick Wo­men sometimes Laugh excessively, and some­times Cry as much, without any real cause for either.

But among all the Symptoms that accompany this Disease, this is the most proper, and almost inseparable, namely a Urine as clear as Rock Water; and this Hysterick Women evacuate plentifully, which I find by diligent inquiry, is in almost all the Pathognomonic sign of this Di­sease [Page 38] which we call Hysterick in Women, and Hypocondriack in Men; and I have sometimes ob­serv'd in Men, that presently after making Wa­ter of a Citron colour, (yea almost the next mo­ment) being suddenly seized with some violent commotion of the Mind, they presently make Water as clear as Crystal, and in a great quan­tity, with a continued violent Stream, and con­tinue ill 'till the Urine comes to its wonted Co­lour, and then the Fit goes off.

And it happens to all Hysterical and Hypo­condriacal People, that sometimes they belch up ill Fumes as often as they eat, though they eat only moderately, and according as they have an Appetite; and sometimes the Wind that comes from the Stomach is sour, just like Vine­gar when it comes into the Mouth, the Con­coction being much impair'd, and the Juices quite differing from their natural state.

Neither are they unhappy upon this account only, viz. that their Bodies are so ill affected, and as it were tottering like ruinated Houses just about to fall; for their Minds are more dis­eased than their Bodies, for an incurable Despa­ration is mix'd with the very nature of the Di­sease; they are in a great rage when any one speaks never so little of the hopes he has con­ceived of their Recovery, easily believing that they suffer all the miseries that can befal a Man, foreboding the most dreadful things to themselves, entertaining in their restless and anxious Breasts upon a slight occasion, or perhaps for none at all, Fear, Anger, Jealousie, Suspicions, and worse Passions of the Mind if any can be worse, abhoring [Page 39] all Joy, Hope and Mirth, and if any one of these do chance to occur, 'tis rara Avis, and soon flies away, and does no less exagitate the Mind, than the sorrowful Passions; so that they never observe a mean, constant only to inconstancy: Some­times they love beyond measure, and presently hate the same without any cause; sometimes they design to do this or that, then presently alter their Intentions, and begin the quite contrary, and yet they don't perform that neither; so wa­vering are they, that their Minds can't be at all at rest; and that which the Roman Orator said of the Superstitious, exactly agrees with these Melancholy▪ People▪ Sleep (says he) seems to be a refuge for the Laborious and careful, but from thence cares and fears arise. Whilst only Funerals and Apparitions of their Deceas'd Friends are repre­sented in Dreams, and they are so tormented in Body and Mind, that one would think their Lives were a Purgatory, in which they were to puri­fie themselves, and to expiate Crimes committed in some other state. Nor does this happen only to Mad People, but also to those who if you ex­cept these impetuosities of Mind, are very Pru­dent and Judicious▪ and who much excel for deep Thought and wisdom in Speech, others whose Minds were never excited by these Provokements to thinking, so that Aristotle was much in the right, when he said Melancholy People are most ingenious.

But this dreadful condition of the Mind which we have above describ'd, seizes on those only that have much and a long while conflicted with this Disease, and have been at length wholly [Page 40] vanquish'd by it, especially if Adversity, Care or Trouble of Mind, or hard Study or the like, joyn'd with an ill habit of Body, have added Oyl to the Flame.

A day would scarce be sufficient to reckon up all the Symptoms belonging to Hysterick Disea­ses, so various are they, and so contrary one to the other, that Proteus had not more shapes, nor the Chamelion greater variety of colours: And I think Democritus reckon'd pretty right (though he mistook the cause of the Disease,) when he said in an Epistle to Hippocrates, that the Womb was the cause of Six Hundred Miseries, and of in­numerable Calamities. Nor are they only very various, but also so irregular, that they can't be contain'd under any uniform type, which is usual in other Diseases, for they are as it were a dis­orderly heap of Phaenomena, so that 'tis very difficult to write the History of this Disease.

The procatartick or external causes of this Disease, are either violent motions of the Body, or which is much oftner, vehement commotions of the Mind from some sudden assault, either of Anger or Grief or the like Passions; therefore as often as Women advise with me about this or that disorder of Body, the reason of which can't be deduc'd from the common Axioms, for find­ing out Diseases, I always diligently inquire of them whether they are not chiefly afflicted with that indisposition which they complain of when they have been disturb'd in their Minds and af­flicted with Grief, which if they confess, I am sufficiently satisfied that the Disease must come under this Tribe we are now speaking of, espe­cially [Page 41] if Urine as clear as Chrystal evacuated copiously at some certain times, makes the diag­nostick more manifest. But to these disorders of the mind which are usually the occasions of this Disease, is to be added emptiness of the Stomach by reason of long fasting, immoderate bleeding, and a Vomit or a Purge that work'd too much. Now having drawn the Picture of this Disease ac­cording to its most vulgar Phaenomena, in the next place its internal efficient causes are to be con­sider'd, as well as we can gather them from all the circumstances join'd together, which we have describ'd: And in my opinion those Diseases which we call hysterical in Women, and hypo­chondriacal in Men▪ proceed from a confusion of the Spirits, upon which account, too many of them in a croud contrary to proportion, are hur­ry'd violently upon this or that part, occasioning Convulsions and pain, when they rush upon parts endued with exquisite Sense, perverting the Fun­ctions of the Organs, both of that, into which they thrust themselves, and also of that from whence they departed; both being much injur'd by this unequal distribution, which is quite con­trary to the oeconomy of Nature.

The origine and antecedent cause of this Ataxy, is a weak constitution of the said Spirits, whether it's natural or adventitious; for which reason, they are easily dissipated upon any occasion, and their System soon broke. For as the outward man is fram'd with parts obvious to Sense, so without doubt the inward man consists of a due Series, and as it were a Fabric of the Spirits, to be view'd only by the eye of Reason; and as this is [Page 42] nearly join'd, and as it were, united with the con­stitution of the Body, so much the more easily or more difficultly is its frame disordered, by how much the constitutive Principles that are allotted us by nature, are more or less firm: Wherefore this Disease seizes many more Women than Men, because kind Nature has given them a more deli­cate and fine habit of Body▪ having design'd them only for an easie life, and to perform the tender Offices of Love: But she gave Men robust Bodies that they might be able to delve and manure the Earth, to kill Wild Beasts for Food, and the like.

But that the said confusion of the Spirits is the cause of this Disease, the Phaenomena now de­scrib'd, will sufficiently prove; the chief of which I will only mention. And I begin with Mother-Fits, here the Spirits are crouded in the lower Belly, and rushing together violently towards the Jaws, occasion Convulsions in every Region through which they pass, blowing up the Belly like a great Ball; which yet is nothing but the rowling together, or conglobation of the parts seiz'd with the Convulsion, which can't be sup­press'd without great violence. The external parts in the mean while, and the Flesh being in a manner destitute of Spirits, by reason they are carried another way, are often so very cold, not only in this kind, but in all other kinds of hyste­ric Diseases (as was noted above) that dead Bo­dies are not colder. But the Pulse are as good as those of People that are well; nor is the Wo­mans life in danger by this Cold, unless 'tis occa­sion'd by some very large evacuation going be­fore.

[Page 43] The same may be said of that violent hysteric Disease, which to outward appearance is like the bilious Colick or the iliack Passion, in which the Woman is seized with a violent pain in the Regi­on, about the Scrobiculum cordis, together with vi­olent Vomiting, by which a matter is cast up, in colour like Herbs, which Symptom I suppose, proceeds only from a vehement impulse of the Spirits crouded together in the said parts, which occasions the Convulsion and pain, and the total subversion of all the Faculties. Nor is it to be presently concluded that this Disease resides in the Humours, because those things that are evacu­ated upward or downward, are sometimes of a green colour, or that the violent pain is occasi­on'd by the acrimony of some Humour tearing the part it adheres to, which for that cause, we ac­count the occasion of the Disease, and therefore suppose it ought to be eradicated by Vomits and Purges; for 'tis manifest that the Sickness which seizes People that go to Sea, (arising from the a­gitation of the animal Spirits in the boisterous Sea) occasions the vomiting up of matter as green as an Herb, from the Stomacks of those that are in perfect health▪ when they first go to Sea, and are a good way from Land; in whom, half an hour before, there was none of that Choler which is call'd porraceous. And don't Infants in convul­sive Fits in which the animal Spirits are chiefly concern'd, evacuate upward or downward, mat­ter of the same colour, to which must be added that which almost daily experience teaches, viz. that tho' such Women and Children shou'd be quite exhausted by repeated Purges, yet the said [Page 44] colour wou'd still appear in that which they evacu­ate by Vomit or Stool; yea, the green matter in­creases by the frequent use of cathartick and eme­tick Medicines, because by both, the confusion of the Spirits is heightned, which I know not how either destroys or Perverts the ferment of those parts, or throws into the Stomach or Guts, by the force of the Convulsions, some juice of a strange nature, which is dispos'd to give the Hu­mours such a Tincture. And tho' Chymists are not so happy as to prepare better Medicines in their fruitful Glass, than are made in a Mortar or a Pipkin, yet they know how to please the vain Humour of the Curious, by shewing two Liquors equally limpid and clear, which being mixt toge­ther, presently change into some deep colour, as if there was conjuring in the case. And truly the speculation of colours is so uncertain and vain, that we can learn nothing certainly from them, concerning the nature of the Bodies they appear in; nor does it more necessarily follow, that those things which are of a green colour shou'd be acrid, than that all acrid things shou'd be green. The thing therefore being throughly consider'd, it will plainly appear, that the violent pain which almost destroys those that are afflicted with the hysterick Colick, and the evacuation of green matter, are wholly occasion'd by the Spirits rushing impetu­ously upon the parts about the Scrobiculum cordis, and contracting the same by Convulsions.

That Symptom which I term'd above clavus hystericus, is to be attributed to this enormity of the Spirits, in which the Spirits in all the compass of the Body, are as it were concentrated in a cer­cain [Page 45] point of the Pericranium, occasioning a pain, boring as it were through; just as if a Nail was driven in to the Head, together with violent vo­miting and casting up of green matter, which Contraction indeed, of all the Spirits of the Body as i were to a Point, is somewhat like that Col­lection of the Raies of the Sun, which is made by a burning Glass: And as the force of these united, burns, so they for the same reason occasion pain, by tearing the membranes with their forces joind.

And then from that inordinate agitation of the Spirits disturbing the Blood, arises that Symptom, which as we have mention'd above, is frequent in hysterical and hypochondriacal People, viz. clear, limpid and copious Urine: For when the oecono­my of the Blood is interrupted, the Sick can't long enough contain the Serum that is imported, but lets it go before it's impregnated with saline par­ticles, by which the citron colour is to be impart­ed to it; whereof we have a daily experiment in those that drink much, especially of thin and at­tenuating Liquors, for then their Urine is very clear, in which case the blood being overpower'd by that quantity of Serum, and being wholly un­able to retain it, puts it off quite clear, not yet dy'd by the juices of the Body, by reason of its too short stay.

Three years ago a Nobleman sent for me, he seem'd to labour under an hypochondriack Colick, that was almost come to an iliack Passion, with pain and violent vomiting, with which he was much and a long while afflicted and almost worn out: I observ'd through the whole course of the Disease, that when he was worst his Urine was [Page 46] always clear, but when he was a little better it was somewhat of a citron colour. Visiting him one day, I view'd his Urine made at three times, kept apart in three Chamber-pots, of a citron colour; he was then merry and chearful, and thinking of eating some meat of easie Digestion, and he said he had a craving Appetite; but one coming in at that very moment, who vext him so much, that suddenly growing ill, he call'd for a Chamber-pot, which he almost fill'd with Urine as clear as Chrystal.

And perhaps that spitting which is common in hysterical Women, proceeds from the Spirits so disturbing the blood; they spit thin for many Weeks, just as if they were salivated by unction; for during this disturb'd condition of the blood, in which 'tis unable to perform evacuations ac­cording to Natures method, the Serum by chance taking this contrary course, is not evacuated ac­cording to the rules of Nature by the Reins, but is put off by the extremities of the Arteries upon the Glands, and so comes forth by the salivary passages in the form of Spittle. The same may be said of those violent nocturnal Sweats which afflict hysterical Women, which proceed from no other cause than the ill disposition of the Serum of the blood, by which 'tis inclin'd to be put off upon the habit of the Body.

As to the cold by which the external parts are so often chill'd in hysterical Diseases, 'tis very manifest that that happens because the Spirits for­saking their Stations, too officiously intrude them­selves into this or that part; nor is it to be doubted that weeping and laughing Fits, which [Page 47] often seize hysterical Women withou any occasion, are procured by the animal Spirits forcing them­selves violently upon the Organs, that perform these animal Functions.

And by the by, Men are also subject (tho' rare­ly) to Fits of weeping. I was sent for sometime ago to an ingenious Gentleman, who but a few days before, recover'd of a Fever; he made use of another Physician, who blooded him and purg'd him thrice, and forbid him to eat Flesh: When I came and saw him with his cloaths on, and heard him discourse judiciously, I ask'd to what purpose I was sent for? One of his friends answer'd, if I wou'd have a little patience I should see; sitting down therefore, and discoursing with him, I pre­sently observ'd that his lower Lip was thrust out, and mov'd frequently (as froward Children us'd to do to prepare for crying) and then wept so vi­olently, that I scarce ever saw the like; with such deep sighs as were almost convulsive: Which sud­dain Torrent in a little time quite asswag'd. I supposed that this disorder proceeded from a con­fusion of the Spirits, which was occasion'd partly by the long continuance of the Disease, and partly by evacuations which the method of cure necessa­rily requir'd; and partly also from emptiness and abstinence from Flesh; which the Physician or­der'd for some days after he was well, to secure him from a Relaps. But I affirm'd he was clear from all danger of a Fever, and that the foresaid Symptom was wholly occasion'd by emptiness, and therefore I advis'd, that a roasted Chick shou'd be provided for his Dinner, and that he shou'd drink Wine moderately▪ which being done, and he re­turning [Page 48] again to the eating of Flesh moderately, was never afterwards troubl'd with this convul­sive weeping.

And now at length to come to a conclusion, (for I omit other Phaenomena which belong to this Disease) that disturbance and varying Intemperies both of Body and Mind, which prevails over hy­sterical and hypochondriacal People, is occasion'd by this inordination of the Spirits; for in both, that firmness of Spirits being wanting, which is always found in the robust, and in those who are continually invigorated by the assistance of brisk Spirits, they can't bear the impressions of cross accidents, but are soon mov'd by anger or pain, and are as apt to be angry, as those to whom ei­ther Nature has given a soft and weak Govern­ment of Mind, or when it has been render'd so by a long series or continuance of Diseases. For the strength and constancy of mind as long as 'tis confin'd in the Body, much depends on the firm­ness of the Spirits that are subservient to it; which indeed, are made of the finest matter, and are plac'd in the confines of immaterial entities; and as the frame of the mind, if it's lawful to call it so, is much more curious and delicate, than the structure of the Body, for it consists in the harmony of the most excellent and almost divine Faculties; so if its constitution is any way spoil'd, by so much the greater is the ruin, by how much 'twas more excellent and more exqui­sitely compos'd when 'twas whole. And this in­deed is the condition of these miserable and de­jected People we have describ'd, for which Dis­ease, some obstinate Decree of the most insolent [Page 49] Stoick wou'd give no greater ease, than he that wou'd prevent the Tooth-ach, by firmly resolving that he wou'd not by any means suffer his Teeth to ake.

And now I suppose that 'tis manifest that this whole Disease is occasion'd by the animal Spirits being not rightly dispos'd, and not by Seed and menstruous Blood corrupted, (as some Authors assert) and sending up malignant Vapours to the parts affected; nor from I know not what depra­vation of the Juices or Congestion of acrid Hu­mours as others think, but from those causes we have assign'd. For that the Fomes of the Disease don't lurk in matter, will plainly appear by this one Instance, viz. a Woman that us'd to enjoy perfect Health being delicate, and of a thin habit of Body, if she chance to be weaken'd and exhaust­ed by some Error, or by a strong Vomit or Purge, will certainly be afflicted with some one of those Symptoms that accompany this Disease; which wou'd rather be remov'd than occasion'd by such vomiting or purging, if the Fomes of the Diseases was contain'd in a Humour. The same may be said of a great loss of Blood, whether it's taken away by opening a Vein, or flows immoderately in Labour, or of Emptiness, or too long Abstinence from Flesh; all which would rather prevent Hy­steric Diseases than occasion them, if the Fomes of them was involv'd in some matter: Whereas on the contrary, nothing does so constantly occasi­on this Disease as these Evacuations.

But tho' 'tis apparent enough that the original Fomes of this Disease, is not lodg'd in the Hu­mours, yet it must be confess'd that the confusion [Page 50] of the Spirits produces putrid Humours in the Body, by reason the Function as well of these parts which are distended by the violent impulse of the Spirits, as of those which are depriv'd of them, are wholly perverted. And most of these being as it were separatory Organs designed for the reception of the impurities of the Blood, if their Functions are any way hurt, it can't be but a great many feculencies will be heap'd up, which had been eliminated, and so the Mass of Blood purified, if the Organs had perform'd their Office; which they had certainly done, if a due oeconomy of the Spirits had invigorated them all. To this cause I attribute great Cachexies, loss of Appe­tite, a Clorosis, and the White Fever in young Women, (which I don't at all doubt, is a Species of hysteric Diseases) and the source of all the mise­ries that overwhelm poor Women, that have Languish'd a long while under this Disease; all which proceed from putrifying Juices heapt up in the Blood, and flowing from thence upon the various Organs. Of this kind is a Dropsie of the Womb in Women, which have been long afflicted with this Disease, occasion'd by deprav'd Juices cast from the Blood upon the Organs, by which, their Faculties being perverted, they first become Barren, the oeconomy of the parts being wholly destroy'd, and then Serum and Sanies are generated, which don't only stuff the Eggs of the Testes, but also insinuating themselves into the Interstices of the Coats, cause them to grow very big, which is perceiv'd by the dissection of those that dye of this Disease: And the hysterical dis­position, is the prime cause of these and other [Page 51] Humours, though they are not of the same kind with it.

As in a quartan Ague, with which any one that's perfectly well may be seized, if he continues two or three days in Moorish and Fenny Places; first some Spirituous Venom of the Disease being im­printed upon the Blood, which continuing a long while, and at length the oeconomy of nature be­ing hurt, it infects all the Juices of the Body, and quite changes their Dispositions; so that the Sick (especially if he begins to grow old,) is ren­der'd obnoxious to Cachexies and other Distem­pers which come upon long Agues; yet these Agues are not to be cured by those Remedies that are proper to Purge off such Humours, but by such things as cure Agues by a Specifick quality.

From all that has been treated of, it's very manifest to me, that that's the chief indication in this Disease, which directs the corroboration of the Blood that is the Fountain and Origine of the Spirits; which being done, the invigo­rated Spirits can preserve that tenor that's a­greeable to the oeconomy of the whole Body, and the particular parts. And therefore when the Ataxy of the Spirits (which we have allow'd above may be) has vitiated the Humours by long continu­ance, 'twill be proper first to lessen those Hu­mours so corrupted, by Bleeding and Purging, if the Patient has sufficient strength, before we en­deavour to corroborate the Blood, and which indeed we can scarce do, whilst a feculent heap of Humours lies in the way. But forasmuch as Pains, Vomiting and Looseness are sometimes so [Page 52] very severe that they will not bear a truce so long until we have satisfied the first intention of fortifying the Blood, therefore sometimes we must begin the cure, by quieting the effects, (the cause being let alone a little while,) with some Anodine Medicine, and then we must endeavour to rectifie the Spirits, whose infirm Constitution is the cause of this Disease, by which we may again endeavour to cure such kind of Symptoms; and because experience teaches, that there are many stinking things that will repel the inordi­nation of the Spirits, and contain them in their Places, (which are therefore call'd Hystericks,) we must make use of them when we would an­swer such intentions.

According to what has been said, I order the Patient to be Blooded in the Arm, and that after she be Purg'd Three or Four Mornings follow­ing, the Patient thinks her self worse of those Days she is Blooded and Purg'd, for these Eva­cuations promote the Ataxy, which I take care to forewarn her of, that she may not despond, the Disease of it self being apt to incline her to do so; but however those vicious Humours we suppose are heap'd up by the long continuance of the Disease, are in some sort to be evacuated before we can conveniently answer the prime in­tention.

After these Evacuations, I prescribe some Cha­lybeat Remedy to be taken Thirty Days to com­fort the Blood, and so by consequence the Spi­rits that proceed from it; and nothing will more certainly answer your intention in this case, for it raises a volatile Ferment in the vapid and lan­guid [Page 53] Blood, by which the weak Spirits are rous'd that before were press'd down by their own weight: And this is very manifest, for as often as Steel is given in a Chlorosis, the Pulse are presently greater and quicker, and the out­ward parts grow warm, and the pale and dead Countenance is chang'd, and becomes fresh and lively. But here we must take notice, that Bleed­ing and Purging must not always be us'd before Chalybeats; for when the Patient is weak, and almost worn out by the long continuance of the Disease, they may and ought to be omitted; and you must begin with Steel, which must be well minded.

But in my opinion 'tis most conveniently gi­ven in substance, and as I have never observ'd nor heard, that so taken, it ever injur'd any Body, so I have been fully satisfied by frequent experience, that the bare substance performs the Cure sooner and better than any of the common Preparations of it, for busie Chymists make this as well as other excellent Medicines, worse ra­ther than better by their perverse and over of­ficious Diligence. I have also heard, (and if it be true, it much strengthens our Assertion,) that the crude Mine as 'tis digged out of the Earth, is more effectual in curing Diseases, than Iron that has pass'd the Fire, and been purified by Fusion, so the Author affirms, but I have not yet try'd whether it is so or not. This I certainly known, that no excellent and powerful Remedy has been any where made, which has not received its chief Virtues from Nature; upon which ac­count grateful Antiquity call'd excellent Medi­cines, [Page 54] God's Handicraft, not Mans. And that some excellent thing does produce wonderful ef­fects by its native goodness and efficacy, may be prov'd by Opium, or the Peruvian Bark. Nor is a Physicians skill so much perceiv'd by pre­paring Medicines, as by choosing such as are fit, which Nature has prepar'd with her own Fire, and freely bestow'd upon us; so that all that we have to do, is to reduce Medicines into that form, whereby either their substance, or their vertue and efficacy may be better imparted to our Bo­dies, for the performance whereof we are suffi­ciently instructed. Next to the substance of the Steel, I choose the Syrup of it, prepar'd with the Filings of Steel or Iron infus'd in the cold, in Rhenish Wine, 'till the Wine is sufficiently im­pregnated, and afterwards strain'd, and boyl'd up to the consistence of a Syrup, with a sufficient quantity of Sugar.

Nor do I use any Cathartick Medicine at set times during the whole Chalybeat course; for I am of the opinion, that the vertue of Steel is destroy'd by a Purge, both in Hysterical and Hy­pocondriacal Diseases; and when my chief de­design is to reduce the Spirits to order, and to renew and confirm their System, if I should use the gentlest Purge but once, I should undo all that I had done in a Week before, and by pul­ling down what I have built, and by building what I have pull'd down, I should trifle with my self and Patient too; and I believe Mineral Wa­ters which participate of an Iron Mine, are ren­der'd less effectual by this means; though I know that some have been cur'd when Purges have not [Page 55] been given only now and then; but daily with the Steel; which does not so much prove to me the Prudence of the Physician, as the extraordi­nary virtue of the Steel; for if they had been omitted, the cure would have been performed in a less time.

Nor indeed do I see what advantage, or ra­ther not what disadvantage Purges often repeat­ed may produce in many other Diseases besides that just mention'd▪ for though it can't be de­nied that they clear the Intestines of Impurities, and likewise that they somewhat discharge ill Humours that are lodg'd in the Mass of Blood, yet on the contrary, 'tis no less certain, that when they are frequently repeated in weak Bo­dies, especially in the tender age, they do much hurt, because upon this account a great many Humours are drawn to the Intestines, and being put off upon these parts, occasion praeternatural Ferments, whereby tumours arise in the Belly, increasing daily so much the more, by how much the oftener the Sick is Purg'd; and at length it happens that those parts by reason of weakness (being as it were overwhelm'd with a burden of Humours,) and by a defect of natural Heat soon become tabid and putrifie. And sometimes also the oeconomy of the Bowels being quite destroy'd by reason of the Causes mentioned, preternatural Kernels, a-kin to the Kings-Evil, and the like, grow to the Mesentery, and make way for Death. For these Reasons I judge 'tis safest in Children after general Evacuations, and those but very few, to direct the Curative Indication, so as to comfort the Blood and Bowels, which may be [Page 56] done with Spanish Wine alone, or with Corrobo­rating Herbs in it, if Morning and Evening some Spoonfuls of it, (according to the Age of the Sick) be given long enough. And because things outwardly apply'd can easily penetrate the tender Bodies of Infants, and so can throughly affect the Blood with their Virtue whatever it is, 'twill be convenient in Swellings of their Bellies, whe­ther occasion'd by the King's-Evil, or by the true Rickets, to use Liniments that are proper to corroborate the Blood and Bowels, and likewise to cure any Morbifick indisposition of them.

Take of the Leaves of Common-Wormwood, of the Lesser Centaury, of white Whorehound, of Ger­mander, of Ground-pine, of Meadow Saxifrage St. John's-wort, Golden Rod, Wild Thime, Mint, Sage, Rue, Carduus Benedict. Penny-royal, So­thernwood, Chamomel, Tansie, Lilly of the Val­lies, (of all fresh gather'd and cut) each Mi, of Lard lb iiij, of Sheep-Suet, and Claret-Wine, each lb ij; let them be steep'd in an Earthen Pot upon Hot Embers twelve Hours, and then let them boil till all the Moisture is consumed; afterwards strain them, and so make an Oint­ment, with which let the Belly be anointed Morn­ing and Evening for Thirty or Forty Days fol­lowing, and also both the Arm-pits.

But as to the Rickets, this must be noted, that in those tumours that afflicted the Bellies of In­fants heretofore after long Agues, not much un­like the true Rickets, Purges repeated seem'd to be indicated; for before the use of the Peruvian Bark, Agues continued a long while, and put off a Sediment, which was the cause of tumours of [Page 57] this kind, which could be carried off only by Purges repeated. But in the true Rickets, Ca­tharticks are not to be us'd above once or twice at the most, before the Patient enters upon the use of Alteratives; and all the time the parts are anointed, let him take inwardly of the Wine above mention'd; or if it may be, let him use for his ordinary Drink Beer, with the foresaid Herbs, or at least many of them put up with it in the Vessel. Lastly, this I have hinted ought to be carefully minded, for I am fully satisfied, that many Infants and Children have been destroy'd by Purges often repeated, which perhaps were given to asswage the Belly: But this by the by.

If any one object that the Filings of Steel may hurt those that take them by sticking in their Bowels, unless they are Purg'd now and then, I answer first, that I never found any such thing in any one, and then 'tis much more probable that being involv'd in the Slime, and with the Excrementitious Humours of the parts, they should all at length pass away with them, than when they are exagitated by Purging Medicines, which occasion unusual compressions, twisting and contraction of the Guts, whereby the Particles of Steel thrust upon the Coats of the Bowels may penetrate deeper into them.

When the Patient is in a Steel course, Reme­dies commonly call'd Hystericks are to be us'd as 'twere by the by, (to comfort the Blood and Animal Spirits,) in that manner and form which is most agreeable to the Patient; but if she can take them in a solid form, they will more power­fully [Page 58] retain the Spirits in their office and place, than things that are Liquid, that is, either De­coctions or Infusions, for the very substance af­fects the Stomach longer with its savour, and works more forceably upon the Body.

Upon the whole, being about to answer all the Indications which I have touch'd upon above, I us'd to prescribe these few and common things, which though they are not at all pompous, yet they most commonly do what I desire.

Let. ℥ viij of Blood be taken from the Right Arm.

Take of Galbanum dissolv'd in tincture of Castor, and strain'd ʒiij, Tacamahac ʒ ij, make an Emplaister to be apply'd to the Navel.

The next Morning let her enter upon the use of the following Pills.

Take of Pill Cocb. Maj. ℈ij, of Castor powder'd, gr. ij, of Peruvian Balsam gutt. iv, make Four Pills, let her take them at Five in the Morning, and Sleep after them; repeat them twice or thrice every Morning, or every other Morning, accor­ding to their operation, and the strength of the Patient.

Take of Black-Cherry-Water, of Rue Water, and compound Briony Water, each ℥iij, of Castor tied up in a Rag, and hang'd in the Glass ʒss, of fine Sugar, a sufficient quantity, make a Ju­lap, of which let her take Four or Five Spoon­fuls when she is faint, dropping into the first Dose if the Fit is violent gutt. xx of Spirit of Harts­horn.

After the Purging Pills just describ'd are taken, let her use the following.

[Page 59] Take of the Filings of Steel, gr. viij, with a suffi­cient quantity of extract of Wormwood, make Two Pills, let her take them early in the Morn­ing, and at Five in the Afternoon for Thirty Days, drinking upon them a draught of Worm­wood Wine.

Or for daily use,

Take of the Filings of Steel, and of extract of Wormwood, each ℥iiij, mingle them, and keep them for use, let her take gr. xv, or ℈i, made into Three Pills.

Or if she likes a Bolus better,

Take of Conserve of Roman Wormwood, and of the Conserve of the Yellow Rind of Oranges each ℥i, of Candied Angelica, and Nutmegs Candied, and Venice Treacle, each ℥ss, of Candied Ginger ʒij, make an Electuary with a sufficient quanti­ty of Syrup of Oranges. Take of this Electua­ry ʒiss, of the Filings of Steel well rubb'd, gr. viij, make a Bolus, with a sufficient quantity of Syrup of Oranges, to be taken in the Morn­ing, and at Five in the Evening, Drinking upon it a Draught of Wormwood Wine.

Take of choice Mirrh, and Galbanum each ʒiss, of Castor, gr▪ xv, with a sufficient quantity of Balsam of Peru; make Twelve Pills of every Dram, let her take Three every Night, and Drink upon them Three or Four Spoonfuls of Compound Briony Water, through the whole course of this process.

But if the Pills last prescrib'd move the Belly, which sometimes happens in Bodies that are very easily Purg'd, by reason of the Gum that's in them, the following are to be substituted.

[Page 60] Takt of Castor ʒi, of Volatile Salt of Amber ʒss with a sufficient quantity of extract of Rue, make xxiv small Pills, let her take Three every Night.

But here we must take notice, that Chaly beats in whatsoever form or Dose they are taken, oc­casion sometimes in Women great Disorders both of Body and Mind, and that not only on the first Days (which is usual almost in every Body,) but also all the time they are taken. In this case the use of Steel must not be interrupted at those times, but Laudanum must be given every Night for some time in some Hysterick Water, that they may better bear it.

But when the Symptoms are mild, and it seems that the business may be done without ta­king Steel, (namely when the Disease is small,) I think it sufficient to Bleed, and to Purge Three or Four times, and then to give the altering Hysterick Pills above mention'd Morning and E­vening for Ten Days, which Method seldom fails when the Disease is not violent; yea, the Pills alone, Bleeding and Purging being omitted, often­times do a great deal of good.

Yet we must take great notice, that some Wo­men by a certain ideosyncrasy do so abhor Hy­sterical Medicines, (which give ease in most of the Symptoms of this Disease,) that they don't only not receive Benefit, but are much injured thereby; therefore they must not be given to such, for Hipocrates says, 'tis in vain to do any thing contrary to Natures inclination.

Which ideosyncrasy indeed is so great and so frequent, that if we have not regard to it, the [Page 61] Lives of the Sick may be hazarded, and not on­ly by Hysterical Medicines, but by many other, whereof I will at present mention but one thing, viz. That some Women that have the Small-pox can't bear the use of Diacodium, for thereby Giddiness, Vomiting, and such Symptoms be­longing to Hysterical Diseases are occasioned, and yet Liquid Laudanum agrees with them very well. Which I observ'd whilst I was writing this, in a Young Woman a Person of Quality, to whom I had given the said Syrup on the Sixth and Seventh Night; the Symptoms above mention'd in­vaded both Nights; nor did the Inflamation of the Pustules duly proceed, but when afterwards she us'd Laudanum, she was quite freed from the said Symptoms▪ the Swelling of the Face and Pustules daily increasing, the anxiety and restless­ness of Body and Mind (which us'd to be as it were a Fit of the Small-pox,) was wholly re­moved as often as this Paregorick was given, the Patient being strengthen'd and reviv'd by it: But this by the by.

And so Hysterical Diseases are most common­ly cur'd, and most Obstructions of Women, but especially a Clorosis, or Virgins pale Colour, and also all Suppressions of the Courses. But if the Blood is so very feeble, and the confusion of the Spirits so great, that Steel order'd to be us'd ac­cording to the Method prescrib'd is not sufficient to cure the Disease, the Patient must Drink some Mineral Waters, impregnated with the Iron Mine, such as are Tunbridge, and some others lately found out, for the Chalybeat virtue of these is better mingled with the Blood, by reason of the [Page 62] great quantity that's taken of them, and also be­cause they are more agreeable to Nature, and they cure Diseases more effectually than Iron, how much soever exalted by art, as imprudent Chymists talk.

But this is more especially to be observ'd in Drinking of them, that if any Sickness happens that is to be referr'd to Hysterical Symptoms, in this case the Patient must forbear drinking them a day or two, 'till that Symptom that hinder'd their passage is quite gone. For though these Waters are less apt to stir the Humours, and so to cause a Confusion of the Spirits, than the gentlest Catharticks of the Shops, yet they do somewhat exagitate them as they are diuretick, though they often also purge by Stool too. But if the Waters themselves hinder their own Passage by disturbing the Humours and Spirits, let those consider how impertinently they act, who order Purging Medicines to be given once or twice a Week, whilst the Patient is Drinking these Wa­ters; or which is yet more foolish, to be mix'd with the Waters, by which means these and o­ther Mineral Waters pass more difficulty.

And here I must acquaint you, that though some think the Iron is in these Waters in princi­piis solutis, (which is plainly the same as if we should suppose Liquid Iron,) yet I don't at all doubt but that they are Simple Waters, impreg­nated with the Mine through which they pass, which will be manifest to any one, if he pour some Gallons of Water upon a sufficient quantity of Rusty Nails, for then he will perceive that this Water, when the Powder of Gauls, or the Leaves [Page 63] of Tea, or the like are put into it, will plainly appear of the same colour with the Waters of a Mineral Fountain, when such things are put in­to them. Nor truly have these artificial or in­artificial Waters (which you please to call them,) when they are taken, different effects, if they are us'd in Summer-time, and in a good Air.

But however it is, if the Disease by reason of its obstinacy does not yield to Steel Waters, the Patient must go to some hot Sulphureous Waters, such as is our Bath, and when he has us'd them inwardly Three Mornings following, the next Day let him go into the Bath, and the Day fol­lowing let him Drink them again, and so let him do by turns for Two whole Months. For in these and in others of what kind soever they are, this must be carefully noted, that the Pa­tient must persist in the use of them, not only till he receives some benefit, but till he is quite well, that the Symptoms may not return again in a short time.

Venice Treacle alone, if it is used often, and a long while, is a great Remedy in this Disease, and not only in this, but in very many other Diseases that proceed from want of Heat and Concoction or Digestion; 'tis perhaps the most powerful that has been hitherto known, how contemptible soever it may seem to most People, because 'tis common, and has been known a long while.

Spanish Wine Medicated with Gentian, Ange­lica, Wormwood, Centaury, the Yellow Rind of Oranges, and other Corroboratives infus'd in it, [Page 64] does a great deal of good, some Spoonfuls of it being taken Thrice a Day, if the Woman be not of a thin and Cholerick habit of Body. And truly a large Draught of Spanish Wine by it self taken at Bed-time for some Nights, by my advice has been very beneficial to some Hysterical Wo­men, for by it the habit of the whole Body was render'd stronger, and they who before were Cachectical, became fresh colour'd and brisk.

Moreover sometimes we find that the Peruvian Bark wonderfully comforts and invigorates the Blood and Spirits, whereof a Scruple taken Morning and Evening for some Weeks, has as I have observ'd restored (both to Hypocondriacal Men, and Hysterical Women that have been ve­ry Sick a long while, and when the oeconomy of their Bodies has been much weaken'd,) a firm and Healthy Constitution. But it succeeds best in that kind of Hysterick Diseases, in which Women are affected with Convulsions, wherein they struggle violently and beyond the strength of Women, and at the same time beat their Breasts. Yet it must be confess'd that this Medicine does not so certainly, and so often cure this Disease as A­gues. But though (to mention this by the by,) the Peruvian Bark does wonders in the cure of Agues, and though we use it freely our selves, and give it to our Wives and Children, as often as there's occasion, yet there are some now as much displeas'd with it, because it cures so cer­tainly and suddenly as they were heretofore, be­cause it was but lately known among us; to which fate the best Men, and most excellent Remedies have been almost always expos'd. But by this [Page 65] we may try as by a Touch-stone our Dispositions, and from thence judge whether we are good or ill Men, namely, according to the degree of our joy or grief, as often as the welfare of Mankind is promoted by some common benefit, or the Blessing of God.

But if any of the Remedies above mention'd don't well agree, which often happens in Chole­rick and thin Constitutions, then a Milk Diet may be us'd; for some Women (which one would wonder at at first) that have conflicted a long while with Hysterick Diseases, and even such as have frustrated all the endeavours of Physicians, yet have recover'd by Dieting themselves for some time only with Milk, and especially those that labour with that Disease I call an Hysterick Colick, which can't be appeas'd by any thing but Narcoticks, to which repeated by intervals, these Women are much accustom'd, the Pain returning as soon as the Vertue of the Anodine fades; but this is chiefly to be admir'd in this Method of cure, that Milk which yields only a cold and crude nourishment, should notwithstanding by use strengthen and invigorate the Spirits; and yet this will not seem disagreeable to reason, if you consider that Milk affording only a simple nou­rishment, does not busie nature much in concoct­ing it, otherwise than Meats and Liquors more compounded use to do, and that an equal tem­per of the Blood and Spirits necessarily follows that perfect Concoction. For this must be also consider'd, that a bare debility of the Spirits consider'd by it self, is not the cause of those Confusions they are under, but the weakness of [Page 66] them compair'd with the state of the Blood. For it may be an Infant has Spirits strong and firm enough with respect to it's Blood, but yet not proportionable to the Blood of a grown Person. Now when by the continual use of a Milk Diet, (tho' 'tis crude and weak) the Blood is render'd more soft and tender, if the Spirits that are made by it, are only equal to it, all's well. Yet all can't undergo those Inconveniencies which most com­monly accompany it the first days, namely, be­cause it curdles in the Stomach, and is insufficient to maintain the usual strength of the Body; but if they cou'd, they might receive benefit by it.

But nothing of all I have hitherto known, does so much comfort and strengthen the Blood and Spirits, as riding much a Horse Back every day for a long while; for seeing by this kind of Exer­cise the lower Belly is most forceably mov'd, in which the Vessels for excretion (as many as are appointed by Nature to drain the Impurities of the Blood) are plac'd: What disorder of the Functions or other natural Impotence of the Or­gans, can be imagin'd so great as not to be helpt by the frequent jolting of the Horse, and that too in the open Air? Whose innate heat is so ex­tinguish'd that it can't be stir'd up by this motion and ferment afresh? Or what preter-natural Sub­stance or deprav'd Juice can there be in any Creek of these parts, which can't by this Exercise of the Body, be either reduced to such a condition as is agreeable to Nature, or scatter'd every way and ejected? Moreover, the Blood being perpetually exagitated by this motion, and throughly mix'd, is as it were renew'd, and grows vigorous again. [Page 67] And indeed, this method, tho 'tis inconvenient for Women that are accustom'd to a slothful and de­licate way of living, for they may be injured by motion, especially at the beginning; yet is it very proper for Men, and soonest recovers their Health. One of our Reverend Bishops, famous for Prudence and Learning, having studyed too hard a long while, fell at length into an hypochondriacal Disease, which afflicting him a long time, vitiated all the ferments of the Body, and wholly subvert­ed the Concoctions. He had pass'd through long courses of Steel more than once, and had try'd almost all mineral Waters, with purging often repeated, and Antiscorbuticks of all kinds, and very many testaceous Powders, which are rec­kon'd proper to sweeten the Blood: And so being in a manner worn out, partly by the Disease, and partly by Physick us'd continually for so many years, he was at length seiz'd with a colliquative Loosness, which is wont to be the forerunner of Death, in Consumptions and other Cronical Diseases▪ when the Digestions are wholly destroy'd. At length he consulted me. I presently consider'd that there was no more room for Medicine, he having taken so many already, without any relief; for which reason I perswaded him to ride a Horse-Back, and that first he shou'd take such a small Journy as was agreeable to his weak condition: Had he not been a very judicious man, and one that weighed things well, he wou'd not have been perswaded so much as to try such a kind of Ex­ercise. I intreated him to persist in it daily, till in his own opinion he was well, going daily fur­ther and further, till at length he went so many [Page 68] Miles, as prudent and moderate Travellers, that go a large Journy upon business, use to do, with­out any regard to Meat or Drink, or the Weather; but that he shou'd take every thing like a Tra­veller as it happens. To be short, he continued this method, increasing his Journies by degrees, till at length he rode Twenty or Thirty Miles daily; and when he found himself much better in a few days, being incourag'd by such wonderful Success, he continued this course a pretty many Months, in which time, as he told me, he rode many Thousand Miles, till at length, he did not only recover, but also gain'd a strong and brisk habit of Body.

Nor is this kind of Exercise more beneficial to hypochondriacal People, than 'tis to those that are in a Consumption; whereof some of my Rela­tions have been cur'd by riding long Journies by my advice; for I knew I cou'd not cure them bet­ter by Medicines of what value soever, or by any other method.

Nor is this Remedy proper only in small Indis­positions, accompanied with a frequent Cough and Leanness, but in Consumptions that are almost deplorable; when the Diarrhaea above mention'd, accompanies the Night Sweats, which is wont to be the forerunner of Death, in those that dye of a Consumption. In a word, how deadly soever a Consumption is, and is said to be, two Thirds dying of it, which are spoil'd by Chronical Diseases: Yet I sincerely affirm, That Mercury in the French Pox, and the Peruvian Bark in Agues, are not more effectual than the Exercise above menti­on'd, in curing a Consumption, if the Sick takes [Page 69] care that his Sheets are well air'd, and that his Journies are long enough. But this must be noted, that those that have pass'd the Flower of their Age, must use this Exercise much longer than those that have not yet arriv'd to it. And this I have learn'd by much Experience, which scarce ever fails me. And tho' riding on Horse-Back is chiefly beneficial to consumptive People, yet riding Journies in a Coach, does sometimes a great deal of good.

But to return to the business in hand, this is the general way of cure in this Disease, which is apply'd to the original cause, viz. the weak cra­sis of the Blood, and so is to be us'd only when the Fit is off; therefore as often as the Fit invades, join'd with any one of the foresaid Symptoms, if the Disease be such, or so great a one, that 'twill not bear a truce, 'till it may be cured by Medicines that corroborate the Blood and Spirits, we must presently make use of hysterick Remedies, which by their strong and offensive Smell, recall the ex­orbitant and deserting Spirits to their proper Sta­tions, whether they are taken inwardly, or smelt to, or outwardly apply'd; such are Assafaetida, Galbanum, Castor, Spirit of Sal Armonicack: And last­ly, whatever has a very ungrateful and offensive Smell.

And in truth, whatever stinks is proper for this intention, whether 'tis naturally ill sented, or made so by Art; and unless I am deceiv'd, Spi­rits of Harts-horn▪ of human Blood, of Urine, and of Bones, and the like; take their chief Ver­tues from the force of the Fire, in their prepara­tion contracting an ill sented empyreuma, which is [Page 70] intimately join'd with their Essence, which is likewise in the Fumes arising from Feathers, and such kind of parts of Animals, when they are burnt. For this is common to the Substances of all Animals, viz. to emit a stinking Fume while they are burning; and if 'tis forc'd by Fire, and receiv'd in Glasses, when 'tis condens'd, it becomes those Liquors call'd Volatile Spirits, which assume Faculties that were not primitively in their Sub­jects; and are indeed, only Creatures of Fire, and their Vertues are really all the same, from whatso­ever Substance (so it is animal) they are extracted.

In the next place we must take notice, That if some intolerable pain accompanies the Paroxysm, in whatever part it is, or violent Vomiting, or a Diarrhaea; then besides the hystericks above men­tion'd, Laudanum must be us'd, which only is a­ble to restrain these Symptoms.

But in quieting these pains which vomiting oc­casions, we must take great care that they are not mitigated either by Laudanum or any other Pare­gorick, before due Evacuations have been made, unless they almost exceed all human Patience. First, because sometimes there is so great a quan­tity of Blood and Humours heapt up, (especially in sanguine Women and Men of a proper habit) that 'tis able to withstand the Operation of the most effectual Narcotic, tho' it be often repeated: And therefore in such, Blood must necessarily be evacuated from the Veins of the Arm, and a Purge must be given before we come to use Laudanum. For when these things are duly perform'd, that which before given in a large Dose wou'd do no good, will now perform the business in a moderate [Page 71] Dose. And then because I have found by fre­quent Experience, that when the Sick has been accustom'd by little and little to Laudanum, and has not been duly evacuated before, she was forc'd by reason of the return of the pain, present­ly after the Vertue of the Medicine vanish'd, to take a Paregorick again; and so daily for some years, the Dose being sometimes by degrees in­creas'd, so that at last they can by no means ab­stain from Laudanum, tho' thereby all the Di­gestions are vitiated, and the natural Functions weakned. Tho' I don't think that the use of Laudanum does immediately hurt the Brain or Nerves, or the animal Faculties. Therefore I judge, and I speak what I have found, that Evacu­ation ought to go before Anodynes, viz. in Vi­rago's, and in Women that abound with Blood, a Vein must be open'd, and the Body purg'd; espe­cially if they have been lately seized with the Fit. But if the weak Women and those of a quite con­trary Constitution, labour with such a Fit and Pain, and have been not long ago afflicted with it, 'twill be sufficient to cleanse their Stomachs with a Gallon of Posset-drink, more or less, taken in and ejected by Vomit; and then to give a large Dose of Venice Treacle, or of the Orvietan Electuary, and a few Spoonfuls of some Spirituous Liquor, that is pleasing to the Taste; with a few Drops of Liquid Laudanum▪ to be taken presently after it.

But if the Sick has vomited a great while before the Physician was call'd, and there is danger, lest by a further Provocation by Emeticks, the Spirits shou'd be put in a rage, and the Sick too much [Page 72] weaken'd; In this case you must give Laudanum without delay, and such a Dose as is not only e­qual to the violence and duration of the Symp­tom, but such a one as is sufficient to vanquish it.

But here two things are to be chiefly noted. First, that when you have once begun to use Laudanum after due and necessary Evacuations, it must be taken in that Dose, and often repeat­ed, till the Symptom is quite conquer'd; only such a space must be betwixt each Dose, that we may know what the former has done, before we give another. And then when we treat the Dis­ease with Laudanum, we must do nothing else, and nothing must be evacuated; for the gentlest Glyster of Milk and Sugar, is sufficient to spoyl whatever has been repair'd by the Paregoric, and to occasion the return of the vomiting and pain.

But tho' the pains above mention'd, as we have said, are apt to overcome the Vertue of the Ano­dyne, yet violent Vomiting indicates the largest Dose of it, and that it shou'd be very often re­peated; for by the inverted peristaltick motion of the Stomach, (by which that which is contain'd in it, ought to be carried downwards) the Pare­gorick is ejected through the oesophagus, before it can do any good, unless after every time the Sick vomits, the Narcotick be given afresh, and chiefly in a solid form; or if it be given in a Li­quor, the Vehicle must be so small, as that it may but just wet the Stomach, so that by reason of the small quantity of the matter, it can't be cast up; for instance, some drops in one Spoonful of strong [Page 73] Cinamon Water, or the like; and the Sick must be admonish'd to keep her self quiet, presently after taking the Laudanum; and that she keep her Head as much as is possible immoveable, for the smallest motion of the Head, provokes vomit­ing more than any thing else, and then the Me­dicine just taken, is ejected. Yet when the vomit­ing ceases, and is as 'twere tam'd, 'tis expedient to give an Anodyne Morning and Evening for a few days, to prevent a Relaps; which also ought to be observ'd after a Diarrhaea, or an hysterick pain taken off by a Narcotick. And so at length by this method, we may readily cure the symptoma­tick pain and vomiting, whereby, because they are very often, like other Diseases, Physicians are easier impos'd upon, than by any other Symptoms whatever, that require their help; concerning which, I will add a few things, for instance: In that kind of hysterick Disease now describ'd, which resembles a nephritick pain, is not the great Parity and Similitude of both Diseases, apparent to any one, both because the pain in both is in the same part, and also for that the Woman vomits in both Diseases? And yet they proceed from causes differing from one another; and the methods for the cure of them so unlike, that that which does good in this, is injurious in the other, and so on the contrary. For whether a Stone or Gravel, fretting upon the Substance of the Reins, occasions Pain, and by consent of Parts, vomiting, nothing is so beneficial, as very large and frequent revulsion of the antecedent cause by Phlebotomy, and Dilatation and Laxation of the Passages, by which the Stone is to be excluded, [Page 74] by emollient Clysters very often repeated, and inward Remedies of the same kind, to which are to be added Linthontriptick and Diuretic Medi­cines. Now if the said Symptoms do no way a­rise from the Stone, but from the animal Spirits rushing impetuously in a great quantity upon the Reins, (in which case, Paregoricks are only in­dicated; nor is the gentlest Clyster injected after the first Evacuations, without danger) in what great danger the unhappy Woman is put into, whose Life is so triffl'd with, I need not say. The same may be affirm'd of that hysteric Disease, which resembles the Bilious Colick, or the Iliack Passion, when 'tis taken for granted, that that Disease, (tho' of a quite different, yea contrary nature) is the Bilious Colick, and proceeds from a sharp Humour cast upon the Bowels, through the Mouths of the mesenterick Arteries; (into which Error the intollerable Pain and the green colour of the Matter expell'd by Vomit and Stool, easily seduces the unwary and unthinking Physician) what method is so proper, as that whereby we endeavour to attemperate the Acrimony of the Humours, by the help of cooling and incrassating Medicines? And what is fitter than Catharticks frequently given, besides Clysters daily injected to exterminate the Humous from the Guts, espe­cially Mercurius dulcis mixt with diagrydiate Medicines, to eradicate perfectly the morbific Matter? But 'tis plain to every one, how ill the Patient wou'd be treated, and in what great Dan­ger he wou'd be, whilst we shou'd insist upon this method, if the Disease which is supps'd to be a bi­lious Colick, shou'd really prove an hysterick or [Page 75] hypocondriacal Symptom, when Experience open­ly proclaims, that after the first general Evacua­tions (which are appointed to remove the Rubbish of the putrifying Humours, which the Ataxy has occasion'd, whereby the Vertue of the Anodyne may be obstructed) nothing remains to be done, besides the quieting the tumultuous Spirits, till the Symptom goes off, and afterwards 'twill be seasonable to give Chalybeats, or any other Re­medy, if there be any that by kindling and invi­gorating the Blood, may eradicate the Disease. 'Tis not my business to reckon up those great Calamities which I have known befal Women, when this hysterick Colick has been suppos'd to pro­ceed from Choler, notwithstanding I affirm, that Evacuations often repeated, which are indeed indicated in the Bilious Colick, have been so far from lessening the Pain and Vomiting, that they have ir­ritated them more, by promoting the Disturbance of the Spirits, which is the true cause of these Symptoms. And at length the Disease being prolong'd for some Months, ends in Convulsions, there being a suddain Translation to the Brain, whereby the Sick is soon destroy'd; and especi­ally when after other Evacuations repeated a long time, by reason of the green colour of those things that are vomited up, a Vomit is given. In a word, if I have learnt any thing by Obser­vation, I judge we must chiefly take care, that those Symptoms familiar to hysterick Women, be not suppos'd by a Mistake in the Diagnostick, to proceed from other Diseases, which they oft­en resemble.

And here I must acquaint you, that besides the [Page 76] Errors before mention'd, whereby Women obnox­ious to hysterick Diseases, are put in danger of their Lives; very many moreover, suffer by these Diseases, by an Error no less fatal, at a time wherein, tho' this Disease is not of its own nature deadly, yet by reason of the Disasters that come upon it ▪and follow'd it, 'tis Destructive to ma­ny: For instance, a Woman of a tender and in­firm habit of Body, brings forth a Child, and all succeeds well, and according to Nature. The Midwife, whether Rude and Unskilful, or Vain­glorious, to shew how well she has perform'd her business, advises that her Woman shou'd rise a few days after she has been brought to Bed, and that she shou'd keep up a while; the Woman does so, and is presently seiz'd upon the first motion of her Body, with an hysterick Indisposition, and according as the Disease increases, the Lo­chia are first lessen'd, then they quite stop, whose Suppression, a long Series of untimely Symptoms follow; which soon destroys the Sick, unless great Diligence and Skilfulness interceed. And sometimes they are seiz'd with a Phrensie on this account, which growing daily worse and worse, occasions Convulsions first, and then Death. But if they escape Death, they are maddish, and sometimes continue so as long as they live. Sometimes after the Suppression of the Lochia, they fall into a Fever, which either turns to that which is then epidemical, or depends only on that beginning. Moreover, the same hysterick Symp­toms which were first occasion'd by the Suppression of the Lochia, rage more now, as if afterwards they proceeded from it. I thought long ago, that [Page 77] of those Women that dye in Child-bed, scarce one in ten, to speak within bounds, dies, because she has not strength necessary for Delivery, or from the pains that accompany difficult Labour, but chiefly by reason they rise too soon, Hysterical Fits being occasioned by that motion, whereby when the Lochia are stopt, a numerous train of dreadful Symptoms follows▪ Wherefore they that are advised by me, keep in Bed at least till the Tenth Day, if they are of a▪ weakly Constitu­tion, especially if they have been long since troubled with Vapours. For besides that, the Rest which they have in Bed, frees them from those Dangers we have so often mentioned; the warmth of the Bed not interrupted, likewise refreshes the Spirits weakned and exhausted by the pains in Labour, and by the Evacuations usual in this case, and recruits Nature, and digests and removes all those Crudities which are heapt up during the time of Child-bearing.

But if by reason of this error committed, any one of the said Symptoms supervenes, the cura­tive Indications are to be directed so, that the Spirits disquieted by this motion should be ap­peas'd, and that the Lochia should flow again, for as much as the suppression of them is the next and immediate cause of these Symptoms. But we must not obstinately insist upon this method, but having given a while those Remedies that are wont to be used with success in this case, if they don't answer according to our desires, we must leave them off; for as strong things must not be us'd, so neither ought we to persevere in the use of gentler, by reason Women in Child-bed [Page 78] so affected, are much weaken'd, and their strength almost worn out. For instance, when it first appears that the Lochia are stopt, 'tis conve­nient to put the Woman presently to Bed, and then to apply an Hysterick Plaister to the Navel, and to order this Electuary following to be taken forthwith.

Take of the Conserve of Roman Wormwood, and of Rue each ℥i, of the Trochisc. of Mirrh ʒij, of Castor, English Saffron, of Volatile Salt of Sal Armoniac, and of Assa Faetida, each ʒss, make an Electuary with a sufficient quantity of the Syrup of the five opening Roots; let her take the quantity of a large Nutmeg every third Hour, drinking upon it Four or Five Spoonfuls of the following Julap.

Take of Rue Water, compound Briony Water, each ℥iij, of Sugar Candy, s. q. mingle them, make a Ju­lap.

And if these things are given as soon as the suppression begins, the Disease is most commonly conquer'd, but if having continued the use of the said Remedies, till the whole quantity is taken, in this case we must try Laudanum once. Here Laudanum though of its own nature 'tis astrin­gent, yet by quieting the disturbance of the Spi­rits whereby the usual Evacuation of the Lochia is interrupted, does sometimes much good, and when Emmenagogs do no good, it may recall the Flux of the Lochia; but Narcoticks are most con­veniently given with Hystericks and Emmenagogs. For instance, Fourteen Drops of Liquid Laudanum in Compound Briony Water, or one Grain and a half of Solid Laudanum made into Two Pills, with half ae [Page 79] Scruple of Assa Faetida▪ But we must be sure to take notice, that if we don't hit the Mark at once, if the Lochia don't follow, we must by no means repeat the Opium, as is usual in other cases, and ought to be: For if here the Paregorick is re­peated, 'twill so powerfully stop the Lochia, that afterwards they can by no means be provok'd; for truly if this dont succeed (some time being pass'd that we may know what it has perform'd,) we must return to the use of Emmenagogs, mixt with Hystericks, and then inject a Clyster of Milk and Sugar; and what was said above of Opium▪ holds good likewise here of Clysters, for unless the first injected bring the Lochia, nothing is to be expected from more, one being sufficient, by turning the Humour gently, to cause the Lochia to flow, but more may divert them another way. These things being perform'd (which are to be touch'd upon lightly,) 'tis most safe and the duty of a prudent Physician, to wait and see what time will do, for every Day the business of the Cure is more and more removed from Danger, and if the Sick live beyond the Twentieth Day, she's in a manner out of danger. For when the Woman has been recruited a little, and gain'd some Strength, in a long Disease whatever 'tis, she will be able to bear that Remedy which is fittest for the cure of that Disease, which was occasion'd by a suppression of the Lochia; where­as Medicines cram'd in obstinately, the first do­ing no good, may increase the Disease, and also the disturbance of the Spirits from whence the Disease arises, which must be carefully no­ted.

[Page 80] Lately a Vertuous Matron of good Parentage sent for me, she upon the foremention'd occasion, presently after she was brought to Bed, was seiz'd with Hysterick Fits, and the Lochia stop'd. I en­deavour'd by the Medicines aforesaid to provoke them, but in vain, the violence of the Hysterick Disease being too powerful for the Medicines; and at length when I perceiv'd she would be well if I did nothing, I committed all to time, by much the best and most successful Physician; and according to my Opinion things went well with her to the Fourteenth Day: Visiting her daily, I found she was no day worse than she was the Day before. After this the Women that had attend­ed upon her, whom I had hitherto kept from do­ing mischief by their over-officiousness, enforc'd the Husband to have a Vein opened instantly in his Wives Foot, which being done, the Hy­sterick Fits so far prevailed, that within a few Hours she was seiz'd with Convulsions, and soon after by Death, that ends all our Mise­ries.

And if it be lawful to speak what I think, I have been a long time of the Opinion, that I have well perform'd the Duty of an Honest Man and good Physician, (not only in the said Disea­ses of Women in Child-bed, but also in all o­ther Acute Diseases, when I can't certainly pro­mise that a Cure will follow this or that method I please to use), as often as I do nothing, when vi­siting the Patient, I find he is not worse this day, than he was the Day before, and when I can con­jecture he will not be worse to Morrow than he is to day; whereas if I proceed in curing the Sick [Page 81] with a method, the efficacy whereof I don't yet know, he will be in danger both upon the ac­count of the Experiment I am about to make upon him, and also by the Disease, nor will he as easily evade two Dangers as one. For though at present there is no manifest sign of his beginning to be well, yet 'tis most certain that according to the nature of Acute Diseases, no one can al­ways labour with them. And besides every Day will more and more secure the Patient, or yield an occasion to the Physician, whereby he may more opportunely and certainly vanquish the Di­sease, than he could before. Which as it may be truly affirm'd of most Disease, so especially of the Diseases of Child-bed Women, wherein the least error may prove fatal, and in which we are so little able to govern that natural Evacua­tion, the suppression whereof occasions the Di­seases we have been treating of.

But forasmuch as Hysterical Diseases dont al­ways owe their Original to the prime cause, namely the native debility of the Spirits, but sometimes to an adventitious weakness; there­fore I design before I make an end, to discourse of this sort of cause, which most commonly is the occasion of Vapours as they are call'd; and 'tis an immoderate Flux of the Courses either in Child-Bed, or at other times as to the first kind, that comes and is very troublesom the first Days after hard Labour, accompanied with a nume­rous train of Hysterical Symptoms; and as it only comes, and is troublesom on these first Days, so it soon goes away, for a Diet that is somewhat thickening, easily drives it away, [Page 82] for which also the following Drink may be u­sed.

Take of Plantain Water and Red Wine, each thi, boil them together, till a third part is Consumed; then sweeten it with a s. q. of White Sugar, whereof when 'tis cold, give half a Pint twice or thrice a day; in the mean while some very gentle Hysterick Julap may be taken now and then, and the following Nodulus may be held to the Nose. Take of Galbanum, and Assa faetida, each ʒij, Castor ʒiss, of Volatile Salt of Amber ʒss, mingle them and make a Nodulus. Or, take ʒij of Spirit of Sal Armoniac, to which let her smell often.

But as to the Flux, when Women are not in Child-bed, though that is wont to happen at any time, yet most commonly it comes a little before the time the Courses are about to leave them, namely about the Age of Forty Five if they flow early, but about Fifty, if they come somewhat later; from these as is said a little before they quite go away, (like a Candle burnt to the Socket, which gives the greatest Light just as 'tis about to go out,) they flow impetuously, and cast the poor Women into almost continual Hysterick Fits, by reason of the great quantity of Blood which is continually evacuated. Now though in this case, Hystericks both inward and outward must be us'd by the by (avoiding those that are strong, lest they should promote the Flux) yet the chief intention must be to stop the Courses, which may be soon done after this manner.

Let ℥ viij of Blood be drawn from the Arm, the next Morning give the common Purgative Potion, which must be repeated every Third Day [Page 83] for Twice, and every Night at Bed time through the whole Course, let her take a Paregorick made with one Ounce of Diacodium.

Take of Conserve of Dry'd Roses ℥ij, of Tro­chisc, of Terra Lemnia ʒiss, of Pomegranate Peel, and Red Coral, each ℈ij, of Lapis Hae­matitis and Dragons Blood, and Bole Armenic, each ℈i, make an Electuary with a sufficient quantity of Simple Syrup of Coral, whereof let her take the quantity of a large Nutmeg in the Morning, and at Five in the Afternoon, Drink­ing upon it Six Spoonfuls of the following Ju­lap.

Take of the Water of Oak Buds and Plantain, each ℥iij, of Cinamon Water hor deated, and of Sy­rup of dry'd Roses, each ℥i, of Spirit of Vi­triol a sufficient quantity to make a pleasant A­cid.

Take of the Leaves of Plantain, and Nettles, each a sufficient quantity, beat them together in a Marble Mortar, and press out the Juice; then clarifie it; let her take Six Spoonfuls cold three or Four times a day. After the first Purge, ap­ply the following Plaister to the region of the Loins.

Take of Diapalma, and of the Plaister ad her­niam, each equal parts, mingle them, and spread upon Leather.

A cooling and thickening Diet must be order'd, only 'twill be proper to indulge the Sick a small draught of Claret Wine, once or twice a day, whch though 'tis somewhat inconvenient, because its apt to raise the Ebullition, yet it may be al­low'd to repair the Strength. And as indeed [Page 84] this Method is very beneficial to Women thus af­fected, so is it also as useful for those that are in danger of Abortion, only the Purges and Juices must be omitted.

There is another cause, though 'tis not so fre­quent of Hysterical Diseases, viz. a falling of the Womb by reason of a hard labour, its accompanied with a large train of this kind of Diseases, yet is it soon and easily cur'd this way.

Take of Oak Bark ℥ii, boyl it in lbiiij of Foun­tain Water to lbij, add at latter end ℥i of Pomegranate Peel bruis'd, Red Roses, Granate Flowers, each Mij; and then add lbss of Red Wine, strain it, bath the parts affected with Flannel Cloaths dipt in it, in the Morning Two Hours before the Woman rises▪ and at Night when she's in Bed; continue the use of it till the Symptom is quite gone. But enough of these things.

And now worthy Sir, I have mention'd the chief of what has been hitherto observ'd in the History and Cure of this Disease, and have no­thing else to do but to beg your Pardon, if I have err'd in describing these things not so ac­curately as I ought to have done, and also to desire you to accept favourably of this small Treatise, which was designedly written to return you thanks for your approbation of my other Works: And indeed I have so seldom receiv'd any thing of this nature, that either▪ I have de­serv'd no such thing, or else those candid and ingenious Men which Nature has fram'd with such excellency of Mind, as to know how to be grate­ful, [Page 85] are very few, scarce so many as the Gates of Thebes, or Entries of Wealthy Nile. Yet not­withstanding I endeavour all I can, and will do so, to learn and promote the method of curing Diseases, and to instruct those that are less con­versant in practice than my self, let other People have what Opinion of me they please. For ha­ving nicely weigh'd whether 'tis better to be beneficial to Men, or to be praised by them, I find the first preponderates, and much conduces to the tranquillity of Mind. But as for fame and popular applause, they are lighter than a Feather or a Bubble, and more vain than the shadow of a Dream. But if any one thinks that Riches got by such a Reputation have something more of weight in them, let them injoy what they have scrap'd together with all my Heart, but let them remember that some Mechanicks of the most for­did Trades, get and leave more to their Chil­dren, yet do they not exceed the Beasts in this, who take as much care as they can of them­selves and theirs▪ and if we except things honest, proceeding from the judgment of the Mind and Vertue (whereof the Nature of Beasts is not ca­pable,) the▪ Beasts are plainly as good as these and all others who don't endeavour to do all the good they can in their Generation.

WIthout doubt Men will think, that either the nature of the Disease we now treat of is almost incomprehensible, or that I who have been vex'd with it Thirty Four Years, am a ve­ry dull Fellow, seeing my Observations about the Disease, and the cure of it▪ do little answer their Expectation. But however it be, I will faithfully deliver those things I have hitherto learnt, the diffi­culties and intricacy, respecting either the account of the Disease, or the Method of Cure, leaving them to be clear'd and made plain by time the guide of truth.

The Gout chiefly seizes those Old Men, who after they have lived the best part of their Lives tenderly and delicately, indulging themselves freely with splendid Banquets, Wine, and other Spirituous Liquors; and at length having by rea­son of the Sloath that always accompanies Old Age, wholly omitted those Exercises of Body which Young Men are accustom'd to. Moreover they who are obnoxious to this Disease, have large Skulls, and are most commonly of a Gross habit of Body, Moist and Laxe, and of a Lusty and Luxuriant Constitution, the best and richest Foun­dation for Life.

Not that the Gout only seizes those that are Corpulent, for sometimes also though seldomer, [Page 87] it invades thin People; nor does it wait always till they are old, for sometimes it seizes those that are in the flower of their Age, when they have receiv'd the unhappy Seeds of the Disease from their Parents, as it were ex traduce; or if this be not the cause, they have too early us'd Venery, or have quite forsook violent Exercises that they us'd formerly; moreover they have great Stomachs, and have drank Spirituous Li­quors immoderately, and afterwards they have suddenly betook themselves to thin and cooling Liquors.

When it first seizes any one when he is very old, it never afterwards has such exact Periods, nor rages so violently, as when it falls upon a younger Man, both because he dies most com­monly before the Disease accompanied with its natural Symptoms can come to its heighth, and also because the native heat and vigour of the Body being lessen'd, it can't be so constantly and violently shot off upon the Joints. But if it seizes any one earlier, though it does not yet fix upon one part, nor handle him so roughly, but comes with uncertain periods upon occasion given, pain­ing him lightly for a few Days, coming and go­ing without any Method, yet by degrees it for­mally besieges the Man, and proceeds regularly, both as to the time 'twill come at, and as to the continuance of the Fit, and moreover assaults him more violently than at first.

I will first Discourse of this Disease as it pro­ceeds regularly, and afterwards of its anomalous and uncertain Phaenomena, when being put out of its course, either by a praeposterous use of▪ im­proper [Page 86] [...] [Page 87] [...] [Page 88] Medicines, or by the weakness of the Subject, it can't attain to its proper and genuine Symptoms. Therefore when the Gout is regu­lar, it seizes the Patient most commonly after this manner, about the latter end of January, or the beginning of February, it comes suddenly, and for the most part without giving any notice, ex­cept that the Patient has been troubled with in­digestion and crudities of the Stomach some Weeks before; moreover the Body is oppress'd and puff'd up with Wind, which daily increases till the Fit thunders upon him; but a few Days before it comes, the Thighs are benumm'd, and there is as it were a discent of Wind through the Flesh of them, with Convulsive Motions, and the day before the Fit the Appetite is sharp, but not natural. He goes to Bed and to Sleep well, but about Two a Clock in the Morning is wak'd by the pain, seizing either his great Toe, the Heel, the Calf of the Leg, or the Ancle; this Pain is like that of dislocated Bones, with the sense as it were of Water almost cold, pour'd upon the Membranes of the Parts affected, pre­sently shivering or shaking follow, with a Fe­verish Disposition; the Pain is first gentle, but increases by degrees, (and in like manner the shi­vering and shaking go off,) and that hourly till towards Night it comes to its heighth, accomo­dating it self neatly according to the variety of the Bones of the Tarsus and Metatarsus, whose Ligaments it seizes, sometimes resembling a vio­lent stretching or tearing of those Ligaments, sometimes the gnawing of a Dog, and sometimes a pressure; moreover the part affected has such a [Page 89] quick and exquisite pain, that 'tis not able to bear the weight of Cloaths upon it, nor hard Walking in the Chamber; and the Night is not pass'd over in pain upon this account only, but also by reason of the restless turning of the part hither and thither▪ and the continual change of its place. Nor is the tossing of the whole Body, which always accompanies the Fit, but especial­ly at its coming, less than the continual agita­tion and pain of the tormented Member. There are a Thousand fruitless endeavours us'd to ease the pain by a continual change of the place where­on the Body and the affected Members lye, yet there is no ease to be had, 'till Two or Three a Clock in the Morning (viz. a Night and a Day being spent from the first approach of the Fit,) at which time the Sick has suddenly ease, by rea­son there's a little Digestion of the peccant Mat­ter, and some discussion of it, though he unde­servedly attributes it to that position of the af­fected part he us'd last. And now being in a breathing Sweat, he falls asleep; when he wakes, he finds the pain much abated, and the part af­fected swell'd afresh; for before there was only (which is usual in the Fits of those that have the Gout,) visible, a Swelling of the Veins intermix'd with the affected Member. The next day, and perhaps Two or Three days after, if the matter apt to genetrate, the Gout is copious, the part affected will be in pain, which will be violent too towards Evening, but 'twill be eased about the time of the Cock's Crowing; within a few Days the other Foot will be in pain, as the for­mer was, and if the former has left off aking, [Page 90] the weakness which render'd it infirm will pre­sently vanish, strength and perfect Health being so presently restor'd, as if it had never been out of order, if the pain is violent in the Foot late­ly seiz'd. And yet it acts the same Tragedy in the other Foot as it did in the former, both as to the violence of the Pain, and the duration of it▪ and sometimes on the first Days of the Di­sease, when the Peccant Matter is so exuberant, that one Foot is unable to contain it, it afflicts both at the same time with the like violence; but most commonly it seizes them successively as we said: After it has vex'd the Feet, the Fits that fol­low are irregular, both as to the time of Inva­sion and Duration, yet the pain always returns in the Evening, and is less in the Morning, and of a Series of these small Fits, consists that which is call'd a Fit of the Gout, longer or shorter, ac­cording to the Age of the Sick; for 'tis not to be supposed, that when any one is afflicted with this Disease two or three Months, that that's one Fit, but rather a Series and Chain of small Fits, whereof every latter is gentler and shorter than the former, till at length the peccant Matter be­ing wholly consum'd, the Patient recovers his former Health, which in those that are brisk, and in others whom the Gout has rarely visited, comes to pass often in Fourteen Days, and in those it has often afflicted in Two Months; but in those who are more debilitated, either by the long continuance of the Disease, or by age; it does not go off till Summer coming pretty well on, drives it away. The first Fourteen Days the Urine is high Colour'd, which after Separatión [Page 91] puts off a red Sediment, and as it were full of small Sand; nor does the Patient render by U­rine more than the third part of what he Drinks, and the Belly is most commonly bound the said first Days, want of Appetite, shaking of the whole Body about Evening, heaviness and a trou­blesom uneasiness of the parts that are not affected, accompanies the whole Fit, a violent itching of the Foot affected, follows the departing Fit, es­pecially betwixt the Toes, and the Feet scale as if the Sick had been Poison'd. The Disease being discuss'd, a good habit of Body and Appetite re­turn, according to the degree of Pain with which the Fit last past rag'd; and so proportionably the following Fit will be hasten'd or deferr'd, for if the last Fit was very severe, the following Fit will not come, till the same time of the Year re­turn again.

And in this manner, the regular Gout shews it self with its genuine and proper Phaenomena, but when 'tis disturb'd by improper methods of Cure, or by the obstinate continuance of the Disease, the very substance of the Body being as it were, perverted to the Nourishment of the Disease; and Nature unable to eliminate the same by its wonted method, then the Phaenomena are much different from those describ'd. For whereas the Pain was hitherto only troublesome to the Feet, (which are the genuine seat of the peccant matter, and if it possesses any other Parts, 'tis most certain, that either the method of the Disease has been alter'd, or that the vigor of the Body, is by little and little diminish'd) now it possesses the Hands, Wrists, the Arms, the Knees, and other regions, [Page 92] tormenting these, as much as it us'd to do the Feet: For sometimes distorting one or more of the Fingers, it makes them like a bunch of Pars­nips, taking away the motion by degrees, and at length it generates Stony Concretions about the ligaments of the Joints, which destroying the Cu­ticle, and the very Skin of the Joints, renders visible, naked Stones, like Chalk or Crabs eyes▪ which may be pick'd out with a Needle. Some­times the matter occasioning the Disease thrust upon the Arms, causes a whitish Swelling, almost as big as an Egg; which is by degrees inflam'd with Redness, sometimes falling upon the Thigh, it feels as if there were a great Weight hanging upon it; yet without any considerable Pain, but passing to the Knee, it handles that more severely, so hindering all motions, that 'tis as 'twere, nail'd to the Bed: So that it can't move a Hairs-bredth from the place wherein it is. And when by rea­son of the restlessness of the Body, or to ease Na­ture, the Patient must be mov'd by the help of others, there's need of great care, lest by chance, the least contrariety of motion▪ shou'd occasion Pain, which for this reason only, is tollerable, viz. because it presently vanishes: And indeed, this carrying of the Body, that must be perform'd so carefully and tenderly, is not a small part of the Troubles, wherewith the Gout is burden'd; for the pain is not violent through all the Fit, if the part affected, be kept quiet.

Whereas the Gout before, did not use to in­vade before the latter end of Winter, and was wont to go off, after two or three Months, now it continues upon the Sick a whole year, except­ing [Page 93] only two or three of the hot Summer Months: And what is moreover to be observ'd, as the great and general Fit is longer than heretofore it was, so those particular Fits, whereof the general is compounded, rage longer; for whereas before those particular Fits did not torment the Patient above a day or two, now wherever it fixes, espe­cially if it possesses the Feet or Knees, it does not cease, till the Tenth or Fourteenth day, moreover the First or Second day after its coming, the Pa­tient feels some Sickness, besides the Pain, toge­ther with a total prostration of the Appetite.

Lastly, before the Disease was grown to such a heigth, the Sick did not only enjoy longer Inter­vals of the Fits, but also during that Intermission, he was well in his Limbs, and in the other parts of Body, all the natural Faculties performing their Offices duly; but now his Limbs are con­tracted and cumbred, so that tho' he can stand, and perhaps go a little, yet he creeps along so very lamely and troublesomely, that when he walks, he seems to stand still; and if he endea­vours to walk beyond his strength, that he may the better recover his Feet, the more he confirms them by walking, and renders them less apt to receive the pain, so much the more the Fomes of the Disease not perfectly dissipated by all this in­terval, hovers more dangerously about the Bowels, when it can't be so freely discharg'd upon the Feet, which at this time of the Disease, are scarce ever free from pain, but are always uneasie more or less.

The Sick is also afflicted with many other Symptoms, as with a Pain of the Haemorrhoidal [Page 94] Veins, with unsavoury Belchings, resembling the taste of the Meat last eat, putrifying in the Sto­mach, when something of hard Digestion is eaten, or only so much as is requisite for People in Health, the Appetite Languishes, and also the whole Body, by reason of a penury of Spirits. Lastly▪ He lives only to be wretched and miserable, and not at all to taste of the Happiness of Life. The Urine that us'd to be formerly high colour'd, espe­cially in the Fits, and render'd in a small quan­tity, now is like that, both for colour and quan­tity which is evacuated in a Diabetes: The Back and other Parts, itch troublesomely about Bed­time.

And this Incovenience also happens in this Dis­ease, when 'tis confirm'd, viz. that upon yawn­ing, especially in the morning, the ligaments of the Bones of the Metatarsus, are violently pull'd, and seem to be hardly press'd with a strong Hand; and sometimes when yawning does not go before, the Sick just dropping asleep, suddenly feels a Blow as it were of a Club, breaking in pieces the Meta­tarsus; so that he wakes crying out: The Ten­dons of the Muscles that sustain the Legs, are sometimes taken with such a sharp and violent Convulsion, that the pain which it occasions, if it should last but a little while, would overcome all Humane Patience. After many and dreadful Tor­ments, and long execution, the following Fits as to Pain are more gentle, as a pledge of the dis­charge which approaching Death is about to give, (Nature being partly oppress'd by the burden of the Peccant Matter, and partly by Old Age, is no more able to expel it constantly and forceably [Page 95] to the extremities of the Body,) but instead of the accustom'd Pain, a certain Sickness with a pain of the Belly, Spontaneous weariness, and sometime a propension to a Diarrhaea supervene. These Symptoms ease the pain of the Limbs when they are violent, and likewise vanish when the Pain is in the Joints; and sometimes the Pain▪ and sometimes the Sickness afflicting alternative­ly, prolong the Fits much. For 'tis to be no­ted, that when any one has had the Gout many Years, the Pain is by degrees lessen'd every Fit▪ and at length he dies more of the Sickness than the Pain: For the Pain which is in these Fits▪ though 'tis longer, yet is it not the Tenth of that which he us'd to suffer when his Strength was more intire. But this Severity of the Di­sease is compensated most commonly by the longer space betwixt the Fits, and by the good Health he in the mean while enjoys. For in this Disease, pain is Nature's most bitter Medicine; and the more violent it is, the sooner will the Fit pass over, and the longer will be the intermission and more perfect, and so on the contrary.

Nor does the Pain, the lameness, and the ob­structed motion of the affected parts, the Sick­ness and other Symptoms describ'd, compleat the Tragedy of this Disease: For it breeds the Stone of the Kidnies in very many, either because the Sick lies long upon his Back, or because the Or­gans of Secretion have ceas'd to perform their due Functions, or for that the Stone is made of a part of the same kind of Matter, but which is the cause I shall not determine; whatever is the origine of this Disease, the Sick has sometimes [Page 96] many sad Contemplations, to know whether the Stone or the Gout is most severe; and sometimes the Stone hindering the passage of the Water in­to the Bladder through the Urinary Passages kills him, not waiting any longer upon the Slow Gouty Execution. Nor is it enough that the Sick is tor­mented in such a Miserable manner, as that he can't help himself, but wants the help of others, but this is also added to the heap of his Sorrows▪ viz. that during the Fit, his Mind is as it were affected with the Contagion, and so far suffers with the Body, that 'tis difficult to say which of them is most afflicted, for every Fit may as pro­perly be call'd a Fit of Anger, as of the Gout, for the Mind and Reason are so extreamly ener­vated by the infirm Body, that they are disor­der'd by the least motion of the Affections, so that he's as troublesom to others, as to himself: Moreover he is as obnoxious to the rest of the Passions, viz. to fear, care, and others of the same kind, by which he's also vex'd, till the Di­sease going off, the Mind also has recover'd its former tranquillity.

At length the Sick (that I may dispatch the Catastrophe of this dreadful Disease,) his Bowels being so hurt by hatching and embracing the Peccant Matter, that the Organs of Secretion can no longer perform their Office, upon which ac­count the Blood stuff'd with Faeculencies stag­nates, and the peccant Matter is not as heretofore cast upon the extream parts of the Body; at length I say the thrice Miserable Wretch is so happy as to Dye.

[Page 97] But (which may be a comfort to me and o­thers that are afflicted with this Disease, though we are but moderately furnish'd with Mony and the Graces of the Mind,) so liv'd and so died great Kings and Potentates, Generals of Armies, and Admirals of Fleets, Philosophers, and many such as these. In a word, this Disease of the Joints (which can scarce be said of any other,) kills more Rich than Poor, more Wise Men than Fools, Nature shewing as it were with the Fin­ger how just the Parent and Disposer of all things is, and how little he sides with Parties; for those that want something, are wont to be abundant­ly replenish'd with an other kind of good, and he allayes profuse munificence, by mixing an equal share of Miseries with it; so that 'tis every where inviolably decreed, that no Man shall be perfectly happy, or compleatly mise­rable, but that all shall partake of both Lots, which mixture of good and ill, so proper to our frailty and mortality, is perhaps very fit for us.

Women are very seldom troubl'd with the Gout, and if they are, not till they are Old or of a Masculine habit of Body: Thin Women who in their Youth or Middle Age are troubled with Symptoms resembling the Gout, receive them from Hysterical Diseases, or a Rheumatism which they were afflicted with here­tofore, the Fomes whereof was not well carried off.

Nor have I hitherto observ'd that Boys or Youths are vext with the true and genuine Gout, yet some that I have known, have perceived some [Page 98] small touches of it, before they have arriv'd to that Age, viz. when their Fathers had this Di­sease when they begat them. And here ends the History of the Disease.

Having very much contemplated the various phaenomena of this Disease, I suppose it arises from the Concoction weaken'd, both in the parts, and in all the Juices of the Body; for in those who are subject to this Disease, they being either worn out by Age, or having by Intemperance hastened Old Age, the Animal Spirits are decay'd through­out the whole Body, being consum'd by the im­moderate exercise of the brisk Functions in the heat of Youth, for instance, by too early, or too much use of Venery, by Mad and Extrava­gant Labours, whereby they unweariedly serve their pleasures; to which is to be added a sud­den intermission or cessation from the Exercises of the Body, to which they have been heretofore ac­customed, either by reason of Years or Laziness, (by the use whereof the Blood was wont to be render'd more vigorous, and the tone of the parts more firm,) upon which account the Body be­comes now wither'd, and the concoctions are no more rightly perform'd; but on the contrary the dross of the Juices of the Body which were dis­charg'd before by the help of such Exercises, are from henceforth laid up in the Vessels, as a Stock for the Disease. And sometimes hard Study or Meditation concerning some serious and lasting Matter, has increas'd the Disease, whereby the Fine and Volatile Spirits are too much diverted from their business of Concoction, which they ought to perform. Moreover they that are sub­ject [Page 99] to this Disease, are not only most commonly greedy of Meats in general, but chiefly of those that are hardest to digest, whereof when they eat as much as they were wont to do when they ex­ercised themselves, they are unable to digest them. Nor does the said voracity or full feeding, so fre­quently (though it does often) occasion the Gout, as the immoderate and mad drinking of Wine, whereby the ferments appointed for various Con­coctions are wholly destroy'd, and the Concocti­ons themselves, and the natural Spirits are van­quish'd and dispers'd by the great quantity of adventitious Vapours. But when at one and the same time, the vigour of the Spirits that are the Instruments of Concoction are lessen'd, and more­over a great haep of Humours oppresses the Blood, 'tis impossible that all the Concoctions should be duly perform'd, when all the Viscera are so over­whelm'd, upon which account the Spirits long a­go weaken'd, are now suffocated. For if this were occasion'd only by a weakness of the Spi­rits, Women and Children, and those which long Sickness has wasted, would likewise be in­vaded by it; whereas for the most part it sei­zes the Strongest, and those that have the most robust Principles of Nature: Yet it does not seize them, 'till Humours are heapt up, by reason of the defect and declination of the Natural Spi­rits, by which join'd together the vitiated Con­coctions are perverted.

Moreover as every one of the causes we have mention'd, promote indigestion, so most of them occasion a Looseness of the habit and muscules of the Body, by which means a passage is open'd for [Page 100] the receiving crude and indigested Humours, as of­ten as they are protruded to the outward parts, and when lying long in the Blood, they increase in bulk and contract an ill Disposition, and at length acquire a putrifying heat, and can no longer be govern'd by Nature, they break forth into a Species, and fall upon the Joints, and by heat and sharpness occasion most exquisite pains in the Ligaments and Membranes covering the Bones, which being either weaken'd and loosen'd by Age, or by Luxu­ry, or Intemperance, make room for them, when they make an attempt; but this falling of the Humours that generate the Gout, which consti­tutes the Fit, happens sooner or later, as occasion is offer'd for putting these Humours into mo­tion.

As to the cure, (I will first mention those things that are to be omitted,) though if we respect the Humours and the Indigestion whereby they are occasion'd, it may seem at first, that the curative indications are chiefly to be directed for the E­vacution of the Humours already made, and for corroborating the Concoctions; so that the heap­ing up of other Humours may be prevented▪ forasmuch as these are the more general Indica­tions, whereby we should do the business in most other humoral Diseases; but in the Gout there's a kind of prerogative in Nature, for extermina­ting the Peccant Matter after its own way, by putting it off upon the Joints, and by discussing it by insensible transpiration.

About Three ways are propos'd, whereby we may eject the containing cause of the Gout, viz▪ Bleeding, Purging and Sweating, and yet nei­ther [Page 101] of these Methods will ever perform the bu­siness.

First, Though Bleeding may seem both to Eva­cuate those Humours that are just ready for a descent, and also those that have already be­sieged the Joints, yet it plainly opposes that in­dication, which the antecedent cause, that is, in­digestion, arising from a depravation and defect of the Spirits, (which Bleeding lessens and op­presses more) requires, and therefore Bleeding is not to be us'd, either to prevent the Fit which is fear'd, or to mitigate that which is now present, namely, in▪ those that are old; for though that Blood that is drawn out, is most commonly like that of Pleuriticks, and of those that have a Rheumatism, yet Bleeding does as much hurt to the Sick in this Disease, as it does good in the Two just mention'd▪ for if Blood is extracted in the intermission, though a good while after the Fit, there's danger lest by the agitation of the Blood and Humours, a new Fit should be occa­sion'd more lasting than the former, and accom­panied with more violent Symptoms, the strength and vigour of the Blood being blunted there­by, by the help of which the nourishment of the Disease should have been diligently and con­stantly expell'd.

And this inconvenience happens as often as Bleeding is us'd at the beginning of the Fit, and if it be us'd presently after the Fit, there's great danger, lest Nature, the Blood having not yet re­cover'd its former strength, weaken'd by the Di­sease, should be so much dejected by this unsea­sonably us'd, that a Dropsie should be occasion'd [Page 102] thereby. But if the Sick is yet Young, and has been over-heated by hard Drinking, Blood may be drawn at the beginning of the Fit; but if in the following Fits it is continually us'd, the Gout is soon confirm'd even in Youth, and will more propagate its Tyranny in a few Years, than other­wise in a great many.

And then as to Purging, whether upward or down­ward, this must be noted, that whereas by the invio­lable Law of Nature annex'd to the very essence of this Disease, the Fomes of it ought to be ex­pell'd always to the Joints; Emetick or Cathar­tick Remedies will do nothing else, but recal in­to the Blood the Peccant Matter, which was put off by Nature upon the Extremities of the Body; upon which account that which ought to be cast upon the Joints, rushes perhaps upon some of the Viscera, and so the Patient's Life is in danger, when before 'twas not in danger at all. Which is often observ'd to be fatal to those who have been accustom'd to Purging Medicines, that they might prevent the Gout, (or which is worse,) to lessen the Fit: For when Nature is put by her usual method, whereby as being best and more secure, she drives the Morbifick Matter upon the Joints, the Humours are turn'd inward upon the Inte­stines, and instead of Pain in the Joints, where there is none at all, or certainly but very little, the poor Wretches are almost destroy'd by Sto­mach Sickness, Gripes and Faintings, with a great troop of irregular Symptoms.

Therefore I am fully perswaded, having learnt by continual and repeated experience, that all Purging whether by gentle or strong Medicines, [Page 103] such as are usually design'd to purge the Joints, do much hurt, whether it's us'd in the Fit to lessen the Peccant Matter, or at the end to dissi­pate the Relicks of the Disease, or in a perfect in­termission or good health, to hinder the approach­ing Fit. For I have found at my own peril, as well as of others, that Catharticks administred at any of these times, have been so far from doing good, that they have hasten'd the Mischief they should have prevented. First therefore Purging when the Fit rages, disturbing Nature when she is busied in separating the Morbifick Matter, and in putting it off upon the Joints, sometimes occa­sions a great confusion of the Spirits, so that the Fit is not only increas'd thereby, but the Patient's Life also is not a little hazarded; and then Ca­tharticks us'd at the end of the Fit, instead of removing the Relicks of the Disease, bring on another Fit afresh, as bad as the former, and thus the Sick being vainly deceiv'd, contrives Misery for himself, which he had not felt, if the Humours had not been inrag'd again: Which in­convenience I have found often, having prepo­sterously crav'd for Medical help, to expel as I thought the relicks of the Disease. Lastly, As to Purging to be repeated at certain intervals, and in perfect Health, to prevent the Fit, though which must be confess'd, there is not so much danger of a new Fit, as in the case just men­tion'd, when the Patient was not wholly freed, yet at this time it produces a Fit; and if by chance the Patient is not presently seiz'd, yet it does not at all free him from the Disease, though he take this or that Purge constantly at [Page 104] due distances, for I have known some obnoxious to this Disease, who have not Purg'd only at Spring and Autumn, but also Monthly and Week­ly, that they might recover their Health, and yet none of these have escaped the Gout, for most commonly it handl'd them more cruelly af­terwards, and with worse Symptoms than if they had taken no Physick at all. For though the said Purging might take away some part of the containing cause, yet no way conducing to the corroboration of Concoction (so far from that is it, that it debilitates the same, and wounds Nature afresh,) it opposes only one cause, and so is wholly unable to cure the Di­sease.

But this must be noted moreover, that from the same defect of the Spirits, whereby the Con­coctions are vitiated, in those who are wont to have the Gout, the frame of the same Animal Spirits is render'd less firm and vigorous, so that 'tis presently disturb'd by any cause, whereby the Mind or Body is somewhat violently mov'd, and so very fleeting and shatter'd is it, as it happens to those that are subject to Hysterick and Hypochondriacal Diseases. From which in­clination of the Spirits to be disturb'd, it comes to pass that the Gout most commonly follows the least evacuation. The tone of the Body be­ing dissolv'd, which the firmness of the Spirits whilst they continue vigorous, keeps compact and brisk, the Peccant Matter moves without resistance; and by this injury to the Body a Fit is presently occasion'd.

[Page 105] But how pernicious soever this Method is, yet some Empericks are much esteem'd for it, by cunningly concealing the Purging Medicine they use; for it must be observ'd, that during the Purging, the Patient has little or no Pain at all; and if Purging could be continu'd many Days, and no new Fit supervene, the Sick would pre­sently recover of that he has now upon him; but truly he will be dreadfully punish'd after­wards by the confusion into which the said a­gitation of the Humours has precipitated Na­ture.

Lastly, The Evacuation of the Peccant Matter by Sweat, though it does less hurt than the fore­said Evacuations, yet it plainly appears to be in­jurious, for though it don't draw back the Fomes of the Disease into the Bowels, but on the con­trary, drives it to the habit of the Body; yet for these Reasons it does hurt. First indeed because when the Fit is off, it forces the Humours as yet crude and not prepar'd for Separation, upon the Limbs, by which means it brings the Fit before its time, and contrary to Nature's consent; and then because the forcing of Sweat in the Fit, does cast the Morbifick Matter too violently up­on the affected Member, and occasions at the same time an intollerable pain; and if the quan­tity of the Peccant Matter is greater than can be contained in the affected part, it forces it presently upon other Members, and upon which account there is a great Ebullition and Fury of the Blood and other Humours; and if the Body abounds very much with serous Matter, fit to generate the Gout, there's danger lest an Apo­plexy [Page 106] should be occasion'd. Wherefore in this Disease as well as in all other, wherein Sweat is provok'd by Art, to cast forth the Morbifick Matter, and does not come naturally, 'tis very dangerous to force them out too violently, and beyond that degree of Concoction whereunto the Humours to be evacuated have come of their own accord. And that excellent Aphorism of Hippo­crates, that things concocted, not crude, are to be me­dicated, is of as much use in provoking Sweat, as in Purging the Belly, which is very apparent in that Sweat that uses to come at the latter end of Agues, which if it is moderate and agree­able to the concocted quantity of Febrile Matter of the preceding Fit, much relieves the Sick; but if it's forc'd beyond Nature's bounds, by keep­ing the Sick continually a-bed, a continual Fever is occasion'd, and instead of extinguishing the for­mer Fire, a new one is kindled. In like manner in the Gout, that gentle Breathing Sweat which most commonly comes in the Morning of its own accord after each of the small Fits, where­of as I have said the great Fit consists, mitigates both the pain and restlessness, wherewith the Sick has conflicted all the Night. But on the con­trary, when at any time this gentle breathing Sweat that naturally soon goes off, is provoked longer and more violently than the proportion of Peccant Matter requires, the Disease is encreas'd thereby. Therefore in this Disease and in all o­ther I have ever seen, except the Plague only, 'tis not so much the Physicians, as Nature's bu­siness to force Sweat, because we can't know by any means what part of Matter is already pre­par'd [Page 107] for such a Separation, and by consequence what Measures we are to take in provoking it.

Now seeing it plainly appears from what has been said, that 'tis not only in vain to endea­vour the cure of the Gout by Evacuating Me­dicines, but that they are also injurious to Gouty People, it remains, that we inquire to what other end the curative Indications are to be directed. I indeed having accurately weigh'd, and dili­gently examin'd the foresaid Phaenomena, ga­ther from thence that we must have respect to two causes chiefly in the cure of this Disease; the first is the Antecedent cause, or the indi­gestion of the Humours arising from a defect of heat and natural Spirits; the other is the con­taining cause, or the heat and boiling of the Hu­mours, when they are putrified and grown sharp by remaining too long in the Body, which their de­lay is occasion'd by the indigestion above men­tion'd: These Causes are so absolutely contrary one to the other, that those Remedies that do good for this, are injurious for the other; up­on which account this Disease is so very diffi­cultly Cur'd. For when we endeavour to remove Indigestion by hot Medicines, there's danger lest on the other hand we increase the heat of the Hu­mours; and when on the contrary we would mi­tigate the hot and acrid Humours, either by cooling Remedies or Diet, we occasion Indige­stion, the natural Heat being weaken'd. But here by the containing cause, I don't only mean that which actually besieging the Joints, forms the Fit, but that moreover which lurking in the [Page 108] Blood, is yet unfit for Separation; for all the Mor­bifick Matter is very seldom so clearly ejected, how long and severe soever the Fit has been, as that there are no relicks of it in the Body, af­ter the Paroxism is gone off, and therefore re­gard must be had to this cause, as well when the Fit is off, as when it rages. But forasmuch as the ejection of the containing Matter is wholly Nature's Business, it must be done by her Method alone, for nothing can be in the mean time at­tempted to asswage the hot and acrid Humours, without injury to the Digestions, only the Sick must forbear hot Medicines and Diet whereby the Humours are inflam'd; so that certainly the greatest and chiefest intention of Curing, consists in helping Concoction, by removing Indigestions, of which I will now treat, yet so as that in the series of my Discourse, I may touch upon those Re­medies occasionally, which conduce to the as­swaging of the Heat, and sharpness of the Hu­mours.

Therefore whatever helps Nature in duly per­forming her offices, either by strengthening the Stomach, that it may concoct the nourishment well, or the Blood, that it may duly assimilate the Chyle brought into it, or by strengthening the Solid Parts that they may the better convert the Juices design'd for their nourishment and in­crease, into their proper substance. Lastly, Whatever preserves the Organs of Excretion, and the emunctories of the Body, in that state whereby the Faeculencies of each part may in due time and order be carried off, these and all things of this kind conduce to the fulfilling this [Page 109] intention, and are properly call'd Digestives, whether they are Medicines, or a Rule for Diet or Exercise, or any other of those things which are call'd the Six Non-naturals.

These kind of Medicines in general, are those which moderately heat, and are either bitter, or gently bite the Tongue, for they are very agree­ble to the Stomach, they purifie the Blood, and comfort the other Parts. For instance, they are such as these Roots of Angelica, Elecampane, the Leaves of Wormwood, the lesser Centaury, Ger­mander, Groundpine, &c. also those that are vul­garly call'd Anti-scorbuticks may be added, as the Roots of Horse-Radish, the Leaves of Gar­den Scurvy-Grass, Water-Cresses, and the like. But yet these acrid and pungent Herbs, how pleasing soever they are to the Stomach, and how much soever they help Concoction, are to be us'd more sparingly than others that corro­borate the Stomach by their gentle heat and bit­terness, and render the Mass of Blood more brisk and lively, for they stir up the Fomes of the Disease that has been long form'd, and in­crease the Heat.

Some Species of them neatly mix'd, are better in my Opinion to concoct the Humours, than any one Simple of their Tribe. For though when we have need of the Specifick Vertue of any Me­dicine, that Rule holds good, the simpler 'tis, the better 'tis; but when we design to cure the Sick by satisfying this or that Indication, every In­gredient contributes somewhat for the cure of the Disease; and in this case the greater the number of Simples is, the more powerfully does [Page 110] the Medicine work; therefore various forms of Medicines tending to this end, may be neatly fram'd of the foresaid, and of the rest of the Materia Medica of this sort. I prefer an Electu­ary before the rest made like Venice-Treacle, as the most excellent, for that a mutual Fermenta­tion of the Simples, increases the vertue of them all, as if it produc'd some third thing, which in the things so join'd, has greater vertue than any one of them in the same quantity. But I wil­lingly leave the choice of such Ingredients, and the forms wherein they are to be given, to the prudent Physician; for I never thought it my business to write Receipts as they call them, but rather to note the Indications, according to which the Methods of Cure are to be directed; and this being not well minded, is the cause why Empericks boast that they are the chief of the Medical art.

But for the benefit of Beginners, I will set down the remedy I am wont to use, which is compound­ed after this manner.

Take of the Roots of Angelica, of the sweet Smell­ing Flag, of Masterwort, Elecampane, of the Leaves of Common Wormwood, of the lesser Centaury, of white Whore-hound, of Germander, of Ground-pine, of Scordium, of common Ca­laminth, of Feverfew, of Field Saxifrage, St. John's-wort, Golden-Rod, Thime, Mint, Sage, Rue, Carduus B. Penny-Royal, Sothernwood, of the Flower of Chamomel, Tansie, Lilly of the Vallies, English Saffron, of the Seeds of Treacle Mustard, Garden Scurvy-Grass, Carraway, Juniper-Berries, each a sufficient quantity; let [Page 111] the Herbs and Flowers and Roots be gather'd when they have most vertue in them; let them be dry'd, and kept in Paper Bags till they may be finely powder'd; to six Ounces of each well mixt, add a sufficient quantity of purified Hony and Canary Wine, to make an Electuary; take ʒij Morning and Evening. Or for want of this, use the following.

Take of the Conserve of Garden Scurvy-grass ℥iss, of Roman Wormwood, and of the Yellow Rind of Oranges, each ℥i, of Candied Angelica, of Nut­megs Candied, each ℥ss, of Venice Treacle, ʒiij, of Compound Powder of Wake Robin ʒij, make an Electuary, with a sufficient quantity of Syrup of Oranges; let him take ʒij twice a day, drink­ing upon it Five or Six Spoonfuls of the follow­ing Water.

Take of the Roots of Horse-Radish slic'd ℥iij, of Garden Scurvy-grass, M. xij, of Water Cresses and Brook-lime, of Sage and Mint, each M. iiij, the Peel of Six Oranges, two Nutmegs bruis'd, of Brunswick Mum lb xij, distil them in a common Still, and draw only Six Pints of Water for use.

Among the Medicines commonly known, Ve­nice Treacle is the best to corroborate the Con­coctions; but because it contains a great many Species that heat too much, and besides, a great deal of Opium, the Electuary above-mention'd may be more commodiously prepar'd of the chief heating Vegetables; but we must take care to choose such Simples as are pleasant to the Taste, for the Sick must take it a long while, viz. al­most as long as he lives, and therefore 'tis very [Page 112] requisite that they should be palatable; among the Simples; the Peruvian Bark is the best, for it strengthens the Blood, and renders it vi­gorous, if some Grains of it are taken Morning and Evening.

And truly as in this Disease we now treat of, so in most other Chronical Diseases, these and such like Remedies that strengthen the Blood, and render it Brisk (if their heat don't consist of Vinous Spirits, for reasons to be shewn here­after,) do most good, forasmuch as every Di­sease of this kind, if I conjecture right, ought to be referr'd to one and the same cause, viz. the indigestion of the Humours.

But it can no way be made more apparent and better prov'd, than by setting in view the diffe­rence that is betwixt Acute and Chronical Di­seases; wherefore I hope the Reader will not take it amiss, if I do a little digress from the business in hand. As therefore those for the most part are accounted Acute Diseases, which either soon kill, or are brought to Concoction, so those are Chronical Diseases which either are not Con­cocted at all, or require a long time for their Concoction; and indeed the very nature of the thing, as well as the words by which 'tis ex­press'd, plainly signifie as much; but the cause of this difference which is perceiv'd betwixt these two kinds of Diseases, is more obscure, and not easily to be clear'd. I suppose 'twill be worth our labour, to spend a little time in the search after it, for the clear and distinct knowledge of these things, contributes much towards the finding out [Page 113] true and agreeable Indications for the cure of these Diseases.

Whether the innermost Bowels of the Earth, if it's proper to say so, undergo various changes, upon which account the Air is infected by Vapours exhaling from thence, which seems very probable to me, or whether the whole At­mosphaere is infected by an alteration occasion'd by a certain Conjunction of Heavenly Bodies: 'Tis most certain, that for this space of time, the Air is stuff'd with Particles which are injurious to the oeconomy of the Human Body; and that at another time 'tis impregnated with such Particles, as are Enemies to the Bodies of some species of Beasts. When at these times we breath into the naked Blood, the noxious Venom that's an Enemy to Nature, and fall into those Epidemical Diseases which that is apt to pro­duce, Nature produces a Fever, its usual en­gine to free the Blood from any disagreeable Matter that lodges within; and such Diseases are commonly reckon'd Epidemical, and are therefore acute and short, because they have so quick and violent a motion. But besides these Diseases occasion'd by an External cause, there are others as acute, proceeding from this or that pe­culiar Inflammation of the Blood, which don't de­pend on any general cause from the Air, but on a particular irregularity or intemperies of parti­cular Bodies, which kind of Fevers I call Inter­current and Sporadick, which happen almost in all Years.

But Chronical Diseases have quite another genius, for though an unhealthy Air of this [Page 114] or that kind may conduce much to the genera­ting these Diseases, yet they don't so immedi­ately take their rise from the Air, but most commonly to the indigestion of the Humours, the common Parent of them all. For when any one has the Principles of his Nature weaken'd and worn out, either by Old Age, or by great and continual errors in the Six non-naturals, especially in Meat and Drink; or if the Secre­tory Organs have been so debilitated, that they are wholly unable to purifie the Blood, and to carry off its Superfluities: In these cases a greater stock of Humours being heap'd up than a Man's strength is able to digest, the said Humours by long continuance undergo various Fermentations and Putrefactions, and at length break out in specie, and occasion various kinds of Diseases, according to the variety of Depravation; and as these deprav'd Juices have a various dispo­sition, so they variously fall upon this or that part which is fittest to receive them, and at length by degrees they shew their long train of Symp­toms, which are wont to arise partly from the nature of such Juices, and partly from the Con­fusion brought upon those parts, which two join'd together, constitute the irregularity of Nature, which is mark'd with the name of some Disease.

Now 'twill plainly appear, that such an im­potency of Nature for the concocting the Hu­mours, is the chief cause of Chronical Diseases, if we consider that Old Men whose Concoctions are weaken'd, and the Spirits the Instruments of them wasted by the repeated functions of a long [Page 115] Life, are more subject to these Diseases than Younger People, whose flame of Life being more kindled, scatters those Feculencies heap'd up, and whose Secretory Organs are constantly as­sisted by the natural heat, that they may not be deficient in purifying the Mass of Blood, unless they are oppressed, and as it were suffoca­ted by too great a quantity of Humours. More­over that such an indigestion of the Humours, is the cause of most Chronical Diseases, is ma­nifest from hence, viz. because Winter is much more apt to breed such Diseases than Summer; though some of them don't actually break out till the latter end of Winter, yet the stock of Humours on which they depend, increasing all the Winter, is inlarg'd by that cold and raw Season, weakening Nature, so that she is not so able to preserve the oeconomy of the Body. Up­on which account it happens, that they who are very well in Summer, seldom escape those Di­seases in Winter whereunto they are most in­clin'd. For instance, the Gout or Asthma, and a Cough, and the like. And from hence we may learn the reason why travelling into more Souther­ly Regions does so effectually vanquish those Di­seases, the cure whereof is vainly attempted in colder Climates. The truth of what I have said already concerning the general cause of Chronical Diseases, will moreover manifest it self by that great and incredible relief which those that are afflicted with most Chronical Diseases, especially with a Phthisis, receive by Riding on Horse-back, which kind of Exercise invigorates and strengthens all the Digestions, the natural [Page 116] Heat being reviv'd by the continual shaking of the Body, and the Organs destin'd for Secretion, assisted in duly performing their Office of purify­ing the Blood, so that a Renovation of the ruin'd Digestions must necessarily follow, and by conse­quence, the best Constitution of Body.

Wherefore 'tis manifest enough by the reasons already alledg'd, that not only in the Gout, but also in other Chronical Diseases, where no mani­fest Symptom contraindicates; such kind of hot Herbs are sometimes very beneficial, for they pro­cure the heat of Summer, in the middle of Win­ter; tho' if we accustom our selves to the use of them in Summer-time, they will the better pre­vent those Diseases, which the contrary Season is wont to occasion: And truly if they are deferr'd till Winter approaches, at which time a great deal of Matter is heapt up, 'tis to be fear'd, we may fly too late to this Refuge. But tho' (as I have discours'd largely above) the Gout by a pe­culiar Disposition, is made worse by Cathar­ticks; yet in most other Chronical Diseases, Bleed­ing repeated as often as there is occasion, and Purging is to be order'd, before these digestive and corroborating Medicines are to be us'd; but when the Patient has once enter'd upon the use of these, he must persevere, without Purging be­twixt whiles; for this must be constantly main­tain'd, that as often as the Cure of any Disease is assay'd by corroborating Remedies, all Evacuati­ons are wholly injurious. Lastly, I don't affirm that these digestive Medicines now mention'd, are better than all others; but this I say, that he that can find out the best Remedy to answer this In­tention, [Page 117] will do much more in curing Chronical Diseases, than he wou'd imagine he was able to do.

But this must be first taken notice of, and chiefly observ'd above all the things I am about to mention concerning the Cure of the Gout, name­ly, That all digestive Remedies whatsoever, whe­ther Courses of Physick, or Diet, or Exercise, are not to be taken up by the by, but must be us'd constantly and daily with the greatest Diligence; for whereas in this Disease, as also in most other Chronical Diseases, the cause of it has pass'd in­to an Habit, and is become as it were a new Na­ture: No Man in his right Senses, can think that some small and short alteration, superinduc'd up­on the Blood and Humours, by any sort of Re­medy or Diet, can perfect the Cure; for the whole Habit of the Body must be chang'd, and the whole Man must be as it were new fram'd; for 'tis not so here, as in some accute Disease, where he that even now was strong, and perfectly well, is suddenly seiz'd with a Fever, and precipitated from the best state of Health, into the most dan­gerous Disease. No, the case of the Gout is quite different, where he that for many years to­gether, by immoderately indulging himself in Surfeiting and Drunkenness, and neglecting his wonted Exercises, is worn out by Sloth and Neg­ligence, or by hard Study, or continual and in­tense Thinking, or by some other Errors of Life; as if he had designedly perverted the various Fer­ments of the Body, and oppress'd the animal Spi­rits, (which are the chief Instruments of Digesti­on) by which means the preternatural Humours [Page 118] that were heapt up, break out at length, when they are arriv'd to the highest degree, and con­found all, the Flesh being soften'd, and the Joynts weaken'd, so that they readily receive the Hu­mours falling upon them. And so at length ano­ther Nature is as it were, superinduc'd by de­grees, the pristine and natural oeconomy of the Body being wholly subverted, and destroy'd: And those Fits about which unwary and unthinking Men are so busied, are indeed nothing else but the Series and order of Symptoms, depending on that method which Nature is wont to use in dri­ving out the Matter that occasions the Disease; wherefore he labours in vain, that endeavours to drive away this Disease, by this or that Medicine or Regimen now and then us'd. For this Habit being chiefly founded, and consisting both in the weakness of all the Digestions, and in the want of the natural Strength of the particular Parts, we must provide a­gainst both these Ills, and the strength of Concocti­on, as well as the Soundness of the Parts, must be re­duc▪d and restor'd by degrees to the former state and accustom'd oeconomy of the Body, tho' to do this fully and perfectly, may not seem possible, not only because any Habit is difficultly chang'd into the quite contrary, but also because Old Age which most com­monly accompanies this Disease▪ violently opposes; yet the Cure is to be endeavour'd as much as the Strength and Years will permit: And the nearer or farther from this Mark the Patient is, he will more or less avoid the Tyranny of the Gout.

And 'tis moreover to be noted, That digestive Remedies, either medicinal or dietetic, are chiefly to be us'd in the Intervals of the Fits, and as long as may be before the next Fit; for by reason of [Page 119] Old Age, much time is requir'd, and a constant use of Remedies, before the corroboration of all the Concoctions and the Restauration of the en­feebl'd Ferments of the Body, and such a Sound­ness as is requisite for the Blood and Viscera can be obtain'd.

But tho these Remedies and other things of the same kind, may do good, yet this intention of corroborating, can't be answer'd by these things alone, but respect must be also had to those things which don't properly belong to Physick. And he will be most certainly deceiv'd that thinks he can perform the Cure of this, or some other Chroni­cal Disease, by Medicines alone. First therefore, a Mediocrity is to be observ'd in Meat and Drink, so that neither more Nourishment be taken in, than the Stomach can concoct, lest the Disease shou'd be heigthen'd by it; nor on the contrary must the Parts, by too much Abstinence, be de­frauded of that Proportion, whereby their Strength and Vigor ought to be sustain'd, for by so doing, they will be more weaken'd, for either is alike injurious, as I have often found in my self and others▪: Moreover, as to the quality of the Meat, tho' things of easie Digestion consider'd by themselves, are to be prefer'd before things of hard Digestion; yet regard must be had to the Patients Palate: For we must take notice, That that which the Stomach earnestly craves for, tho' of difficult Digestion, is sooner conquer'd by Na­ture, than that which is accounted to be of easier Digestion, if it be offensive to the Stomach; but those things that are reckon'd of hard Digestion, are therefore to be eaten more sparingly; and I [Page 120] suppose the Patient ought to feed upon one sort of Meat at a Meal▪ for various sorts of Flesh eat­en at once, disturb the Stomach, more than one sort eaten in the same quantity. As to other things beside Flesh, let him eat at Pleasure, if they are not Sharp, nor Salted, nor Spic'd; which tho' they don't hurt Concoction, yet are they injurious, for that they exagitate the Fomes of the Disease.

As to the times of eating, a Dinner is only ne­cessary; for the Bed being most proper to digest the Humours, that time ought not to be wasted a­bout concocting the Meat; therefore they that are subject to the Gout, shou'd not eat Suppers, yet they may allow themselves a large Draught of small Beer, for such are also most commonly in­clinable to breed the Stone in the Kidnies, the Concretion whereof, is much hinder'd by such a kind of Liquor, drank at this time▪ the Reins be­ing cool'd and cleans'd thereby.

The drinking of Milk, or a Milk Diet, either crude or boyl'd, without any thing else, except perhaps a piece of Bread with it once a day, has been much us'd these Twenty years, and it has done more good to many, than any other sort of Remedy for this Disease, as long as they kept to it: But as soon as they return'd to common Diet, tho' of easie Digestion, the Gout return'd more violently than before, and held them longer; for the Principles of Nature being weaken'd by this method, the Sick was render'd less capable to repell the Disease, upon which account 'twas more dangerous and lasted longer. Therefore he that intends to betake himself to this method, ought [Page 121] first to consider seriously whether he can persist in the use of it all his Life long, which perhaps is not in his Power, how resolv'd so ever he may be. For I knew a Noble Man, who after he had been dieted with Milk only, a whole year with Pleasure, (all which time, he went to Stool daily once or oftner) was forc'd to leave it off, by rea­son he was suddenly bound in Body, and the Tem­per of his Body alter'd, and because his Stomach at length nauseated Milk, tho' the inclination of his Mind still continued. But some hypochondri­acal People of a gross habit of Body, or who o­therwise have accustom'd themselves much and a long while to spirituous Liquor, can by no means bear a Milk Diet. Moreover, that very short and fading Benefit that they receive by this Diet, to whom Milk is agreeable, proceeds hence, viz. not only for that this Diet is most simple, (for I don't doubt but that Barly-Broath, if the Sto­mach will bear it, may do as well) but also be­cause it renders the Blood more mild and sweet by quelling the Acrid Particles in it; and more­over, which I suppose is most considerable, Milk being a sort of aliment very unfit for grown Peo­ple, suppresses that Turgescency of the Hu­mours, which occasions the Gout; and for that reason those few with whom a Milk Diet agrees, are so long free from the Gout as they feed upon it, and no longer; for by being wholly contra­ry to the original cause of the Gout, viz. the weakness of the Ferments and Concoctions, 'tis much more injurious than beneficial. And because this has not been sufficiently regarded, some un­wary People have fell into great and fatal Errors; [Page 122] for by endeavouring to oppose the containing cause, viz. the heat and sharpness of the Humours, they have destroy'd the concoctions and all the natural Functions.

As to Liquors, those in my opinion are best, that are neither as strong as Wine, nor as weak as water, of which sort is our London Small-Beer, with or without Hops; for extreames on either hand are hurtful. First as to Wine, tho' the Proverb says, Drink Wine and have the Gout, and drink no Wine and have the Gout: Yet 'tis without Controvesie, and confirm'd by various Ex­periments of gouty People, that Wine de facto is injurious. For tho' it may be suppos'd to do good by helping the Concoctions, the Disorders whereof, I have long accounted the antecedent cause of the Gout; yet with respect to the con­taining cause, it mst be reckon'd wholly injurious, for that it fires and exagitates the Humours, the Fomes of the Disease, already prepar'd to give Battel: Yet I don't grant that Wine us'd for or­dinary drink, does promote Concoction, but ra­ther spoyls it, unless in those that have been ac­custom'd to Wine a long while; for tho' as it passes by it imparts some Heat, yet it certainly injures the Ferments of the Body, and destroys the natural Spirits; and for this reason I suppose, great Drinkers dye of the Gout, Dropsie, Palsie and other cold Diseases. Moreover, a continual and immoderate swilling of Wine, renders the Body soft like Womens Bodies, whereas tempe­rate Liquors strengthen and confirm the Tone of all the Parts; for which reason, they that have always us'd small Liquors, seldom know what the [Page 123] Gout means. 'Tis moreover to be noted, That those Men are most inclinable to this Disease, who tho' their natural Concoction is lessen'd, are nourish'd more than enough by reason of a cer­tain Luxury of the Blood, and they grow bulky by some indigested Matter, instead of good Sub­stance and well compacted. And drinking of Wine does more increase this Luxury of the Blood; and moreover, heaps up a new Stock of Matter, and actually occasions the Disease, by firing as it were the Fomes of it, which has been laid up a long while. And besides, the Blood of gouty People, being very like that which is taken from those that have a Pleurisie, or some other inflamatory Disease; 'twould be a mad thing to inrage it more with spirituous Liquors. Nor on the con­trary, are Liquors too much cooling to be us'd; for these by quite spoyling the Concoctions, and by extinguishing the natural Heat, occasion the greater Mischief; not Pain as Wine does, but Death it self: As Experience teaches in those who freely indulging themselves in drinking Wine, till they are Old, and betaking themselves sud­denly to drink Water or small Liquors, have soon destroy'd themselves.

Therefore those that are subject to the Gout, must take care that they use those Liquors, that can neither cause Drunkenness when they are ta­ken in a large quantity, nor yet injure the Sto­mach by chilling it; of this kind as I said, is our Small-Beer, and a proper Liquor may be made in other Countries, by mixing a little Water with a great deal of Wine. I count Water by it self, crude and injurious, and I have found it so to my [Page 124] hurt. But Water may be safely drunk by young People, wherewith at this day, the greatest part of Mankind quenches Thirst, being more happy with their Poverty, than we with Plenty and Luxury. To confirm which, I produce that great Train of Diseases, whereby our Bodies on this accout are tortur'd, viz. the Gout, Stone, Apoplexy, Palsie and the like; and that Vio­lence upon the Mind, whereby 'tis driven con­trary to its native Rectitude, while the adventiti­ous Spirits of such Liquors, complicated with the animal Spirits, serving for the forming Thoughts, disturb the Mind, by volatilising it too much, suggesting vain and frivolous Fancies, instead of things that are solid and of some moment; and so makes us Jesters and merry Fellows, instead of Wise Men, between which, the difference is al­most the same, as betwixt a Substance and a Sha­dow: But enough of this.

But now, tho' it may be sufficient for him that has the Gout but a little, and at some times only, to use Small-beer and diluted Wine, the degree of his Disease not requiring a more sever usage; yet when the whole Substance of the Body is as it were, degenerated into the Gout, he will be less able to conquer the Disease, who does not wholly abstain from any sort of fermented Liquors, tho' Small and Mild; for all these contain a pungent Spirit, and some degree of Sharpness, and what is worse, as they have a Ferment in them, (even as Yeast put into Liquors, imparts a fermentative Vertue to the whole Mass) so they incline the Humours to a perpetual Fermentation. Therefore a Die­tetick Drink must be prescrib'd of the Ingredients [Page 125] commonly known and appointed for this use, for ordinary Drink, if it be not too strong, for if so, the Humours will be almost as much inrag'd as by Wine: And on the contrary, it must not be so small, as to injure the natural Functions, by over­cooling them. This sort of Drink if it be made of such Ingredients as are least displeasing to the Sick, tho' the constant taking them, may cause some loathing for a Week or too, will afterwards be as pleasing and as acceptable, as any o­ther Liquors to which he has been most accu­stom'd. And by this kind of Liquor, the Appe­tite will be increas'd, and become more natural than it us'd to be with fermented Liquors. And moreover, there will be this advantage, that he that uses this dietetick Liquor for his ordinary Drink, may the freer indulge himself in other Diet, than when he drank Beer or Wine, for the Errors in Diet (all which 'tis almost impossi­ble for a Man to avoid) will by this means, be somewhat corrected and amended. But which is the chiefest of all, the Sick may prevent the Stone by this means, which is usually the constant com­panion of the Gout; for all sharp and attenuating Liquors, occasion a Fit of the Stone, as well as generate it. The following Liquor being of a pleasant Taste and Colour, pleases me best.

Take of Sarsaparilla ℥vi, of Sassaphras, China, and the Shavings of Harts-horn, each ℥ij, of Liquo­rish ℥i; boyl them in Two Gallons of Fountain Water for half an hour, afterwards let them stand cover'd upon hot Ashes 12 hours, after­terwards boyl it to the consumption of a Third part; as soon as 'tis taken from the Fire, infuse [Page 126] half an Ounce of Anniseeds, after 2 hours strain it, and let it stand till it's clear; keep the clear Liquor in Glass Bottles well stopt for use.

This Liquor is most conveniently us'd at first, when the Patient recovers of the Fit, and he must persevere in the use of it all the rest of his Life as well when he has the Fits, as at other times. At the same time the foresaid Electuary must be us'd daily, as well in the Fits, as when they are off; the Heat of this will somewhat allay the Water­ishness of the dietetick Drink, affording a due de­gree of heat to the Blood and Bowels, without that agitation which us'd to be occasion'd by the heat of fermented Liquors.

If any one shou'd object that that Life is scarce vital, wherein a total Abstinence from Wine and other fermented Liquors is observ'd: I answer, it must be consider'd whether it be not much more miserable and less tolerable, to be rack'd and dreadfully tortur'd by the Gout, grown strong by continuance, (for when the Disease is gentle, this is not requisite) than to be confin'd to this Liquor; the use of which being continued, he may indulge himself in almost all sorts of Food: Not to repeat now that this Drink (as all other things) grows pleasant by custom. Certainly he that has felt this Disease, if he be a Man, will not long dispute which is best.

Yet notwithstanding, if the Sick by reason of a long and too great use of intoxicating Liquors, or by reason of Old Age or Weakness, can't concoct his Meat without Wine or some other fermented Liquor, he can't leave it off suddenly without great danger, the doing whereof has been fatal [Page 127] to many. Therefore in my opinion, he shou'd not use the dietetick Apozem above describ'd; but if he be resolv'd to use it, let him be accustom'd to it leisurely, (drinking a Draught of Wine at Meals for some time) more like a Remedy than a Diet, till the Decoction becomes more familiar: But Spanish Wine is to be preferr'd in this case before French or Rhe [...]sh Wine, the two last be­ing apt to inrage the Humours, and to increase the Fomes of the Disease, tho' they are very grate­ful to the Stomach. Moreover, they are almost as crude, and scarce more concocted than our Sy­der, and besides they are not so cordial and hot, as the case requires. And so much may suffice for the Meat and Drink of gouty People.

There's another thing which tho' it may seem small, yet is it of great moment, as well for digesting the Fomes of the Disease, when the Fit is violent, as for hindering the generation of the Matter, when the Fit is off; namely, that the Sick, especi­ally in Winter, go to Bed early; for besides, Bleeding and Purging, nothing does so much de­stroy the strength of Nature, as watching a Nights, which every sickly person can affirm by Experience, if he considers how much brisker and more chearful he rises▪ when he goes to Bed early, and how languid and faint he is when has sat up late; and tho' it may seem as well, if he lyes a Bed so many hours, whether he goes to Bed soon­er or later: For instance, whether he goes to Bed at Nine, and rises at Five, or goes to Bed at Eleven, and rises at Seven; yet 'tis not so, and I suppose chiefly for this reason, viz. in the Day­time the Spirits are dissipated, either by the Exer­cise [Page 128] of the Body or Mind, which in People that are sickly, are so infirm and weak, that they have need of Rest earlier in the Evening; for the approach of Night occasioning as it were, a kind of Relaxation of the Economy of the Body, which was kept up in the Day-time, by the in­fluence of the Sun; 'tis necessary that the heat of the Bed shou'd supply the want of the Sun, especi­ally in Winter. But in the Morning, the Spirits being refresh'd and invigorated by the rest of the foregoing Night, and the warmth of the Bed, (besides, for that the supervening day adds Firm­ness and Strength to the Tone of the Body) rising early at this time, tho' an hour or two is taken from the Morning Sleep, Nature is not so much injur'd as by Evening Watchings protracted an hour or two. Wherefore I wou'd perswade those that are subject to the Gout, to go to Bed early; especially in the Winter, and to rise early, tho' Sleep somewhat shorter, may intice them to lye longer; for sleeping in a Morning, prevents so much Sleep the next Night, and so at length, a force being brought upon Nature, and its wise Institutions despis'd, Night is turn'd into Day, and Day into Night.

Moreover, Tranquility of Mind, must by all means be obtain'd; for all Perturbations, when they break the Bounds, mightly dissolve the frame of the Spirits, that are the Instruments of Di­gestions; and so by consequence, much promote the Gout. Therefore the Sick shou'd prudently consider his own mortal Condition, and not foolishly imagine that he is freed from those Troubles, that necessarily follow it; for whether [Page 129] he suffers this Affliction of Mind, either by his own Fault, or Fault of others, he can never pre­scribe Laws to the World, who has not been al­ways obedient to any one, how Potent and Wise soever he has been; nor does ever all things fall out so exactly, according to any ones Mind, as he fondly imagines, but suddenly as he is busied in Mind about the ordering of things, he becomes the Specimen of humane Frailty, having unrea­sonably depriv'd himself of the Enjoyment, of the fading Fruits of Life. The same Inconveni­ence, follows too great an Application of Mind to Study and serious things▪ for Melancholy always accompanying this Disease more than any other, those that are subject to it, are wont to tire and overwhelm the Animal Spirits, by think­ing much and long, without the artificial help of Books; and they do so mightly overthink, that the oeconomy of the Body, can't any longer pre­serve it self whole: For which reason in my opi­nion, this Disease seizes (except my self if you please) very few Fools.

But the Exercise of the Body is more profitable, than all other things that are us'd to hinder the Indigestion of the Humours, (which I reckon the chief cause of the Gout) and to corroborate the Blood, and to restore strength to the Parts: But it must be noted, which I have mention'd above, that as in this Disease, more than in any other Chronical Disease, the Habit of the whole Body ought to be chang'd,; the Exercise of the Body, unless 'tis daily, will do no good; for this kind of Exercise intermitted by turns, as it does scarce conduce any thing▪ to the change of the Habit of [Page 130] the Body grown Languid and Esseminate, by Sloth and Indulgence, so perhaps it may prove injurious, by occasioning the Fit when the Pa­tient has disus'd it a long while. But this ex­ercise ought not to be violent, but such as is a­greeable to Old Men, which are most usually the subjects of the Gout. For too violent a motion of the Body does too much dissipate the Spirits, and by consequence hurts the Concotions, where­as constant and moderate Exercise strengthens them. Though this may seem hard to a Man, who besides Old Age and Sloth, and the unfit­ness of the Body for motion, which is as it were natural in this Disease, is moreover punish'd with Pain; and yet if this be omitted, nothing which has been already found out will do any good. And as the Intervals of the Fits without constant Exercise of the Body can't be long, so such a one will be more prone to breed the Stone, which is more dangerous and more tor­menting than the Gout.

Moreover (which is of great moment) the Stony Matter is much increas'd by long rest in the Joints of the Body, especially of the Fin­gers, so that at length they are wholly depri­ved of all motion. For how confidently soever some People affirm, that the Matter▪ of these Stones is nothing else but the Tartar of the Blood put off upon the Joints, yet 'twill easily appear to any one that does a little weigh the thing more seriously, that when a great deal of unconcocted Matter causing the Gout, flows up­on some of the Joints, and renders the neigh­bouring parts tumid a long while, at last it hap­pens [Page 131] that partly by reason the assimulative ver­tue of these is choak'd, and partly by reason of a suffocating obstruction which this dull Humour breeds in them, the said Matter is generated, which is turn'd into this kind of Substance by the heat and pain of the Joints, and is daily in­creas'd, changing the Flesh and Skin into its own nature, which now lies naked, and may be pick'd out with a Needle, and is like Chalk, or Crabs Eyes, or some such thing. But now this ill may be prevented by daily exercise, by which the Humours causing the Gout, which are apt to seize on one part, are duly scatter'd through the whole Body. So that it come to pass as I have observ'd in my self, that long and daily exercise does not only hinder the generation of this Stony Matter, but also dissolves the Stones when they are hard and old, if they have not prevail'd so far, as to change the outward Skin into their own Substance.

As to the kind of Exercise, riding on Horse­back, when Old Age or the Stone does not hin­der, is much to be preferr'd before the rest: And truly I have many times thought with my self▪ that if any one knew a Medicine which he cou'd also conceal, as effectual in this and most other Chronical Diseases, as constant and daily riding on Horse-back, he might easily get a vast Estate. If this can't be us'd, riding in a Coach does almost as well; and on this account at least 'tis well with Gouty People, for their Riches which enti­ced them to Luxury▪ whereby the Disease was bred, can provide them a Coach, which kind of [Page 132] Exercise they may use, when they can't the o­ther.

But 'tis to be observ'd, that 'tis best to use Exercise in a good Air, viz. in the Country, and not in a City, where the Air is fill'd with Va­pours exhaling from the Shops of various Arti­ficers, and thicken'd by the closeness of the Buildings, as 'tis here in London, which is ge­nerally suppos'd to be the most spacious City in the whole World. But how great the difference is betwixt Exercising in the Country, and Exer­cise in Town, any one that has the Gout will soon find.

As to Venery, he that is Old and Gouty (be­ing now destitute of a stock of Spirits, where­by the Concoctions ought to be promoted, and by consequence his Joints and the neighbouring parts to them are but too much weaken'd and loosen'd without this adventitious destruction,) is equally as improvident in my opinion, if he indulge himself in these allurements, as he that having undertaken a long Journey, should con­sume all his Provisions before he sets out; for besides the Mischief he brings upon himself by not restraining the impotent desires of fee­ble Age, he deprives himself of the great privi­ledge of injoying that Jubile which is reserv'd as the great and special favour of Nature for Old Men only, whereby in the last Scene of their Lives, they are at length emancipated from the impetuosities of Lust, which like a rave­nous Beast worried them all the time of their Youth Night and Day: For the full satisfaction of these Appetites, can no way compensate for [Page 133] that long train of Miseries that either accom­pany or follow it. And so much for the Regi­men.

But though Rules of this kind respecting Diet and the other Regimen, if they are carefully ob­serv'd by those that are subject to the Gout, may preserve them from violent Fits of it, and may restore that strength to the Blood and Solid parts▪ whereby they may be freed from the ma­ny Miseries, on which account this Disease exceeds Humane Patience, and at length becomes Mor­tal; yet after some intervals, especially at the latter end of Winter, they will be sometimes seiz'd with the Gout▪ for though in the Sum­mer-time, when the tone and vigour of the Blood is excited and preserv'd in its state by the heat of the Sun, and there is likewise a due Elimina­tion of the Humours through the Pores, 'tis reasonable to suppose, that the Concoctions should proceed much better than in the Winter; yet when Winter approaches, the strength of the Blood being lessen'd, and the perspiration through the Pores hinder'd, there must needs be a great heap of indigested Matter, which by its long continuance causes a Fit, as soon as occasion is offer'd, either by the Humours put into Motion by the Patients so near approach to the Sun, or by drinking of Wine, or by violent Exercise, or any other evident cause.

'Tis manifest from what has been said, that he that endeavours to cure this Disease, ought to make it his business to change the habit of his whole Body, and to restore its old Constitution, as much as Age and other Circumstances will [Page 134] permit, which must be endeavour'd in the Spa­ces betwixt the Fits; not when the Fits are on, for when the Fomes is not only generated, but now is cast upon the Joint, 'tis too late to strive to change it, or to cast it out any other way, for 'tis to be ejected by no other method than Na­ture shews, wherein alone we must acquiesce; which is observ'd in the Fits of Agues, and for which-reason we do nothing till the heat is o­ver: Nor is he more absurd, that is anxiously busied about taking off the heat, drouth and restlefness, and other Symptoms of these Fevers, than he that thinks he has cur'd the Gout, when he has only labour'd to restrain the Symptoms; for by this means he has only made the cure of it more difficult; for the more he eases the Pain, the more he obstructs the Concoction of the Hu­mours, and the more he takes off the Lameness, the more he hinders the expulsion of the Mor­bifick Matter. Moreover the more the fury and the sharpness of the Fit is suppress'd, 'twill not only last longer, but the space betwixt the Fits will also be shorter, and less free from every de­gree of the Symptoms which accompany this Di­sease; which no one will deny that has well con­sider'd what I have treated of above concerning the History of this Disease.

But now though no great Matter must be at­tempted during the Fit, only the removing those Symptoms, which a false method of cure some­times occasions, yet seeing all allow that this Di­sease proceeds from an abundance and an exu­berancy of Humours, it may perhaps be con­venient for the Patient to abstain from Flesh for [Page 135] some Days when he's first seiz'd, and instead of it, to use Simple Barly Broth, or some such kind of Food, which sort of thin Diet conduces much towards the lessening the Morbifick Matter, and will give Nature an opportunity to digest it sooner. But forasmuch as there's a vast difference betwixt the Body of one Person and another, some not bearing abstinence from Flesh, but by reason of it are seiz'd with a confusion of the A­nimal Spirits, with Fainting, and other Symptoms which are wont to befal Women that are sub­ject to Hysterical Fits, these People are injur'd if they forbear Flesh any longer than their Sto­machs loath it, which seldom lasts beyond the first or second day of the particular Fits, all which join'd together as I mention'd above, make a whole Fit; but whether any one eat Flesh soon­er or later, great care must be taken, that they eat no more during the Fit than is necessary to sustain Nature. Nor is less care to be taken a­bout the quality of the Diet; for as in the in­tervals of the Fits, so more especially when the Fit is present, the Sick ought to take the greatest care, that he don't at all err in the quality or quanti­ty of his Meat or Drink. And moreover, more than ordinary care must be taken in observing every other Regimen, as well as this in the intervals; and though the pain as well as the unfitness for motion, may seem to contraindicate Exercise which I have commended above all others things, yet this labour must be undertaken. For though at the beginning of the Fit it may seem impos­sible that the Sick should bear to be carried into a Coach, and to be sure he's much less a­ble [Page 136] to bear the motion of it, and yet if he try it, he will soon perceive that he's less pain'd by such a motion, than when he keeps at Home in his Chair. And moreover he has this advan­tage, if he ride some Hours in his Coach, in the Morning, and after Dinner, that whereas when he sat at Home all day, he lay awak'd the great­est part of the Night, now he can sleep away the pain a great part of the Night; for very moderate Exercise does so weary a Gouty Man, that he falls asleep: And besides the same Exer­cise does somewhat prevent the Stone, which an easie Life most commonly occasions. But what is most considerable, the total impotence of the Limbs for motion, is help'd by constant Exer­cise, which happens to many after the First or Second Fit, the Tendons of the Hams and Heels being contracted; for when by reason of the tormenting Pain they have allow'd themselves to lye still a long time (being unwilling to ex­tend their Legs when the Pain has seiz'd their Knees,) at length they are depriv'd of the mo­tion of their Legs and Feet all the rest of their Lives, as well when the Fits are off, as when they are on, for they are not freed from them. Furthermore in Old Men, whose Concoctions are much vitiated, and who by reason the Disease has afflicted them many Years, have as it were the very substance of their Bodies turn'd to the Gout, 'tis not to be hop'd that the Disease without Exercise, can ever be brought to Dige­stion; for when the Disease is too strong for Nature, they often dye by Fainting and Sick­ness, which the abundance of the furniture for [Page 137] the Disease that can't be concocted produces, and they are destroy'd by this matter, that can't be concocted as by Poyson.

But notwithstanding what has been said of the Utility of Exercise in the Fits of the Gout, yet if the Sick by reason of the violence of the Fit, is as it were overwhelm'd presently by the first assault of it, (which happens to those for the most part in whom the Gout has now come to its height, nor is yet grown gentle by a course of many Years,) in this case if the Sick is con­fin'd to his Chamber, 'twill also be convenient that he keep his Bed for some of the first Days, 'till the violence of the Pain is abated, for the Bed does somewhat supply the want of Exercise, for the continual use of it does more powerful­ly digest the Morbifick Matter in a few Days, than keeping up in many, especially at the be­ginning of the Disease, if the Sick can abstain from Flesh without Fainting or other ill Symp­toms, and can be contented only with Barly Broth, Small Beer, and the like. But we must take notice that if the Gout is inveterate, and inclines the Sick to Fainting, Gripes, a Loose­ness, and such kind of Symptoms, he will scarce avoid being destroy'd by one of the Fits, if he don't use Exercise in a free and open Air: For a great many Gouty People have perish'd by these Symptoms, to whom they have been obnoxious by being confin'd to their Chambers, and espe­cially to their Beds; whereas had they bore the fategue of riding in a Coach the greatest part of the Day, they had not died so soon. For though he that is troubled with Pain only in [Page 138] one of his Limbs, may confine himself to his Chamber, yet another that instead of violent Pain is afflicted▪ with Sickness, and the other foresaid Symptoms, should he do the same, wou'd endanger his Life; and indeed 'tis well for the Sick when the pain is so violent, that he can't bear motion, for then there's no great need of it, the very pain which is the bitterest Remedy in nature, securing his Life.

But as to the Symptoms of the Gout, we must apply our selves to those whereby the Life of the Patient is indanger'd; the debility and faintness of the Stomach, with Gripes of the Belly as from Wine, is the most frequent of these which befalls those who either have been subject to the Gout many Years, or those who though they have not been long afflicted with it, have not­withstanding invited this mischief too early, by suddenly changing Spirituous Liquors for those that are thin and much cooling, or by applying repelling Plasters, and other cooling Medicines to the Parts affected, to asswage the Pain; upon which account the material cause of the Disease which ought to have been put off upon the Joints, is cast upon the Bowels. I have tried many things for the Fits of the last Years to lessen this Symptom; but nothing did so much good as a small Draught of Canary Wine taken now and then, when the Sickness and Faintness afflicts the Sick: Nor is Red French Wine, nor Venice Treacle, nor any other Cordial thing which I have yet known, so effectual. But we must i­magine that neither this Wine, nor any other [Page 139] Cordial if Exercise be not us'd, can wholly pre­serve the Patient.

But if any great Symptom scarce bearing a Truce comes suddenly by reason of the striking in of the Gouty Matter, and threatens Death, we must neither trust to the Wine, nor to the Exercise above commended; but in this case, if it does not fall upon the Head, but upon the Natural or Vital Parts, we must presently fly to Laudanum, namely, give Twenty Drops of Li­quid Laudanum, mix'd with a small Draught of Epidemick Water, and let the Patient compose himself to rest in his Bed. But if the Matter occasioning the Gout produces a Diarrhaea, be­cause 'tis not yet cast upon the Limbs, if it be not the Crisis of a particular Fit, and if notwith­standing Laudanum above commended, and Ex­ercise of all sorts, (for this must be first used for the Cure of the Diarrhaea,) the Looseness continues, accompanied with Sickness and Gripes, there's only one Remedy that I know of, viz. to provoke Sweat, by a Method and Medicines de­sign'd for this use, which if it be done Two or Three Days, Morning and Evening, for Two or Three Hours at a time, it most commonly stops the Looseness, and forces the Fomes of the Di­sease upon the Limbs. I cur'd my self by this Method some Years ago, after I had imprudent­ly cast my self into this Disease by Drinking Water for my ordinary Drink, when I had us'd Cardiack and Astringent Medicines of various sorts in vain.

There is another Symptom not so frequent, though I have seen it divers times, viz. a translation [Page 140] of the [...]eccant Matter upon the Lobes of the Lungs, when a Winter Cough by reason of Cold taken in the time of the Fit, has by degrees drawn the Matter upon the Lungs, the Limbs in the mean while being wholly or almost freed from the Pain and Swelling, by reason of the transla­tion of the Morbifick Matter upon another re­gion; in this one case the curative indication is not to be directed to the Gout, but this Symp­tom is to be treated as a true Peripneumonia, viz. by Bleeding repeated, and Cooling and Thickening Remedies and Diet; for the Blood drawn in this Symptom especially, is exactly like the Blood of Pleuriticks. Moreover the Sick must be Purged betwixt the Bleedings, whereby the Filth that's fallen upon the Lungs may be carried off. But Sweating how powerful soever 'tis in forcing the Fomes of the Disease upon the Limbs, does hurt in this case, by hardening the Matter that's thrust upon the Lungs; upon which ac­count small abscesses are generated, and at length the Sick certainly dies.

Moreover 'tis to be noted, that almost all Gouty People, when they have conflicted a long while with this Disease, are subject to the Stone of the Kidnies; and that they are wont to be troubled with Nephretick Pains, either in the state, but most commonly at the declination of a general Fit, which don't only torture him much, but also weakens him much, whereas he was but too much weaken'd and worn out be­fore. In this case, setting aside all other Me­dicines, let him presently take a Gallon of Posset-Drink, wherein ℥ij of the Roots of Marsh Mal­lows [Page 141] has been boyl'd, and let the following Clyster be injected.

Take of the Roots of Marsh-Mallows, and Lillies, each ℥i, of the Leaves of Mallows, Pellitory of the Wall, Bears Breach, and of the Flowers of Chamomel, each M i, of Flax and Fennu­greek Seeds, each ℥ss, boil them in a S. Q. of Water to lbiss, dissolve in the straining of Brown Sugar and Syrup of Marsh-Mallows, each ℥ij, mingle them, and make a Clyster. As soon as he has render'd all the Posset-Drink by Vomit­ing, and has rejected the Clyster, let him take a large Dose of Liquid Laudanum, viz. to xxv Drops, or xv Grains of Mathew's Pill.

If any one inquires for External Remedies to ease the Pain of the Gout, I have hitherto known none, (though I have tried many in my self and others,) excepting things meerly cooling and re­pelling, the use whereof I have shew'd above is dangerous. And I considently affirm, that the greatest part of those who have perished in the Gout, have not so properly been kill'd by the Disease, as by an improper use of Medicines. But if any one will try the vertue of External Remedies, which are certainly accounted Ano­dines, don't let him impose upon himself, by ap­plying them at the declination of a particular Fit, at which time the Pain is about to cease of it self; but rather let him use them at the be­ginning of a Fit, and then he will soon perceive how fruitless they are, and how vain his hopes. For indeed these Epithems may do hurt some­times, but they can never do any good. For which reason I have us'd no External Remedies many [Page 142] Years. The Pultis made with White Bread and Saffron boil'd in Milk, adding Oyl of Roses in small quantity, did heretofore do me more good than other things, and yet this signified nothing at the beginning of the Fit. Therefore if the pain be very violent, 'twill be better for the Sick to keep himself a Bed, 'till the Pain is a little abated, than to use external Anodines. But 'twill not be amiss to take a little Laudanum in the Evening, if the Pain is intollerable, other­wise 'twill be better to omit it.

But seeing I am now speaking of External Re­medies, I must say something of the Indian Moss, call'd Moxa, greatly esteem'd of late for the cure of the Gout, if it be burnt a little upon the part affected. Though this kind of Reme­dy is said to be receiv'd from the Oriental In­dians, being wholly unknown by the Europeans▪ yet 'twill appear to be known among us many Ages, to him that shall consult the Writings of Hip­pocrates, published above Two Thousand Years ago. He says in his Excellent Treatise of Di­seases, That if the Pain continues obstiuate in any one part, and can't be expell'd by Medicines, in what ever part it is, you must burn it with crude Flax. And afterwards speaking of the Gout, he says, the same things are good, which are proper in the Diseases of the Joints; and indeed this Di­sease is long and grievous, but not deadly. But if the Pain remains in the Fingers, burn the Veins in the Fingers, above the Joints, with crude Flax. Now I suppose no one will think that there's any Specifick difference betwixt the Flame rais'd by Flax, or by this Indian Moss, no more than [Page 143] he can suppose that a Fire kindled with pieces of Oak, can do any thing more than the Wood of the Ash-Tree. This Burning of the part af­fected may be useful for mitigating the Pain, the most Spirituous part of the Morbifick Matter cast off upon the Joints, being drawn out by it; but the benefit obtain'd by this means, forasmuch as it does not any way cure Indigestion, the an­tecedent cause of the Gout must needs be very short and fading, and to be used only when the Gout is beginning. For when the Gout, as it sometimes happens, is turn'd inward, either by its long Continuance, or by an unseasonable and undue use of Medicines, and so afflicts the Patient rather with Sickness, Gripes, and a great many other Symptoms of this kind than with Pain, I suppose no one will think that Fire is to be used.

THough it may seem imprudent to publish an Observation, whereof I have had only experience in my self, yet I suppose no un­prejudic'd Person will be angry with me, who have been so much and so long troubled with a Bloody Urine, occasion'd by the Stone in the Kidnies, for commiserating those that are af­flicted with the same Disease, and for discover­ing those Remedies that have eas'd me; though they are vulgar perhaps, and lightly account­ed of.

In the Year 1660, the Gout seiz'd me more violently, and continued longer than ever; and when on this account I lay'd continually for Two Months in the Summer-time, either in or upon a soft Bed; towards the latter end of the Fit I began to feel a dull and heavy pain, especially in my left Kidney, and sometimes, though rarely, in my right. And when I recover'd from the Gout, yet notwithstanding the Pain of the Kid­nies remain'd, which made me fear the Stone, though the Pain was not at all Acute, but tollerable enough; for I had not yet had a Ne­phretick Fit, which is accompanied with violent Pain, stretching it self through the Passage of the Ureters, and with violent Vomiting. But though [Page 145] these signs of the Stone in the Kidnies did not appear, yet I had good reason to believe, that I had a large Stone in the Pelvis of the Kidnies, which because 'twas too large to pass into the Passage of the Ureters, did not occasion the foresaid Symptoms. And many Years after I found I was not mistaken; for when in the Win­ter, 1676, presently after the breaking of a vio­lent Frost, I had walk'd much and a long time, I immediately render'd Urine mix'd with Blood, and so I did as often as I walk'd much, or rode in a Coach in Pav'd Streets, though the Horses went gently; but this did not happen to me, how far so ever I travell'd in the great Roads that are not pav'd The Urine that I void­ed then, though it look'd terrible as I render'd it, almost like pure Blood, yet soon after 'twas limpid and like it self at the top, the Blood clodding by it self at the bottom. For the cure of this Disease, I bled largely in the Arm, and after general Purges, I us'd cooling and incras­sating Medicines of various kinds, and a Diet agreeable to these things, and carefully avoided Acid and Acrid and Attenuating Liquors. But these and many other things which it would be tedious to mention, doing no good, and fearing to provoke the Stone forward, which I suspected was too big to be expell'd by Chalybeat Wa­ters, at length I left off all hopes of doing any good by them, and chiefly because I had ob­serv'd, that some Old Men of my acquaintance had hasten'd their end, while they were at­tempting in vain to cure this Disease by such Remedies. Wherefore I resolv'd to try no more, [Page 146] only by avoiding as much as I cou'd the motion of the Body, to prevent this Disease. But at length considering how wonderfully some praise the Li­thontriptick Vertue of the Seed of the Ash-Tree, I imagin'd that if the Seed of it had so much Vertue, 'twas very probable that the Manna of the Ash, shou'd have more; that as the Excellent Botanist Mr. Ray, and many other Writers say, not being airy Hony or coelestial Dew, but rather a Liquor sweating out of the Leaves, the Trunk and Branches of Ash-Trees in Calabria; the Truth whereof, was confirm'd to Mr. Ray, (when he travel'd Italy,) by a Learned Physician, who oft­ten gather'd Manna from the Branches and Leaves, when they were exactly cover'd with Linen Cloaths▪ See Ray's Catalogue of English Plants. Therefore being about to make the Experiment, I drank ℥ijss of Manna dissolv'd in lbij of Whey, swallow­ing now and then a little of the Juice of Lemons, while I was purging, to quicken this Cathartick, which us'd to work slowly, and to render it more pleasing to the Stomach. It can scarce be said how much Ease I receiv'd about the Region of the Reins, by the use of this Remedy; for tho' before they did not alwas ake, yet they were af­fected with a heavy and troublesome Pain. And because it succeeded so well with me, I took the same Cathartick on a set Day once a Week, for some Months; and after every Purge, I plainly found my self better and could bear the shaking of a Coach when it went fast, and was indeed wholly freed from this Symptom till the last Spring, at the approach whereof, having been miserably af­flicted with the Gout all the foregoing Winter, [Page 147] and by reason of my unfitness for motion, having liv'd without Exercise more than I us'd to do, the Bloody Urine return'd again; and now I doubted whether I shou'd betake my self again to purging, because of late years, the whole substance of my Body being as it were, turn'd into the Fomes of the Gout, the gentlest Purge did most certainly occasion a Fit of the Gout; at length I consider'd, that if I gave a Paregorick every Night after purg­ing, to quiet the Tumult the Purge had rais'd, I might safely resume my old method of taking Man­na once a Week. Therefore in the Morning I took ℥ijss of Manna in lbij of Whey, and in the Evening xvi of liquid Laudanum in Small-Beer, repeating the Manna and Laudanum in the said manner, twice a Week for Three Weeks; afterwards I us'd the Manna only once a Week, the Filth of the Humours being so copiously discharg'd by the Cathartick, that the Gout was not greatly to be fear'd, and my reason telling me, that if the Man­na was endow'd with any Faculty that is dissol­ving, or any other way Lithontriptic, to be sure the Vertue and Efficacy of the Remedy I trusted in, wou'd be somewhat lessen'd by such an astrin­gent Medicine as Laudanum is; and therefore I thought it better to omit the Hypnotic, seeing I purg'd only once a Week. I continued this me­thod some Months, always purging of the same day of the Week; nor wou'd I break this Custom, upon any account whatever. Tho' the pain of the Back remitted after the first Dose of this Remedy as formerly, yet soon after purging repeated, made the Gout appear, threatning War some­times in the Limbs, and sometimes in the Bowels; [Page 148] but Laudanum strongly repress'd these Motions of the Disease: And this method succeeding well hi­therto, I thought I ought to continue it, both to prevent the return of the Bloody Urine, and to lessen somewhat the Matter that generates the Stone, which answer'd according to my desire, this Hemorrhage wholly vanishing from the time I first publish'd this Treatise, and therefore I quite left off the Manna. Therefore as to purg­ing, (if there is a Bloody Urine, and if Manna be only us'd according to the method above deliver'd) I must retract my opinion which I publish'd con­cerning the Gout, viz. that 'tis no way fit that People subject to the Gout, shou'd be purg'd either at the beginning, or at the declination, or in the Intervals of the Fit. For then it did not come into my Mind, that the Fit occa­sion'd by the Purge, cou'd be restrain'd, by giving an Hypnotic at Night. Yet with respect only to the Gout, all Evacuations do much hurt, and therefore are not to be admitted, unless the fore­said Symptom requires the use of them.

I will add these things concerning the Regimen and manner of Diet, which seems to me, proper for those that are troubl'd with either of these Diseases; for I wou'd by no means pass by any thing that may be of use to those that are afflicted with the same Diseases I am. In the Morning when I rise, I drink a Dish or Two of Tea, and then ride in my Coach till Noon; when I return home, I moderately refresh my self with any sort of Meat of easie Digestion that I like; (for Mode­ration is necessary above all things) presently after Dinner every day, I drink somewhat more [Page 149] than a quarter of a Pint of Canary Wine, to pro­mote the Concoction of the Meat in my Stomach, and to drive the Gout from my Bowels: When I have dined, I betake my self to my Coach again, and when I have leisure, I ride into the Country Two or Three Miles for good Air. A Draught of Small-Beer, is to me instead of a Supper, and I take another Draught when I am in Bed and a­bout to compose my self to Sleep, that by this Julap I may cool and dilute the hot and acrid Juices lodg'd in the Kidnies, whereof the Stone is gene­rated. And I prefer at this time, and at Dinner-time, Small-Beer that has Hops in it, before that which has none. For tho' that which is not hopt, is smoother and softer, and so fitter to carry off the Stone from the Kidnies, yet that which is hopt, by reason of the stiptic quality which the Hops impart to it, is not so apt to generate sandy and stony Matter, as that which is not hopt; the Substance whereof, is more viscous and slimy. I take care to go to Bed early, especially in Win­ter, than which nothing is better to render the Concoctions perfect, and likewise to preserve that Form and Order which of right, belongs to Na­ture. Whereas on the contrary, Night-works lessen all the Concoctions of Old Men that la­bour with any Chronical Disease, and danger­ously wound their Vital Principle. And to pre­vent a Bloody Urine by reason of the Stone, I take great care that as often as I am to ride a long way upon the Stones, (for if I travel never so far in a Coach in the common Roads, I receive no damage) to drink a large Draught of Small-Beer before I go into the Coach, and also before [Page 150] my Return, if I have been abroad a pretty while, whereby I secure my self very well from the Bloody Urine. But as to the Gout, I will add this one thing, of late Years by reason of some Errors about the Six Non-naturals, the Gouty Matter sometimes strikes in, the Signs whereof are violent Sickness with Vomiting, and some pain of the Belly, the Limbs in the mean while are suddenly free from Pain, and more fit for motion than is usual. In this case I drink a Gallon of Posset-Drink, or Small Beer, and as soon as 'tis all rejected by Vomiting, I drink a small Draught of Canary Wine, with Eighteen Drops of Liquid Laudanum in it to compose me to rest; and by this means I have divers times rescued my self from imminent Death.

Though perhaps it may seem ridiculous, (es­pecially for one who's being well or dead, is scarce of any consequence,) to make such fre­quent mention of one's self, yet these things are said, to the intent others may be benefited thereby, whose Lives or Health are of greater value or moment.

Lastly, 'tis to be noted into what great danger some that are afflicted with the Gout and Stone cast themselves, by taking unadvisedly Manna dissolv'd in Purging Mineral Waters; for though when 'tis taken this way, it works quicker, and is not so nauseous, yet these little Convenien­cies can't equal an Injury occasion'd by the Wa­ters on another account. For if the Stone in the Kidnies is so large, that it can't pass through the passage of the Ureters into the Bladder, these Waters most commonly occasion a Fit, which [Page 151] indures to the great hazard of the Patient's Life, till the Stone returns into the Pelvis. Nor can the Sick safely venture upon Chalybeat Waters, unless he can can certainly know first that the Stone is not so large, but that it may either find or make a way through the Ureters, which so far as I understand, can be known only certain­ly this way; viz. If before he has been seiz'd with a Nephritick Fit, (with violent pain in ei­ther of the Reins, stretching it self through the passages of the Ureters with violent Vomiting,) he has found that there is not so properly a large Stone in the Pelvis, as a heap of small Stones, whereof one will now and then fall into the U­reter, and so cause a Fit, which does not go off 'till the Stone is thrust down into the Bladder. When the case is so, there's no more effectual Remedy, either to prevent the increase of small Stones, or to drive them from the Reins, than the Drinking freely of Chalybeat Waters a long while every Summer.

But because it often happens, that one is seiz'd with a Nephritick Fit, when these Mineral Wa­ters are not to be got, or when the Season of the Year is not favourable for drinking of them. In this case you must proceed in that short Me­thod for the Stone in the Kidnies, mention'd at the latter end of the foregoing Chapter. But if the Sick is of a Sanguine Constitution, and not Antient, ℥x of Blood must be first taken from the Arm of the same side with the affected Kid­ney.

But Old Men worn out by some Chronical Di­sease, and Old Women subject to Vapours, (es­pecially [Page 152] if at the beginning they void a black and Sandy Urine,) must not bleed; but as to o­ther things, they must proceed wholly according to the Method now deliver'd.

But to return to the Stone when 'tis large, the business in Hand, if the Nephritick Person was never seiz'd with a Fit of the Stone, that being too large to fall out of the Pelvis, Iron Waters can't be us'd for Reasons above-mention'd, with­out present danger. Nor does the use of Mine­ral Waters prove better in Gouty People, if they are old, as they are most commonly, and of a Weak and Phlegmatick habit of Body, for in these the strengh of Nature is so much les­sen'd, that 'tis greatly to be fear'd that such a quantity of Water may wholly overwhelm it. But whether this is the cause of the Injury that falls upon Men of such a habit of Body or Con­stitution or not, I am sure many whose Bodies have been much broken by this Disease, have been kill'd by these Waters.