CHAP. I. Instructions concerning Vomiting, with Precepts of Vomits.

THat a Vomitory Medicine may be duly Admini­stred; We ought to consider what are the Indications or Signs which foreshew the want of it, what things permit it, and which pro­hibit it.

It is a sign that a Vomit is needed, when a bilous and bitterish humour floats in the Ven­tricle, so that from thence a nauseousness, an ungrateful savour, or a Head-ach is caus'd: Also if the Stomach be burthen'd with a viscous Phlegm, as in the longing disease of Maids, and in Men after Surfeiting, and disorderly eating or drinking.

In most cases when with a difficulty of breathing, the loaded Ventricle is affected with a lothing of meat or nauseousness, up­ward Purging is a common Remedy.

Moreover, when the Stomach is beset with some Exotick fer­ment, so that it presently casts up whatsoever is taken into it, even though the cause of it proceeds from some remote parts; Vomiting is often advis'd with good success: for by this means, the Vessels that contain the Gall being very much drain'd, the Choler is emptied from the Blood in a more plentiful manner, and its Feaverish distempers are taken away.

Again, forasmuch as the Superfluities or Stagnations of the Ner­vous humour are most easily Cur'd by this means of Evacuation; the use of Emeticks contributes not a little toward a Cure in the Gout, Asthma, Epilepsy, Madness, and very many other Di­seases which are accounted great, and most difficult to be con­quered.

Secondly, As to things that permit this Remedy, it may be given where there is a strength of the Viscera, and a firm consti­tution of Body, and especially to those whose Neck and Breast are but short, so that there is a nearer passage from the Stomach to the Mouth: We are encourag'd also to give a Vomit to such as Vomit easily, and bear it well, and when the matter to be ex­pell'd is lax, and comes away readily; also when we find Nature in a calm, and as it were at leisure for such an undertaking.

Thirdly, The use of Emeticks seems to be prohibited, where there is a difficulty of Vomiting, or an unaptness to it found by former experience, where there is a tender and weakly Constitu­tion, a tall and slender Stature, infirm Inwards, and especially if there be a Consumptive Disposition, with an Ulcer of the Lungs, or Spitting Blood; also where there is a too great Cachexia, in which there is danger, lest the humours should be forc'd from the whole Body all on a sudden into the Ventricle: Moreover an un­usual effervescence of the Blood, the fits of Feavers, and an expe­ctation of a Crisis, do wholly exclude this sort of Medicine.

CHAP. II. A Cure for over-working of Vomits; and Anti-Emetick Medicines, or such as stop Vomiting, with Instructions.

IF a Vomit over-works, let the Patient presently be put to Bed, and let him make use of both External and Internal Reme­dies; and first of all to appease the disorders in the Stomach, let there be outwardly administred to it, either a warm-Fomenta­tion of the decoction of Sea-Wormwood, Mints and Spices in Red-Wine, or let a slice of the Pith of Bread be Toasted, and dip'd in Claret-Wine warm'd and apply'd thereto: Let there be a Glister given of Milk, with Treacle dissolv'd in it. Let also warm fricti­ons of the Members be us'd, and strong Ligatures above the Knees to keep Convulsions from those parts; let the Stomach in the mean time be kept empty, unless an inclination to faint, or swouning otherwise requires, but as soon as it is able to receive any thing of Food, or Medicine, give some Cordial Water or m [...] Burnt-Wine: In case the Affect be very violent, and the Pulse admit it, Venice Treacle or Diascordium, sometimes also a Solution of Laudanum or an Opiatick Tincture do well.

Praeternatural Vomiting stirr'd up from other causes, is either Critical or Symptomatical: In the former nothing must be done too much in haste or unadvisedly; that excretion so there be a sufficiency of strength ought not to be stay'd, but the discharge [Page 4]of the matter to be expell'd, is either to be facilitated or hastn'd, or it is to be converted some other way; hence when a person is urg'd by a nauseousness, or striving to Vomit, you may properly give either plain Posset-drink, or with the Leaves of Carduus boil'd in it; also sometimes Oxymel or Wine of Squills, or Antimonial Wine; sometimes it may be good to use Glisters, sometimes also a gentle Purge carries away the matter offending the Stomach, by a more easie way of Evacuation through the Intestines.

Symptomatick Vomiting proceeds from a conjunct cause, either subsisting in the Ventricle, which produces that Idiopathick Affect, or fix'd in other parts, which stirs up their Convulsions, and con­sequently Vomitive Convulsions of the Ventricle, by a commu­nication of the Nerves; the Cure of which Sympathick Vomiting depends on the Cure of the Primary Disease.

When the Stomach is Primarily Affected, it is because its Fi­bres are irritated to an Excretion by some matter which it can­not duly digest or overcome, or press forwards into the the In­testines, which matter becomes so disagreeing or refractory, ei­ther by its own offensive quality or quantity, or through the fault of the Stomach it self, its Tome being become lax, and its Fibres so weak, that they are not able to brook or indure the Chyle it self, much less the Excrementitious humours, but cast all forth by Vomiting: There being various cases and manners of affect­ing of both these, we shall here briefly set down some of the chief of them together with the Remedies.

The Emetick matter subsisting in the Ventricle, is either brought into it from elsewhere, or what for want of digestion, or because it is vitiated, is engendred there; in either respect, the present offensive load is first of all to be carried off, and then care must be taken to prevent any farther supply of it.

To cleanse the filthy Mass of viscous matter forth of the Sto­mach, prescribe a gentle Vomit of Carduus Posset-drink; or of Oxymel, or Wine of Squills, or of a Decoction of the Flowers of Chamomil, or of the Roots of Eupatorium, or give a Solution of the Salt of Vitriol, or such like; then let the remainder be gently carried off by Glisters, or by a Purge of Pilulae Mastichin: or Pil. Stomach. cum Gummis, Tinctura Sacra, or an Infusion of Rhubarb.

Moreover, when an impure or rank Blood, conveying ever and anon new Stores of offensive matter to the Stomach, either by the Arteries, or by the Gall-Vessels which often overflow, causes a disposition to Vomit, Bleeding frequently affords relief, and therefore Women with Child troubled with Vomiting, are often Cur'd by this means; those things also do good which so temper the Blood, that they keep it free from breeding adust Excre­ments: Hence Whey, Mineral Waters, Juices of Herbs, Sal Pru­nella, [Page 5]and such like, for as much as they fuse the Blood, and convey its dreggy Particles some other way, often remove Vo­miting dispositions. These sorts of Remedies may also be us'd in case a frequent and daily Vomiting proceeds (as some think it may) from the meetings and contest of the Bilous and Pancrea­tick humours, and from their regurgitation into the Ventricle.

The more frequent Vomiting, and harder to be Cur'd, is that which proceeds from a disagreeing matter, and consequently E­metick engendred within the Ventricle, to wit, by reason of the vitiated ferment of the Stomach, whatsoever is taken into it de­generates into an irritating Mass of Corruption; wherefore in this case, after that the filth of the Stomach is cleans'd forth by gentle Evacuatives, Remedies commonly call'd Digestives are generally us'd; which according as the fermenting Juice of the Stomach (being for the most part of a Saline Nature, and sometimes of a Sulphurous) is in a various state of fixtness, flowing, or adusti­on, are variously prescrib'd, and sometimes these, sometimes the others do most good.

In Belching and Acid Vomiting, these following Medicines may be try'd, and you may fix upon your method of Cure according to what you find agrees best.

Take Powder of Aron Compound an Ounce and a half, Salt of Worm­wood two Drams, Sugar of Roses three Drams, make a Powder: give a Dram of it in the Morning, and at five a Clock in the Afternoon, in a little draught of Beer boil'd with Mace and a Crust of Bread, or give it in the distill'd Water, or Tincture of Roman Wormwood.

Take the Powders of Ivory, Crabs Eyes, and red Coral, of each two Drams, Calcind Coral one Dram, red Saunders, Cinnamon of each half a Dram, make a Powder: the Dose is half a Dram after the same manner.

Take the Powders of Lignum Aloes, yellow Saunders, Winters Bark, of each two Drams, of white Chalk six Drams, Sugar-Candy half an Ounce, with the Solution of Tragacanth in Mint Water as much as suffices, make a Past, and let it be form'd into Troches, weighing half a Dram; let the Patient take three or four of these thrice, or oft­ner in a day.

Take Tincture of Salt of Tartar an Ounce, the Dose is from a Scru­ple to half a Dram twice a day in some proper distill'd Water.

In hot and sharp or tartish Vomiting, Medicines endow'd with a sharp or tartish and vitriolate Salt are more proper. The famous Medicine of Riverius in this case does well.

Take Salt of Wormwood a Scruple, give it in a spoonful of Juice of Limmons.

Take prepar'd Coral two Drams, Salt of Wormwood a Dram and a half, Juice of Limmons four Ounces, let all stand in a large Glass; [Page 6]add to it of strong Cinnamon-water two Ounces, give a spoonful or two twice a day, first shaking the Glass.

Take Powders of Ivory and Coral of each two Drams, Vitriol of Steel a Dram, Sugar-Candy a Dram, mix them, then divide the whole into six or eight parts, of which take one part twice a day in some convenient Vehicle.

In this case, Purging Mineral Waters which have much Nitre in them, also Waters that come from an Iron Mineral, and like­wise our Artificial Chalybeate Waters prove of notable effect.

When at any time the Stomach perverts the most part of what comes into it, into a bilous and bitterish Mass of filthy cor­ruption (as it often uses to do) and for that reason is prone to frequent Vomitings, then both acid and bitter things are pro­per.

Take Elixir Proprietatis an Ounce, the Dose is a Scruple twice a day in some fit Vehicle.

Take Rhubarb Powdred twenty five Grains, Salt of Wormwood a Scruple, Cinnamon-water half an Ounce, Juice of Limmons an Ounce, let it be taken alone, or with some other Liquor.

Take Powder of Aron Compound an Ounce and a half, white Chri­stals of Tartar three Drams, Vitriol of Steel a Dram, Sugar half an Ounce, make a Powder: the Dose is half a Dram, or two Scruples eve­ry Morning, drinking after it a draught of the Tincture of Roman Wormwood, or some Coffee.

Take Powder of Crabs Eyes half an Ounce, Chalybeat Tartar two Drams, Sugar-Candy a Dram, make a Powder: the Dose is half a Dram, with a fit Vehicle twice a day.

Oftentimes the cause of a frequent and habitual Vomiting, is not so much the matter irritating the Ventricle, as the extream debility of its Nervous Fibres, which are neither able to Concoct what is taken into the Stomach, nor to endure the weight or burthen of it, but are presently irritated by any thing lying up­on them, and stir up the Carnous Fibres to Excretory Convul­sions.

There are two principal causes of this sort of Affect, viz. ei­ther the debility of the Stomach arising from the Fibres them­selves, is gotten by disorder in eating and drinking, so that those Fibres, for as much as they are beyond measure extended or o­ver-heated, and as it were scorch'd, are not capable of admitting or containing a sufficient plenty of Animal Spirits: Or Secondly, These Fibres though they may be well enough dispos'd of them­selves, yet for that the Nerves are in some other place obstruct­ed, they are destitute of a due Afflux of Spirits, whence becom­ing languid and flaxid, they cannot bear what is taken in, but pre­sently finding themselves over-charged, throw all forth by Vo­miting.

In the former Affect, those Remedies are indicated, which by their Styptick force cause the too much distended and tenuated Fibres to corrugate and contract themselves into a shorter space; also such as by their most grateful refreshment enliven their lan­guishing Spirits, and allure others more plenteously to them.

Take Mynsicht 's Elixir of Vitriol an Ounce, give from ten Grains to fifteen twice or thrice a day in a spoonful of the following distill'd Water, drinking seven or eight spoonfuls of the same after it.

Take Cypress Tops six handfuls, Clary Leaves four handfuls, the out­ward Coats of twelve Oranges, Cinnamon, Mace, of each an Ounce, the Roots of Cyperus and the lesser Galingal of each half an Ounce, be­ing slic'd and bruis'd, let them be put into eight pounds of Brunswich Beer, and distill'd in an ordinary Still.

Take Tincture of the Balsam of Tolu, extracted with the Tincture of Salt of Tartar an Ounce: the Dose is twenty Grains with the same Vehicle: the Tincture of Wormwood prepar'd with the same Menstruum may also be try'd.

Take Powder of the Leaves of Wormwood and Myrtle dri'd in the Sun in the Summer time, of each two Drams, Cinnamon, Flowers of red Roses of each a Dram, Cubebs, Roots of the lesser Galingal of each half a Dram, red Coral prepar'd a Dram; make of all a subtle Pow­der, then with six Ounces of double refin'd Sugar dissolv'd in Cinna­mon-water, and boil'd up to a consistency, make it up in little Cakes, weighing half a Dram, let one or two of these be eaten often in a day, as the person pleases.

Take Conserve of red Roses vitriolated four Ounces, Myrobalans con­dited six Drams, Ginger condited in the Indies half an Ounce, Species of Hyacinth two Drams, the reddest Crocus Martis one Dram, Syrup of Corals what will suffice, make of all an Electuary, the Dose is a Dram twice a day, drinking after it a little draught of the distill'd water.

In the debility or resolution of the Ventricle, by reason of the Nerves being somewhere else abstructed, Paralytick Remedies joyn'd with Stomachicks must chiefly be insisted on.

Take Elixir Proprietatis Tartariz'd an Ounce, the Dose is a Scruple twice a day, with the water above prescrib'd. The Tinctures of Salt of Tartar, of Coral, of Antimony may be us'd after the same manner. In this case also the sweet spirit of Salt, tht spirit of Sal Armoniack, or its Flowers are of great effect: Moreover Vomits, Purges, and even Diaphoreticks are often successively administred, I have known this Distemter sometimes happily Cur'd by Bathing in our hot Baths at Bathe.

CHAP. III. Instructions concerning Purging, with prescripts of Purges.

AS Nature often Purges it self according to three Degrees, so there are three Degrees of Purging by Medicine.

The first is soft and easie, gently expelling any loose matter contain'd in the Ventricle and the Intestines.

The second reaches not only that, but Purges likewise other humours from the Bilous and Pancreatick Passages, and from the Mouths of the Vessels.

The third performs all this, and that in a more full manner, and going yet farther, strongly Purges from the Blood, and con­sequently from the Nervous Juice and other parts, an Excremen­titious matter which is brought by the Arteries into the Inte­stines.

As for what concerns the choice to be us'd in Purging Medi­cines, though we do not approve of those cry'd up Classes of Medicines appropriated to this or that Juice or Humour; yet we do not think that all Purges are indifferently to be us'd in all ca­ses, but that there is need of a strong Judgment, and a wary cir­cumspection in a Physician, that according to the strength of his Patients, their temperament, the state and ability of the Viscera, their bearing, custome, and fancy, and so according to the nature, of the Disease, its time and quality, he prescribe a Purge more gentle or strong; and that of hot things, or temperate, gentle or more smart, and in a solid substance or a liquid, or something of some other certain kind and form, as he shall see good.

A Purge therefore being not convenient at all times, nor in every state of Body; to proceed as we ought, we must take a fit season, and use a certain preparation, and both these have regard to the first passages, and to the Mass of Blood.

As to the first, if at any time the Stomach be loaded with a Mass of viscous Phlegm, or troubled with the boiling of Turgid Choler, a Purge most commonly either becomes of no effect or does hurt, unless those contents are first of all cleans'd forth by a Vomit, or unless their oppression and effervescency be corre­cted by digestives.

As to what regards the Blood, a Purge is often unseasonable, sometimes also inconvenient, and in neither of these cases Prepa­ratives commonly so call'd, but only Alteratives are proper, for [Page 9]the business is not to dispose those imaginary humours for evacu­tion, but the Blood it self ought to be reduc'd from its troubled and confused state to a calm condition, or from its debility and fall'n Crasis to its vigour and ev'n temperament. Whilst the Blood Feaverishly boiling is disturb'd in its mixture, Purging is always found hurtful; and so whilst its Mass being become lan­guid and weak, does not arise to its due fermentation, that sort of Evacuation is no less forbidden. Moreover, when the Blood is too bilous or watry, or too much inclin'd to Coagulations or Fusions, Purges for the most part do not take away those its defaults or depravations, but most commonly encrease them: Wherefore in those cases altering Remedies are rather Indicated which may destroy the undue Separations and Combinations of the Salts, Sulphur and Serum, and take away other their enormi­ties. Of these Digestives and Alteratives which supply the place of common Preparatives, we shall speak particularly here­after.

The chiefest Compositions of Purging Medicines being Potions, Powders, Bolus's, Electuaries, Morsels or Tablets, and Physick-Ales or Wines, we shall here set down certain of the more Select Forms of each of them, and those of a threefold kind, according as the operation of the Medicine ought to be gentle, mean, or strong; to which in the fourth place we shall add Prescripts of easily pre­par'd Purges for poor People.

1. Gentle Potions. Take Rhubarb slic'd three Drams, yellow Saun­ders half a Dram, Salt of Tartar a Scruple, make a cold Infusion all Night in Cichory water and White-wine, of each two Ounces and a half, to three Ounces of Cleer straining, add Syrup of Ci­chory with Rhubarb half an Ounce, Cinnamon water two Drams, make a Potion.

2. Mean Potions. Take of the best Senna three Drams, Rhubarb, Troches of Agarick of each a Dram and a half, yellow Saunders two Scruples, Salt of Tartar half a Dram, Coriander-seeds a Dram; let them have a close Infusion all Night in Spring-water and White-wine made warm, of each three Ounces; to four Ounces of it strain'd, add of the Purging Syrup of Apples an Ounce, Aqua Mirabilis two Drams, make a Potion: Or, Take the decoction of Senna Gerionis four Ounces, Syrrup of Roses Solutive an Ounce, Cream of Tartar half a Dram, Cin­namon water two Drams, make a Potion.

Take the best Senna, Cassia Fistula, Tamarinds, of each half an Ounce, Coriander-seeds two Drams, boil all in ten Ounces of Spring-water, till a third part be consum'd, strain it, and Clarifie it with the White of an Egg, add to it the Syrup of Apples an Ounce, make a Potion.

3. Strong Potions. Take of the decoction of Sena Gerionis (with the addition of the strings of black Hellebore and Agarick, of each a [Page 10]Dram and a half) six Ounces, Syrup of Roses Solutive, or of the flow­ers of Peaches an Ounce, Aqua Mirabilis two Drams: Or,

Take of the best Sena half an Ounce, strings of black Hellebore, Tur­bith, of each two Drams, yellow Saunders a Dram, Coriander-seeds a Dram and a half, Salt of Tartar half a Dram; let it infuse close all Night in eight Ounces of White-wine made warm, to five Ounces of the Cleer straining, add of the Electuary of the Juice of Roses three Drams, Syrup of Buck-thorn six Drams, Cinnamon water two Drams, make a Potion.

Potions of easie preparation for the Poor. Take of Flaxweed a handful, sweet Fennel-seeds two Drams, boil them in a sufficient quantity of Spring-water till it comes to six Ounces, add to it of White-wine two Ounces, make a Potion. After the same manner you may make a Purging Potion of the Flowers of Damask Roses; also of Peach Leaves, and so of the Roots of Eupatorium Avicennae.

PILLS. First of a gentle Operation. Take of Stomach Pills with Gums, from a Scruple to half a Dram, Tartar vitriolated two Grains, Balsam of Peru what will suffice, make thereof three or four Pills. After the same manner may be made Pills of the mass of Pilul. Ruffi, of Pilul. Mastichin: of Pilul. de Succino, and of our extract Solutive, the description of which you may find in our Tract of the Scurvy.

2. Mean Pills. Take of Stomach Pills with Gumms half a Dram, Rosin of Julap from four Grains to ten, Tartar vitriolated six Grains, Ammoniacum dissolv'd, as much as will suffice, make four Pills. After the same manner may be made Pills of the mass of Pilulae de Succino, Tartari Quercitani: Also instead of Rosin of Jluap, you may put Scam­mony Sulphurated, from six Grains to twelve, or Rosin of Scammony from eight Grains to fourteen. Or, Take Stomach Pills with Gumms a Scruple, Rosin of Julap from six Grains to twelve, Balsam of Peru as much as will suffice, make four Pills.

3. Strong Pills. Take Pilulae Rudii half a Dram, Rosin of Julap from eight Grains to twelve, Balsam of Peru what will suffice, make four Pills to be taken cum Regimine. After the like manner Pills may be made of the mass of Pilulae Cochiae, de Sagapeno. Take of Pilulae ex duobus from a Scruple to half a Dram, Calamelanos a Scruple, make four Pills to be taken Cum Regimine.

4. Pills easily prepar'd, and cheaper. Take Powder of the best Ja­lap two Drams, Diagridium a Dram, Cloves, Ginger, of each a Scru­ple, Ammoniacum dissolv'd, as much as will suffice, make a mass, the Dose is half a Dram.

Take of Pilulae Cochiae, from half a Dram to two Scruples, let four Pills be made.

POWDERS. First, such as are gentle. Take of Rhubarb Pow­dred half a Dram, Salt of Wormwood half a Scruple, Cloves two [Page 11]Grains, make a Powder, give it in a spoonful of small Cinnamon-water, or in a little Broath.

Take of the greater Compound Powder of Sena, from half a Dram to a Dram, in a little draught of Posset-drink.

Take Powder of the Leaves of Sena a Scruple, Calamelanos seven­teen Grains, yellow Saunders half a Scruple, make a Powder, give it in a spoonful of Panada.

2. Mean Powders. Take Powder of Diasena a Dram, Cream of Tartar a Scruple, make a Powder, give it in a little draught of Broath.

Take Rosin of Jalap ten Grains, Calamelanos a Scruple, Cloves six Grains, make a Powder, and take it after the same manner.

Take Species of Diaturbith with Rhubarb, from half a Dram to a Dram, Cream of Tartar from a Scruple to half a Dram.

3. Strong Powders. Take Turbith, Hermodacts of each three Drams, Diagridium a Dram, Ginger a Scruple, make a Powder, the Dose is from half a Dram to a Dram.

Take Pulvis Cornachini a Dram; after the same manner may be given the Compound Powder of Hermodacts; also the Hydrotick Pow­der of Riverius.

4. Cheap Powders and easie to be got. Take Powder of the Roots of the best Jalap a Dram, Ginger a Scruple, give it in a little draught of White-wine; so you may give Powder of the Roots of Mechoachan, also of the Leaves of Sena in any Liquor.

BOLUS's and ELECTUARIES. First, such as work gently. Take of the Lenitive Electuary half an Ounce, Cream of Tartar half a Dram, Syrup of Roses what suffices, make a Bolus. Take fresh Cassia half an Ounce, Powder of Rhubarb half a Dram, Cream of Tartar a Scruple, Syrup of Roses as much as suffices, make a Bolus.

2. Mean. Take of the Lenitive Electuary half an Ounce, Cream of Tartar half a Dram, Rosin of Julap six Grains, Syrup of Roses what suffices, make a Bolus.

Take of the Electuary Diaphaenicon half an Ounce, of the Com­pound Powder of Hermodacts half a Dram, Syrup of Elder what suffi­ces, make a Bolus.

3. Strong Workers. Take of the Electuary of the Juice of Roses half an Ounce, Rosin of Julap ten Grains, Cream of Tartar half a Dram, Syrup of Elder what suffices, make a Bolus.

Electuaries are Compounded of the same things made up in a great­er quantity, by adding Conserves of Damask Roses, or of the Flowers of Peaches; the Dose is the quantity of a Chesnut to be taken betimes every Morning, or twice or thrice a Week.

4. Bolus's and Electuaries easily prepar'd. Take Powder of the Roots of Julap an Ounce, of Mechoachan half an Ounce, of Ginger two Drams, of Cloves a Dram, Cream of Tartar three Drams, Salt of [Page 12]Wormwood a Dram, Sugar two Ounces, Syrup of Roses Solutive what suffices, make an Electuary, the Dose is the quantity of a Wallnut.

Confectio Solutiva, & Passulae Laxantes, the Diapranum of Sylvius in the 30. Page of his Practice of Physick.

5. Morsells or Tablets of a mean operation. Take Powder of Me­choacan, Gummous Turbith of each half an Ounce, Scammony sulphu­rated two Drams, Rosin of Jalap a Dram, yellow Saunders a Dram, Cream of Tartar two Drams, Conserve of Violets an Ounce, Sugar dissolv'd in Rose-water, and boil'd up to a fit consistency a Pound. Make Tablets according to Art, each weighing a Dram, the Dose is one or two. The Purging Tablets of Sylvius, Page the 28. of his Pra­ctice of Physick.

6. Physical or Purging Wines and Ales of a mean operation. Take Leaves of Sena an Ounce and a half, Turbith, Mechoacan of each six Drams, strings of black Hellebore three Drams, Cubebs, Ga­lingal Roots, choice Cinnamon of each two Drams: Put all in a large Glass, with four Pounds of Rhenish-wine, adding to it Salt of Tartar a Dram and a half, let it stand cold and close cover'd for six days, add to it Sugar-Candy three Ounces, strain it through Hippocrates Sleeve, the Dose is three or four Ounces.

Take Leaves of Sena three Ounces, Roots of Polypody of the Oak, and of sharp Pointed Dock prepar'd, of each two Ounces, Turbith, Mecho­acan, of each an Ounce and a half, Epithymum, yellow Saunders of each an Ounce, Coriander-seeds an Ounce and a half; let them be slic'd and bruis'd, and put in a Bag according to Art, for four Gal­lons of Ale. the Dose is from twelve Ounces to a Pound, either every Morning, or twice or thrice a Week.

CHAP. IV. A Cure for Over-purging, or of Medicines that stay too much Purging, or a Looseness: Also the Cure of the London-Flux; with Instructions in each Case.

TO prevent over-purging upon giving any Purging Medicine, we must proceed thus: Before we give a Purge, we must first consider well the Constitution, Strength and Custome of the Body to be Purg'd; as also the Nature, Dose, manner of Work­ing, and ordinary effects of the Medicine to be given, and then [Page 13]by comparing the one with the other, we must proportionate the vertue of the Agent according to the bearing of the Patient. Secondly, whilst the Medicine is working, let the Viscera where digestion is perform'd, the Blood, and the Animal Spirits be kept free from any other perturbation: Wherefore during that time, let not the Patient eat gross or viscous food, or too great a plenty of any food, which may offend the Stomach, let him carefully avoid the admittance of any outward cold, by which the Pores of the Body are shut up, also let the mind be kept calm and undi­sturb'd, free from all Cares and toilsome Studies. Thirdly, The Operation of the Medicine being ended, we must appease the an­gry rage of the Animal Spirits, and allay the effervescence of the Blood and Humours; for which ends let an Anodine Medicine, or a gentle Hypnotick be given according to the following forms.

Take Water of Cowslip Flowers two Ounces, Cinnamon-water hor­deated, Syrup of Maeconium, of each half an Ounce, Pearls half a Scruple, make a draught to be taken going to rest: Or,

Take Conserve of red Roses vitriolated two Scruples, Diascordium half a Dram, Pearls half a Scruple, Diacodium what suffices, make a Bolus to be taken going to sleep.

In case this Provision be either omitted, or does not hinder a Purging Medicine from working to excess, let the Patient pre­sently be put into a warm Bed, and be ordered as follows. First, Let either a Plaister of Mithridate be apply'd to his Stomach, and to the whole upper Region of the Belly; or let those parts be fo­mented with warm Linnen Cloaths, dip'd in a decoction of Worm­wood, Mints, and Spïces in red Wine, and so wiung forth; present­ly upon it let him take inwardly either a Bolus of Venice Treacle, or a Solution of it in Cinnamon-water. Moreover, let him drink every now and then a spoonful or two of Burnt-wine, diluted with a little Mint-water; if he be troubled with Gripes, give him a Glister of warm Milk with Treacle dissolv'd in it, and warm frictions must be us'd to the remote parts, and sometimes Liga­tures to draw the Blood outwards, and so keep it from too great a Colliquation, and from discharging it self into the Cavities of the Viscera; then in the Evening if there be strength, and a pretty good Pulse, let him take a Dose either of Diacodium, or of Li­quid Laudanum with some fit Vehicle.

As to other kinds of excessive Purging, which are wont to happen without the Administration of a Purging Medicine, for the most part they are meerly Symptomatical, depending on other Diseases, and their method of Cure is wholly the same as of those Diseases, whose off-spring they are: Nevertheless sometimes a Looseness, or Flux seems to be a Disease of it self, and because this kind of Distemper Raging almost yearly in the City of Lon­don, [Page 14]is commonly accounted Endemious, or a Disease peculiarly attending Inhabitants, I shall here set down its method of Cure.

I have often and long observ'd that there are two, and that very different kinds of that Flux (usually call'd the Griping of the Guts) which happens here almost yearly about Autumn: In one of them the Stools are watry, and in a manner cleer, with a sud­den failing of the strength; in the other they are bloody, but to­lerable withal.

In the Year 1670. about the Autumnal Equinox, a World of People here were seized with a most dangerous Flux (though without Blood) and joyn'd with a cruel Vomiting, which pre­sently caus'd great faintings, and a total decay of strength.

For the Cure of this Disease no Evacuation did good, nay Bleeding, Vomiting, and Purging always did hurt; only Cordi­als, and those of the hottest nature, to wit, such as abounded with Spirit and Sulphur, or a Volatile Salt prov'd commonly of good effect; insomuch that Brandy burnt a little with Sugar was a Popular, and as it were Epidemick Remedy, and in that sort of Flux was seldome given without success, though in the other sort of Flux which carry'd Blood with it, having been us'd with­out due regard, it has often been found to be hurtful: The me­thod of Cure which I then took successfully enough with many, and am wont still to take in the like case, is after the following manner.

Take Venice Treacle from a Dram to a Dram and a half; let the Patient take it in Bed, and drink after it seven or eight spoonfuls of the following Julap, and let him repeat this Dose every third, fourth, or fifth hour.

Take Mint-water, Cinnamon-water hordeated, of each three Oun­ces, strong Cinnamon-water, Plague-water, Treacle-water, of each two Ounces, Powder of Pearls a Dram, Sacchari Crystalin half an Ounce, mingle them and make a Julap: At the same time take a piece of Bread, spread some Treacle on it, and dip it in Sack or Red-wine warm'd, and let it be apply'd to the Stomach as hot as it may be suffe­red, and change it every now and then.

In the Evening, if the Pulse and Breathing seem strong enough to bear it, let the Patient take of Liquid Laudanum Cydoniated twenty Grains in a draught of Plague-water.

Take Diascordium a Dram, Liquid Laudanum half a Scruple, Compound Powder of Crabs Claws a Scruple, Cinnamon-water what suffices, make a Bolus to be taken going to sleep.

To those to whom Treacle or Mithridate prove nauseous or disa­greeing, give a Dose of the following Powder, or Spirit of Trea­cle every third hour, with the Julap.

Take Compound Powder of Crabs Claws, Roots of Contrayerva, or Serpentaria Virgin, of each a Dram, Cinnamon, Roots of Tormentil, of each half a Dram, Saffron, Cochinele of each a Scruple, make a Powder, the Dose is from half a Dram to two Scruples.

Take Spiritus Theriacalis Armoniacus three Drams, the Dose is a Scruple, with the Julap every fourth hour, or give that, and the Doses of the Powder interchangeably, one, one time, and the other, the other: After the same manner the Spirits of Harts-horne. or of Soot may be given; let the persons Drink be Ale or Beer with a Crust of Bread, Mace, add Cinnamon boil'd in it and sweeten'd; or let it be Burnt-wine diluted with Mint-water; let his Food be Chicken-broth, Gruel or Panada, with the shavings of Ivory, Hartshorn, and the Roots of Scorzonera, &c. boil'd in it.

About the Autumnal Equinox, in the Year 1671. a desperate Bloody Flux seiz'd on many persons in this City; from the first seizing they voided Blood by seige in abundance, and that fre­quently, and for the most part it was attended with a Belly-ach, and Gripes, continual watchings also with a Feaver, and a mighty thirst usually troubled them; nevertheless their strength held com­monly pretty well for some considerable time, and if the Flux were stopt sooner than it ought, it rendred the Patients conditi­ons worse.

The method of Cure, with the Remedies which I found to give Relief in many persons, was according to the following manner.

Take Venice-Treacle a Dram, Liquid Laudanum Cydoniated twenty Grains, make a Bolus to be taken going to rest.

Take Conserve of red Roses vitriolated two Ounces, Venice-Treacle an Ounce, Powders of the Roots of Tormentil, Contrayerva, Pearl, Co­ral prepar'd, of each a Dram, Syrup of dry'd Roses what suffices, make an Electuary to be taken every fourth or fifth hour, and let the person drink after it of the following Julap three Ounces.

Take the Waters of Mint, Baum, Cinnamon hordeated, of each four Ounces, Treacle-water, Plague-water, of each two Ounces, Pearl a Dram, Sugar an Ounce, mingle them and make a Julap.

After a day or two give a Purging Potion, which leaves an Astringency.

Take Rhubarb slic'd two Drams, yellow Mirobalans slic'd a Dram and a half, red Saunders, Cinnamon of each a Scruple; let them in­fuse all Night in the Waters of Plantain and Cinnamon hordeated, of each two Ounces and a half, wring it forth hard, then add of strong Cinnamon-water a Dram and a half, make a Draught.

Every Evening, and also in certain cases in the Day-time, I was wont to give a pretty large Dose of Laudanum; nor have I ever known this Medicine to have done any prejudice to a person [Page 16]troubled with the Flux, which happen's either because the Nar­cotick force of the Medicine is subdued, or made more gentle by the Acid Juice of the Stomach, or rather that its Particles which are transmitted to the Blood, are thence presently cast forth a­gain with the Bloody Stools, so that they do not affect the Brain.

If the above-mention'd Electuary be found nauseous to any per­son, or disagrees with him, the following Powder may be given in its stead.

Take Pulvis Pannonici Rubri a Dram, Roots of Contrayerva half a Dram, make a Powder, divide it into three parts, and give one part in any Liquor.

Take Bole Armenick alexiteriated (that is, impregnated with the Juices of the Leaves of Tormentil, Bistort, red Roses, &c. and dry'd in the Sun) Roots of Contrayerva, of each a Dram, Pearl, red Coral, white amber, of each half a Dram, make a Powder: the Dose is from two Scruples to a Dram.

Take the Roots of Avens and Scorzonera, of each an Ounce, of Tormentil, Bistort and Contrayerva, of each two Drams and a half, burnt Harts­horn three Drams, shavings of Ivory and Hartshorn, of each two Drams, Cochinele half a Dram, red Rose-leaves two Drams, boil all in a sufficient quantity of Spring Water, till it comes to two Pounds, to­wards the end of the boiling add conserve of red Roses three Ounces, to the Cleer straining add Plague-water four Ounces: the Dose is three Ounces.

To appease the Gripes and fretting of the Bowels, Glysters are commonly prescrib'd.

Take the decoction of the Tops of St. John's-wort, in which Sheeps Trotters or their Mesentery has boil'd eight or twelve Ounces, Venice-Treacle two Drams, Oyl of St. John's-wort an Ounce and a half, make a Glister.

The Therapeutick Indications into which the method before exprest of curing the Bloody Flux may be resolv'd, are chiefly four, &c. two regard the Blood, and as many the Viscera. First, as to the Blood, its recrementitious and depraved dreggs which tend inwards, must be driven forth into the habit of the body, that they may exhale by perspiration, and its coagulations must be dissolv'd, and its Crasis restor'd, as soon as may be. Secondly, as to what regards the Viscera, the irksome sensation of the Ner­vous Fibres, and the irritation of the Carnous Fibres to excre­tory Convulsions must be appeas'd, and the Mouths of the Vessels must be shut, to keep them from discharging the blood and hu­mours into the Intestines. The first of these is usually perform'd with Opiats, and the other with Stiptick or Astringent Remedies: Besides these we must have regard to urging Symptoms, and ill affects usually attending this Disease, the chief of which are a [Page 17]Feaver, with a Thirst and Wakings, Gripings of the Guts, and sometimes their fretting, Inflammation, and Ulcers.

We must not proceed upon those four chief Indications seve­rally and successively, but we must take them altogether, and set upon them at once; wherefore the Prescripts ought to com­prehend Remedies of divers kinds, to wit, Alexipharmicks, Styp­ticks, Diaphoreticks and Opiats: And because it is not an easie thing to put these into a set method, and under set Rules, which may be generally apply'd; I have rather chosen to give you here some Examples of Cures performed by me in the Bloody Flux in the year 1671.

To a Gentleman 25 years of Age, to whom I was call'd the third day after he was seiz'd. I prescrib'd the following Bolus.

Take Venice Treacle a Dram, Liquid Laudanum Cydoniated a Scruple, mix them, let him drink after it a little draught of the fol­lowing Julap. Take waters of Tormentil, Mints, and Cinnamon hordeated, of each four Ounces, Treacle water and Plague water of each two Ounces, Pearl a Dram, Sugar an Ounce, make a Julap. He took besides of the following Electuary about a Dram and a half every third hour, with the said Julap.

Take Conserve of Red Roses two Ounces, Venice Treacle an Ounce, Powder of the Roots of Tormentil, Contrayerva, Pearl, Coral prepar'd of each half a Dram, Syrup of Red Poppies what suffices.

By the use of these Remedies the rigour of the Disease soon a­bated, so that he had not above six or seven stools in the space of twenty four hours, and those also were not very Bloody as be­fore, but appear'd full of little flakes of Flesh, and of fragments, as it were of Membranes: Every Evening he took an Opiate with Laudanum.

The Fifth day of his illness he took the following Potion.

Take Rhubarb slic'd two Drams, yellow Mirobalanes a Dram and a half, yellow Saunders half a Dram, Powder of Cinnamon a Scruple; Salt of Wormwood half a Scruple; let them infuse all night in the wa­ters of Plantain and Cinnamon hordeated, of each two Ounces and a half, to the straining add strong Cinnamon water two Drams

It purg'd him three or four times, and gave him ease, and the next day the Feaver being abated, he was better; so that seeming to grow well, he eat flesh. But shortly upon it fell into a Relapse, so that the Flux returning with the Feaver, it presently became more violent than it was at first: Then because the former Medi­cines began to nauseate him, I prescrib'd after the following man­ner.

Take Powders of Tormentil Roots, of Contrayerva, Bole Armenick Alexiteriated, of each a Dram, Pearl, Red Coral prepar'd, White Am­ber, [Page 18]of each half a Dram, make a Powder, the Dose is half a Dram in the following distill'd water.

Take Tops of Cypress and Myrtle, of each four handfuls, Leaves of Meadow-sweet, Burnet, St. Johns-wort, Avens, of each four hand­fuls, Roots of Tormentil, Bistort, of each six Drams, Red Rose-flowers four handfuls, Kermes Berries four Ounces, Cinnamon, Mace, of each one Ounce. Being all slic'd and bruis'd together, pour to them Red Florence Wine, and Red Rose water of each four pounds; distil all in a common Still; let the whole Liquor be mingled and sweetned with Syrup of Coral. He took also three or four times a day of the fol­lowing decoction three or four Ounces.

Take Roots of Avens and Scorzonera, of each an Ounce, of Tormen­til two Drams, Hartshorn burnt and powdred six Drams, shavings of Ivory and Hartshorn, of each two Drams, Tops of St. Johns-wort a handful, Flowers of Red Roses and Balaustiae, of each a pugil. Boil all in three pounds of fountain water, till it comes to two, adding towards the end of the boiling, of Red Lisbon wine four Ounces; let it boil close cover'd for an hour, then let it be strain'd through Hippocrates Sleeve.

Every night he took a Scruple of Liquid Laudanum in three Ounces of the Bloody Flux water ev'n now describ'd, with three Drams of Syrup of Clove Gilly-flowers in it.

His common drink was a decoction of burnt Hartshorn with Barley, a Crust of Bread, Mace and Cinnamon; to a Pint and a half of which, a Pint of new Milk was added.

He took the Purging Infusion a second time, by the use of which, and the things before mentioned, within ten days the Feaver left him, and the Flux became much more gentle, which though without Gripes or much Blood, yet still continued with the little pieces of Flesh, the fragments of Membranes, and a bloody Phlegm or Gelly, which daily came from him.

Therefore to strengthen and heat the intestines, the following things were given.

Take Tops of St. Johns wort, Leaves of Perwincle and Mousear, of each a handful, Red Rose Flowers two pugils: Boil them in the Broath of a Sheeps Guts: To a pound of the Liquor strain'd, add Oyl of St. Johns-wort two Ounces, Honey of Roses an Ounce and a half: mingle them for two Glysters, whereof one was given him in the Morn­ing, the other at five a Clock in the Afternoon. He wore Emplast. de minio & Paracelsi upon him Belly. He took moreover twice a day three Ounces of Juice of Plantain wrung forth with water of Scordium and Plague water. He eat also every day a Quince made hollow, and fill'd with the Powders of Olibanum, Mastick, and Balsam of Tolu, and so rosted in the Embers.

By the constant use of these Remedies, he grew perfectly well within a Month.

About the same time another robust young man, fell into a dreadful Bloody Flux; from the first day he was seiz'd, frequent stools and very bloody, presently brake forth with violence, be­ing accompanied with a Pain and Gripes: Moreover a strong Fea­ver, with a cruel Vomiting, Thirst and Wakings molested him. These Symptoms being a little mitigated with Opiats, a Delirium and a Vertigo, with an intermittent Pulse, and horrible extensi­ons and contractions of his Limbs presently seiz'd him; this hap­ning because the malignant matter which was inwardly restrain'd, presently flow'd into the Brain and Nerves: Nevertheless as often as the Looseness and Vomiting return'd, these affects were pre­sently appeas'd. On the fifth day Vomiting up a bloody matter, he complain'd of a great torture in his Stomach, and of a Pain, as though it were Ulcerated, and in truth I suspected that there might be a beginning of some Inflam'd Blisters, or Ulcers in it, as it usually happens in the Intestines; but by giving him Emollient Broths with Milk in them, his Vomiting and the tortures of his Stomach soon ceased, his Flux in the mean time encreasing. He took that night of Diacodium an Ounce, Cowslip water and small Cinnamon water, of each an Ounce and a half; by which Medicine he was so much reliev'd, that in twenty four hours space his Vo­miting and Pains left him, and he was only troubled with a few Stools, and having a good indifferent Pulse, and frequent Sleeps, he was pretty well; yet the following night, though he took a­gain the same Opiate, his Flux return'd, and that with very fre­quent Stools, and bloody as before. The next day after, he took an Infusion of Rhubarb with Mirobalans, Red Saunders and Cinna­mon: He often voided Bilous and very sharp Excrements, but without the least of Blood; then in the Evening he took Liquid Laudanum Cydoniated twenty five Grains in a good spoonful of Cinna­mon water hordeated; he had moderate and quiet Sleeps. After­wards loathing any more Medicines, he took only an Opiate eve­ry Evening, sometimes of one sort, and sometimes of another, and in a short time grew very well.

CHAP. V. Instructions concerning Diuretick Medicines, or such as work by Ʋrine, with Diuretick Prescripts.

THe chief Scopes, or ends of Diuretick Medicines, are as fol­lows.

First, If at any time the Blood becomes so compact and tena­cious from a fixt Salt, Sulphur, and Earth fermented together, and mutually combin'd in it, that the Watery Particles do not easily separate from the rest, Diureticks fit to loosen its Texture, and to fuse the Serum, must be such as excel in a volatile or acid Salt; for such Particles chiefly dissolve any coalitions caus'd by a fixt Salt. But in regard this disposition is common both to a Feaver and the Scurvy, in the former affect, the most proper Diureticks are the temperate Acids of Vegetables; also Sal Nitre, the Spirits of Sea-Salt, of Vitriol, &c. And likewise such as have a Volatile Salt, as the Spirits of Hartshorn, of Sal Armoniack, Salt of Amber, of Vi­pers, and others of this kind which we have also rang'd amongst Diaphoreticks. In a Scorbutick disposition when the Urine is but in a small quantity and thick, the Juices of Herbs, and preparati­ons both of a sharp, or tart and acid nature are of excellent use; also Salt and Spirit of Ʋrine, of Sal Armoniack, of Tartar, &c.

Secondly, Sometimes the Blood does not retain the Serum long enough within its Body, but either being obnoxious to Fluxions, or rather Coagulations, it deposes it here and there in a great a­bundance, even more than enough; whence it breeds Catarrhs, or Tumours in many places: Or, the Blood being become of a weak habit, and withal of a depraved constitution, to wit, incli­ning to a sourness its apt to coagulate, as to its more gross Par­ticles, so that the more subtle Particles being every where thrown off in circulating, and falling on the weaker parts, cause some­times distempers of the Head or Breast, sometimes an Ascites, or Anasarca: And we shall hereafter shew how a Diabetes happens from the like cause: And in truth many difficult Diseases which are falsly imputed to the ill constitution of the Viscera, arise from hence, viz. that the Blood being distemper'd and obnoxious to coagulations, when it cannot continue its full course of circulati­on, deposes the Serum in many places, this being too apt of it self to recede from it. The Diureticks to be given in these cases, are such as do not fuse the Blood, but make void its coagulati­ons; [Page 21]of this kind are those things that are endow'd with a fixt Volatile, and likewise Alkalisate Salt; and they must be such as re­store and strengthen the Ferment of the Reins, which is done by certain Sulphureous and Spirituous things. For these ends are given Sulphureous and mixt Diureticks, Lixivial Salts of Herbs, Powders of shells, Salt and Spirit of Ʋrine, &c. Millepedes, Horse-Raddish, Parsly-seed, Nutmegs, Turpentine, and preparations made of it, Spirit of Wine: The vertues of all which are not to fuse the Blood, and to precipitate serosities from its Mass (these things are chiefly done by Acids, and in those cases do commonly hin­der any Purging by Urine) but to dissolve the coagulations of the Blood; so that its Body recovering a perfect mixture, and be­ing more readily circulated through the Vessels, drinks up the Serum every where extravasated or depos'd, and finally delivers it to the Reins to send it forth. Now we shall shew after what manner according to both these, as it were opposite, ends of Cu­ring, Diureticks of all kinds operate, and in what forms they are chiefly prescrib'd.

CHAP. VI. Instructions and Prescripts for Curing too much Pur­ging by Ʋrine, and particularly the Diabetes or Pissing Evil.

IN a Diabetes, as in most other affects there are three Primary Therapeutick Indications, viz. Curatory, Preservatory and Vital. The first of these regarding the Disease, and attempting to stay the too great Effusion of Urine cannot be accomplish'd without the second, which aiming at the cause of the Disease, en­deavours to preserve and restore the mixture and due Crasis of the Blood: Wherefore as to the Cure of this Disease, the chief inten­tions of healing must be to keep the Blood from fusion, and in case that happens to take it away.

First the fusion of the Blood is prevented, so its gross and a­queous parts reciprocally contain each other, and do not readily and abruptly sever themselves, which thing is effected by Incras­satives (commonly so called) whose viscous and glutinous Cor­puscles being admitted into the Mass of Blood, strongly adhere to its Active Particles, and so part them from each other, and hinder them from mutually combining betwixt themselves, or with Saline Particles coming from elsewhere, as might otherwise happen through fluxions. In this respect, Rice, Amylum, Mucila­ginous Vegetables, also Gumms and some Rosins are wont to give re­lief in this Disease.

Secondly, To restore the Blood after fusion, those sorts of Re­medies are indicated which dissolve the concretions of Salts, so that all the Elementary Particles in it coming again to be at li­berty, recover their former places, and so restore the Crasis of the Blood to its first vigour. Now its well known that this effect is produc'd in coagulated Milk by the addition of a fixt, volatile, or a nitrous Salt to it; also by the infusion of Spirit of Hartshorn, [Page 29]of Sal Armoniack and the like. The reason of which doubtless is, that whilst the Salino-fixt, volatile or nitrous Particles, being in a sufficient quantity put into the Milk, meet with the Acid or Precipitatory Particles, and are combin'd with them; the other Saline Particles which before were bound, being now freed, and diffus'd through the Mass of the Liquor, loosen the Sulphureous and Earthy Parts combin'd betwixt themselves, and disperse them every way, so that all the Particles being again equally mixt, mu­tually contain themselves, and are contain'd; yet because Saline Medicaments are accounted by many to be always Diuretick: We do not give them lightly, or without consideration for the Cure of a Diabetes, though in this Disease I have prescrib'd the Tincture of Antimony with good success. And a water of the Solution of quick Lime with the Raspings of Sassafras, Aniseeds, Raisins and Liquorish, according to the vulgar Receipt, is highly commended by some.

The Vital Indication is made good in this Distemper by a thickning and gently cooling Diet, and by temperate Cordials, and chiefly by apposite and seasonable Hypnoticks.

A Nobleman in the vigour of his Age, became very prone to an excess of Pissing, and when for many Months he had been us'd at times to undergo this great Flux of Urine, he fell at length into a confirm'd Diabetes as it seem'd, and almost past hope of recovery: For besides that, in the space of twenty four hours, he voided near a Gallon and a half of clear water, and wonderfully sweet, as though Honey were mixt in it: He was moreover affected with a cruel Thirst and a Fever, seemingly a Hectick, with a mighty Languor of the Spirits, a fall of strength, and a Consum­ption of the whole Body. I then prescrib'd him the following Remedies, by the use of which he seem'd in a short time to re­cover.

Take Cypress Tops, eight handfuls, Whites of Eggs beaten two pounds, Cinnamon half an Ounce, being cut small, pour to them of new Milk eight pounds, distill it in an ordinary Still, taking care of an Empyreuma. Let him take six Ounces thrice a day.

Take Gum Arabick, and Gum Tragacanth, of each six Drams, Pe­nids an Ounce: Make a Powder, let him take about a Dram, or a Dram and a half twice a day, with three or four Ounces of the di­still'd water.

Take Rhuba-b powdred fifteen Grains, Cinnamon six Grains: Make a Powder, let him take it in the Morning, and renow the Dose with­in six or seven days.

Take Cowslip water three Ounces, Cinnamon water hordeated two Drams, Syrup of Meconium half an Ounce: Make a draught to be taken every Evening.

His Diet was only Milk, which he took pretty often in a day, sometimes crude or diluted with the distill'd water, or with Barly water; sowetimes boil'd with White-bread, or with Barly: Growing daily better by the use of these things, within a Month he seem'd to be almost Cur'd: As he began to grow a little well, his Urine which was Insipid, did not much exceed the quantity of Liquids he took, and afterwards turning a little Salt, it became less in quantity than what he drank, and so by degrees recovering the wonted tone of his Spirits and a good strength, he took to his former Diet.

Nevertheless the disposition to this Disease did not so through­ly cease, but afterwards being apt frequently to Relapses upon disorders in Living, and haply upon changes according to the seasons of the year; he first made Water in a greater measure than ordinary, which by degrees grew clear and sweetish, a Thirst and Fever, with a Languor of the Spirits accompanying it: But by the use of the same Medicines he us'd in a short time to reco­ver again: Not long since after a large interval of health, a little before he fell into a Flux of Urine, he found great irregularities and failings in the Genus Nervosum; viz. He was seiz'd with a dull numbness of his Brain, and a Vertigo, and was taken with sudden Cramps in his Limbs, and felt little Leapings of the Tendons, and various runnings about him, as though it were of a wind creeping here and there. And when by the use of fit Remedies, the aforesaid Symptoms seem'd to be Cur'd; the Diabetes after its wounted manner burst forth afresh; viz. the matter flowing forth in abundance from the Fibres and solid parts into the Blood, and thence to the Reins and the Urinary Passages.

In this Juncture the same Remedies were prescrib'd again, by the use of which, when within a few days he began to grow bet­tr, he was ordered to take thrice a day Water of quick Lime to five or six Ounces: Having continued this Remedy four days, he made water in a moderate quantity well ting'd, and somewhat salt, and as to other things he seem'd well as he was before.

By the same method, and chiefly with the Water of quick Lime, I Cur'd another of a Diabetes, who was look'd upon as past recovery.

CHAP. VII. Instructions concerning Sweating and Diaphoreticks, or Medicines causing Sweat, with Prescripts of them.

FOr a ready and plentiful eruption of Sweat, these three things are requir'd. First that the Blood boiling more than its wont, circulates with a more rapid motion. Secondly, That its Latex abounds with many watry Particles, and those loose, that is, apt to be separated from the rest of the Liquor, and to be resolv'd into Vapours; for if there be a deficiency of Serum, or if it be not easily separable from the Blood through its too great com­pactness, or incrassation by reason of Faeculencies strongly mixt in it; scarce any sweat at all will follow, though the intense heat of a burning Fever presses for it, and most powerful Diaphore­ticks [Page 35]are given at the same time. Thirdly, The Pores of the whole Body must be set wide open for a free passage of the Sweat.

Therefore Sweating Medicines to be taken inwardly must be such as make the Blood boil more than ordinarily, and conse­quently cause it to evaporate: Also such as somewhat loosen and fuse its often too compact and incrassated Mass, that its Serosi­ties may more readily depart from it and be separated, and they must be such as at the same time dispose them so separated, rather to pass forth by Sweat, than by Urine or Seige. As to the third thing requir'd, to wit, the opening of the Pores, this is done in a manner wholly by outward Administrations.

Now because the same Saline preparations which are given to procure Sweat, are often given to move Urine, and sometimes also for Cordials; we must shew by what preparation, and other requisites, Sweating is to be promoted alone without the other intents.

And we observe that Sudorificks inwardly taken, seldom or ne­ver work of their own accord, as Emeticks, Catharticks, or Di­ureticks; but always need some Governance to actuate the Medi­cine, and to determine it to that Energy: Wherefore a Diapho­retick being given, the Patient must presently be so ordered that the Pores of his Body may be open'd, and the beat of his Heart very much heighten'd. For these ends, either let him be kept in a Bed, Bath, or Hot-house, or let him exercise his Body with some quick or laborious motion; and that these things may suc­ceed the better in promoting Sweat; when it is in our power, let us make choice of a fit time and subject for it, viz. when the Blood enjoying a laudable, or not very evil Crasis, both suffici­ently abounds with a Serous humour, and has not its Particles in too great a confusion or perturbation, but is in a disposition readily to be loosen'd, and to separate it self, and run into parts. For in a Bilous temperament, in a thin and dry constitution, and in the mindst of a burning Fever, when all things are in a trouble and undigested: Diaphoreticks commonly prove of no effect or do hurt. Moreover when Diaphoreticks are judg'd proper, we must not give all sorts of them indifferently, but peculiar Medi­cines must be chosen according to the various disposition of the Blood, and the different predominancies of the Element in it, sometimes of this, sometimes of that, and according to the states of the Salts.

CHAP. VIII. Instructions and Prescripts for Curing an Excessive, or Depraved Sweating.

FRequent and immoderate Sweating, is sometimes the Sym­ptom of some other Disease then affecting the Person; for in the Phthisick and Scurvy this is a common thing: The rea­son of it is, that the Blood tainted with some filthy infecti­on, or become of an ill habit, is not able duly to concoct and assimilate the nutritive Juice still passing into its Mass, and there­fore [Page 43]always degenerating, and coming now and then to be full charg'd by the addition of other Excrements, it separates them, and expells them by Sweat.

The Cure of this Sweating depends wholly on the Cure of the Diseass whose Symptom it is: In the mean time those copious Night-sweats happening in those Diseases, plainly shew that the Persons Diet ought to be altogether of light food; viz. Milk, Grnel, Cream of Barly and the like, whose gentle and mild Par­ticles the Blood can bear, and not of Flesh, or strong substan­ces.

Sometimes an excessive Sweating is the effect of some fore­going Disease which is brought to an end, and this is so common a thing after long Agues, that scarce any recover of them; but this Indisposition still sticks upon them more or less. I knew a young man, who as he grew well of a Quartan Ague, which had held him ten Months, and began to lose its fits, daily melted into such profuse Sweats, that he was fain to change his Shift and Sheets thrice a Night, being as wet as though they had been dipt in water: This Evacuation continuing so for many Weeks, his Flesh so fell away, and his strength was so exhausted, that he look'd like a Skeleton. This Person when he had us'd many Me­dicines a long time without much benefit; at length by drinking Asses Milk Mornings and Evenings, and his other Diet being or­dered of Cows Milk, he grew very well in a short time.

The chief cause of frequent and copious Sweats seems to consist in the ill habit and weakness of the Blood, in that it is apt conti­nually to be fus'd and precipitated into Serosities: The Pores of the Body in the mean time being open and free for an Evacuation by Sweat. Now the Blood is so apt to fusions and flowings for the most part from a predominancy of a Fluid or Acid Salt in it, and sometimes the Nervous Juice growing sharp, empties its A­cid superfluities into the Blood, and so precipitates its Mass into Serosities.

This excessive Sweating does not only arise from the vitiated Crasis and Fermentation of the Blood, but sometimes from its de­praved Accension, and through an excess of Sulphur in it, as sometimes through a deficiency of it.

In order to the Cure of this Over-Sweating, the Therapeutick intentions must be chiefly these three. First, To take away or correct the ill habit or weakness of the humours. Secondly, gently to close the Pores of the Skin which are too open. Third­ly, To derive the Serum of the Blood, and the watry superflui­ties to the Reins.

1. The first of these is perform'd by those Remedies which destroy the predominancy of the Acid Salt in the Blood, or Ner­vous Juice; and which promote the Exaltation of the Sulphur (if haply it grows weak) for which ends Anti-scorbuticks, Chaly­beats: Also medicines endow'd with a Volatile, Nitrous or Al­chalisate Salt most commonly prove effectual. I shall set down certain forms of each of these.

Take Conserve of the Flowers of Cichory and Fumitory, of each two Ounces, Powder of Ivory, Hartshorn, Coral prepar'd, of each a Dram, Pearl half a Dram, Species of Diarrhodon Abbatis a Dram, Lignum Aloes, Saunders both red and yellow, of each half a Dram, Sal Pru­nella four Scruples, with a sufficient quantity of Syrup of Fumitory, make an Electuary: Give the quantity of a Wallnut in the Evening, and the next Morning, drinking after it either of the following Julap or distill'd water, three Ounces.

Take the Waters of Fumitory and Wallnuts simple, of each six Oun­ces, the Waters of Snails and Earth-worms, of each an Ounce, Sugar six Drams: Mix them, make a Julap.

Take tops of Firr, Tamarisk, Cypres, of each four handfuls, of Myrtle two handfuls, Leaves of Watercresses, Brooklimes, Agrimony, St. Johnswort, Harts-Tongue Fluellen or Speedwel, of each three hand­fuls, the outward Coats of twelve Oranges: Being slic'd and bruis'd, pour to them of Brumswick Beer eight pounds, distill it in common Or­gans: Let the whole Liquor be mixt, and sweeten it at pleasure, the Dose three Ounces twice a day.

Take Leaves of Dandelion, Watercresses, Plantain, Brooklimes, of each three handfuls, being bruis'd, pour to them of the distill'd water above written a pound, wring it forth hard: The Dose is from three to four Ounces in the Morning at Nine of the Clock, and at Five in the Afternoon.

According to this method, I use to prescribe in a failing of strength and Night-sweats after long Agues, and if these remedies do no good, we must come to Chalybeates.

Take Syrup of Steel six Ounces; let a spoonful be taken in the Mor­ning, and at five in the Afternoon, with three Ounces of the Water above prescrib'd.

Take Powder of Ivory, of Coral prepar'd, of each two Drams, Crocus Martis, Salt of Steel, of each a Dram and a half: Make a Powder, the Dose is half a Dram twice a day, with three Ounces of the same distill'd water.

Take Tincture of Salt of Tartar an Ounce: The Dose is from twen­ty to thirty Drops twice a day with the distill'd water. After the same manner may be given the Tincture of Coral, and Tinctures prepar'd out of Gums and Balsams. Moreover in these cases the Spirits of Hartshorn, Ʋrine and Seet are given given with success.

The second intention for the Cure of excessive Sweating, con­sisting in a due state of the Pores, is perform'd in a manner only by outward Administrations: For which end let the whole Body be anointed with Oyl of Date-kernels, with an Oyntment of Orange Flowers and the like, and let Linnen done over a little with the same be worn; sometimes Bathing in cold Water, or in a River, sometimes change of Air may do well.

It seems here proper to speak a little of a certain troublesome Distemper, relating to Sweating, or at least to an excessive per­spiration. I often observe that some Persons have their Bodies so disposed, that if upon any occasion the least Breath of Wind or Air comes upon them, their Spirits are presently in a mighty trouble, all their Powers are in a Consternation, and their whole Body is discompos'd.

This extream tenderness in some Persons more than in others to take cold, or to be offended with it, happens either through the fault of the Animal Spirits, or of the Blood, or of the Pores of the Body, to wit, of one of them, or of more of them together.

1. First, The Animal Spirits are sometimes in fault, because be­ing very weak, they are not able to endure any thing harsh, or rough outwardly pressing upon them; but presently upon the ap­pulse of the bare Air, are put to flights and distractions. And sometimes this Indisposition happens through their fault, for that being degenerated, and become of an eager, restless and uneasie disposition, they are put into disorder upon every such pressure of Air. Wherefore those who by reason of the Spirits so dispos'd become Hypochondriacal, being also subject to the Affect before mention'd, on every little occasion are troubled with Cold.

2. The Blood disposes to a habit of depraved Perspiration in a two-fold manner, viz. both in respect of its temperament, and of its mixture: As to this latter oftentimes the Texture of the Blood is so loose and open, that upon every light accident, and e­spccially upon the appulse of a cold moist Air, it's presently stirr'd to fluxions and precipitations of Serosities; insomuch that Persons who have such Blood, dare not step forth of doors, nay scarce look forth. Again, the Mass of Blood being often hot in its tem­per, and very full of vapours, Breaths forth Effluvia's very sharp and penetrative, by which the Pores of the Skin being too much loos­ned and laid wide open, the Spirits and the Vital Flame are expos'd to the injuries of the naked Air, and the Winds more than they ought.

3. The ill constitution of the Pores, gotten either by sickness, or other ways, or being natural from our Birth, very much in­clines to that habit of depraved Sweating. For in regard those passages being too wide, do always in a manner gape, the Blood [Page 46]and Spirits in the whole Body, or in certain parts of it are not sufficiently guarded against the encounter of the outward Air.

The Intentions for Curing this Distemper are chiefly these three' viz. first to help the weaknesses, or dejections, or depauperations of the Blood and Spirits. Secondly, To take away their Dyscrasies if they have any. Thirdly, To procure a due Confirmation of the Pores.

The chief stress of this business consists in the first intention, which regards the strengthning of the Animal Spirits, and the in­largement of the whole sensitive Soul; for unless the Patients re­solve to take courage, so as to attempt to go abroad, to set forth their strength to their utmost, and accustome nature daily to in­ure it self to hardship, all medicines prove useless: Wherefore a plentiful and cheerful way of living are no less necessary than Phy­sick, that thereby the stock of Animal Spirits may be daily re­new'd and increas'd, and so confirm'd in strength by greater pra­ctices now and then insisted on; for which ends strong Wines with good Dishes of meat are very proper. Moreover all Studies and Cares, (with which the Soul is deprest) being laid aside, let the time be past in idleness and recreatious, or in moderare exer­cises. As by such a kind of living duly ordered, the Animal Spirits are greatly refresh'd, so it repairs the decay and depauperations of the Blood.

For the same ends also the following Medicines may be given with good effect.

Take Spirit of Amber Armonicacated what suffices; fifteen or twen­ty drops be taken in the Evening, and the next Morning in aspoonful of the following distill a water, drinking after it nine spoonfuls of the same.

Take Leaves of Sage, Rosemary, Time, Savory, Marjoram, Costma­ry, of each four handfuls, Roots of Angelica and Master-wort, of each six Ounces, of Zedoary, the lesser Galingal, Calamus Aromaticus, Florence Orris, of each an Ounce and a half, Cubebs anOunce and a half, Nutmegs, Cloves, Cinnamon, of each an Ounce, the outward Coats of twelve Oranges, and of six Limmons; being slic'd and bruis'd, pour to them of Whitewine and Canary of each four pounds: Distil it in common Organs, let the whole liquor be mixt and sweetn'd with Sugar perlated. In the distil­ling hang in the head of the Alembick a Nodulus, with a Scruple of Amber-greece in it, and half a Scruple of Musk.

Take Tincture of Antimony, or of the Balsam of Tolu an Ounce; let fifteen or twenty drops be taken in the Morning at Nine a Clock, and at Five in the Afternoon, in a spoonful of the water before prescrib'd, drinking after it three Ounces of the same; or rather in the Morning drink after it a Dish of Tea, or Cofee, or Chocholate prepar'd of a De­coction of Sage.

A little before Dinner drink a Glass of Sherry, Sack.

When these things have been used some time, and you think good to intermit them, take the following things in their place.

Instead of the Spirit, take a Dose of the following Electuary in the Evening, and early in the Morning with the distill'd water, or Viper Wine.

Take of wet preserv'd Citron Pills, an Ounce and a half, Miroba­lans Condited an Ounce, Nutmegs, Ginger Candied, of each half an Ounce, Confection of Hyacinth, Alchermes, of each three Drams, Pearl prepar'd, red Coral prepar'd, of each a Dram and a half, with the Sy­rup of the Juice of Kermes make an Electuary.

Let the ordinary drink be a Physick Ale made after the follow­ing manner, viz. into a vessel of four Gallons put the following bag.

Take an Old Cock half boil'd and mash'd, Leaves of Sage and Harts-Tongue dry'd, of each two handfuls, six Dates slic'd, Raspings of Sassa­fras two Ounces; being slic'd and bruis'd, mix them, put them in a little bag, and hang it in a Vessel after it had done working.

The second intention which undertakes to correct the Dyscra­sies, or depraved dispositions of the Blood and Spirits, is perform'd by the same Remedies, as in the Hypochondriacal distemper and Melancholy: Wherefore the prescripts which I formerly gave for the Cure of those affects may serve here.

As to the third intention, which for keeping the Pores in a due State, ordains a meet way of Government as to cloathing, the Air, the Fire, &c. there is little left for a Physician to do; for commonly every Patient will be his own Councellour as to these things: There is only one kind of advice which they are apt to receive, and is wont to do them good, viz. that they change their habitation, by which often the Mind is also chang'd; for those that are never so much addicted to keep themselves pen'd up in a Chamber, or in Bed, when they travel into foreign Coun­tries, where they breath a warmer and more serene Air: It's almost incredible in how short a time they recover.

So much concerning this depraved Perspiration which has not been touch'd by others.

There remains yet a third kind of this immoderate Sweating which is not as the first, the Symptom or effect of another pre­sent or past Disease; but it self first beginning, is either a Disease of it self, or the parent of some Morbid affect: To the first sort chiefly belongs the Pestilential Sweat, which was heretofore call'd Sudor Anglicus: But I shall not now, go about to prescribe Medi­cines for a Disease which I hope will never return.

CHAP. IX. Instructions concerning Cordial Medicines, and A­lexipharmicks, or Preservatives against Venome, with Prescripts of them.

IF the thing be duly considered, the notion of Cordial Medicines was not well introduc'd, but is a meer vulgar errour; for since it is not the Heart which is the Subject of Life, but chiefly, and in a manner only the Blood, and in regard the Soul it self (on whose existence and act in the Body Life depends) is founded partly in the Blood, and partly in the united stock of Animal Spi­rits, it plainly sollows that Medicines which preserve Life entire, or restore it when in danger, do rather and more immediately re­gard these parts of the Soul, to wit, the Blood, and Animal Spi­rits than the Heart, which is a meer Muscle, serving for the Circulation of the Blood, and as often as it slackens in performing this duty, or gives it off: This does not happen through its own fault, but through that of the Blood and Animal Spirits, by which it is actuated.

Therefore to know the ways and manners of working of those Medicines which are call'd Cordials, we must consider these two things, viz. First, how many, and particularly what ways the Blood being ill dispos'd, and often endangered, either as to its accension, or mixture, requires Physical helps, which may preserve or cor­rect it. Secondly after what manner by reason of a defect or de­linquency in the Animal Oeconomy the Heart is hindred, or per­verted from its due motion, so that Medicines are Indicated, which encrease the stores of the Spirits, and better compose them. [To be well instructed concerning these things, read Dr. Willis at large.]

CHAP. X. Of the Passions of the Heart, and their Remedies.

AFter Cordial Medicines, vulgarly, though improperly, so call'd, it now follows for us to treat of the Passion of the Heart, in which the Heart is really ill affected, and therefore requires true Cordial Medicines: Under that name two affects, somewhat dif­fering betwixt themselves are commonly denoted, to wit, The trembling of the Heart, and its panting: In both affects the motion or beat of the Heart seems to be disorderly, and in a manner Convulsive; but the irregularity of the first consists in the frequency of its Vibrations, and of the other in their vehe­mency.

As to the Cure of the panting of the Heart, since its Causes are various and manifold, its Cure also must be various; for what some affirm, that those sorts of Remedies vulgarly call'd Cordials, which are reputed to revive the Heart, and to relieve it when ill affected, are proper in any of all these Cases, it is con­trary both to reason and common experience.

We say then that the palpitation, or panting of the Heart, proceeds either from the fault of the Blood, or of the Arteries belonging to the Heart: If it happens through the fault of the Blood, the chief intent of Curing must be to raise the Blood to a better Crasis, it being then become too watery and unmeet for accension and fermenting, and to exalt or encrease its active principles which are then depress'd or diminish'd; for which end spirituous Medicines, also saline Medicines of all kinds, Sulphu­reous and especially Chalybeates conduce: And to this place may be referr'd those things which are wont to be prescribed in the Pica or longing Disease, in the Leucophlegmatia, and in the cold Scurvy.

Take Conserve of Sea Wormwood, the outward yellow Coats of O­ranges and Limmons, of each two Ounces, Powder of Winters Barke two Drams, Species of Diacurcuma a Dram, Steel prepar'd with Sul­phur three Drams, Salt of Wormwood a Dram and a half, with a suf­ficient quantity of Syrup of Citron Pills: Make an Electuary, the Dose is the quantity of a Nutmeg in the Morning, and at five in the Af­ternoon, drinking after it of the following Julape three Ounces, and walking upon it.

Take water of the Leaves of Wake Robin a pound, of Pennyroyal and Hyssop, of each four Ounces, Sugar an Ounce: Mix them, make a Julape.

Take of the Tincture of Antimony an Ounce; the Dose is from twenty to five and twenty drops twice a day, with the said Julape. Moreover, amongst these we may place the Tincture of Steel, and its Syrup, also Elixir proprietatis, with many others.

Secondly, The panting of the Heart, which is more frequent, and much more violent, happens through some fault in the Arte­ries belonging to the Heart, which fault is either an Obstruction, or a Convulsive affect.

The first default for the most part is continual, and often in­curable, but especially if it arises from Consumptive Lungs, or because the Roots of the Arteries are half stop'd, or compress'd, by reason of some Tuberculum, or bony Excrescency in them: And in this case all that can be done, is to give some ease now and then by Hypnoticks.

Moreover, it is not improbable that the Arteries sometimes are almost fill'd up with Polypous Concretions engendred in them, and sometimes within the Cavities of the Heart it self, and that thereby the free passage of the whole current of Blood is hin­dred; but as it is diffcult to be satisfied when this is so, so it is as rare to find a Cure for it. When there is a suspicion of it, Sa­line Medicines seem to be most proper, and of those we must give such as have a Volatile, or Acid Salt; but we must not give them together, but for a time those (which failing of success) try the others.

Take Spirit of Sal Armoniack Compound, viz. distill'd with Mille­pedes, or with other Anti-Asthmaticks three Drams, the Dose is from fifteen drops to twenty thrice a day, with the Julape, or some proper distill'd water: After the same manner you may try the Spirits of Hartshorn, Soot, Blood, and of an old Scull.

Take Spirit of Sea Salt, or of Vitriol distill'd, and often Cohobated with the Spirit of Wine, impregnated with Pneumonick Herbs three Drams; the Dose is from fifteen drops to twenty after the same man­ner; for these purposes the Spirits of Tartar, Guaiacum, and of Box are often us'd.

The panting of the Heart is very often a Convulsive affect, and wont to be produc'd from the like Cause, and manner of affect­ing, as other Hypochondriack and Asthmatick affects; and its Cure also ought to be attempted by Antispasmodick Remedies; but a cholce of them must be made with some difference, ac­cording as the Disease happens in a hot or cold temperament.

In respect of the former, the following Medicines may be prescrib'd.

Take Spiritus succini Armoniaci three Ounces; the Dose is from fifteen Drops to twenty twice a day, with the Julape, or some proper distill'd water. After the same manner may be given interchangeably the Tincture of Tartar, of Steel, or of Antimony.

CHAP. XI. Instructions concerning Opiats, or Medicines that cause Sleep, with their good and ill Effects; to­gether with Prescripts of them.

OPiats exert their Force not by raising vapours to the Head, nor by opening the Pores of the Brain, for any vapours or other Soporiferous matter to be admitted into it, but only by destroy­ing some of the Animal Spirits, so that the residue being in a con­sternation, or forc'd inward, or at least called back from their wonted Emanation into the nervous parts, quit their office, or in some measure remit of it.

The Narcotick force of Opiats consists in this, that as the Ani­mal Spirits are most subtile Corpuscles, compos'd of Spirit and a volatile Salt united together, and exalted to a very high pitch; so Opiats on the contrary consist of a fetid Sulphur, that is, of a Sulphur, together combin'd with a fixt Salt, and an Earthy matter, and carried up to a most high degree in like manner: Which sort of Concrets are well known to be so contrary to the subtile Texture of the Animal Spirits, that sometimes they put them to flights, or subvert them at a distance by meer Effluvia's, which are very hardly, or indeed not at all perceivable by the smell.

Opiats given in a small quantity chiefly and in a manner only regard those Spirits to which the particular charge of natural and ordinary sleep is committed, the rest being either untouch'd, or little letted by them: Wherefore after a Dose of Laudanum is taken, both the inward and outward senses are bound, but the Pulse, Respiration, also the functions of Concoction and Separa­tion are continued after their usual manner, and after some time the Spirits of the first employ return to their wonted Post.

But if an Opiat be stronger than it ought, it extends its Force father into the Province of the Animal government, so that an over-great Dose of it being taken, the Appetite for the most part is dull'd, Respiration is much streightn'd, and rendred not only difficult, but likewise uneven or interrupted, and sometimes also the motion of the Heart is so far debilitated, that the Pulse pre­sently grows weaker, with a cold Sweat, a deadness, and an E­clipse as it were, of all the faculties, so that a perpetual sleep sometimes follows this Medicine.

CHAP. II. Instructions and Prescripts for the Cure of the Falling-sickness.

THE Epilepsy, or Falling-sickness is thus describ'd; First, as to the Idaea of the Disease, a Fit of the Epilepsy seems to be an Universal, and only a more violent sort of Convulsion; in which the Spirits that are in the Brain be­ing first irregularly mov'd, and as it were in Confusion; all the rest residing in the Appendix both Medul­lary and Nervous of the Brain fall together into Convulsive [Page]motions, or disorderly contractions, and continue them for some time, with frequent twitchings. The access of the Disease for the most part is by way of surprise, so that the Diseased fall sud­denly on the ground, grind their Teeth, foam at Mouth, and often beat their Heads against the ground; their Arms, and Leggs in the mean time, nay and their Neck and Back either presently become stiff, or are twisted in and out with various Flexions; some violently beat their Brest, others stretch forth their Arms and Leggs with great force, and impetuously throw them, and sometimes the whole Body from one place to a­nother: In many the Praecordia and Hypochondres, and all the lower Venter swell, and are greatly blown up: After some time, which is sometimes shorter, and sometimes longer, these Symptoms cease on a sudden, and then the Sick come to them­selves again, and recover their Senses, there remaining never­theless after the Fit a pain of the Head with a drowsiness, and a deadness of the Senses; and often a Vertigo and Scotoma. Epileptical Fits are wont to return sometimes, at set times of the day, month or year, but for the most part they are wont to have a more certain return, and to seize more violently ac­cording to the greater changes of the year, or the conjunctions, or opposite aspects of the Moon or Sun; sometimes the ac­cesses are erring and uncertain according to the occasion and variety of evident causes: And the Fits are sometimes more mild, soon passing away, so that the Diseas'd scarce fall on the ground, or are depriv'd of Sence; sometimes they are more violent, keeping the person Senseless for many hours, and in­ducing other dreadful Symptoms. Sometimes, though seldom, certain Signs, forewarning a Fit, give notice to the Diseas'd be­fore hand, as a heaviness of the Head, a flashing of the Eyes, a ringing in the Ears: Sometimes in some exteriour part, to wit, in the Arm, or Legg, or also in the Back, or Hypochondres, a Convulsion precedes, which, ascending thence like a cold wind, and creeping towards the Head, seems to cause a Fit of the Falling-evil: Nor is it less usual for it to have its beginning in the Stomack, Spleen, Womb, Intestines, Genitals, and other of the Viscera, and to pass thence to the Head in like manner.

It is to be observ'd that sometimes the Epilepsy terminates of its own accord, viz. about the time of Puberty, so that those who are not Cur'd before that period is past, viz. the twentyfifth year, scarce ever recover their Health: For about the time of Puberty a double alteration happens to humane Body, and there­fore often a release from the Epilepsy, or any other Disease more deeply rooted: For First, at this time the Genital Hu­mour begins to be gather'd together in the Spermatick Vessels, [Page 240]whence it follows that the Spirituous Particles, and the Nitro­sulphureous which are wont to accompany them, and such as are Morbifick, are not only depos'd in the Brain, but also in the Testes, wherefore if the Heterogeneous Combination of the Spirits, before taking to the Brain, and causing the Epilepsy, be freely carried into that new Store-house, the Brain also be­ing more free, often shakes off the Epileptical, or otherwise Morbid Disposition. Secondly, about the time of Puberty, as the Blood conveys somewhat, which before was design'd for the Brain, to the Genitals by the Spermatick Arteries, so also it receives some ferment from those said parts by way of re­turn by the Veins, viz. some particles imbued with a Semi­nal Tincture are carried back into the Mass of Blood, which strengthen it, and inspire into it a new and sprightly Vigour, wherefore at that time the endowments of the Body and Mind chiefly exert themselves, the Hairs shoot forth, the voice be­comes more sonorous: The Menses flow from Women, and other Accidents supervene, by which it manifestly appears that the Blood and Nervous Juice are impregnated with some new Fer­mentation: Wherefore unless the Morbifick Ferments, or Semi­nal Roots are overcome by this new Natural Ferment, they continue afterwards unconquered to our dying Day: If the E­pilepsy does not cease about the time of Puberty, nor can be Cur'd by the use of Medicines, it either terminates immedi­ately in Death, or is chang'd into some other Disease, viz. a Palsy, Stupidity, or Melancholy, for the most part incurable.

Concerning the Cure of the Falling-sickness the Indications (as vulgarly set forth) are either Curatory, having regard to the Fit, and either keep it off as it is coming, or soon force it off when it has seiz'd: Or they are Prophylactick, and re­gard the cause of the Disease, which if they remove, its accesses will be kept off for the future.

As to the first intention, general Evacuatives have scarce place; nor ought a Vomit, or Purge, and very seldom Bleed­ing to be us'd in a Fit; if the person continues depriv'd of Sense a long time, Clysters are sometimes wont to be admi­nistred; but the chief thing to be done is to fix the Animal Spirits, which are too Exorbitant and Volatile; and to sup­press their beginning Explosions: For which ends two kinds of Remedies chiefly conduce, viz. First, Such as repress the Animal Spirits, apt to rise to an Exorbitancy and to shoot, and repel them by a certain Fumigation as it were ungrateful to them; and force them into their due course: Which Medicines en­dow'd with a Volatile, and Armoniack Salt, or also with a Vi­triolick Sulphur will effect. Of which kind are Salt and Oyl [Page 241]of Amber, Spirit of Blood, of Harts-horn, of Soot, Tincture of Castoreum and the like: For these being inwardly taken, or held to the Nostrils often give relief; nay and are thought to drive away the evil Spirits of this Disease, even as in Tobit the Fume of the Gall of a Fish burnt did the Devil. Secondly, the Animal Spirits are diverted, or hindred from entring upon Explosions, when they are allur'd to, and kept imploy'd in some work that is usual to them, wherefore in the Fit, Frictions us'd over the whole Body, and continued for some time often do good: But as to raising up persons seiz'd, and wholly re­straining the Arms and Leggs from the Convulsive motion, or binding them in this or that Posture (as some people use to do) and so, as to blowing Sneezing-powder into their Nostrils and pouring strong Cordials into their Mouths, or applying Cupping-glasses and Scarifications, and dealing roughly with the Diseas'd by other ways of Administration, thus disturbing the course of the Fit: I say this sort of practice is very often ill taken in hand, because by this means Nature is doubly toil'd, viz. both by the Disease, and no less by standers by, and Ser­vants, whereas it were much better to let the Fit pass ac­cording to its course, that so the Diseas'd might escape with one affliction.

Truly the greatest care of a Physician and efficacy of Re­medies is in the Prophylactick part of this Disease, that its cause being taken away, or its root cut off, all the Fruit may wi­ther: The Medicines requir'd for this Indication have regard to many intents, which nevertheless may be reduc't to these two chief heads, viz. First, that the fuel of the Disease sup­plyed immediately from the vitious Blood and Nervous Juice, and more mediately from the Viscera and first passages, be cut off; And then Secondly, that the evil Disposition of the Brain, and Spirits in it, which is peculiar to the Epilepsy, be remov'd.

As to the first thing indicated, here Vomits, and Purges, and other both Evacuatives, and Alteratives, nay and Bleeding, and Cauteries have place; for as much as by these means and ways the Impurities both of the Viscera and Humours are drawn away, and their Discrasy is corrected: For though these Me­dicines and Physical Administrations seldom or never Cure the Epilepsy alone, yet they remove Impediments, raise up Nature, and stir her up to set upon her Enemy: They also pre­pare the passages that thereby Specifick Remedies may more certainly and efficaciously exert their Vertues: Wherefore when the Cure of this Disease is attempted Spring and Fall, and at other fit seasons, by Secrets and Arcana's, it's usual to use betwixt whiles those sorts of Medicines.

As to Specifick Remedies which are affirm'd even alone, though not always, to reach the cause of the Epilepsy, and to over­come it, of which kind are the Male Peony, Mistletow of the Oak, Rue, Castoreum, Elks-hoof, preparations of Mans Scull, Amber, Coral, with many others: In regard these things are taken without any sensible Evacuation, or even Disturbance following in the Viscera or Humours, it seems strange by what formal way, or Vertue of working they are wont ever to do good in this Disease.

If there be any room for conjecture in this intricate and obscure thing, in regard the Procatarctick cause of the Epi­lepsy consists in the Heterogeneous Combination hapning to the Spirits in the Brain it follows that those things which over­come, and remove such a cause are of such a Nature, that by strengthening the Brain, and constringing its Pores they keep off that Combination, and so fix, and as it were constipate the Spirits that abound in the middle of the Brain, leaving their Combination, that they are no longer apt and prone to ir­regular Explosions: After the like manner haply as when the Powder of Aurum Fulminans ground with Sulphur, and sprinkled with Spirit of Vitriol loses its fulminating Vertue: And in truth we may conjecture nay in some measure discover that these kinds of properties, to wit, one, or both of them toge­ther, are in many Antiepileptick Remedies; for the Peony, Mist­letow, of the Oak, Rue, Lillies of the valley, with many others excel in a manifest sort of Astriction, whence it is very likely that their Particles inwardly taken, and so, by the Vehicle of the Blood, or Nervous Juice, convey'd to the Brain, so constringe and close its over Lax and Gaping Pores, that they no longer lie open for the entrance of the Morbifick matter: Moreover because these concrets breath forth an Armoniack as it were, and dis­sipating vapour, therefore the same are said to purify the Ani­mal Spirits, and to fix and corroborate them, having left their He­terogeneous Combination. This Vertue of purifying the Spirits, proceeding from the Armoniack Salt, shews it self most in Re­medies taken from Minerals and Animals, such as are the pre­parations of Mans Scull, Blood, Amber and Coral; as the o­ther Astringent Vertue appears most in the parts and prepara­tions of Vegetables.

There is no need for us here to set forth a compleat Method of Curing the Epilepsy with exact Forms of Prescripts, be­cause general Precepts and excellent Remedies are every where to be had amongst Authors, and a prudent Physician will easily accommodate both the Indications, and that plentiful Apparatus of Physick to particular cases of sick persons: But because we [Page 243]give a clearly new Theory of this Disease, a Therapeutick Method also adapted to the same ought to be here given; Which we shall presently fully delineate, after I have given you a story of a person troubled with the Epilepsy.

The Daughter of an Alehouse-keeper at Oxford had been very subject from her Infancy to a Catarrh falling on her Eyes, be­ing otherwise strong and sound enough, she liv'd also daily us'd to hard labour; about the fourteenth year of her Age she be­gan to be seiz'd with Fits of the Epilepsy, whereof she under­went many, they chiefly following her according to the greater changes of the Moon: Being entreated to endeavour her recovery, I gave her a Vomit of the Solar Praecipitate, and advis'd her to repeat the same three Days before every new and full Moon, and likewise that every time, for four Days after the Vomit taken, she should take twice a Day a Dram of Pow­der of the Roots of Male Peony, with a draught of black Cherry water: By these Remedies the Fits intermitted so long that the Disease seem'd to be Cur'd. When afterward they return'd again, she was again recovered by the use of the same Medi­cines: And then her Menses hapning to flow, and keeping their due course, she continued for the time to come free from that Disease.

CHAP. II. Instructions and Prescripts for Curing the other kinds of Convulsions, and in the first place of the Convulsive motions of Children.

IT happens that Infants and Children are so generally, and frequently, troubled with Convulsive affects, that this may be accounted as the chief and almost only kind of Convulsions; for those kinds of Symptoms in Adult persons are denoted by other Names, and are wont to be refer'd to the Epilepsy; Hysterick, Hypochondriack, or Colick passions, or also to the Scurvy; but in Children, as it were by way of excellency, they are call'd Convulsive motions.

Concerning these we may observe, that Children are found to be very subject to Convulsions chiefly at two times, viz. within the first Month after they are Born, and about the time of the eruption of Teeth: Though Fits of this Disease happen also often at other times, and for certain other causes.

For, in those in whom the Seeds of a Convulsive Disposition are rooted, these Seeds sometimes display themselves, and come to a Morbid Matureness either presently after the persons are Born, (as is said before) or lying hid for a while, sometimes precede in them the Eruption of Teeth, sometimes follow it at a great distance of time after, and at length in an uncertain course break forth in act for other evident causes, viz. either inward or outward, such as are an unhealthy or pregnant Nurse, Milk coagulating in the Ventricle, or degenerating into an acid or bitter Cor­ruption, a Feverish Distemper of the Head, and Ulcers of other parts, breakings forth suddenly disappearing, changes of the Air, Conjunctions or Opposite Aspects of the Sun and Moon, and the like.

These Convulsions in Children are wont to infest three Regions of the Body, viz. the parts of the Head and Face; the Mem­bers and outward Limbs; and the Praecordia and Viscera: And we observe that sometimes these, sometimes the others, some­times two of them, or all the Regions together are troubled with the Morbifick cause, according as the same is fixt either about the Origines, or extremities of the Nerves. And when the first of these happens, according as the superiour, middle, [Page 251]or lower spinal part of the Medulla Oblongata, to wit, one of them alone, or more of them together are set upon by the Morbifick cause.

In Children obnoxious to Convulsions hereditarily, the Con­vulsive Fits are excellently provided against, if presently after a Child is Born an Issue be made in the Nucha, and Blood be drawn from the Jugular Veins by Leeches, for by the for­mer the Corruptions of the Nervous Juice are convey'd away, and by the latter the impure Efflorescencies of the Blood are withdrawn from the Head: A person whose Children dyed all of Convuisions within three Months time, at length to pre­vent the like fatal Accident in a Child fresh Born, sought for Remedies: Being call'd after some Days after the Birth, I ad­vis'd that in the first place an Issue should be made in the Nucha, and then the next Day after, that a Leech being ap­ply'd to the Jugular of both sides, Blood should be drawn to the quantity of two Ounces: moreover that near each of the Conjunctions and Opposite Aspects of the Sun and Moon about five Grains of the following Powder should be given in a spoonful of Julape for three Days, Mornings and Evenings.

Take Mans Scull prepar'd, Roots of Male Peony of each a Dram, Pearl powdred half a Dram, double refin'd Sugar a Dram, mix them, make a subtile Powder.

Take black Cherry water three Ounces, Langius's Antiepileptical water an Ounce, Syrup of the Flowers of Male Peony six Drams, mix them.

I ordered also that the Nurse at the same Physical hours should take a draught of Whey, in which Seeds and Roots of the Male Peony, and Leaves of the Lilly of the valley were boil'd: The Infant continued well for about four Months, but then began to be troubled with Convulsive affects: At which time the same Remedies were given in a greater Dose both to the Infant, and to the Nurse. Vesicatories were also applyed behind his Ears, and Blood was drawn by Leeches from both Jugular Veins; and within two or three Days the Child grew well: afterward when within four or five Months the Con­vulsions return'd at times, still by the use of the same Re­medies he was Cur'd: After a year and a half the Convulsive affects wholly ceast, but about the lower part of the Back­bone a Tumour without Pain grew up, whence some Crooked­ness of the Vertebrae, and a weakness of the Leggs, and at length a Palsy were caus'd. It seems in this case that the Convulsive matter which was wont to assail the Origines of the Nerves, at length entering the Spinal Marrow, and be­ing thrown down into its lower part, wholly stopt the Mouths [Page 252]of the Arteries belonging to it; to wit, because to the ex­plosive Particles, other narcotick and grosser Particles had joyn'd themselves.

CHAP. III. Instructions and Prescripts for Curing Convulsive Dis­eases in Adult Persons, hapning by reason of the Origine of the Nerves being chiefly affected.

THough Convulsive affects which happen to Adult Persons, being denoted by other Names, are also vulgarly accounted to have another Origine, and are wont to be refer'd to those they call Hysterical, Hypochondriacal, or Colick passions, or to the Scurvy; nevertheless if the thing be a little more attentively considered, it will easily appear, that certain Convulsive Symptoms frequently happen both to Men and Women, which properly and duly claim the name of a Convulsion: Now these may be va­riously distinguisht according to the Manifold seat of the Mor­bifick cause, but especially into these three kinds, viz. into cer­tain Convulsions caus'd by reason of the Origine of the Nerves being chiefly affected, and into others which are caus'd by rea­son of the extremities of the Nerves being stopt with a Morbi­fick Matter; and lastly into others whose Morbifick Matter de­scending from the Head, gets possession of the whole, or the greatest part of the Ductus's of some peculiar Nerves, or of them altogether. We shall treat of each of these kinds of Con­vulsions one after the other.

Therefore first of all as to Convulsions hapning by reason of the Origine of the Nerves being affected, we must note first that the Morbifick Matter besetting the Origines of the Nerves, sometimes passes chiefly into the foremost Pairs of Nerves, viz. which attend the Muscles of the Eyes and Face; and thence Con­tractions and tremblings sometimes of the Nose, Cheeks or Lips, sometimes of the Eyes or Mouth ensue. Secondly, sometimes the Par Vagum and Intercostal chiefly imbibe the Heterogeneous Particles, and then Inflations or Contractions of the Abdomen and Hypochondres, and also a Palpitation and Trembling of the Heart, a difficult and interrupted Breathing, an intermitting Pulse, and other Symptoms of the middle or lower Region of the Belly chiefly molest us. Thirdly, but sometimes the Morbifick Cause lying behind, chiefly affects the Spinal Marrow; and there­fore the outward Members and Limbs are rendred obnoxious to Twitchings and Contractions.

Moreover as we may conjecture from various Types of the Con\vulsive affect, it seems that the Convulsive Matter going to these or those Nerves, or to many of them together, either lodges it self in a manner only about their Origines, so that upon frequent Explosions of the Spirits there, an almost continual and very troublesome Vertigo arises; and so Tremblings, and a short Faint­ing, and danger of Swounding are perceiv'd about the Praecordia, and often Twitchings and gentle Contractions in the Bowels or Muscles: Or Secondly, the explosive Particles convey'd to the Origine of the Nerves, enter deeper into their Processes, and often falling down into the Plexus's of the Nerves, belonging to the Prae­cordia, or Viscera of the Belly; or also to the outward Members, make there other seats, as it were of Convulsive affects, so that as often as the Spirits are forc't to Explosions about the Origine of the Nerves, presently Fits, as it were Hysterick, Asthmatick, or otherwise Convulsive arise in the Belly, Thorax, or outward Members. I shall now give you some instances of Persons in whom the Morbifick Matter besetting the Origine of the Nerves, and not yet fall'n deeper into their Processes, caus'd frequent Vertigo's, and only gentle Convulsions of the Viscera and Praecordia.

1. A Lady of great Quality, about Thirty years of Age, of a tender Constitution, and of a thin habit of Body, was wont to be sorely afflicted every Winter with a Catarrh distilling on her Trachaea and Lungs, with a Cough, Hoarsness, and great Spit­ing, but the last year, through a diligent care and caution us'd, she escaped that evil: But after the Winter solstice, upon taking cold, she was seis'd with a violent Head-ach, a ringing in the Ears, a Vertigo, with a mighty Distillation of Rheum at the Eyes and Nose, whence it easily appear'd that the filthy Mass of Serum which was wont before to distil on the Brest, was then wholly depos'd within the Head and Brain: The effect whereof more­over was, that as often as she began to sleep, she was very much troubled with a sort of Hysterick Fits, to which she had never before been obnoxious: For if at any time beginning to sleep, she clos'd her Eyes, presently it caus'd a rising of a heavy thing in her Belly, a Suffocation in her Throat, and Tremblings and Twitchings about the Praecordia: Which affects nevertheless, when she was perfectly awak't, presently ceas't, so that the Dis­eas'd was forc't to abstain in a manner wholly from sleep for many days and nights together.

Being call'd to this Lady after she was become very weak up­on many days Sickness, I was forc't to use only gentle Medi­cines: Therefore I ordered four Ounces of Blood to be taken from her Foot, and a Clyster of Milk with Sugar to be daily [Page 258]given her, after which she was wont to have three or four Stools: Moreover every eighth hour I gave her a Dose of Spirit of Harts­horn in a Spoonful of the following Julape.

Take Water of Penny-royal, Wallnuts, black Cherries of each three Ounces, Hysterick Water two Ounces, Syrup of Clovegilly-flowers an Ounce and a half, Castoreum tyed in a Nodulus, and hung in the Glass half a Dram, Pearl powdred a Scruple, mix them.

I applyed with good effect Vesicatories behind the Ears, and Ca­taplasms of Leaves of Rue, and Aron, with Bryony Roots, Sea Salt, and black Soap to the Soles of the Feet.

Sometimes in the Evening I gave half an Ounce of Diacodium in a little Draught of the Julape before ordered, which was fol­lowed by a moderate sleep without being attended according to wont with Convulsions: Which kind of effect I have often ex­perienced in such a case after Opiats given: For quenching Thirst I gave a Ptisan with Diuretick Ingredients boil'd in it: By the use of these things she was very much reliev'd within a short time: But that which fell out much for her good was, that an Abscess in the left Ear, breaking of its own accord, first dis­charg'd a yellow Gore, and afterward for many days a vast quan­tity of thin Ichor: After which Evacuation the Convulsions of the Bowels and Praecordia wholly ceasing, the Disease was per­fectly determin'd.

I have known many Persons both Men and Women Diseas'd after this manner, who being ill of a Head-ach, an oppression of the hinder part of the Head, or a Vertigo, perceiv'd in their sleep presently Convulsive motions in the Praecordia or Bowels, or in both of them together: Which happens from the Salley of the tumultuary Spirits reflected from the Brain into the Ori­gines of the Nerves: And as an Opiate gave the Patient before mention'd a quiet sleep without the wonted Sequel of Convul­sions, so I have often successfully Cur'd terrible Convulsive Fits, both Asthmatical, and as it were Hysterical, by giving Opiats.

1. A Woman sixty seven years of Age having still a florid Coun­tenance, and being of a gross habit of Body, and who first had liv'd long subject to a Swelling of the Face, and great Fits of the Head-ach, upon the Weathers growing very cold in the Winter, fell into a very grievous Vertigo, with a Trembling of the Heart, a Fainting of the Spirits, and a frequent striving to Vomit: Be­ing put to Bed if she open'd her Eyes, or was turn'd from one side on the other, she was presently seiz'd with a mighty Scoto­mia, a danger of Swooning, and moreover with a cruel Vomit­ing. As I was to see her I did not doubt but the cause of the Disease was the Convulsive Matter convey'd from the outward [Page 259]Region of the Head to the inmost Recesses of the Brain, by the ill Breath, or Heterogeneous Combination of which the Animal Spirits being struck, they rais'd the Vertiginous affects as they made their disorderly sallyes towards the Brain, and when they tumultuarily rusht into the Roots of the Nerves, they caus'd the Scotomia, the disorders of the Praecordia, and the striving to Vomit: The Cure of this was perform'd within a few days by the application of large Vesicatories to the Nucha, and behind the Ears; the dayly injection of Clysters, and by a frequent use of Spirit of Harts-horn, and a Cephalick Julape.

Dr. Willis gives Instances of Persons in whom some portion of the Morbifick Matter which besets the Origine of the Nerves, descending from the Head, often enters deeper into the Ductus's of the Nerves, and so about their middle and extream Processes and Plexus's makes a fomes of an explosive matter, as it were of Gun-powder: But for brevity sake I omit them.

It is observ'd that when a Convulsive Fit begins within the Brain, at the Origine of the Nerves, presently the remotest Spi­rits residing in the extremities of the Nerves (as many as are pre­dispos'd for that Symptom) fall upon Explosions, and so con­vey upwards, the Convulsive affect there more strongly be­gun; which happens for this reason, that when some whole Se­ries of Spirits is disturb'd, those which are in the extream parts, are first destitute of their Original Influx, wherefore those, before others begin to grow in a tumult, and to be irregularly dispos'd, as when a Nerve of the Arm or Thigh is constring'd by lying on it, so that it is hindred of its wonted influence of the Spirits, a stupor with a sense of pricking is first perceiv'd in the Fingers or Toes of the hands or Feet; whence it creeps upwards by de­grees towards the places affected: And hence it is we find that if whilst the outmost Spirits are exploded, a strong Ligature, or Compression intercepts the succession of others into the same space, or their progress towards the parts, the Convulsion is usu­ally hindred from ascending upward: Wherefore (as Physical Histories testify) when a stupor beginning at the top of a Finger or Toe of a hand or Foot, creeps to the upper parts with a sense of Formication, or like a cold wind; and at length taking to the Brain, causes terrible Convulsions: If presently at the first seizure the Arm or Leg be strongly bound about, the Convulsion being not able to pass that place, is hindred from getting to the Head: Nay and its an usual thing for Hysterick Women, assoon as a Swelling of their Belly, or an ascent of a heavy lump is first perceiv'd in their Abdomen, to bind about hard the Trunk of their Body with Swathes, and so commonly the Praecordia, and [Page 260]the Region of the Head are kept from being affected with the Convulsive Fit.

It's likewise observable that if Blood be let forth of a Vein in the midst of a Covulsive or Apoplectical Fit, it presently seems to be congeal'd, so that being receiv'd in a Bason, it does not keep an even and plain Surface like Liquids, but accumulating it self drop upon drop, it rises in a heap like Tallow melted and distill'd into a cold Vessel: Yet as to what some conclude hence, viz. that Convulsions depend wholly on the thickness, obstructed mo­tion, and stagnation of the Blood, we must not allow of it: For Blood drawn from Persons that are subject to Convulsions a little before the Fit, is diluted with Serum, and fluid enough: Wherefore we may opine that that Congelation is caus'd by the Fit it self: To wit, because in Convulsive motions, from the ex­cessive Contractions of the Muscles and Viscera, the Blood passing bet wixt them, its Spirit and Serum exhaling, is a little solv'd in its mixture, and therefore is somewhat coagulated, just as when Milk by reason of its too great agitation and Separation of parts one from another, hardens into butlter, wherefore this kind of Coagu­lation of the Blood seems rather to be the effect of Convulsions than their cause.

CHAP. IV. Of Convulsive motions, whose cause lyes about the Extremities, or within the Plexus's of the Nerves.

THat Convulsive affects, sometimes without any fault in the Head, arise from the Irritation and Explosion of the Spi­rits lying about the extremities of the Nerves, it plainly appears even from this, because when Medicines smartly twitch the Coats of the Stomack or Intestines, or when Worms gnaw them, Con­vulsions do not only follow in those parts, but likewise Convul­sive motions are sometimes retorted on the Members and out­ward Limbs: For as we have shewn elsewhere, when a sense of great pain torments any part, and is communicated from that to the Primum Sensorium, presently upon it, the Spirits being there irritated, an involuntary and irregular motion is wont to be thence reflected; and that not only by those Nerves, by which the sense of pain was brought, but sometimes the Convulsion is reciprocated also by others, either of the same pair, or belonging to a pair wholly differing: Thus a Stone fixt in the Ureter cau­ses Convulsions, not only in the Vessel affected, but in a man­ner in all the Viscera of the Belly, and cruel vomitings for the most part follow upon it: Wherefore it is not to be doubted but Convulsive Diseases also, and some such Symptoms are often caus'd by reason of some outward offence offer'd the extremities of the Nerves within the Membranes, Muscles or Viscera: Nay and if at any time in Hysterick, Hypochondriack, and certain other pas­sions, Convulsive motions are rais'd through the fault of the Womb, Spleen, or some other of the Viscera, the Head being without hurt; truly those arise and are propagated on every side into various Regions of the Body only this way, viz. by the an­noyances of the rest of the parts by the Way of the Nerves, and not at all by vapours convey'd to the Head. I shall now give you some instances and observations of Convulsions arising from the Extremities of the Nerves.

A delicate Virgin about the sixteenth year of her Age falling from a Horse, and dashing her self against a rough Stone, sorely hurt her left Brest, whence a Swelling with a pain arose, which Symptoms nevertheless at first seem'd to be mitigated by the use of Remedies, and afterwards for a long time to pass indifferently well; but after three years upon taking cold, and having us'd a [Page 265]very ill Diet, all things began to return a new; the place hurt swelling up in a greater bull, was affected with a most acute and almost continual pain, so that the Diseased, through the mighty torment, passed many days and nights without sleep; nor could she indure that the Glandules of her Brest, then become more swollen, shonld be toucht or handled, nay nor any noise or con­cussion to be made in her Chamber.

When to this Tumour, degenerating towards a Cancer, Fo­mentations and Cataplasms of Hemlock and Man-drake, and other stupifying things, and Repercussives were apply'd, the noble Lady began to undergo certain Convulsive affects, which often molested her: In the first place as often as a violent pain came in her Brest she felt there prickings, and likewise Convulsions and Contractions shooting in and out: Presently after the Ven­tricle and Hypochondres, and after that the whole Abdomen were wont to be blown up, and mightily distended with a rumbling and a straining to Vomit: By and by the same affect being con­vey'd by degrees to the upper parts, took away her Senses, and shortly upon it so strong Convulsions followed in her whole Body, that the Diseas'd could scarce be heal'd by three or four robust Men.

These kinds of Fits at first came at random, and were only rais'd occasionally, viz. they ensued as often as the pain of the Brest was rendred more intense by some evident cause: After­ward those Convulsions more frequently molested her, and at length becoming periodical and habitual, they return'd twice a day, viz. constantly justsomany set hours after Meals: And when Diseas'd had been miserably afflicted after this manner for six Months; at length she began to be troubled with a certain Ver­tiginous affects which continually followed her: For which evil when a Fomentation of Aromatick and Cephalick Herbs had been for some time applyed, she grew better as to her Vertigo; but from thenceforwards she was continually molested with a new and very wonderful Symptom, viz. a violent dry Cough follow­ing her day and night, unless when she was fallen asleep: After this noble Virgin had tryed divers sorts of Remedies, prescrib'd by several Physicians, without much benesit, at length vpon the use of the Baths of a moderate heat at Bathe, she was reliev'd, and being marryed presently upon it, after conception and her being delivered of a Child, she recovered by degrees.

As to the violent Cough above mention'd, it seems that that Symptom depended on the Origine of the nerves being affected, and not on any stuffing in the Lungs, for she spit forth nothing with the Cough; we say therefore that the Morbifick matter de­por'd near the Origint of the Nerves being rarified and mov'd [Page 266]by the Fomentation, entred deep in at the Mouths of the Nerves that go to the Lungs, and stirr'd up perpetual Convulsi­ons in the Fibres and Filaments thereof.

A noble Matron Fifty years of Age, after that her Menses had ceas'd to flow for a year and a half, first began to complain of a pricking pain in her left brest, then afterward that affect ceasing, she was taken ill about the Stomack: To wit, a hard, and as it were schirrous Tumour arose there with an oppressing pain; this was presently followed by an inflation of the Ventricle, with a diffi­cult Breathing, a Nauseousness and frequent Vomiting. Then the Disease growing worse and worse, with a more acute pain, and shooting in and out every way, she fell into Conulsive af­fects of the Ventricle: To wit, the Convulsions shooting in that place several ways, she was almost continually in such a torment, as though the Stomack were torn in several pieces: Moreover a continual Perturbation of mind, and frequent Fainting Fits lead­ing even to Death's door, accompanied with a Thirst and Watch­ings, pursued the sick Lady; all which Symptoms she plainly per­ceiv'd always to arise from that Tumour of the Ventricle (to wit, its sharp and heterogeneous Particles continually entring the Ex­tremities of the surrounding Fibres and Nerves.) To this Per­son all Vomitory, Cathartick, Antiscorbutick and Hysterick Me­dicines, without giving any ease, seem'd rather to have prov'd offensive and prejudicial: After Bleeding by Leeches, and the use of Asses Milk she receiv'd some benefit, and afterward by long drinking Mineral Waters, she was very much reliev'd.

What has been said here of Convulsions from a Morbifick cause besetting each end of the Systema Nervosum will be made more clear when hereafter we shall treat particularly of the chief kinds of Convulsions, viz. of Hysterick, Hypochondriack and other Passions: In the mean while it will not be necessary to add a The­rapeutick method to this Hypothesis of Convulsions hapning by reason of the Extremities of the Nerves being affected; because the ways of Curing this affect may better be accommodated to those that we shall hereafter deliver in particular.

I have found also by ocular evidence, that there are Convul­sive affects whose cause, or Morbifick matter lyes within the Plexus's of the Nerves: For opening the Body of a noble Lady, who had been horribly troubled with those affects they call Hy­sterical a little before her decease, I found the Womb wholly without fault, but along the Nervous Plexus's of the Mesentery, which (as it seem'd) had been wont to swell and rise up in a bulk, I found the Membranes of that Entral loosen'd and severed from each other, so that they appear'd every where swoll'n and lax, as if blown up in little bubbles or bladders. Nor is it less [Page 267]probable that the pains of the Colick often proceed from a sharp and irritating matter contain'd in those same Plexus's Moreover such a kind of matter within the Pexus's of the Heart, seems to cause there horrible Tremblings and Passions, and with­in the Plexus's of the Lungs or Neck, terrible Fits of the Asthma, &.

CHAP. V. Of Convulsive motions arising from the Liquour ly­ing in the Nervous Bodys, and irritating all their Processes into Convulsions.

IT is obvious almost to daily experience, that Convulsive affects ren through the whole Genus Nervosum, and infest sometimes these parts, sometimes others, sometimes many together: For in some we may observe that the Tendons of the Muscles every where leap, and are drawn with Convulsions; in others that all the outward Members are in many places bent or extended this way, and that, with various flexions and contorsions: We see some forc't by a masterless and ungovern'd impetus of the Spi­rits, sometimes being struck as it were with a rage, to run or leap, sometimes strongly to belabour the earth, or any thing that comes in their way with their Fists, which unless they did, they would fall presently into Swoonings and horrible Faint­ing Fits. It would be too tedious to enumerate all cases of those general Convulsions passing through the whole Genus Nervosum: But such like Symptoms, though various and manifold, may in some sort be reduc't to three chief heads, viz. as they chiefly depend on three sorts of causes: For since in these Convulfions passing from place to place, we ought to suppose the whole Ner­vous Liquour to be vitiated, and the Animal Spirits, every where abounding in it, to be adulterated, and consequently to be al­most continually exploded: We may observe that that taint for the most part is communicated both to the Nervous Juice, and the Spirits every where accompanying it, by one or the other of these three ways; viz. First, Either from Poyson or Witchcraft; Secondly, from a malignant or ill-determin'd Fever, viz. in which the Morbifick matter is discharg'd on the Brain, or Genus Ner­vosum; Or Thirdly, When the Nervous Liquour in long process [Page 268]of time, by reason of a Scorbutick or otherwise vitiated affect, degenerates from its due Crasis into a sharp, acid, or otherwise Preternatural and Convulsive Liquour. We shall here consider of each of these cases, and first of Convulsive Fits, which are product from Poyson or Witchcraft.

First therefore, That some Poysons act on the Nervous Li­quour rather than on the Blood, and depraving it, cause chiefly Convulsive affects, it plainly appears from eating of Cicutaria Apium risus, deadly Nightshade, the wild Carrot, and other offensive Herbs, which is wont to be followed in a short time after with horrible Contractions of the Stomack, a Numness, Delirium, and Twitchings and Convulsions in the whole Body of the tendons: Moreover those kinds of Convul­sive affects ensue in such as are bitten by a mad Dog, and other Venemous wild Beasts when the Virulent Miasm receiv'd by the Nervous Juice, having lay n hid in it a long time, at length exerts it self, and infects and poysons with its ferment the whole Mass of the Liquour in which it is involv'd: And this is more clearly manifested by the wonderful Symptoms, viz. the pain­ful Convulsions, and continual Dancing which are affirm'd by Authors of Credit to ensue upon the bite of a Tarantula: Which doubtless happen, because upon the bite of that Animal, some Ve­nemous Miasms are convey'd into the Body of Man, which ne­vertheless being little injurious to the Blood and vital Spirit, assoon as they have past from it into the Nervous Liquour, pre­sently spread themselves like a Ferment, through its whole Mass, and infect the Animal Spirits, every where abounding in it; so that they being forc't apart from one another, and driven hi­ther and thither in a disorderly manner, cause Convulsive affects, which sometimes are accompanyed with a Contraction of the containing parts, sometimes with a languor and resolution of them.

If it be asked why the painful Convulsions which are rais'd by the bite of a Tarantula, being presently appeas'd by Musick, are wont to be chang'd into a Dancing, I answer, that the Ve­nom communicated to the Nervous Juice by the bite of a Taran­tula is more mild than to be able wholly to extinguish the Ani­mal Spirits, or altogether to dissipate and force them to very vio­lent explosions, being driven into divers parts; but can only put them to flight, and being driven hither and thither, egg them to slght, and in a manner only pain-causing Convulsions: Now Musick by its gently soothing Nature, readily gathers together in one, and mutually associates the Spirits so dissipated: Where­fore when the said Spirits, by reason of Virulent Miasms sticking to them, are continually prone to Involuntary and Convulsive [Page 269]motions, the Melody disposes and directs them, being allur'd together, into such Convulsions, that entring the Bodys of the Nerves in a certain feries and order, they are carryed in certain limited I racts as it were, till at length the Particles of the Venom being wholly evaporated, and the fury and impetus of the Spirits wearyed, they have wholly shaken off that rage: And indeed Musick readily forces sound and sober Men, even against their wills, or thinking of other things, to actions emulating the Tune heard; so that a Piper no sooner begins his Lesson, but the standers by begin to move their Hands and Feet: We need not wonder therefore in Men bitten by a Tarantula, where the Ani­mal Spirits being stimulated to motion as it were, are forc't to skip and wander from one place to anothe of themselves, if up­on playing on a Harp, they are put upon Dancing, and observ­ing of regular motions.

To this is a kin the Evil, which is call'd the Dance of S. Vitus, concerning which Horstius relates, that he spake with certain Women, who visit yearly the Chappel of S. Vitus, which is within the Precincts of Ʋlmes, and there exercise themselves so long in Dancing day and night, with a Perturbation of mind, till they fall on the Ground like Persons in an extasy: By which means they seem to be restor'd to themselves, so that they feel little or nothing for a whole year, till the time of May following. and then they declare themselves tormented with such a rest­lessness of their Members, that they are forc't to betake them­selves again about the Feast of S. Vitus to the foresaid place, to renew their Dancing.

Indeed it is a usual thing (as I have often observ'd) both for Men and Women to be infested with such a restlessness, and cer­tain rage as it were of the Members, that they are forc't to walk till they are a weary, and also to dance and run up and down, by this means to avoid greater Disturbances and Swoonings, which would otherwise seize them: The reason of which seems to be, that the Animal Spirits, because stimulated in the whole Genus Nervosum from a Heterogeneous Combination, become wholly in a rage and ungovernable, which therefore ought to be so exercis'd and wearied, both that they themselves may be mastered, and that the Heterogeneous Combination may be shaken off.

That Convulsive affects are sometimes caus'd by Witchcraft, it is both vulgarly believ'd, and every where affirm'd by many Authors that deserve Credit: And to grant that wonderful affects are often produc't in the Body of Men by tricks of the Devil, viz. in as much as by the wonderful subtlety in operating, in which he excels, he insinuates Atoms or Heterogeneous Cor­puscles [Page 270]into the sensitive Soul, or the Texture of the Animal Spirits, and so sometimes stimulates its Functions, sometimes binds them, sometimes violently perverts them: Nay and far­ther in some manner he enters the Body of Man himself, and be­ing as another Soul of a more powerful Nature, is co-extended to it, actuats all the parts and members, inspires them with an unwonted Vigour, and governs them at his pleasure, and stirs them up to the performance of wonderful and supernatural acti­ons: Grant this I say, yet all kinds of Convulsions which appear prodigious, as being besides the common course of this Disease, ought not presently to be imputed to inchantments of Witches, or tricks of the Devil, for often, though appearing strange, they proceed from meer natural causes, and stand in need of no other Exorcisms for a Cure, than Remedies which are wont to be pre­scrib'd against Convulsive affects: In truth the Animal Spirits when indued with a very great explosive Combination, and dis­charg'd together by it, exert so much of strength and vigour above their proper and wonted force, as a flash of Gun-powder above the burning of a common flame, so that such, who, being obnoxious to this Disease, may when they are out of the Fit be govern'd, carryed, and led at pleasure by the guidance of one Man, when the Fit comes upon them, are not to be manag'd by the greatest strength and endeavours of four or more robust Persons: But if when any Person is distempered there be a suspi­cion of Witchcraft or Fascination, there are chiefly two kinds of motion which are wont to create and maintain it; viz. First, If the Patient uses such Contorsions and Gesticulations of the Members, or of the whole Body, which no sound Man, even a Mimick, or any Tumbler, is wont to imitate; And secondly, if he exerts a strength, which exceeds all humane force, to which if there be joyn'd excretions of monstrous things, as when heaps of Pins are cast up by Vomit, or living Animals are voided by seige, it comes to be without dispute that the Devil has, and acts his part in this Tragedy.

CHAP. VI. Of General Convulsions which are wont to be rais'd in Malignant, Ill-determin'd, and some Anoma­lous Fevers.

EVery Man knows that Convulsions sometimes happen to Per­sons in Fevers, and that from thence a great Prognostick is taken of death or danger: For as in Malignant Fevers, and sometimes in ordinary Fevers of an Ill-determination, a Vertigo or Delirium arise from the Morbifick Matter's being depos'd from the Blood in the Brain; so from the same fall'n into the Genus Nervosum, Contractions and Twitchings of the Muscles and Ten­dons, and also sudden shakings of the Members and Limbs, and sometimes horrible stiff extensions in the whole Body ensue, which forts of Convulsive affects happen for the most part about the height of Fevers, when the Morbifick Matter, first heap't to­gether in the Blood, is convey'd thence into the Brain, and that being either presently past through, or infected together with it, is carryed into the Systema Nervosum, and thence Convulsive affects, with or without a Delirium are rais'd.

Nevertheless besides these kinds of Convulsive affects which ensue upon Fevers, and are secondarily rais'd, we may observe sometimes in a Malignant Constitution of the Air, and after a breath of a pestilential Contagion, that the Nervous Liquour is infected before the Blood, or apart by it self from it, and that then a Delirium and Convulsions precede the Feverish Distemper. Moreover I have often observ'd that some Anomalous Fevers have been rife, in which the Blood being scarce seen to boil or to be extraordinary hot, the beginnings of a slow, and very dan­gerous Fever have been first laid in the Nervous Humour; which being rais'd by degrees to a Maturity, caus'd Convulsive affects with a Delirium or Mania, and other failings or exorbitancies of the Animal Spirits: For the Diseas'd not complaining of heat or drought, on a sudden becoming weak, and as it were enervated, were presently rendred obnoxious to a frequent Giddiness, also to Tremblings and Leapings as it were of the Limbs, and likewise to Twitchings and Contractions of the Muscles and Tendons, and to pains moving from one place to another. This kind of Sickness, in regard it seems to consist in the solid parts, rather than in the Blood, is call'd by some Physicians a Malignant [Page 272]Hectick Fever, when in truth the same being chiefly rooted in the Nervous Humour, is better said to be a Convulsive Disease of the Nerves.

Horstius mentions a Convulsive and Malignant Disease, which heretofore was Epidemical in Hassia, Westphalia, and the Neigh­bouring parts; those that were seiz'd with it, without any Fe­verish heat, or immoderate effervescency of the Blood, as they were about their househould affairs, on a sudden scarce per­ceiving themselves sick, were wont to feel a Formication with a Numness passing in and out about their Hands or Feet, and sometimes in both: Presently after their Fingers and Toes, and likewise their Arms and Legs, one while were closely contracted, another while strongly extended, as though they had grown stiff: These Contractions and Extensions followed each other alterna­tively, and now and then chang'd places, so that at one time the affect lay in this part, and then presently in another: But in case (as it often fell out) the Disease seiz'd the whole Brain all at once, Universal Convulsions, and often Epileptical Fits infested the Dis­eas'd; Moreover they were obnoxious at certain times to a Di­lirium, Mania, and sometimes to a Lethargy: This Distemper continued a long time without a Crisis, or being perfectly resol­ved, and could scarce ever be so throughly Cur'd, but ill and morbid Dispositions of the Brain and Nervous parts lasted after­wards during the whole Life.

It plainly appears that this Disease and its Symptoms wholly depend on the Corruption and mighty Depravation of the Ner­vous Juice: And the reason why in this Nervous Fever, there happen'd a difficult, or rather no Grisis, or Solution at all, was because the Nervous Juice being tough and mucilaginous, as it were, and consequently slow in motion, is not purg'd as the Blood, by an excretory effervescence, nor does it easily fall into such a fermentation, whereby the pure is separated from the impure.

I have known a Disease like this, often to have reign'd in our Country, and to have past through whole Families, at least amongst the Children and younger People. Some years since a popular Fever sorely infesting the Brain and Genus Nervosum very much reign'd about Oxford, and indeed almost throughout England: The Narrative of which Disease, written at the time it reign'd, viz. An. 1661. I shall here briefly insert; for from hence it appears after what manner, and by what causes Con­vulsive Symptoms which happen in all Fevers, are wont to be rais'd.

CHAP. VII. Of General Convulsions which are wont to arise by reason of a Scorbutick disposition of the Ner­vous Juice.

SOmetimes universal Convuisions, without Poyson, or a Fever­rish Miasm, are caus'd by reason of aScorbutick or other wise vi­tious dyscrasie of the Nervous Juice; for the Liquor which lies in the Nerves, and Nervous parts, sometimes falling from its natural and due Crasis, is so much fill'd with Heterogeneous and Explosive Particles, that the Animal Spirits admitting an incongruous com­bination, some ways accruing to them, are irritated to continual Explosive Convulsions; which kinds of affects of the Spirits are either divided or separate, betwixt which no Communication or dependence happens, viz. when many parts of the body are af­fected together with so many Convulsions peculiar to them, which do not follow each other successively, but are terminated in the same Mnscle or Member where they begin: Or secondly, The Convulsive affects which are rais'd together in the whole Genus Nervosum, are continual or connected, and being continued by a per petual sort of Vicissitude betwixt themselves, succeed each o­ther, so that the disorderly motions of all the Members through a Mutual Succession when they begin at one part, presently pass in­to the others. We shall consider the nature of both those convul­sive affects, and shall shew what method of Gure is to be us'd in each case.

1. As to the former kind it plainly appears that such affects are not simple, but complicated, viz. of a Convulsion and Palsey, for though the Muscles and Tendons are continually intested with Convulsive Motions, yet the Diseas'd being Enervated cannot move strongly any Members, or the whole body: nay to these affects Pains Diffus'd through all the Limbs are added: hence we may infer that the Animal Spirits are indued with a Manifold Combination, viz. with particles both Explosive, and Narco­tick, and in some sort irritative; so that tho' being always op­prest, they fall upon Explosions, yet neither many of them to­gether, by reason of other Particles of another kind mixt with them, nor indeed any of them have a free and lively Explosion wherefore the Impetus of Motion does not reach far, but is al­ways [Page 284]short and interrupted. A strange instance of this affect take as follows.

A nobleman descended from Parents and Ancestors who had been subject to evil affects of the Brain, or other Morbid disposi­tions of the Nerves, about the time that his Age. began to de­cline, first was wont to be troubled with a weakness, a numness, and gentle Convulsions in his Limbs, after having lain long un­der these affects, at length he went to Bathe for a Cure, but ufing there the hot Baths too other, instead of a cure he got only so great an exasperation of his disease; that from that time the foresaid Symptoms did no longer follow him at times, but almost constantly, viz. Convulsive Motions, and Painful Tensions inces­santly occupied all his Limbs, nay and each part of his Body, so that all the Muscles together were perpetually Convuls't with repeated Twitchings, and that not without a mighty Torture: the only way of appeasing which was, that sometimes his whole Body, sometimes some of its Members were continually exer­cis'd with a local Motion: for as long as he was awake, he was forc't to be kept moving in his Bed, or in his Seat, or to be car­ryed in a Coach, or to have his Members prest or rub'd; for which end Chairs and Beds were made for him with rockers, like Childrens Cradles, in which as he lay, or sate upright, he was continually rockt to and fro: without which, he was tor­mented with a cruel Pain, and a violent Tension of the Muscies; the diurnal oppression of this Convulsive affect was followed in the night time, and presently after sleep with much more severe Syniptoms; for he no sooner awaked, but presently his whole Body fell a shivering, the Muscles were very much toyl'd with painful Convulsions, and all the Limbs, as in an agony of Death, were wont to be all over in a foul Sweat, which was so Corrosive, that the sheets, unless they were presently washt, were soon eaten and rotted by it, as by Aquafortis: the sick person during this con­flict, was tortur'd betwixt Sweating and Shivering for many hours, till being quite tired, a sleep stealing upon him, brought some ease: but if, as the fit was coming, he was taken out of his Bed, he was better, and so he prevented the wonted violence of the Fit: therefore assoon as he was awaked from his sleep, tho' this happen'd within half an hour, presently to escape the torture, he call'd his servants, and was taken forth of Bed: being well e­nough as to his Akppetite, he did Eat without nauseousness, nor was his Stomack troubled by what was taken into it, yet he of­ten complained of a Cardialgia; and sometimes a troublesome Spitting, with a stinking Breath, as tho' he had taken Mercury, molested him for many days; any Hot things, as well Food as Phylick, did not agree with his constitution: he dar'd not so [Page 285]much as Sip of Wine, or Strong-beer: in the first years of his Sickness he was seiz'd with a horrour at the sight of Fire, afterward becoming weaker, her refus'd to sit by the Fire, even in the Winter: his Urine was always of an Orange Colour, which if Evaporated on Coals in an Earthen Pot, a Saline filth, amounting to above half the Liquour, fell to the bottom: The Belly being always Costive, never depos'd its burthen unless irri­tated by a Medicine or Glyster: Moreover, besides the Convulsive Motions, a Bastard Palsey possest all the Members of his Body, for he could neither lift up his Hands, nor walk with his Feet; his Tougue faultring brought forth only imperfect words, but some­times when on oocasion his mind was possest with a sudden Joy, his Spirits and Strength being strangely rais'd, he was able on a sud­den to rise from his Chair and to walk upright, and skip about without help; which interval nevertheless scarce lasted a minute of an hour, but the Members faultered afresh, and were troubled with their wonted Languor and Trembling. As this person was ill after this manner above twelve years, he got the advices of the most Famous Physitians of all England, and tryed a great many remedies and almost of all kinds, viz. Antiparali­ticks, Antiscorbuticks, Drying, and Sweating Dyets, Purges, Cauteries, Baths, Liniments, nay and was twice Salivated but could not be Cured by any of those Methods, wherefore all hope of Cure being laid aside, for the seven latter years of his life he used only remedies that had regard to some of the chief Symp­toms; viz. he took thrice a week a Loosening Medicine of Sena and Rhubarb with Correctives, sometimes in the form of a Sy­rup, sometimes of an Extract; he us'd to take every night a Dose of an Opiate made of temperate Conserves and Species: Moreover he had a Julap in a readiness to be taken on occasion, when the Spirits faultered: He also Drank Oat-bear, Alter'd with temperate and Diuretick Herbs: By the use of these things he past at least seven years, without any great alteration for the worse: At length Old Age pressing opon him and the Disease together, the Convulsive fits growing more violent, seis'd him, not as before when his sleep was over, but as soon as he was warm in his Bed, so that he was forc't wholly to forbear going to Bed, and he put off his Cloaths but seldom, unless it were to change Linnen: Hence transpiration being hindred, the Serous and o­ther Filthy Dregs which were wont to evaporate, were fixt on the Lungs, which first brought a thick Breathing, afterward an Asthmatick affect, and lastly a Mortla Consumption.

If the reasons of the foresaid affects be enquired into: it will appear that all these Evils proceeded from the ill Constitution of the Brain, and Genus Nervosum, and more immediatly from the [Page 286]Dyscrasy and Default of the Juice that lies in these parts.

The reason is plain why this Disease, first increasing by degrees, was soon rais'd to a far worse state by the use of hot Baths, for it is manifest by experience that hot and sulphureous Baths very much exalt the Saline, and other Morbid Particles, that a­bound within the Viscera, or Humours of Human Body, and soon carry them to the highest pitch, viz. by exagitaing them they render them more wildly exorbitant, and froce them from the first passages into the Blood, and thence into the Brain and Genus Nervosum, nay and joyn them together being first sever'd, and lying idle, and stir them, up to a certain Fermentation: Wherefore such as being hereditarily obnoxious to the Gout or or Stone, have not yet felt any Fits of those affects, after the use of hot Baths, very often find that both those diseases are pre­sently brought to a maturity in them. [You may find the reasons of the other Symptoms in Dr. Willis at large.]

So much for universal Convulsions, which for the most part being joyn'd to the Paralytick affect, are raised at once in many places separately: there remain others which we call continual, viz. because being conveyed on a sudden from these parts to o­thers, they mutually succeed each other, and force the Members sometimes these, sometimes others, and often the whole Body to be mov'd involuntarily, and to be bent and agitated divers ways. I shall give you an instance or two of this affect.

A Beautiful Virgin, tall and thin grown, begotten of a Father obnoxious to very great distempers of the Genus Nervosum, a­bout the twentieth year of her Age was afflicted for many days with a very violent and Periodical Head ach, at length the Win­ter Solstice being near at hand the pain of her head remitted, but in its stead, a mighty Catarrh succeeded, with thin and much Spittle, and with an Ulcerous affect of the Nostrils, Mouth, and Throat; having undergone the tediousness of this for some time, at length by the advice of some old Women she drew into her Mouth the smoke of Amber through a Tube, and was presently Cur'd, viz. the Catarrh was suddenly stopt, but presently upon it she complain'd of a mighty giddiness, with a Pain of the Head, and a Ringing in the Ears: on the third day the Tendons of the Neck were Convuls't that her head was bent sometimes forward, some­times backward, sometimes sideways, and sometimes it stood stiff and immovable, in a short time after this such a Convulsive affect seiz'd the ontward parts of the whole Body, and the Limbs: the Arms and Hands were so wonderfully twisted, that no Jugler of Mountibank was able to imitate their Flections and Convolutions: Her Legs qand Feet were forc't awry this way and that, and were made to beat aginst each other, and to cross each other alterna­tively [Page 287]after this manner she was perpetually affected with Con­vulsive Motions either sitting in a Chair, or lying in Bed, unless when she was overwhelm'd with sleep; and when she contained her members a little, by much forcing her self, presently she was seized with a difficult, and short Breating, and with a danger of being Choakt, yet in the mean time the Eyes, Jaws, Mouth, and inferiour Viscera continued free from any Convulsion: Nor was she troubled with a Vomiting, Rumbling, nor Inflation of the Hypochondres: Moreover her mind held always sound, and she duly performed the functions of Memory, Understanding, and Imagination, she neither spake nor did any thing shewing want of Reason, or Indiscreetly: but amongst all these stupendi­ous evils always using Pious and Vertuous expressions, she gave an admirable specimen of Christian Patience and Piety: her appe­tite was soon dejected, so that she was averse from all food unless very much press'd to it; but thirst continually prest upon her, she was so very weak, she could neither stand nor go: Her Urine was of an Orange Colour, very much Impreguated with a Saltness, on the Surface of which a thin Tartareous Film grew.

Being call'd to this Lady the sixth day after her being ill, I pro­ceeded in order to her Cure as follows: In the first place having made a gentie preparation of the Body, I gave her a Loosning Potion of an Infusion of Sena and Rhubarb, with the addition of Yellow Saunders and Salt of Wormwood, whereby she had twelve stools which gave her great ease; the day following I drew eight Ounces of blood from her left Arm, every evening I gave her an Opiate of the Water and Syrup of Cowslip flowers with the Powder of Pearl: Moreover once within six hours I ordered her a Dose of Spirit of Harts Horn to be taken with a little draught of the fol­lowing Jalape.

Take Water of black Cherries, Wall-Nuts, and Peony Flowers of each three Ounces, the Antiepileptical Water of Langius two Ounces, Syrupe of Male Peony Flowers two Ounces, Pearl powdred a Scruple, mix them make a Julape. Because she could not bear much Pur­ging, Glysters of Milk and Sugar were frequently us'd: Besides Anticonvulsive Liniments apply'd to the Neck and Spine, we or­dered Frictions of the Members affected with Woollen Cloths moistned in an appropriated Oyl, and warm'd.

By the use of these things, within six days the diseased seem'd to be very much relieved; for the Convulsive Motions in a manner wholly ceast, she could keep her Members in their due Site, and without Motion, only she was forc't sometimes by a slight Con­traction to bow her head gently this way and that: Moreover she was able to arise from her Chair and Walk a little, but as she Walk't, she did not go upright, but inclining to one side's Par­ting [Page 288]from her at that time, I left her in a manifest state of Reco­very, she seeming to be much better: But somewhat more then a week after, a boistrous North Wind arising in the night time, and blowing strongly on the diseas'd as she lay in her Bed, the window being not well shut; presently upon taking Cold she fell into such a relapse, that she became not only obnoxious to Convul­sive affects, but likewise to a Universal and Periodical Palsey: For from thence forward her Head and Members being bent and toss'd again from Morning to the Evening as before, she was made to Wind, Bend and variously Wrest all her Limbs successively; till about night those Motions being wholly appeas'd, a Resolution or Palsey of the Members ensued, so that she could neither move Hand, nor Foot, nor any part else, or exercise any effort of Moti­tion of the Body, lying in the Bed like a Stone, immovable: But being somewhat refresht with sleep, about the morning, as she recovered some strength of the regular moving Faculty, viz. e­nough, to bend the Arms and Leggs, to and fro, tho' weakly, so also the Convulsive and Involuntary Motions constantly re­turn'd, and continued for the whole day after, which in the e­vening were again Chang'd into resolutions of the Limbs.

From what is said it plainly appears, that the sick Lady lay un­der a double disease, viz. APalsey, and Convulsions: And besides the remedies before mentioned a great many others almost of all kinds, viz. Antiscorbuticks. Antiparaliticks, Sudorificks, Decoctions, Distilled Waters, Spirits, Elixirs, Tinctures, Baths, Liniments with many others were carefully administred; by the use of which the Symptoms were a little remitted, but the disease was not perfectly Cur'd: The Universal Palsey ceast in a short while, so that she could move her Limbs and bend them to and fro at all times; nay and the involuntary Motions of her Members sel­domer molested her, yet she still continued faint and weak, and as she was of a tender Constitution, and inclin'd to a Consumpti­on, and now become unapt for all exercise, the filthy Dregs of the Blood depos'd in the Lungs, by reason of her letted transpiration, brought a Cough, which dayly growing worse and worse, she dyed at length Pthisical.

Many years since I was call'd to a noble Virgin taken almost after the same, and somewhat a worse manner. For this under­went Involuntary Motions of the Head and Members, viz. ei­ther Shakings of them, or Bendings this way and that, or Wrest­ings of them, returning almost in a constant Course: Moreover she was affected with a very troublesome, and wholly wonderful Convulfion of the Diaphragm, and Muscles that serve for respirati­on for every minute of an hour and oftener, the Back Bone a­bout the middle of it was made crooked, and at the same time [Page 289]Breast Springing forward, and the Hypocondres contracting in­ward, a very Sonorous Sobbing, and the same sometimes doubled, sometimes tripled, but still less and less Shrill came from her; she was wont to continue these Motions, and Reciprocation of noise many hours, so that she was heard throughout the whole house; if at any time a short intermission of this happen'd, present­ly she was forc't strongly to beat or clasp her arms and hands one with the other, sometimes her Legs and Feet, and some­times to throw her Head after a most violent manner; by and by to hold her Neck as it were still and immovable. Sometimes in speaking her Tongue was so taken, that she repeated the same word often, nay more than at least twenty times. When the Convulsive Motions were strong in the Exteriour Members she was a little somewhat free from that stridulous Sobbing affect; and she call'd this the space of Intermission and the time of her ease; tho' in the mean while her Head and Members were drawn every way with violent Motions: If at any time she lay on her Left Side, presently an inward Contraction of the right Hypo­condre, with a Sobbing happen'd, within a few days, her strength being very much dejected by the assidnity of these affects, she got such a weakness in her Loins and Knees that she could nei­ther stand nor go: The Stomach being affected either with a Languor, or Convulsion threw up all by Vomit that was put into it.

Coming to her the fourth day I gave her a Vomit, after which she Vomited sever times a viscous Flegm, with store of Yellow Choler; but without any relief: The day after I drew six Ounces of Blood from her Arm, wereupon the Blood presently taking violently to the Head, she complain'd very much of a Head-ach and Giddiness; but being Blooded in the Foot, within three days, she was better: She tooks afterwards remedies appro­priated to the Nerves, viz. Spirit of Harts-horn, and of Blood, Powders of Shells, Bezoars, Anticonvulsive Julaps, and Electu­aries: by the use of thse things the Symptoms seem'd some­what to abate, yet continued still in some Measure according to the Forms before described: After a fortnight, by the advice of some Country Woman, she took six spoonfuls of Blood, drawn from the Ear of an Ass, in a draught of bear, whereuopn on a sudden she seem'd to be Cur'd: For the Convulsive Motions presently all ceast, and she past twenty four hours free from them, nevertheless the disease returning shortly upon it with its wonted violence, yielded not easily to that Medicine, nor indeed to any other whatsoever, therefore for the time to come she took Me­dicines methodically prescribed: She Purg'd gently once in six days, besides she took a Powder made of Bezoar, Pearl and Coral, with the Seeds and Roots of Peony, also the Electuary prescribed [Page 290]by Horstius against these kinds of marvellous Convulsions; and like­wise Julaps and Decoctions appropriated to Convulsive affects: Glysters were frequently given: Frictions, Vesicatories and Line­ments, were administred with good effect; within a fortnight the Sobbing affect wholly ceast, nay and the rest of the Convulsive Motions, being rendred more mild by degrees, remitted very much; but as she was recovering of those affects she was so troubled with a Catarrh falling on her Throat, that she Spit forth almost continually a Sharp, and as it were Corrosive Spittle, as if a Salivation were rais'd by taking Mercury: Which kind of remedy the event prov'd to be extreamly proper in this case; tho' I whol­ly forbore using it, because the diseased and here friends were not free to admit of it.

After that this Copious and very troublesome Spitting had con­tinued for many days the disease seem'd to be in a manner wholly Cur'd: So that the Noble Lady, being free from theConvulsive Motions, walk't abroad, and had a good Strength and Stomach [...]: Only she complain'd that at certain times in the day, she was affected on a sudden with a Shivering of her whole Body for a­bout a quarter of an hour: which kind of affect, sometimes also hapning by night, broke her sleep. Within a months space this Symptom also, and likewise the Catarrh, wholly ceast: but after­ward she was so afflicted, sometimes with a Sharpness in the Ventricle and Passage of the Aesophagus, sometimes also in the Jaws and Palate, that she fear'd lest those parts, the inner Skin being worn away, would contract an Ulcerous affect: More­over often in her sleep, and sometimes also waking, she us'd to be troubled with an Incubus. I ordered her a gentle Purge to be given Spring and Fall with the use of Antiscorbutick remedies, and sometimes Chalybeats: Which kind of Method she observed with so great advantage to her, that she has enjoy'd her health for many years, and enjoys it still.

Among many remedies which she took against that Sharp­ness, and Ulcerous disposition as it were of the Palate and Aeso­phagus, I ordered that she should Drink every Morning her own Urine fresh made: This for the most part being very Salt, was wont to give a mighty relief; but at certain times the Urine that came from her was thin, and in a great plenty, which ne­vertheless was not Salt, but manifestly Acid like Vinegar, after the Drinking of which she found little or no benefit. The rea­son of the good effect of the one, and not of the other is this: In as much as Saline Particles of a differing state, and not those that are of the same, mutually act on each other, and weaken their strength, therefore the Salt Urine and not that which was Sharp of sour Cur'd the Sharpness of the Throat: And it [Page 291]appear'd from hence that the Humour distilling on the parts of this Ladies Mouth and Throat was Acid and drew near to the na­ture of a Vitriolick Vinegar, because the smoke of Tobacco receiv'd in the Mouth of the Diseas'd seem'd wonderfully Sweet as it uses ot do in any that tast Vitirol before.

Ten years since I went to see the daughter of a certain Noble­man, troubled with Convulsive Motions after such a manner, that some thought her obsess't with an evil Spirit: This Virgin being about sixteen years of Age, Fair, and well in flesh, but begotten of a Father troubled with the Palsey, about the winter Solstice began to be ill without any evident cause: First for some days she was affected with a Head-ach and a Giddiness, though in no severe manner; afterward she perceiv'd a Trembling, and sud­den Contraction in one Arm, and presently in the other, which kind of Convulsions, returning often that day, scarce lasted a mo­ments space: The next day after sitting by her Sister in a Chair, on a sudden she started up, and made a leap or two, and many others successively to many feets distance with a wonderful Agility: Then when she was come to the end of the Room, she stood for some while leaping up in the same place, and every time to a wonderful height, when her legs were able to hold Leaping no longer, she fell on the ground and presently threw her Head several ways, as though she would have thrown it off her Neck, assoon as she ceast from this Motion, through her being tired, presently the same fury seiz'd her Hands and Feet, that she was forc't to keep these members a going in a violent manner, striking them against the Walls and Doors, or stamping on the Floor: When through Modesty, or Reverence due to Friends, or Persons pre­sent she kept her self from these Motions by main force (for she was always present to her self and spake with sobriety) presently the affect being convey'd inward, she was very much infested with mighty oppression of the Heart, a Sighing, and very loud Sobbing, then when she gave way to her self, presently the Rage being con­vey'd to the Muscles of the outward Limbs, she was forc't either to Leap, or to throw her Head or Arms this way and that in a violent manner, or also to run swiftly up & down the Chamber, or to stamp on the Ground with her Feet: Thus these kinds of violent Com­motions of the Limbs or Viscera mutually succeeded each other, the Tragedy of the distemper returning as it were in a Circle.

Coming the fifth day after this Lady had been ill, I gave her a Vo­mit of the Infusion of Crocus Metallorum, Wine of Squills, and Salt of Vitriol, after which she Vomited a great store of Aeruginous Cho­ler, with a mixture of a most Sharp, and as it were Vitriolick Hu­mour: The next day after I drew ten Ounces of Blood from the Saphaena Vein: Moreover she took twice a day Antidotes of the [Page 292]Powders of Precious Stones, Mans Scull, and the Male Peony: by the use of these things seeming to be recover'd, she liv'd for ma­ny days after free from the foresaid affects, but after a fortnight, the full Moon coming, she fell into a relaps of the same disease more violent than before, for besides the wonderful Leaps, the vi­olent Contorsions, and Convolutions of the Head, and Members, she was also forc't to Run up & down in a Vehement manner in her Bed Chamber: She took at this time, by the Praescripts of o­thers, Antihysterick Remedies, and Purges at some set intervals of time, but without any relief: Being call'd again, in re­gard thatshe was of a Robust habit of Body, and seem'd affect­ed with a mighty raging of the Spirits, I gave her a strong Vo­mit, after which she Vomited ten times a Choler as green as Ver­d [...]grease, with a Flegm as Sharp as Aqua Stygia, and was suddenly reliev'd: I gave her afterward, every morning a draught of White-wine Diluted with Black Cherry Water, pour'd on Mil­lepedes bruis'd, and strongly exprest. By the use of these things seeming to be Cur'd, she was perfectly well for a Month, and more: and when afterward she at any time perceiv'd any forerunning signs of a return of the affect, presently by the use of a Vomit, and the same expression of Millepedes, she kept off the Fit: With­in three Months she so recover'd her former Health, that she has now lived many years wholly free from such Convulsive af­fects: But from the time that the Convulsive Passions wholly ceast, she was sometimes troubled about the parts of the Mouth and Throat with a Defluxion of a most Acid Humour, like the distill'd Liquor of Vitriol: Moreover she has sometimes been obnoxious to the longing disease of Maids, sometimes also to a Cough with a discolour'd Spittle threatning a Ptizick, which ne­vertheless were easily Cur'd by remedies usual in the like cases.

Whilst I was writing these things, I went to see a Noble Vir­gin, who was troubled with Convulsive affects of another kind, and those Universal, and no less Admirable: This about the eighteenth year of her Age, being of a fresh Colour, Handsome, and before sound enough, now happening unawares to incur the danger of being infected with the Plague, it being rife here­abouts, fell into a Panick Fear, with frequent Swooning Fits, the night following the underwent such Failings and Disorders of the Spirits that she seem'd even ready to Dye. But having past that evil with much ado, she had afterward every day Convul­sive Fits, though returning first at uncertain hours, and in several forms: But within a short time the accesses of the disease be­coming regular, they return'd constantly twice a day, viz. at ele­ven of the Clock in the forenoon, and at five in the afternoon, that no intermitting Fever keeps its periods more exactly, nay and [Page 293]all the circumstances of the Fit happen'd daily after the same manner.

When she had been thus ill three weeks, I was call'd on a cer­tain day, that I might observe all the Symptoms, and the whole form of the disease: Rising from her Bed at ten a Clock in the Morning, she was well, and carryed her self so well in her coun­tenance, walking, and discourse, that no man would have sus­pected that any thing ail'd her: At eleven, a Clock she began to complain of a Plenitude, and as it were Inflation in the Brain, and a Deadness of the Spirits with a light Scotomia: by and by she felt in the left Hypocondre a mighty beating, and Spring­ing as it were of a live Animal: I plainly felt this Motion by ap­plying my hand to her side, then a Retching and great Crying followed, whereupon she was presently led to Bed, and given to be held by a maid servant sitting on the Bolster: This person clap­ping her Arms about the middle of the diseas'd, held her very hard in her Lap, during the Fit. Moreover servants were at hand, and relations standing about her, who sometimes held her Hands and Arms, sometimes prest down her Belly and Hypocondres which rise to a mighty Bulk, still forcing upwards: The chief Symptoms of the disease, which being rais'd by turns, divided in a manner the whole Fit, were these two, viz. Sometimes violent Convulsions of the Viscera infested her, so that the Abdomen rising to a mighty Bulk, withstood the hands of standers by, prest against it, that it could not be kept down, and withal the Praecordia being drawn upward, the Motion of the Heart and Blood was in a manner stop't: For which space of time the Virgin hanging down her head, with a weaken'd, and no Pulse as it were, lay Speechless and almost insensible: After two or three minutes of an hour these Fits ceast: And then the Sick raising her self, look't round her chearfully, and for some time converted the Impetus of the disease into Discourses and Songs, both which she uttered most Pleasantly and Elegantly above her Natural disposition; she past such Sayings and Scoffs on all persons about her, that there is nothing in any Comedy to be met with more facetious; then she would Sing most Sweet and Pleasant Tunes of Harmony, such as neither any person else could Sing, or herself at another time: After the she had thus past about six or seven Minutes of an hour, in Jesting and Singing, she fell again into the Convul­sions of the Viscera and Hypochondres, and the loss of Speech as before: And these remitting in a short time, and the Impetus of the Spirits flying back from the inferiour Nerves to the Brain, she gave her self again to the pleasantryes of Talking and Singing. When at any time she discourst with the standers by, if any thing that was Sharp or Ignominious were replyed by them, she fell [Page 294]into more Violent and Lasting Convulsions of the Bowels: After this manner she uses to be troubled with an alternate affect of the Viscera and Brain for about the space of an hour: Then the Fit drawing toward an end, the Convulsions of the Bowels becom­ing more gentle, return'd three or four times with very little in­termission: Afterward these wholly ceasing, the Impetus of the disease passes into the outward Members, whence presently it whol­ly vanishes: For the Arms and Legs undergo contractions and twitchings for a minute of an hour, and presently after the dis­eased rising up, comes off from her Bed, and is free from all Con­vulsion till a new Fit returns, nay and having an indifferent good strength, walks up and down the house, and during the interval of the affect, cheerfully performs the usual Offices of Life, still excepting that her Stomach being weak, loaths food during the day time, in the evening after the second Fit of the disease, she eats a little supper.

About the beginning of this sickness of the Convulsions of the Bowels were much more violent, and she lay Senseless with them, and during their intervals she would talk absurdly, Sing Songs out of tune, and fall out a Laughing, or Crying, without any ground of reason: But at length the Animal Spirits being forc't into lasting explosions, perform'd them so regularly, sometimes this way, sometimes that, as it was most proper, that they seem'd to be done in some sort by the moderation and command of the will.

After I had been again to see this Lady, having lain under these periodical Fits for many weeks, I ordered that three hours before the second Fit, ten Ounces of Blood should be drawn from the Vein of her foot, whereupon the Fit, expected in the Even­ing, wholly left her, nor did it ever return afterward: But the other Fit obsrving its ancient course return'd daily, till upon Bleeding a little before its coming, the Patient was free of it that day, which nevertheless returning the next day after followed her for many months according to the same form: In the mean while, because the winter cold was very fevere, she delai'd for some time the use of Remedies: But as the Spring came on the noble Lady being brought to Oxford was cur'd by the following Me­thod.

In the first place I gave her this Purge, and took care for it to be repeated every sixth or seventh day.

Take Sulphur of Antimony six Grains, Mercurius Dulcis a Scruple, Rosin of Jalap four Grains, Ginger six Grains: Let them be bruis'd together on a Marble, then adding Conserve of Violets a Dram, make a Bolus. It was wont to make her Womit twice or thrice, and to give her three or four Stools: Her Menses constantly flowed from her at set [Page 295]time in a plentiful manner: Wherefore her Blood seeming to be in great plenty and hot, in the middle time betwixt the monthly periods I ordered Bleeding twice or thrice: Moreover on all those days that she did not Purge, she took four Pills of the fol­lowing Mass, Drinking after it a little Draught of the Julap beneath prescribed.

Take Roots of Male Peony half an Ounce, of Virginia Serpentary, Contrayerva, and Bastard Dittany of each two Drams, Mans Scult prepar'd a Dram and a half, Elks Hoof a Dram, red Coral prepar'd, Pearl Powdred of each a Dram, Salt of Wormwood two Drams, Salt of Coral a Dram, with a sufficient quantity of Syrupe, of Male Peony flowers make a Mass.

Take the Waters of Male Peony Flowers, Black Cherries, and Wall­nuts of each four Ounces, the Antiepileptical Water of Langius two Ounces, Syrup of Peony Flowers an Ounce and a half, Castoreum tyed in a knot and hung in hte Glass a Dram, mix them make a Julap.

When she began to loath the Pills, omitting them, she took twice a day, viz. early in the morning, and late at night, about a Scruple of the following Powder in a spoonful of the Julap, Drinking after it four or five spoonfuls of the same.

Take Bezoar Stone of both kinds, White Amber, Pearl prepar'd, Red Coral of each a Scruple; Mans Scull two Scruples, Roots of Virgi­nia Serpentary, Seeds of Rue of each half a Dram, mix them, make a Powder, let her take a Scruple Morning and Evening with a Dose of the Julap above prescribed.

Afterward when this also began to nauseate her, she us'd Pills, or also Elixir Proprietatis, sometimes also Spirit of Harts-horn for many days: afterward at long run upon taking that Powder daily for some space she began to find help.

Inthe mean while that this Method of Cure was followed; her Hair being Shav'd off, her Head was cover'd only with a thin Dress, she wore the Hysterick Plaister with a mixture of Galba­num on the Abdomen: She drank for her ordinary drink a Bo­ [...]het of Sarsa and China with the Roots of Male Peony, and o­ther appropriated things infus'd and boil'd in Fountain Water: Within a Month the Fits remitted a little: Afterward becoming more mild by degrees and lesser, at length they ceas'd in a manner altogether, unless that near the time of her Menses she was wont to be troubled with an assault or two of that disease: Moreover she was troubled almost with a constant Giddiness and a loathing of Meat; in the midst of Summer the drank Astrope Waters for six weeks, and grew perfectly well.

As to the way of Cure to be us'd in general for such Marvel­lous Convulsions, it is not an easie thing to assign Remedies e­qual to so Hereulean a Disease, or a certain method of its Cure [Page 296]confirm'd by frequent experiments: For besides that cases like those seldom occur, we may likewise observe, that the same Medicine which did good to this sick person at one time, gave not the least relief to another person, or the same, when given at another time, the reason of which seems to be that the cause of the Disease seems to consist in the Discrasy of the Nervous Juice: Which liquor is not always perverted after one and the same manner: But from the manifold combination of the Salts and Sulphurs, gets a Morbid disosition of a various kind and con­dition, and often changes it: Wherefore in those difficult affects, we must not prescribe vulgar Medicines, taken from Apothecaries Shops, but Magisterial ones, as occasion requires, according to the appearances of the Marvellous Symptoms. A Gentle Vo­mit, a Purge, and Bleeding ought in the first place to be us'd, and sometimes to be repeated, as it shall seem convenient. And as to Specifick Medicines, and such are appropriated in those cases, since the chief Indication will be to amend the Crasis of the Nervous Juice, we may try a great many things and sift their vertues from the effect: Therefore we may try what things endued with a Volatile or Armoniack Salt will do: For this purpose let the Spirits and Salts of Harts-horn, Blood, Soot, the Flowers and Spirits of Sal Armoniack be taken: These giv­ing no relief we must come to Chalybeats; let the Tinctures and Solutions of Coral and Antimony be given: which sort of Medi­cines must be given in such a Dose, and form, and for so many times, that some alteration may be made by them in the Blood and Nervous Juice: Again, if these have not success we must proceed to Alexipharmicks, which are good against Poyson and a Malignity gotten into the Humours, viz. of these we must or­der Decoctions, Destillations, Powders, Conserves, and o­ther Preparations of Vegetables, and we must variously com­pound them the one with the other, and administer them several ways: It seems likely that those sorts of Medicines which being inwardly taken are wont to do good to such as are bit by a Viper, or by a Mad Dog, and likewise against Wolfs-bane, and Napel­lus, may also be of use in the above mentioned Convulsions: We may here, after the example of Gregor Horstius in his Tracts of the Malign Convulsive disease, prescribe also Magisterial Remedies in form of a Purging Electuary, also of a Powder, and Convulsive Antidote for these Marvellous Convulsions, and variously Com­pound the same of Simples, partly Alexipharmical and partly An­tiepileptical.

CHAP. VIII. Of the Affects which are vulgarly call'd Hysterical.

IF at any time an unusual sort of Sickness, or of a very Secret Origine occurs in the Body of a Woman, so that its Cause lies hid, and the Therapeutick Indication be wholly uncertain, presently we accuse the evil influence of the Womb (which for the most part is guiltless) and in any unusual Symptom, we cry out that there is somewhat Hysterical in it; and consequently the Physical intentions and the uses of Remedies are directed for this end, which often is only a starting hole for Ignorance.

The passions which are wont to be rank't in this number are found to be various andmanifold, which seldom agree in divers Women, or happen wholly after the same manner: the most common of them, and which are vulgarly said to Constitute the formalstate of an Hysterick affect, are these, viz. A Motion in the lower part of the Belly, and an Ascent as it were of some round thing there, then a Belching or Straining to Vomit, a distention of the Hypochondres and a Rumbling with a Belching forth of Wind, an uneven and for the most part a letted Respira­tion, a Suffocation in the Throat, a Giddiness, an Inversion, or Rotation of the Eyes, often Laughing, or Weeping, a Talking Idly, sometimes a Speechlesness and Immobility with an ob­scure or no Pulse, and a Cadaverous aspect, sometimes Convulsive Motions rais'd in the Face, and Limbs, and sometimes in the whole Body: But universal Convulsions seldom happen, and not unless the disease be raised to its worst state, for the Tragedy of the Fit is acted through for the most part without any contraction of the Members only in the Belly, Breast and Head, viz. one of them, or successively in all. Women of all Ages and Con­ditions are obnoxious to these affects, to wit Rich and Poor, Virgins, Wives, and Widows: I have observed those Symptoms in Girls before the time of Puberty, and in old Women after their Menses ceast to Flow, nay and men are sometimes troubled with such kind of Passions, instances of which are not wan­ting.

The cause of these Symptoms must not be imputed to the Ascent of the Womb, and to vapours rais'd from the same; nor to the Impetuous rushing of the Blood into the Lungs, as the Learned Highmore has Judg'd; But we say that the affect call'd Hysteri­cal, [Page 298]chiefly, and primarily is Convulsive, and depends principally on the Brain and Genus Nervosum being affected, and is produc't wholly by the exposions of the Animal Spirits, as o­ther Convulsive Motions. And whatever disorder or irregula­rities happen else about the Motion of the Blood, they are only secondary and depending on the Convulsions of the Viscera. The way of the difference whereby the kinds of this disease both differ from each other, and from the other Convulsive affects is taken from the various Origine, and chiefly from the extension of the Morbisick Cause: for the Origine of this, as of many o­ther Convulsive affects sometimes resides in the Head, the Womb being wholly without fault: Though sometimes this affect hap­pens through the fault of the Womb, and sometimes through that of other parts: As to the extension of the Disease, from whatever Origine it proceeds, for the most part it chiefly af­fects the Interiour Nerves, to with those that particularly regard the Viscera and Precordia and their appendixes, and chiefly troubles the Spirits lying in them: Sometimes also, though rare­ly, the Spirits that presides in the Exteriour Nerves and likewise those in the Brain and Cerebellum, are involv'd in the same affect.

As to the Morbifick Matter, or Explosive Combination, which, accruing to the Spirits within the Brain, and deriv'd with them in­to the Processes of the Nerves, often is the cause of the af­fects, which are vulgarly call'd Uterine, or of the Mother: We say this to be Heterogeneous Particles sent from the Blood, as in other kinds of Convulsions; and which are wont to be made to cleave to the Spirits that pass into the Origines of the Nerves, on two chief occasions, viz. either through the fault of the Spirits themselves, or through the great force of the Matter: in­stances of both kinds every where occur: Through the fault of the Spirits themselves as when through a sudden Passion, suppose of Fear, Anger, Sadness, they are very much Troubled and forc't into Irregularities; through the Exorbitant force of the Matter, as in the evil Crises of Fevers, also in any Malignant, and Scorbutical, and other Chronical affects of an ill Determina­tion: these causes are much upheld and promoted by an ill or weak Constitution of the Brain and Genus Nervosum, whe­ther it be hereditary, or acquir'd by an ill dyet, hence Women are more obnoxious to Convulsive affects than Men, and those one more then another.

Tho' these they call Hysterical affects very often arise from the Brain, yet sometimes they are rais'd by a cause beginning either in the Womb, or in other of the Viscera; and this either by rea­son of a solution of continuity, through a Tumor or Ulcer, [Page 299]or Stimulation of the part; or by reason of the obstruction of the Nervous Juice in its Circulation; thus when some accusto­med evacuation, whereby the superfluities of the Nervous Li­quour were wont to be discharged, is stop'd, as upon the sudden stopping of Issues, or drying up of old Ulcers without Purging, many have fallen into Convulsive affects, which sometimes also happen to Virgins and widows through a retention of the Se­mianl homour, which ought to be Voided its proper way: And sometimes the Nervous Juice regurgitates toward its Origine, because its passage is somewhere stop't by a Cancrous or Scirr­hous Tumour. To illustrate our doctrine of the, vulgarly call'd, Passions of the Womb; I shall now give an instance of a person troubled with them.

A Renowned Lady, extreamly beautiful, and endowed with an excellent temper of mind and manners, lately lived in these parts, who for many years was obnoxius to Convulsive affects, she having contracted this valetudinary disposition fro her Birth, or Hereditarily, and having found in herself these fruits of the morbid root almost every fourth year of her Age; but especially as often as she conceived with Child (as she often had, and undergone frequent Abortions) she was wont to be extraor­dinarily troubled with Convulsive passions, in a manner Hysteri­cal: For presently upon the stopping of the Menses, the Hete­rogeneous Particles being convey'd to the Brain, and Genus Ne­vosum, brought violent Fits of the distemper.

After that she had last conceived, in the first Months accor­ding to her ancient wont, she was often troubled with Convulsive affects, about the uinth week of her being with Child, upon taking Cold, she fell into a dangerous Fever, in which very acute Pains sorely infesting her in the Loins, and about the lower part of the Belly, seem'd to threaten an Abortion: But those Pains, as it appear'd at last, being rather to be judg'd of the Co­lick, proceeded from a Sharp humor, falling from the Brain into those parts by the Ductus's of the Nerves; for about the de­clining of the Fever, that matter being convey'd elsewhere, a Diarrhaea, Pains of the Feet, and a Blistering as it were ensued.

As soon as this Lady grew well of her Fever, and Pains, the Convulsive affects returned, for every morning as she awaked from her sleep, she was wont to undergo violent Contractions and Convulsions about the parts of the Mouth and Face, and also in the Arms and Legs, which Syptoms doubtless arose from the Serous filth heap'd together in the Head about the Origines of the Nerves; and deeply Imbib'd by them during the sleep, toge­ther with the Juice that passes in them; and when afterward the same matter was caryed again by the conveyance of the In­teriour [Page 300]Nerves, into the Plexus's of the Mesentery, and the Loins, most violent Pains of those parts, and likewise Fits as it were Hysterical sorely infested her.

For those Convulsive Motions of the Face and Members ceast in a short time, yet she continued still Weak and Infirm, with a Pale Countenance, Trembling as she went, and having a mind to no Food but such as was improper, and to hot Liquors: a­bout the end of the third Month, at which time she used con­stantly to Abort, her Menses broke forth, which passing from her for two or three days together, with pieces of broken Mem­branes, she expected the Abortion: But the Flu ceasing, Pains, like those of a person in Labour, arose in the Abdomen and Loins as before, and miserably tormented her day and night for a week: At length having us'd a Bath of Emollient Herbs, and then being put to bed to sweat, she was delivered of the burthen of her Womb: the Conception thus passing from her with a mighty torture was as a Pea-hens Egg in bigness and figure; the outward coat of this was ragged and broken; the inward coat remaining whole, contained about half a pound of clear Water, and nothing else: And no rudiments, of a Faetus that was form'd, or about ot be form'd, did appear: Afterward for four or five days the Lochia flowed from her with some pieces of Membranes: Mean while Pains troubled her with their wonted violence: And in regard that after a week was past, they did not cease of their own accord, at length remedies were desir'd for appeasing them.

For this end in the first place, Liniments, Fomentations, Baths, and Glysters were freuently administred: And Medi­cines cleansing the filth of the Womb, on which the cause of the whole distemper was charg'd, were inwardly taken: Upon the use of the former, short intermissions of the Pains followed: But now and then the affect returned and was mighty tedious: Nay and within three weeks, the disease growing much worse brought many other horrible Symptoms along with it: For besides the Pains in the Abdomen and Loins, which grew daily more vio­lent, she was now troubled likewise with a great torture in her Back, Neck, Shoulder Blades, also in the Arms and Leggs, and that more severely as often as she grew warm in her Bed: More­over she was afflicted with a frequent Giddiness, a Vomiting and Nauseousness, and often in a day with vehement Convulsive Fits, viz. First a great heavy thing seeming to Ascend in the lower parts of the Belly, presently raised up the Belly with violence: By and by, respiration being stopt, she became senceless with a Cadaverous aspect: After that she had lain thus dead, as it were, for three or four minutes of an hour, she was wont to start up [Page 301]on a sudden, that she could scarce be kept down or held by persons present: Then followed violent contractions and distor­tions in all the parts of the Mouth and Face, and in all the Mem­bers of the Body. These Symptoms were judg'd really Hysteri­cal, because the noble Lady had so lately Aborted.

But considering all these things, I was at length of this opi­nion, That the cause of both Fits, viz. the Paining, and Convul­sive, depended wholly on the evil affects of the Brain and Genus Nervosum, without any fault in the Womb, to wit, that the sharp humour heapt together within the Brain, descended thence, by the passages of the Nerves, into parts very remote, and lying in the Membranes and Fibres, and fermenting with the humour coming to it from the Mass of Blood, irritated them very much, and caus'd violent pains: then afterwards, when the heterogeneous and explosive Particles, admitted into the Brain with that Hu­mour, and entring the Ductus's of the Nerves, joyn'd with the Spirits, thereupon the Convulsive disposition, now and then break­ing forth into violent Fits, was caus'd, as it will by and by appear more at large.

Directing my curative intents according to this Aetiology, I ordered the sick Lady, at the time she was extreamly ill, that Blood should be drawn from the Saphaena Vein, That a gentle Purge should be given her within two days, and that it should be repeated once or twice a Week: Also on other days I gave her, Morning and Evening, Spirit of Harts-horn; and at other hours, twice or thrice in a day, Powder of Pearl and Crabs-eyes, with a Dose of the following Julape.

Take Water of Snails, Magisterial Water of Earth-Worms, of each three Ounces, Water of Saxifrage, and of Black-Cherries, of each four Ounces; Hysterick Water, an Ounce; Syrup of Coral, an Ounce and a half; Tincture of Castoreum, a Dram: mix them.

She us'd frequently a Bath of fresh Herbs when necessity requi­red it; she took Opiats always with good success: Vesicatories were applied to the inward part of each Thigh, and to her Neck. Moreover Fomentations, Liniments, Glysters, Cupping-glasses, Sneezing-powders, and many other ways of Administration were prescrib'd, according to the exigency of Symptoms.

After this method of Curing used about fourteen days, the no­ble Lady, being very much relieved, was wholly without the Convulsive Fits; nay, and the pains of the Bowels and Members, and other Symptoms, being very much mitigated, gave us a ve­ry fair hope of a speedy Recovery; but after this, partly by rea­son of an ill Dyet, to which the Diseased, upon never so little an amendment, always indulg'd herself, but especially by reason of a sudden passion of terriour or sadness, which a severe accident [Page 302]happening within her own House, had rais'd, falling into a Re­lapse, the Disease was presently brought to a much worse condi­tion; for both the Convulsions, and Pains troubled her in a more violent manner, nay, and the Stomach, being stirr'd up in a man­ner with a continual Vomiting, neither admitted Food nor Me­dicines: she took Asses Milk for some days, with some Benefit; yet in regard it turn'd to Choler in her Stomack, and gave her some offence, it was soon left off. At length, in despite of all Remedies prescrib'd with all diligence by the advice of many Physitians, the noble Patient languish't daily more and more, and by degrees drew near to Death. Two days before her De­cease, the pains of her Belly and Loyns remitted very much, and becoming more chearful than her wont, she had some hope of her Recovery; but in the mean while she complain'd of a pain and a mighty oppression of her Head; and falling into a profound Sleep, about the beginning of the Night, upon her awaking, she fell into a very horrible Convulsive Fit, which presently past into a mortal Apoplexy, for becoming insensible and speechless, she departed this Life within twelve hours. The Body of this person being open'd after her Decease, the Womb was found wholly without fault, tho' many of the Viscera were preternatu­rally dispos'd: in the Mesentery, about the midst of it, where it is fixt to the Back, and contains great Plexus's of the Nerves, a lax substance, and blown up as it were with many Bladders, was seen, it equalling a hands breadth in extent: opening this place, I found no Humour in it, but only that the Membranes were separated from each other, and that nothing was included in the spaces betwixt them but a Wind, which Separations doubt­less were caused by the Convulsions and Explosions of the Spi­rits, sent from the Head into those Plexus's: and as to those pains in the Belly, and the ascent of the great heavy thing, as it were, and the Inflation of the Abdomen in the Convulsive Af­fects, it is not to be doubted but the Seat of the morbifick Cause lay hid in that part of the Mesentery.

As to the method of Curing to be us'd in the Passions vulgar­ly call'd Hysterical, since the greatest part of the Symptoms of this Disease are Convulsive, it is thence plain that anticonvulsive Remedies, such as above written, are chiefly indicated. Ne­vertheless, since these Affects very often happen to the Female Sex, in which the Menses, and other accidents of the Womb, are most commonly taken in as a part of the Morbifick Cause; there­fore Medicines having regard to various dispositions of the Womb ought to be added to the former, and be sundry ways complicated with them. The Therapeutick Indications are ei­ther Curatory, to be us'd in the Fit, or Preservatory, which be­ing [Page 303]prosecuted out of the Fit, remove the cause of the Disease, and prevent its Accesses. As to the former, if the Fit be but small, let it pass off of its own accord, without any farther per­turbation of the Spirits; but if it so forely presses that it is need­ful to give aid to Nature, as being greatly opprest, let this one thing be endeavoured, That the Spirits being made free from the Embraces of their Heterogeneous Combination, remit of their Disorders and Explosions: For this end it is very usual in the first place to apply to the Nostrils stinking and strong-smel­ling things, the effluvia's of which repress and reduce to order the Spirits, which are grown too wild and apt to make exorbi­tant efforts, nay and discuss their Heterogeneous Combination, and often wholly exterminate it. Assa Foetida, Castoreum, Gal­banum, tyed in a fine Linnen Cloth, and held to the Nostrils, are proper; also the Feathers of Partridges, or old Shoes burnt, or Sulphur kindled: moreover the Spirit and Oyl of Soot, or of Harts-horn, often give help; tho' I have known that these kinds of Suffurnigations have prov'd very offensive to some Women, and have encreas'd the Fit; it's probable that sometimes they irritate the Spirits too much, and force them into greater dis­orders. As stinking things held to the Nostrils, so the like be­ing pour'd into the Mouth, often give help; wherefore we of­ten give with good success, to Hysterical persons, the Tincture of Castoreum, Solutions of Assa Foetida, and of Galbanum, also the Spirits of Harts-horn and of Soot, with appropriated Wa­ters.

Take Spirit of Harts-horn, from twelve drops to fifteen or twenty, let them be taken in a little Draught of the following Julape.

Take Water of Penny-royal and Mugwort, of each four Ounces, Wa­ter of Bryony compound, two Ounces; Castoreum tyed in a Nodulus, and hung in the Glass, half a Dram; double refined Sugar, an Ounce; Mix them.

Take Tincture of Castoreum; from, a Scruple to half a Dram; let it be taken in a little Draught of Small-beer. Take Assa Foetida, or Galbanum, two Drams; let them be dissolved in Spirit of Wine till a red Tincture be extracted: the Dose is a Scruple in two or three Spoonfuls of Water of Featherfew, Riverius greatly extols that of Solenander; Take Musk, Dragons-blood, of each a Scruple; let more or less be taken in three or four Ounces of Water of Navews. Jo­hannes Anglicus commends the Seeds of Parsnips, or of Columbines in Wine, or an appropriated Water, as most certain Remedies. If the Fit, continuing a long time, renders the Person senseless, or without any Pulse, let smart Clysters, as of the Roots of Bri­ony, with Carminatives boil'd with them in Water, be injected; let Frictions be us'd to the Legs and Feet; and if we must pro­ceed [Page 304]to stronger things, let Cupping-glasses be applied to the Belly or Groin, nay and let sneezing be often provok'd: it is good for some to give them, in the midst of the Fit, a Draught of cold Water, either simple, or in which Camphire has burnt.

The preservatory Indication comprehends these three chief in­tents, viz. First, To take away, or to drive to some place else, the impurities of the Blood, which are apt to be discharg'd on the Brain and Genus Nervosum. Secondly, To fortifie the Brain, and so strengthen the Spirits in it, that they either admit not at all the Heterogeneous Combination, or readily shake it off. Third­ly, to amend whatsoever is amiss in the Womb, and contributes to the Convulsive Disposition.

1. The first Intention is perform'd by Purging and Bleeding, and other common ways of Cleansing and Purging the Blood and Humours. If there be room for a Vomit, I Judge we must al­ways begin with that, especially in Cacochymical persons, or such as are troubled with the longing disease, in whom a migh­ty load of Viscous Phlegm, sticking in the Folds and Coats of the Stomach, hinders the vertues of other Medicines: Within a few days after the Vomit, (unless somewhat indicates the contra­ry,) let Blood be drawn, in Women of a hot temperament, presently from the Arm, and afterward, if need be, from the Foot, or from the Veins of the Fundament, by Leeches; but in Bodies troubled with obstructions and less hot, let Blood be drawn more sparingly and rarely, and only in places seated below the Womb. After these evacuations (provided always that they are indicated) being duly perform'd, let a Purge be given once within six or seven days according to the forms following.

Take Pil. Foetidae Majores a Dram and a half, Rosin of Jalap twelve Grains, Tartar Vitriolated, Castoreum of each a Scruple, Ammo­niacum dissolved in Hysterick Water what suffices, make twelve Pills for three Doses. (Or)

Take Rosin of Jalap eighteen Grains, Calomelanos a Dram, Castoreum a Scruple, make a Powder, divide it into three parts for three Doses, give it in the Pap of a boil'd Aple, or in Conserve of Borage: To persons of a Hot temperament a dose of our Extract, or Loosning Syrup may be properly given: For the revulsion of the Morbisick mat­ter from the Head an Issue in the Leg, or Thigh, and somtimes Vesicatories, Ligatures and Painful Frictions are wont to be us'd. Nor must we only have regard here to the cleansing of the Blood, and to the Revulsion of its superfluous Dreggs from the Head, but likewise to the alteration of its Liquor, and the reducing of it to its due Crasis: Wherefore in certain Hysterical persons Chalybeats prove beneficial, in others Mineral Waters or [Page 305]Whey, in some the use of Hot Baths are wont to do mighty good.

2. The second intention, viz. the rectifying of the Brain, and of the Animal Spirits, is perform'd by Cephalick and Particularly by Anticonvulsive Medicines, and let them be carefully given al­most every day when there is no Purging, or Bleeding; There being various kinds and ways of Administration of such Medi­cines, I shall here give you some of the more choice forms of them.

Take Faecula of Briony, Assa Foetida, Castoreum, of each a Dram, Salt of Coral, Amber, and of Jupiter of each half a Dram; Galba­num dissolv'd in Hysterick Water what suffices, made a Mass; the Dose is from half a Scruple to a Scruple, Morning and Evening, Drinking after it a Dose of an appropriated Liquor.

Or, Take seeds of Wild Parsnips and of Nettles of each two Drams, Vitriol of Mars a Dram, extract of Gentian and Feverfew, of each a Dram and a half, with a sufficient quantity of a Syrup of Mugwort make a Mass, let it be taken to half a Dram after the same manner.

If the form of a Powder be more grateful. Take roots of Vir­ginia Serpentary and Contrayerva of each a Dram and a half, Co­ral prepar'd, Pearl, White Amber of each a Dram, mix them, make a Powder, the Dose is from a Scruple to half a Dram Morning and Evening with an appropriated Liquour.

Let Opiates be made after this manner. Take Conserves of the Flowers of Lillies of the Valley, Male Peony, and Betony of each two Ounces; Peony Seeds, Red Coral prepar'd of each two Drams, Powder of Bastard Dittany a Dram and a half, Salt of Wormwood two Drams, with a sufficient quantity of Syrup of Citron Pills, make an Electuary. The Dose is Morning and Evening the quantity of a Nutmeg. After the same manner to the Poor, let Conserves of the Leaves of the Tree of Life, or of the Leaves of Rue be given twice aday.

The Liquours appropriated to Hysterical affects, and to be Drank after the foresaid Medicines are either Distilled Waters, which may be taken by themselves, or with others in the Form of a Julape, or they are Decoctions, or Tinctures and Infusions.

Take Water of Mugwort and Pennyroyal of each half a Pound, Hysterick Water four Ounces, Tincture of Castoreum half an Ounce, Syrup, of Coral an Ounce and a half mix them; the Dose is from an Ounce to an Ounce and a half with any of the Medicines above prescribed.

Take Leaves of Penny-royal, Feverfew, both Southernwoods, Cala­mint, Nep, both Horehounds, of each a Handful; Briony Roots four Ounces, Parsnip-Seeds two Ounces, being Slic't and Bruis'd, pour to them of White-wine or Sider six pounds distil them according to Art.

Take roots of Male Peony, Angelica, Valerian, of each half an Ounce, Leaves of Mugwort, Ground Pine, Calamint, Peny-royal, Misteltoe, of the Oak of each a handful; Seeds of both the Wild Carrots of each three Drams, Raisins a handful; let them Boyl in four Pounds of Fountain Water till half be Consum'd; add of Whitewine two Pound and a half: Strain it, Let it be kept in Vessels close stopt. The Dose is three or four Ounces twice a day.

Take Seeds of Wild Carrots bruis'd two Ounces, Castoreum an Ounce, put them in a Glass with two Pounds of White-wine. The Dose is two Ounces twice a day.

3. As to the third intent, which putting a stop to the disor­ders of the Womb, advances the Cure of the Hysterick affect: I say in the first place that what was formerly believ'd concerning the Cause of the Disease, and the Scope of Curing it, viz. That the Womb did Ascend, and therefore that it ought to be restor'd to its due place, is altogether Fictitious, as we have shewn else­where: The descent, or falling forth of the Womb often hap­pens, but this seldom or never produces Hysterical affects: More­over a Dislocation of the Womb sometimes happens to Child­bearing Women presently after Child-birth, viz. When the body of the Womb being enlarged and newly emptied, does not settle in a right place within its Cavity, but leans high, sometimes to the right side of it, sometimes to the left, and there be­ing Constring'd like a Purse is folded up in a great Lump, which Lump lying a long time in the side of the Inguen, is wont to Cause suspicion of another Foetus, or of the after Birth being left be­hind, or also of a Scirrhous Tumour there Growing but afterward, when upon the Lochia's passing away freely, the Womb is re­duc't to its due magnitude, that Tumour vanishes by degrees: And whilst it continues there, unless haply the Lochia are there­by stop't, it does not cause Hysterick Passions: For the quick re­ducing of this part to its due position, Fomentations, Liniments, and Plaisters contribute much: But very often that Symptom passes away of its own accord without any further offence: We have shewn elsewhere ex professo to what affects else the Womb is obnoxious after Child-birth, and with what methods of Physick we must obviate them: As to the other Distempers of this part, which happen to other Women, viz. to such as do not Bear Children; we observe those chiefly to be either a Disease of the Womb caus'd by a Solution of continuity, which is either a Tumour or an Ulcer; or to be a Stoppage of some usual Excre­tion, viz. either of the Sanguis Menstruus, or of the Fluor albus, or of the Seminal Humour; by reason of the Menses retain'd the Heterogeneous particles being often discharged on the Head [Page 307]Cause Convulsive Passions: In like manner when the White Hu­mour is stop't the Excrementitious Matter being drank in again by the Blood is delivered to the Brain and Genus Nervosum. Moreover when a wonted evacuation of the Seed is stop't, the superfluities of the Nervous Humour Regurgitate into the Brain, and infect the Spirits in it with a Morbifick and Explosive Tincture. It will not be necessary for us to discourse particular­ly and at large on these particular affects of the Womb, but to Complicate Medicines and Physical Administrations appropriated to Womens Diseases, with Anticonvulsive Remedies.

CHAP. IX. Of Affects vulgarly call'd Hypochondriacal, which are shewn to be for the greatest part Convulsive, and by the by of Chalybeate Medicines.

AS we have shewn before that the Passions vulgarly call'd Hysterical do not always proceed from the Womb, but oftner from the Head's being affected: So though it has been vulgarly held that the affects call'd Hypochondriacal are caus'd for the most part by Vapours arising from the Spleen, and running hither and thither; yet in truth those distempers are for the greatest part Convulsions and Contractions of the Nervous parts; which may better appear after we have considered the Symptoms.

As to the affects therefore which are vulgarly call'd Hypochon­driacal it is to be observed that they chiefly happen to persons of a Melancholick Constitution, with a wan aspect and a thin habit of body: It is seldom that Disease troubles persons who are well in flesh, and have a florid, or also an over Phlegmatick countenance: About the time that persons come to a set age it discovers itself with manifest signs; Men are found to be more frequently obnoxious to this than Women, in both being become habitual it is cur'd with great difficulty, or searce at all; in Wo­men by reason of their weaker Constitution, it is attended with far more Convulsive affects: Wherefore it is commonly said in this Sex, that the Hysterick affect is joyn'd to the Hypo­chondriacal.

The Symptoms which are accounted as belonging to this Dis­ease are commonly very many, and of a differing Nature, nor have they in all a like Origine, or the same mutual dependance on each other: For we see that in these the Viscera of the Belly, in those the Praecordia, in others the Confines of the Brain are most affected: in a great many, but not in all, the Stomach much Labours; as to appetite it has often too much of it, but is pre­sently opprest by what is taken into it; and when the food through slowness of Concoction tarries a long time in it, the Saline par­ticles of it being rais'd to a state of flowing, pervert the whole mass of the Chyle into a Pap, sometimes Acid or Austere, some­times Salt or Tart: Hence a Cardialgia, a mighty store of Flatus's, a Rumbling, and a frequent Vomiting ensue; and be­cause through a defect of a Pneumatosis the Chyme is not volatilis'd throughout, and carryed forth, but a Mass of Viscous Matter, sticking to the Coats of the Stomach is left behind, an almost continual Spitting molests them, a distention in the left Hypo­chondre and often there and under the Ventricle a violent beating is felt, and there pains every where arise; which shoot here and there at random, and miserably torture the person with a certain pungent Pain for many hours. Mean while, from the Contractions of the Membranes and the Fluctuation of the Flatus's thence rais'd, Croakings and Rumblings are produc't: So in the Thorax there is often a great Straitness and Constriction, so that the Breathing becomes difficult and painful upon any mo­tion; nay farther, in some very terrible Astmatick Fits supervene: Moreover the diseas'd are wont to complain of a Trembling and palpitation of the heart, with a mighty oppression of the same, also frequent Failings of the Spirits, and danger of Swooning come upon them, that the diseased always think Death at hand: In this Region about the Membranes, and especially the Mediasti­num, an acute Pain, which one while is determin'd in one part; another while is extended to the Shoulder, is a familiar Symp­tom of this Disease: But in the Head an Iliad of Evils for the most part troubles Hypochondriacal persons, to wit, most violent Pains Periodically returning arise; also Scotomia's, frequent Gid­diness, Obstinate Watchings, a Fervency and a most troublesome Fluctuation of thoughts, inconstancy of mind, a disturb'd fan­cy, a dread and suspicion of every thing, an Imaginary being Af­fected with Diseases of which they are free, and many other distractions of the Spirits, nay sometimes Melancholy, and a Mania accompany this Sickness: Besides these interiour Regions of the Body being beset with this Disease; wandring Pains, al­so Cramps and Numbnesses with a sense of Formication seise like­wise almost all the outward parts; Night Sweats, Flushings of [Page 309]Blood in the Face and Palms of the Hands, Fevers of uncertain returns, and many other Symptoms of an incertain Origine on all hands arise, of which in regard it has not been easy to assign the Genuine causes and ways of their coming to pass, Physicians have charg'd, (though unjustly) all the blame on the Spleen: In the mean while it is to be observ'd that the chief Symptoms of this distemper are convulsive and depend immediatly upon the Irregularities of the Animal Spirits, and Nervous Juice, rather than on the Dyscrasies of the Viscera that serve for Con­coction.

As a great many have ascribed this valetudinary disposition to the only fault of the Spleen: So others making all the confines of this Entral a party in the fault, will have the Blood lying in any part soever of the Vessels of the Spleen and Epigastrick Region to give the Origine to this evil. But the renowned Highmore has charg'd the chief cause of this Disease wholly on the faulty Con­stitution of the Stomach.

Concerning this opinion, though I so far agree with this fa­mous Author, that I may grant the Ventricle to be often greatly distemper'd in this affect: Yet I cannot be brought to think that all the Symptoms of the Hypochondriacal Disease depend on­ly on the Ill constitution of the Ventricle, for I have known many sorely afflicted with that Distemper, whose Stomachs were well enough; and I have known others who through an ill dyet have brought their Stomachs to be greatly Distempered, yet, as to the Precordia and Animal Faculties being sound enough, they were not at all accounted Hypochondriacal.

As to what the Spleen contributes to this Disease, Dr. Willis first curiously observing the use of this part, to wit that from the Blood brought to it from the Arteries, a certain Dreggy Por­tion, viz. consisting of an Earthly matter and a Fixt Salt, is de­pos'd in this Entral, which being there exalted as it were by Di­gestion, and rais'd to the nature of a Ferment, is again com­mitted to the Blood as it passes back by the Veins, which in­spires it with a certain Fermentation, and performs the same thing as to its Pneumatosis, as our common Leaven does when mixt in a Mass of Meal, so that as the Leaven inables the sluggish parts in the Bread for Motion, so the Ferment of this Entral raises the sluggish Particles of the Blood to a state of activity. And secondly considering the intimate communication betwixt the Brain and the Slpeen by the means of the Nerves, of which there are a world of Plexus's and Fibres arising from them in this part; he says that the ways of affecting with which the Spleen being evil dispos'd, produces, or at leastwise contributes to the rise of the Symptoms of the Hypochondriacal Distemper are chiefly these following.

Viz. First it sometimes happens that the spongy substance of the Spleen is very much stuff't and obstructed by the Faeces of the Blood sticking too much in its Pores and there Stagnating, so that afterward it does not admit into it the Dreggs of the Mass of Blood as much as it ought, but the same being brought thither, but not receiv'd, Regurgitate into the neighbouring Branches of the Caeliack Artery, whence presently they are convey'd into the Membranes of the Ventricle, the Caul and Me­sentery, and other neighbouring parts, and are wont to stick in them, hence the Tone of those Viscera is so much perverted, that they cannot rightly execue their due Functions in order to the Concoction of the Chyle, and the Circumjacent Mem­branes, being very much fill'd with Heterogeneous and Irritative Particles, become mightily obnoxious to Convulsions arising here and there, to running Pains, Contractions, Distentions and a multitude of Flatus's.

2. Though the Slpeen should receive freely enough the Me­lancholy Juice brought by it from the Blood to the Arteries, yet often it does not duly Concoct the same, but the salt being very much exalted, perverts it into a humour too Sharp, or Austere, or faulty some other way; wherewith when the whole Mass of Blood, and the stock of Nutritive Juice contained in it, are in­fected, the fruits of a Hypochondriacal seed display themselves throughout the whole body; the Blood boiling more then it ought, is driven violently into certain parts, and at the same time in others it is apt to stagnate: Hence some presently up­on eating have Flushings in the Face, the palms of their hands burn, &c. In some again running pains with a Pricking happen in many parts of the Body.

3. From the Blood thus deprav'd through the fault of the Spleen, a prejudice also is often brought on the Animal functi­on, the Heterogeneous and Convulsive particles being often dis­charged on the Brain and Genus Nervosum, hence persons are troubled with fancies and thoughts, with Giddiness, Scotomia's, Head-aches, and often Paralitick affects. Then as the Morbifick matter passes from the Brain into the Genus Nervosum, Convul­sive affects are raised in many parts of the Body, but chiefly a­bout the Precordia, and Viscera of the Belly, the Spirits that are in the Nerves which regard those parts being greatly troubled by the passions of the mind.

4. It is also very probable that the Nervous Fibres (whereof there are a world disperst through the Spleen, sometimes receive [Page 311]into them its most Sharp Juice, which creeping up the Passages of the Nerves, often is the cause of Convulsive Motions: And there being an intimate commerce betwixt the Spleen and the Brain, we judge that besides the long way of the Blood, they have a nearer way of communication by the Nerves of the Par Vagum and Intercostale by which they mutually affect each o­ther; so that sometimes the Melancholy being disturb'd in the Spleen, conveys thence the passion to the Brain, whence disor­derly and Hypochondriacal fancies happen: And on the contrary, when a violent Passion of the mind, occasionally rais'd within the Brain, troubles the Spirits residing in it, the impression given the fancy, is convey'd to the spleen by the course and successive affect of the Spirits, lying within the Nerves of the Per Vagum and Intercostale; whence many disturbances are caus­ed in that Entral and in the parts adjacent. I shall now give an instance of a person troubled with the Hypochondriacal affect.

An honourable person of a Melancholick temperament, and al­ways accounted to be troubled with the Spleen, complained very much of a Pain and Inflation of the left Hypochondre, with a frequent Rumbling, and a Sour Belching, also a Trembling of the Heart, a continual Giddiness, a want of Sleep, and a Troubled Fancy; about the thirty fifth year of his Age, the Dis­ease growing worse, he began to get Sleep with difficulty, or very seldom by night, and so in the day time to be troubled with a Fervency and Inconstancy of thoughts, to be suspicious of all things and persons, and to be Scar'd at every thing that came in his way; the Praecordia seem'd to be very much Constring'd and Straitn'd, and to fall in, as though the Heart it self were de­prest into the Belly, which Symptom pressing him he became very sad, and dejected in mind: Yet afterward, those affects of the mind remitting, he plainly felt at once both the heart to be a little rais'd, and the Praecordia to be Relax't and Dilated: Moreover he had very frequently Pains and Contractions vari­ously rais'd about the Muscles of the Viscera and Membranes, and passing from one place to another.

He us'd a great many Remedies and Physical Administrations a long time for the Cure of this Affect, but without any great good; at length, being somewhat relieved by the use of Mineral Waters, and afterwards growing better by degrees, he became free from those severe Symptoms, tho' he still continues obnoxi­ous to the Hypochondriacal Affect.

The Therapeutick Method to be us'd against Hypochondriacal Affects, requires chiefly these four general Indications, viz. First, that the Impediments of the Cure be remov'd, which intention chiefly regards the cleansing and keeping of the first Passages. Se­condly, [Page 312]We must endeavour to correct the Obstructions or other disorders of the Spleen. Thirdly, we must see that the excrementi­tious Dregs of the Mass of Blood be Purg'd forth, and that its due Crasis be restored. Fourthly, that the Irregularities of the Brain and Genus Nervosum, and also of the Humour and Spirits residing in them, contracted through the fault of the Blood and Spleen, be amended or abolish't. Since we must drive at many of these Intents together, or at all of them, let fit Seasons be chosen, in which we may satisfie each of these purposes without any prejudice to, or neglect of the Rest.

1. As so the first Indication, since a great Mass of crude or adust matter is wont to be heapt together in the first passages, and since the Tone of the Stomack uses to be weaken'd, and its Ferment to be variously perverted, let us seasonably obviate these Evils of each kind with fit Remedies; therefore mild and gentle Evacuations, both by Vomit, if it comes easily, and by Seige, ought to be given. I advise those whose Stomack easily discharges its Contents upwards, that once in a Month, by taking the Liquor of Squills, or Salt of Vitriol, and drinking good store of Posset-drink, or warm Water, they cause themselves to Vomit several times: In the interval of time, let a gentle Purge, and only le­nitive, be often given. For this end the Pilul. Tartareae Bontii, or Stomac. cum Gummis, or our Solutive Pills, may be used

Take of the best Senna, an Ounce; Rhubarb, six Drams; Epi­thymum, three Drams; Yellow-Saunders, two Drams; Salt of Worm­wood, two Drams; Celtick-spike, a Dram: being sliced and bruised, let them digest in White-wine and Fumitory-water, of each ten Ounces, for twenty four hours, let the clear straining evaporate by a gentle Bath-heat to the consistency of an Extract, adding toward the end, Powder of Senna, Rhubarb, and Cream of Tartar, of each two Drams; let them be bruised together in a Glass Mortar, and reduced to a Consistency for Pills. The Dose is from half a Dram to two Scru­ples or a Dram.

The Remedies that regard the Tone and Ferment of the Sto­mach, since they are manifold, and of divers kinds, let such as are most proper for the Constitution of each Stomach be chosen; for with one Person bitter things, with another Salt, with others sharp, or haply smart things, best agree. Of the number of these Medicines (which are vulgarly called Digestives) are Elixir Pro­prietatis, Tinctura Sacra, the Compound Powder of Aron Roots; Salt of Wormwood, Cream of Tartar, Tartar Vitriolate, Vitriol of Mars, with many others. Besides these inward Remedies, outward appli­cations also often give help: For to a Stomach ill dispos'd a fomen­tation of White Wine with Wormwood, Centory and other bitter [Page 313]Plants boil'd in it; also Liniments or Plaisters often give relief, of which it will not be needful to discourse particularly, and to prescribe forms of those Medicines.

2. The Indication that undertakes to amend the Faults of the Spleen, (whether the same be an Obstruction, or a Tumour or Pain, or a simple Dyscrasy) is wont to be perform'd, or at least­wise attempted by Remedies both inward and outward; those that are of the former kind are coincident with those that are indicated in the third place, (to wit, with which the purifying of the Blood is intended) for since the chief, or in a manner all of that which is brought into or carried out of the Spleen, is by the conveyance of the Blood, the Irregularities, both of the blood's Latex, and of that Entral, ought to be cured by an associated Operation, the vertues of the Medicines being joyn'd together; and we shall presently shew after what manner: meanwhile some outward applications, in the form of a Plaister or Liniment, or Fomentation, have a more near and immediate regard to the body of the Spleen, and often give a mighty relief, viz. in as much as they discuss the Tumours, restore to Circulation the melancholy Filth there stagnating, nay and ap­pease and restrain the Corrugatious and Convulsive Affects of the Fibres. There is a mighty store of these outward Medicaments to be found every where amongst Authors, the choice of which, in regard it ought to be ordered according to the various pas­sions of the Spleen, and the differing Constitutions of Patients, it will not be expedient in this place to deliver particular forms of them.

3. The Remedies indicated in the third place, viz. such as take away the Dyscrasies of the Blood, contracted by the Spleen, and withal cleanse the primary taint of the Spleen, are manifold, and of a differing kind and condition; the choice of which ought to be made according to the various taint of this and of the other. Of these some are more compounded, to be prepared ac­cording to the prescript of a Physician, as Electuaries, Powders, Apozems, Tinctures, Infusions, and the like: others are more simple, as Whey, Asses Milk, Spaws, and hot Bath Waters.

There are two chief Cases of sick persons, in which Magi­sterial Remedies ought to be accommodated according to their strength and qualities, viz. either the Blood is thick, coldish, and earthy, with an Obstruction of the Spleen, which requires hot fermenting, and especially chalybeat Medicines; or the Blood be­ing manifestly adust, and intensely hot, ferments above measure, and withal the Hypochondres are in a great trouble, and the Blood and Vapours boyl in them, in which state only temperate Reme­dies [Page 314]are indicated, for appensing the fervency and immoderate Fer­mentation of the humours, where Chalybeats are altogether to be shun'd.

When therefore to a cold Stomach cold Dyscrasies also of the Blood and Spleen are joyn'd, I use to prescribe according to the following forms.

Take Troches of Rhubarb, Powder of Aron Roots, Winters bark, of each two Drams; Roots of Virginia Serpentary, Contrayerva, Diatrion Santalon, Crabs-eyes, of each a Dram; Extract of Gentian and Cen­tory, of each a Dram and a half; Ammoniacum dissolved in Water of Earth-worms, what suffices; make a Mass for Pills: let four Pills be taken in the Morning, and at four a Clock in the Afternoon, drink­ing after it a little Draught of Wormwood or Chalybeat Wine, with a moderate Exercise.

Take Conserve of the Yellow Coats of Oranges and Lemons, of each three Ounces; Myrobalanes Condited, in number two; Species Aro­matici Rosats, Winters bark, of each two Drams; Salt of Wormwood, two Drams; Vitriol of Mars, a Dram (or Steel prepar'd, three Drams) with a sufficient quantity of the Juice of Citron-Pills make an Ele­ctuary; let it be taken twice a day, drinking after it a Draught of Wormwood-wine, or of Wine in which the Bark or Flowers of Tamarisk are infus'd.

To those that like none but nice Medicines, and in a small quantity, you may properly give the Tinctures of Antimony, of Coral, also of Steel prepar'd with Spirit of Wine, ( the Body being first open'd by fit Menstruums, and brought to a Calx) nay, and I have known that Spirit of Soot, also of Blood or of Harts-horn, taken twice a day, to twelve drops, more or less, in an appropriated Liquor, have proved mighty beneficial, above any other Medicines. Again, the assiduous drinking of Coffee, and of Tea, has done some very much good.

But if a Fervency and over-great Fermentation of the Blood be joyn'd to the Hypochondriacal Affect, with a fervent heat of the Spleen, and a restlesness of mind.

Take Conserve of Hips, six Ounces, (or of Flowers of Tamarisk, and Leaves of Wood-sorrel, of each three Ounces) Species Diarrho­don Abbatis, the Confection of Alkermes, of each a Dram; Ivory Powdered, a Dram and a half; Pearl, half a Dram; Salt of Tamarisk and of Wormwood, of each a Dram; with a sufficient quantity of Syrup of the Juice of Citrons, or of Clove Gilliflowers: Make an Opiate; let the quantity of a Nutmeg be taken twice a day.

Take Ivory Powdered, two Drams; Pearl powdered, a Dram, Species Diarrhodon Abbatis, and Diamargariti frigidi, of each a Dram and a half; make a subtle Powder; add of double refined Sugar dissolved in Baulm Water and boiled to a Consistency for Tablets, six Ounces; Make Tablets according to Art: Take from a Dram and a half to two [Page 315]Drams twice a day. Or to other Medicines of the like kind let the use of Spaw-waters be joyn'd, which indeed in either, nay in any cases of Hypochondriack Melancholy, are in a manner always taken with good Success. For wa [...] of these Waters, let our Artificial Spaw Waters be taken in th [...] stead: nay, and let Whey, and if there be a considerable Atrophia, let Asses Milk be daily taken.

Besides these inward Remedies, and the other outward Ap­plications above mentioned, let Bleeding or Drawing of Blood from the Vessels of the Fundament by Leeches, be frequently used, nay, and it is proper sometimes, according to the Prescripts of the Antients, to open the Salvatella Vein. Moreover Cauteries and Issues, which continually derive forth the Recrements of the adust Blood, and discharge them by little and little, are wont to do good to all.

4. The Fourth Indication, having regard to the Affects, or Convulsive Symptoms of the Brain, and Genus Nervosum, which ensue upon the former, is seldom put in practice by it self, and apart from the others, but the Remedies appointed for this end are complicated with those above written. Liquors endowed with a volatile or Armoniack Salt, as Spirit of Harts-horn, of Soot, are very proper for this intent, and often likewise for the others, even now mentioned: Wherefore let such Remedies, unless somewhat indicates the contrary, be daily given at a seasonable hour: Moreover, when the Spaw Waters are Drunk, let Tablets or Pills, such as are above prescrib'd for Convulsive Affects, be taken at least twice a day. In a frequent giddiness. and Scotomia, also in Passions of the Heart, Faintings of the Spi­rits, with a fear, and a dread, as it were, of present Death, I have known a mighty Cure often performed by the use of Chalybeat Medicines.

CHAP. X. Of the Convulsive Cough and Asthma.

IT is Usual in Children (and I have known it also sometimes in Men) for a Cough to arise from Mass of Serous Filth flow­ing in the Lungs: Which being at first Simple and Moderate af­terward becomes vehement, and Convulsive, so that in Cough­ing the Diaphragm being contracted upward, and so held by a long, or very often repeated Systole; the Lungs are greatly straitned and very much hindred, in their motion: Mean while by reason of the respiration being hindred, and the Blood being restrain'd within the Praecordia, and con­sequently its Stagnating in other places, the Diseas'd are in danger of being Suffocated and often turn of a Livid or Cadave­rous aspect: Moreover in this case, besides Convulsions with a violent Coughing, rais'd about the Praecordia, the Stomach also being often drawn in as a party concern'd, throws up all by Vo­miting that is contain'd within it; nay and I have known, in some Tenderlings affected after this manner, that the Disease now and then passing into other parts, has rais'd Convulsive Motions in the Face, Eyes and Limbs, and at length has become Mortal. This Convulsive Cough happens very often amongst Children, and in certain years it seizes so many, that it seems plainly Epidemical, when it has got a Root, it is very difficultly con­quered with remedies, but commonly drawing out in length, is scarce ever Cured but upon the change of the season of the year.

The cause of this Distemper seems to be from the Redun­dancy of the Scrous Humour in the Mass of Blood, and in some measure in the whole Body: A portion of which matter Di­stilling from the Mouths of the Arteries on the Lungs, creates an ordinary Cough; afterward when the Serous Filth, still aboun­ding in the Blood, and being fill'd with Convulsive Particles, is conveyed also into the Head, the same entring the Nerves of the Lungs, raises the Simple Cough to a Convulsive one: Moreover, when it sometimes happens, that the same Matter gathered together in the Head, enters some other Nerves; then other sorts of Convulsive affects often ensue upon the Convulsive Cough.

As a Cough arises, neither only, nor always through a fault in the Lungs, but sometimes from a Convulsive cause alone, though oftner from this coming upon an affect of the Lungs: So we may say the same of the Asthma; for whether this Dis­ease be continual or periodical, in both cases the Symptom which chiefly presses, is a difficulty of Breathing; which indeed seems therefore to be rais'd, because the Lungs being too much puft up and Distended greatly, Fill the Cavity of the Thorax, and do not subside by turns as they ought: Hence neither can the Breath which lies within be freely sent forth, nor indeed the fresh Air be easily introduc't, by reason of the space being fill'd before. Whilst the Lungs are thus detain'd, for a long time in a continued, or little remitted dilatation, oftentimes the Dia­phragm, against its Custom, is forc't to a violent Systole, and being contracted upward, is wont to raise the Lungs more and more, and to withstand their Subsiding: Whence it happens that the Breathing becomes yet more difficult and laborious.

That this affect of difficult Breathing sometimes happens through the fault of the Lungs, it has plainly appear'd to us by an Anatomical Inspection; for if a mighty Mass of Serous Filth depos'd in the Thorax, very much stuffs the Lungs, that the Blood being letted in its Circulation, does not pass freely the Pneumonick Vessels, then persons so affect­ed are always short and thick Breath'd. Again, as often as the Blood becoming too Hot, or being rarified by exer­cise, or the heat of a Bed requires a larger space for its Cir­culation, Then presently on such an occasion every thick Breathing, or an Asthmatick Fit is rais'd, which often becomes Terrible and almost Suffocative when the Serum Boyls very much within the Lungs. Moreover sometimes besides the Roots of an Asthma fixt about the Praecordia, some Branches of the same disease springing from the Brain meet with the former, and being Complicated with them, produce more Terrible fruits of a difficult breathing.

There are Instances enough of these affects, viz. of a diffi­culty of Breathing, rais'd through the Single and Partial fault of the Lungs: For nothing is more usual than that persons troubled with an inveterate Cough, or with some other evil disposition of the Lungs, at length upon the access of a Drop­sie or Scurvy, become Asthmatical, to wit, when the Blood be­ing rendred very impure deposes also its Serous Filth in the Head, this enters more readily and easily the Nerves of the Lungs than others, as being become Weak, and frequently Ir­ritated in their extremities, and heaps together in them a mat­ter for a Convulsive straitness of Breath.

Moreover I have sometimes observed that great Fits of the Asthma have happen'd without any considerable fault in the Lungs, so that I have really judg'd this Disease sometimes to be meerly Convulsive, and that its Fits are only rais'd because a Se­rous Filth, fill'd with explosive Particles, entring the Nerves that serve for the Dilatation of the Lungs, joyn'd with the Spirits there abounding, which afterward through a fulness, or Irritation being exploded together, and for some time, the Lungs are held as it were stiff, and blown up, that they can neither perform the functions of Expiration nor Inspiration: But the Fit being ended, and also before it is begun, the Breath is drawn free and evenly enough, there appearing no signs of a Cough, or of a Valetudi­nary disposition of the Lungs: I shall give an Instance of a person troubled with this Shortness of Breath.

A Gentleman of a Robust and Gross Habit of Body having us'd for some time a full and disorderly dyet, without any exer­cise, about the beginning of Winter began to find himself ill: First he was affected with a Heaviness and Pain of his Head, with a mighty Giddiness, and danger of Swooning, believing himself now and then, even a Dying, being otherwise sound e­nough; within a few days these Symptoms past into a manifest Stupor or rather Lethargy; Being let Blood in the Arm, I ordered that Cupping Glasses, Vesicatories, smart Glysters, with many o­ther remedies shoul'd be carefully administred to him: With­in the space of twenty four hours, coming to himself, he was sound in his mind and shook off all Stupidness: But though his Brain came to be clear, he was seiz'd with a great Weakness and Deadness in his Members: which affects nevertheless were Cur'd in a short time with Antiparalytick, and Antiscorbutick remedies: But after a fortnight he complain'd again of the heaviness of his Head, and the Giddiness, and the next day after he fell into a horrible Asthma, so that the Lungs were blown up on a sudden, and rise upward; and being scarce at all able to draw his Breath, which was very short, painful, and greatly letted, he was in danger of being Suffocated every minute of an hour. This fit, as Violent as it was, past off within twelve hours with­out a Cough, Spittng, or Vomit, and for above a week afterward he was without any impediment in his Thorax: But then a like fit of the Asthma returning, treated him a little more mildly, and afterward he was wont to be troubled with a like assault of the Asthma upon great changes of the Air, especially when an intense Cold and Snow were at hand.

Moreover we judge that sometimes this Convulsive straitness of Breath is rais'd by reason of the Bronchia of the Trachea being too much straitn'd, and often wholly clos'd by the Constriction [Page 323]of the Nerves and stocks of Nervous Fibres, which every where compass about the Ramifications of the Aspera Arteria, that Con­striction happening when those Nerves are forced to frequent Convulsions from a Morbifick matter besetting them.

A fine young Virgin, of a soft and tender Constitution, and of a florid Countenance, was scarce turn'd of eight years of age but began to be sorely troubled with Asthmatick Fits; and she lived at least four years obnoxious to them before she was com­mitted to my care; sometimes she continues two or three Months free from any Invasion of this Disease, yet oftentimes, by reason of errors committed in Dyet, or upon great changes of the Year, or of the Air, she falls into cruel Fits of straitness of Breath, so that the Lungs being blown up and raised towards the Throat, and there held by an almost continual dilatation, the Diseased can scarce breath at all: mean while the Diaphragm and Muscles of the Breast are laboriously occupied in thick repeated efforts of motion, in order to draw the Breath by one means or other; this access, within seven or eight hours, remitting by degrees, ceases a while; but now and then within a Week or two it is wont to return either of its own accord, or on any light occasion being offer'd: after the violence of the Disease is past, its matter being spent in many such Fits, the young Lady continues well enough for many Weeks, nay sometimes Months, and being free from any Distemper of the Thorax, she Breaths freely. I order'd her Spring and Fall the following Method of Cure; and now she has been without any Fit of the foresaid Affect above two Years.

Take our Sulphur of Antimony six Grains; Cream of Tartar, six Grains; mix them: Let it be given in the Pap of a boiled Apple. After taking this Medicine, she is wont to Vomit four or five times: After four days, she takes this Purge, which also she is wont to repeat twice, allowing six or seven days betwixt whiles.

Take Calomelanos twelve Grains; Rosin of Jalap five Grains; Castoreum four Grains; with a sufficient quantity of Ammoniacum dissolved: make three Pills. She takes besides every day, Morning and Evening, twelve Grains of Tincture of Antimony in a Spoonful of the following Julape, drinking after it six or seven Spoonfuls of the same.

Take Water of Snails, six Ounces; of Earth-worms, four Ounces; Water of Pennyroyal and Rue, of each four Ounces; Hysterick Water, three Ounces; Castoreum tyed in a Nodulus, and hung in a Glass, half a Dram, double refined Sugar, an Ounce: Mix them in a Glass; make a Julape.

About Autumn the last Year, another young Girl of Quality, being ill after the like manner, viz. with a Periodical Asthma, [Page 324]was brought to me to be cured, who using the foresaid Reme dies in a little less Dose, and repeating the same the last Spring found a mighty Relief.

As to the Remedies and Method of Cure that ought to be us'd, if at any time to a Cough, or straitness of Breath, first raised through a fault in the Lungs, Convulsive Symptoms also super­vene, by reason of an injury communicated to the Brain; let care be taken that Anticonvulsive Medicines be aptly complica­ted with such as have regard to any intents whatsoever of the Thorax; and also sometimes, That one while, these, another while the others being given apart, the times of Curing be in­terchangeably observed. It will be needless to give here Bechick or Pneumonick Medicines and their forms, whereof there is a vast store every where to be found amongst Physical Authors; it will be more to our purpose to set down a method of Physick, and some select Remedies that are proper in a Cough and Asthma, which are meerly Convulsive.

As to the former Affect, which is chiefly familiar to Children, and for the most part is not Cured but with difficulty, and after a long time; the chief Indications will be, both to purge the se­rous and sharp Humours from the Blood and Viscera, for pre­venting their Incursion and discharge on the Brain, and some­times haply on the Breast, and to strengthen these parts that they do not easily admit into them the Superfluities of the boiling Serum: for these ends Vomits and gentle Purges in a manner always are conducing, and ought by some means to be re­peated. Vesicatories are often beneficial; and if the Disease be obstinate, let Issues be made in the Nape of the Neck, or in the Arm, or about the Arm-pits: Let Drink and Liquid Food be taken in a less quantity than usual; instead of Drink, let a Bochet of Sarsa, China, the Saunders, Shavings of Ivory and Harts-horn, with Diuretick and Anticonvulsive Ingredients, be used. In this case certain specifick Remedies as it were are greatly commended, of which kind are Cup Moss, given in Powder, or boil'd in Milk, and so given frequently every day; the Decoction, or Syrup, of Ca­storeum and Saffron, the Decoctions of Peony-Root, Misteltow of the Oak, also of Hyssop, have helpt many; Water of Black-Cherries, of Saxifrage, Water of Snails distilled with Whey, and appropriated Ingredients, are often given with success.

2. I have shewn you before by what method, and with what Bemedies I have Cured a Periodical Asthma in some; but besides, the famous Riverius has observ'd that Vomits do most good to many affected with this Disease; for that Medicine, greatly sha­king and irritating the Emunctories that are seated about the [Page 325]first Passages, strongly expresses and draws away from the same the filthy Dregs of the Blood and Nervous Juice, which were apt to be forc'd into, or to stagnate in the Brain and Genus Nervo­sum. Zacutus Lusitanus greatly extols, and not without reason. Cauteries burnt, sometimes in the Bregma, sometimes in the Nape of the Neck, or about the Arm-pits: Preparations of Millepedes, viz. in the form of a dry Powder, or of a Distill'd Liquor, seldom want success; for such withdraw the superfluities of the Serum or Genus Nervosum from the Head, and convey them to the Urinary Passages: For the same reason gentle Purges, and such as evacuate per Epicrasin, are frequently used: for this purpose the Decoction of an old Cock, with altering and gently Purging Medicines, sown up in the Belly of it, is commended by many. Besides the Remedies hitherto mentioned, some are said to be ap­propriated to, and as it were Specificks for the Asthma, such as are Balsam of Sulphur Teribinthinated; also Spirit of Harts-horn, or of Soot, impregnated with the same; Syrup of Tobacco, of Ammo­niacum, our Syrup of Diasulphur, Lohoch de allio, Pills of Elecampane Roots, Milk of Sulphur, Flowers of Benzoin, made up with Tar or liquid Amber; with many other things, which it would be tedious here particularly to enumerate.

And now having given you the ways of curing the chief kinds of Convulsions, it seems time to put an end to this Tract; but since there remains another kind of Disease, viz. the Scurvy, which contains Passions of a mixt nature, viz. partly Convulsive, and partly arising immediately from the Dyscrasies of the Blood and Viscera, I think it expedient to give you briefly the way of Cu­ring that; for both these Affects, viz. the Scorbutick, and Con­vulsive, being placed together, will mutually illustrate each other.

CHAP. I.

THE Nature of the Scurvy being so diffused, and extended to so various and such a multi­plicity of Symptoms, that it cannot be com­prehended in one only Definition, or scarce in one particular Description, I think it fit in the first place to heap together all the Phaenome­na of this Disease, or to set forth in full all the chief accidents of it, and then to accommodate some Hypothesis for duely Solving those appearances.

As to the former, to consider the signs of the Scurvy from Head to Foot, we shall begin with those in the highest part: To this place belong violent and habitual Head-aches, and those ei­ther happening at random, or periodical; sometimes a deadness and drowsiness of the Spirits; sometimes obstinate Watchings, [Page 327]frequent Giddinesses 's and Scotomia's, Convulsions, a Palsey, much Spitting, soreness of the Gums, a looseness of the Teeth, a stinking Breath. 2. Meanwhile about the Region of the Breast, Pains in various parts of the Membranes, and especially in the Sternum, which often being acute and pricking, miserably torture the Diseased for many Days and Nights, a frequent Asthma, a diffi­cult and uneven Breathing, a Constriction and straitness of the Breast, a husky Cough, a disorderly Pulse, a trembling of the Heart, frequent Faintings of the Spirits, a frequent Swooning, and a continual being in danger of it. 3. In the Region of the Belly this Disease establishing, as it were, its principal Seat, pro­duces Iliads of Evils. For there are often a nauseousness, a Vo­miting, a Rumbling, a Cardialgia, Inflations and Murmurings of the Hypochondres, a frequent Colick, and most troublesome Pains shooting every way, an almost continual Diarrhaea, sometimes a Dysentery or Tenesmus, an Atrophia, and sometimes an Asci­tes.

The Urine is commonly very ruddy and lixivial, with a Scum swimming on it, or sticking to the sides of the Glass; tho' now and then, at certain times, the same being pale and Watry, is voided in a great plenty. 4. Besides these inward Affects, in the outward Members, nay in the whole Habit of the Body, wan­dering Pains, and often very violent, and chiefly infesting by night, are felt; a spontaneous Lassitude, a Consumption of the Flesh, an Ach in the Loins, and a weakness and enervation of the other Limbs, Spots of various colours in the Skin, Tumours, Tubercles, and often malignant Ulcers break forth; about the Muscles a Stupor, Formication, and ascent as it were of a cold Wind, also Contractions and Twitchings of the Tendons: More­over to Scorbutical Persons, disorders of the Blood, unconstant Boilings of it, restless distemperatures Feavers, without any con­stant Course, and great Haemorrhagies, generally happen. Besides these common and very usual Symptoms of the Scurvy, whereof sometimes more, sometimes fewer, and those one while of this kind and fashion, another while of that, infest the Diseased, some­times also unusual and prodigious Accidents ensue upon this Disease.

As to the evident Causes of the Scurvy, though an ill Dyet, a sedentary Life, a disorder of the Spleen, and Crudities heap't together in the first Passages, are very much accus'd, yet the unwholsomness of the Air, and the Crasis of the Blood vitiated by former Distempers are wont to be much rather in the fault; wherefore the Scurvy, in Maritime and Marshy places, is often endemious: It frequently seizes suh as are long at Sea, and use in the mean while Salt Meats, and such as are dryed in the Smoak, [Page 328]and also corrupted Water: It every where succeeds long conti­nued Feavers, and other Chronical Diseases ill Cured, also over great Haemorrhagies and other immoderate Excretions, nay and the suppression of usual Evacuations, as of the Menses and Hae­morrhoids. Moreover this Disease, without any great procatarxis is often wont to be raised by Contagion, and sometimes is he­reditary.

The material cause of this Disease, or the Scorbutick taint diffused through the whole Body, is founded either in the Blood, or in the nervous Juice, or in both of them together. That the Scorbutick Taint is fix't in the Blood, its disorderly Boilings, the Eruptions of Spots and Pushes, the ruddy and as it were lixivi­ated Urine plainly testifie; which is also shewn by the diversified production of this Disease, which for the most part succeeds the depravation of the mass of Blood: That the Taint sticks also in the Nervous Liquor, is shewn by the most troublesome Pains raised both inwardly in the Membranes, and outwardly in the Genus Nervosum, by the weaknesses or resolutions of the Mem­bers, the Giddiness, the Convulsions and frequent Failings of the Animal Spirits. Since therefore both general Humors are in fault, let us see which is first or chief in fault, whence it drew its Taint, and after what manner it is communicated to the other Humour, and likewise to any other Parts that are wont to be affected.

As to the Blood, (in whose Mass the Scurvy seems chiefly to spread its Roots) we have shewn elsewhere that in its Crasis it consists of the like kind of Particles, and is temper'd almost af­ter the like manner as Wines. Moreover we have intimated that as Wine, even so the Blood, for two causes chiefly, is ill dispo­sed, viz. either because some extraneous thing, that will not duely mix with them, is got into this or the other, or because the Crasis or temper of the Liquor is perverted, in as much as one Element, or haply two, to which the Dominion is due, being supprest, others which ought to be kept under, are ex­alted.

Concerning the former, we observe in Wine, that when the Foeces, first sever'd and thrown to the bottom, being stirr'd a­gain are rais'd; or if any Heterogeneous thing, as Sewet or an exotick Sulphur be cast into the Vessel, a mighty working is thence caus'd, which unless it be appeas'd in a short time, the Crasis of the Wine is in danger of being subverted: In like man­ner there are many immiscible things, which coming into the Blood disturk its Motion and Circulation, and hinder the course of its Oeconomy from being duely performed: The Nutritive Li­quor being filled with filthy Dreggs, Ferments the Blood in a [Page 329]disorderly manner: Nay and its Liquor being become degene­rate, causes Fits of intermittent Fevers: The Vapoury, Serous, Bi­lous and Melancholy Recrements of the Blood retain'd within it, beget Catarrhs, the Dropsie, the Jaundise, Melancholy, and ma­ny other Affects: Now if that extraneous thing be seasonably removed, the Blood even as the Wine being free from that Extraneous Mixture, soon recovers its former Constitution: But each of those Liquors being for some time infected with Heterogeneous Contents, at length degenerates from its due Crasis, and consequently is not easily restor'd.

Again, both Wine and the Blood fall from their due Temper for many other causes: 1. Concerning Wines we may observe, that sometimes the same do not come to a ripeness, but for want of a Pneumatosis, because the Spirits, and other active principles of Salt and Sulphur, being involv'd in such as are more Gross, cannot clear themselves, remain wholly Crude: Wherefore they do not become Spirituous; but being of a Gross consi­stency, and of an ingrateful savour, degenerate into a Flat Wine without strength: Even so the Blood, sometimes the Spirit and Sulphur being deprest, remains Crude and Watry, also without vigour, and unapt for a sprightly accension in the Heart; such a disposition causes the longing Disease, and an Hydropical Dia­thesis. 2. The Sulphureous part of the Wine being exalted a­bove the rest, causes an Immoderate Effervescency, or an ebul­lition in the Liquor; we call it a Fretting of Wines: In like manner the Sulphureous part of the Blood being too much exalt­ed, and consequently apt to Boyl, and be kindled in the Heart too much, brings a Feverish distemper, and is really the cause of many continual Fevers. 3. Often in Wine the Spirit becoming faint, and the Sulphur being bound, the Saline part is rais'd to a State of flowing, and praedominates over the rest, wherefore the Liquor, passes into Vinegar; from such an Acetous dis­position of the Blood, Melancholy is caus'd. 4 It's a vulgar ob­servation in Wines, that besides that they degenerate into a Flat Wine, or into Vinegar, the same sometimes upon the Spirits being deprest, and the Salt and Sulphur's being together exalted, become either Rank, or Pendulous, or Mucilaginous, we call it, Wines become over Fretted or become Ropy: In both changes, the Spirit being brought under, the Sulphureous and Saline Par­ticles are joyn'd together and are above the other Elements, and bring the Crasis of the Liquor to their nature: But the thing is not done in both wholly after the same manner; for in the for­mer dyscrasie of the Wine the Sulphur is a little above the Salt, and in the latter, the Salt is above the Sulphur: Nay and either of them being in power, and having thrown off the Dominion [Page 330]of the Spirit, takes the other to it, and raises it above its due state.

Now it's probable that the Blood is altered after the like manner in the Scorbutick affect, as Wines when upon being overheated, become over Fretted, or become Ropy, and we may conclude the Dyscrasy of the Blood, which is the Parent of the Scurvy, to be two fold as that of Wine, viz. Sulphureo-Saline, and Sali­no-Sulphureous. For there being a very great variety of affects, which are accounted of, as belonging to the Scurvy, all of them may be aptly enough reduc't to these two, as it were, chief heads, or as the two fountains of the evil: viz. First that the Blood be­ing touch't with a Scorbutick taint, either is very hot, as in which the Sulphur having gotten the Dominion takes the Salt to it: wherefore being become rank it Boyls disorderly in the Ves­sels, and discharges continually from it self adust Recre­ments, viz. the concretions of the Salt and Sulphur, and dis­perses them every way, which being outwardly spread, produce Spots, Wheals, Pushes, or Ulcers: But being inwardly depos'd cause Vomitings, Cardialgias, Diarrhaeas or Dysenteries, and also violent pains. In this kind of Scorbutick rankness of the Blood only temperate remedies and frequent Bleedings agree; and not Scurvygrass, horse Raddish, and other things of a smart and instigating Nature: After the same manner as overfretted Wines are Cur'd by Racking them from the Lees, and likewise by pouring Milk, Amylum, Ichthiocolla, and other Lenifying things to them. Or, Secondly in the Blood which Foments the Scurvy, the Salt having got the Dominion takes to it self the Sulphur, wherefore it is not so hot, but like Ropy Wine becomes thick and Mucilaginous, as it were, is Circulated slowly in the Vessels, and is apt to stuff the Vessels as it passes through them, Fur­ring them with a Muddy Filth. Such as are so affected for the most part being without Pushes or Cutaneous Eruptions, be­come Dull, Pursy, and enervated, are troubled with a Sponta­neous Lassitude, a Straitness of the Breast; nay and are found obnoxious to Passions of the heart, Faintings of the Spirits, to a Giddiness and Convulsions: And in this kind of Scorbutick disposition, Hot remedies, and such as are endued with a Vola­tile Salt, nay and Galybeates, which Fuse and exagitate the Blood are wont to be most of use; after the like manner as Ropy Wines are dealt with, to wit they ought to be very much stirr'd, and agitated and also quicklime, burnt Allom, Lime Plaister, Sea Salt Calcin'd, and other things of a very smart nature are put into them I shall now shew after what manner the seeds of that Dis­ease are laid in the other general humour, viz. the Nervous Juice.

About the beginnings of a Scurvy, till the Crasis of the Blood, and the Tone of the Brain are wholly vitiated, that Subtle Li­quor which passes in the Brain and Nerves, and is distill'd from the Blood coming to the Brain, both as the Matter and Vehicle of the Animal Spirits, is yet Spirituous and Sweet, and not very un­apt for any offices it ought to perform, but afterwards from the Mass of Blood become depauperated, and very much Effaete, a much thinner Latex, and inclining to a Sourness is distill'd: Moreover from the Dreggy, and as it were Rank, or Muddy Blood, Heterogeneous Particles, and such as are very injurious to the Animal Oeconomy, are sent, and are admitted without dif­ficulty into the Brain, which is become weak, and thence are diffus'd into its appendix both Medullary and Nervous with the Juice which passes in them: Hence follow the Fallings and E­clipses, sometimes Distractions, and Painful and Convulsive Ex­plosions of the Animal Spirits, that happen in each of the Re­gions. Wherefore the Palsey, Convulsions, a Giddiness, Pains, Tremblings, and other Praeternatural affects of the Brain and Genus Nervosum are wont to ensue upon a Scurvy when deeply rooted. Mean while, we may observe in general that the Scor­butick Taint, fixt in the Nervous Juice, Consists in these three things, viz. In some one of them or in all of them together, viz. that the Liquor lying in the Brain and Nerves becomes much more thin or poorer; that it degenerates from its Spirituo-Saline Crasis towards a Sourness; that it is stuff't with Heteroge­neous and Morbifick Particles.

As to the Prognostick of the Scurvy, let your judgment in this case be wary, long suspended, and not rash, for many (as it has occurr'd to our observation) accounted for desperate, have recovered: I have seen some even ready to be Choak't with a horrible Asthma; others just a dying with frequent Swoonings, nay and others seiz'd with a Palsey or Convulsive Fits, or a ter­rible Colick, who were wholly freed in a short time by the help of Medicines: I have known some Scorbutical persons Swoll'n all over their body by the Dropsy, others brought to an extream Leanness by an Atrophia, who were restor'd again to their perfect health. Therefore though persons troubled with this Disease are sometimes press't upon with very dangerous affects, if nevertheless the Viscera are still indifferently sound, or at least not very much vitiated, you must not despair of those evils, caus'd meerly by the Scorbutick taint: But on the con­trary, when the Symptoms appear less terrible, if the contents of the Hypochondres and Abdomen are become hardned, and as it were Scirrhous, or if the Lungs begin to be corrupted, promise nothing great or favourable concerning the Cure of the Disease,

Since as this affect grows to a high pitch, a manifold and di­versifyed Morbifick Matter, causing Symptoms of a various kind, and nature, is engendred, therefore let remedies not only of one kind be administred: But when any Method of Phy­sick, though prescrib'd with great judgment, does little or no­thing towards a Cure, the Diseas'd are not presently to be left, but let other Medicines, and now and then others be try'd; for the same do not agree with all persons, nor always with the same person. In the affected Body the Powers and Combinations of the Salts and Sulphurs every where vary, even so let the Medi­cines that do no good be sometimes chang'd, till you light upon some one that agrees very well, and gives help.

But if notwithstanding the use of Remedies, or upon their not being well applyed, the Scurvy getting ground by degrees is daily rais'd to a worse State; it brings at length the Dropsy or Ptisick: From this or that Disease there is a ready passage to Death; for after that the Blood is very much depraved it dis­charges its dreggy Excrements, when at long run they are much heap't together, either on the Lungs, or on the Viscera of the Belly, and consequently, it brings one of those two affects which are alike Mortal.

CHAP. II. Of the Cure of the Scurvy.

AS to the Cure of the Scurvy, since it is no one single preter­natural affect, but a Legion that is to be conquered, there­fore the Method of curing ought to comprehend manifold in­dications, and those variously complicated and subordinate; which nevertheless according to our wont we shall reduce to three heads, viz. that they be Preservatory, which have regard to, and take away the cause of the Disease; and Curatory, which have respect to, and remove the Disease it self and its Symptoms; and lastly Vital, which uphold or restore the strength and vigour of the Patient.

From the very beginning of the Cure we ought to level against the Cause of the Disease, for this being cut off, or torn up as the root, presently the Trunk, Branches, and Fruits wither away: Since therefore we have shewn that the cause of the Scurvy is founded in the Dyscrasie of the Blood, viz. Sulphureo­saline, [Page 333]or Salino-sulphureous: In the first place we must endea­vour the best we may, the amendment of that Dyscrasie, as well of the one kind, as of the other: For this purpose, first let the impediments be remov'd, then let the primary intention it self be effected: For both intents, remedies are taken from Dyet, Chirurgery and Pharmacy. As to the Dyet, we shall set. down a particular form of it hereafter: Mean while to proceed with the rest.

The reducement of the Blood to its due Crasis by appropriat­ed remedies is chiefly hindred by reason of these two things; viz. first because none but a vitious stock of nutritive juice: is continually carryed into it; and secondly, because the Recrements produc't within it are not sufficiently discharg'd by fit Com­mon-shores; therefore we must provide both that the work of Chylification be rightly perform'd in the first passages, and that the Vapoury Recrements be sufficiently discharg'd by Perspira­tion, the Serous by the Reins and Lymphaeducts, the Bilious by the Gall Bladder, the Melancoly by the Spleen, and others of any other kind else by proper Emunctories: Afterward, these of­fices being rightly Instituted, let us endeavour to reduce the Dyserasie of the Blood by specifick Medicines, and especially by such as are endow'd with a Volatile Salt. The remedies regar­ding every of these intents, ought to be Complicated together, and to be applied joyntly to use, but after what manner, and by what ways of administrations, I must yet more particularly set forth.

1. That Chylification may be rightly perform'd in the first Passages, we must take care that the load of Excrementitious Matter heapt together in them, be clear'd forth, that the lost or deprav'd Ferments be restor'd, that the Passages and Pores howsoever stuff't and obstructed be open'd: For these ends Ca­thartick, Digestive and aperient Medicines are design'd.

2. When the Recrements gathered together in the Mass of Blood, are not sufficiently discharg'd by their proper Emuncto­ries, let them be now and then led forth by others ways that are most proper: For this purpose Catharticks also, and like­wise Diaphoreticks, and Diureticks are proper.

3. Let the Scorbutick Dyscrasie of the Blood be corrected by Bleeding and Specifick Remedies; wherefore to draw all that concerns the preservatory indication to a Head, let the Rome­dies, which perform its chief intents, be Catharticks, Blood­ing, Digestives, Aperients, Diaphoreticks, Diureticks, and An­tiscorbuticks, [Page 334]or Specificks. Moreover, in regard digestive Re­medies and Aperients are often Coincident, since both are chief­ly Imbued with Acid, Smart, or Saline Particles; Moreover in as much as those kinds of Medicines aptly enough move Sweat or Urine; therefore the Physical Apparatus required for the fore­said intentions, may be brought yet to narrower limits viz. that it may consist in a manner only of Cathartick, Digestive, and An­tiscorbutick Medicines, to which Bleeding is added as occasion presents, I must now set down certain Forms and Praescripts of them, and likewise the manner of using them.

CHAP. III. Of Medicines of each kind of the foregoing forms, which have regard to the Scurvy raised in a hot Constitution, and in a Sulphureo-Saline Dyscrasy of the Blood.

IN certain Scorbutical persons the use of Scurvy-grass, Horse-Radish, Winters-bark, and of other smart things, and such as are greatly endow'd with a volatile Salt, is found to be very of­fensive; wherefore in those kinds of cases, where the Morbifick Cause consists in a hot Dyscrasy of the Blood, resembling over-fret­ted Wine, temperate Medicines, and such as do not exagitate the Particles of the Humours, which are apt to boil too much of them selves, are indicated: Wherefore we shall set down Forms after the same order, and running as it were parallel with those before; and in the first place we shall give you solid Medicines.

CHAP. IV. Of the Curatory Indication of the Scurvy, where­by we obviate the Disease it self, and the Symp­toms that are most pressing.

HItherto we have shewn concerning the Cure of the Scurvy, what regards the Preservatory Indication, to wit, the re­moval of the Morbifick Cause, viz. both the intentions of Curing, and the Remedies indicated: Which kind of method being sea­sonably begun, and duly prosecuted, often does the whole work; viz. in as much as the Cause of the Disease, or the Root of it being cut off, the affects depending of it dye of their own ac­cord: Nevertheless we must not go on with this course of Phy­sick always directly, but turning aside several ways: For some­times severe Accidents and Symptoms happen, which require a peculiar, and as it were, extraordinary Physical help, to which we must Immediately attend, and often interrupting the general Cure. Concerning these we must observe, that as affects which happen upon the Scurvy, require Appropriated Remedies, ac­cording to the Nature of each of them, and to the disposition of the Patient, yet Antiscorbuticks ought always to be mixt with them: I will not be needful to order a Method of Cure against all diseases and affects, with which the Scurvy is wont to be attended, for so the whole Practice of Pyhsick would be here transcrib'd, but we shall have regard only to the Sym­ptoms that are chiefly pressing, by which either the life of the Patient is endanger'd, or the principal Cure Obstructed; after what manner, and by what Medicines such are Cur'd, I shall now shew.

CHAP. V. Of the Vital Indication, in which are included Cordial Medicines, Opiats, and the Diet requisit in the Scurvy.

HItherto we have set forth at large the Indications both Pre­servatory and Curatory, which belong to the Method of Curing the Scurvy; there remains yet to speak of the Vital In­dication, to wit, that it may be declar'd by what Method, and with what Remedies the powers of the Diseas'd, which either being too apt to faint, may be upheld, or being weakn'd or dejected may be restor'd: For these ends Cordials and Opiats, according to the Exigencies of the Diseas'd, are prescrib'd to be taken, and moreover let a right Form of Diet, if at any time it [Page 370]be needful, Resumptive, and always Antiscorbutick be prescrib'd.

As to Cordial Medicines, viz. such a exagitate the Blood stagnating in the Heart, renew its flame half extinct, restore the opprest, or distracted Animal Spirits to their liberty and due irradiation, it is obvious that many Remedies, which are pro­perly call'd Antiscorbuticks, perform these intents, of which kind are, Raddish-water compound, the Magistral Water of Snails and of Earth-worms, Spirit of Harts-horn, of Soot, Powders of Shells, with many other things, which may be taken with good effect, not only at certain hours, and according to a set Method, but likewise as occasion presents, as often as a Swooning, or any failings of the Spirits happen.

But besides, those who are found to be very obnoxious to Passions of the Hearts, frequent Faintings, a Nauseousness, Vo­miting, Trembling, Vertigo and other terrible Symptoms, may also have in a readiness, Medicines of another kind, more pro­perly Cordial, with hich, all failings of the Spirits are imme­diately reliev'd: In this case, Quercetan's great Elixir of Life, does excellently well; the second Water in the distillation of the same Elixir being sweetned, may be given to a spoonfull; also Aqua Mirabilis, Aqua Bezoartica, Gilberts temperate Water, Treacle-water, Cinnamon­water; to each of which, or to a Composition of them, let the Con­fection of Alkermes, the Confection of Hyacinth, Powder of Pearl, or Magistery of Coral, Syrup of Clove-gilliflowers or of Coral, of Ci­tron-pills, of Cinnamon be added: Of these, and others of this kind various forms of Medicines are wont to be prescrib'd. For example;

Take Treacle-water, and Aqua Mirabilis, of each three Ounces, Bawm-water four Ounces; Syrup of Clove-gilliflowers an Ounce and a half; Confection of Alkermes a Dram; mix them. The Dose is three or four Spoonfuls.

Or, Take Aqua Mirabilis six Ounces; Water of Snails and of Wallnuts, of each two Ounces, Pearl powdred a Scruple; Confection of Hyacinth a Dram; Syrup of Clove-gilliflowers an Ounce; mix them.

When Scorbutick Women are wont to be troubled with Hy­sterick Fits, and Men with Convulsions Take Water of Bawm and Pennyroyal, of each three Ounces; compound Briony-water four Ounces, Tincture of Castoremn half an Ounce; Tincture of Saffron a Dram; Syrup of Clove-gilliflowers a Dram and a half; Castoreum tyed in a Nodulus, and hung in the Glass a Dram. The Dose is three or four Spoonfuls.

For those who desire rather to have Cordial Medicines in a solid form; let Electuaries or Tablets be prescrib'd.

Take Conserve of Clove-gilliflowers three Ounces; Confection of Alkermes half an Ounce; Pearl powdred a Dram, with a sufficient quantity of Syrup of Coral; make an Electuary.

Take Species Diamargariti Frigidi, and Diarrhodon Abbatis, of each a Dram and a half; Pearl powdred a Dram; double refin'd Sugar dissolv'd in Treacle-water, and boil'd to a consistency for Ta­blets four Ounces; Oyl of Cinnamon six drops; make Tablets accord­ing to Art.

As to Opiats and Anodine Medicines, in some certain affects of Scorbutick persons, I had rather be without any kind of Medi­cine besides, than the use of them. For not only against obsti­nate Pains and Watchings, but in Asthmatick Fits, in Vomitings, a Diarrhaea, and also in a Vertigo and Convulsive Passions, as often as nature being irritated above measure, falls into extream irregularities, I have found no Remedy more excellent, than to procure sleep by giving a safe Narcotick: Mean while there is need of a very great caution, that they be not taken, if at any time something in the Constitution of the Diseas'd, or in the nature or time of the Disease, forbids the giving of such a Medicine.

Besides the Hypnoticks usual in Apothecaries Shops, viz. Lauda­num Opiatum, Nepenthe, the Philonia, Diacodium, and Syrup of red Poppies, two other preparations of Opium are known to me, which I use to give in the form of a Tincture, or of a liquid Ex­tract from ten drops to twelve with some other appropriate Liquour.

The Diet, or Form of Living to be observ'd in Scorbutical persons, is of no small importance in the Method of Cure; for that being neglected or ill ordered, the other Prescripts of Phy­sick do little or nothing towards Health: The Rule of Diet being extended to various things, is chiefly concerning the Air and Situation of the Habitation, Meat and Drink, and the motion or rest of the Body.

As to the first, what kind of habitations and places of Resi­dence, in respect of the Heavens and the Earth, cause the Scurvy, and consequently ought to be shun'd, it is sufficiently manifested by what we have said before: Those that endeavour to prevent or cure this Disease, ought to take care to choose an Air mo­derately hot and dry, and which also is subtle and pure, and suf­ficiently expos'd to the Winds.

Such Food only is proper which has a good Juice, and is easie of Concoction, let such as is gross, viscous, and dryed in the Smoak, mouldy and rank, also such as is unfermented or greatly compounded, all manner of Pulse, Milk-meats and unripe Fruits [Page 372]be shun'd. I so much disapprove things preserv'd, or very much season'd with Sugar, that I judge the invention of it, and its im­moderate use to have very much contributed to the vast increase of the Scurvy in this late Age: For that Concret consists of a very sharp and corrosive Salt, though mitigated with a Sulphur, as it plainly appears from its Chymical Analysis: For Sugar di­stil'd by it self, yields a Liquour scarce inferior to Aqua Stygia: And if you distil it in a Vefica with a great deal of Fountain-water, pour'd to it, though the fixt Salt will not so ascend, ne­vertheless a Liquour will come from it, like the Hottest Aqua Vitae, burning and very pungent; when therefore Sugar mixt almost with any sorts of Food, is taken by us in so great a plenty, how probable is it that the Blood and Humours are ren­dred salt and sharp, and consequently Scorbutical by its daily use? A certain famous Author has laid the cause of the English Consumption on the immoderate use of Sugar, amongst our Countrymen: I know not whether the cause of the spreading Scurvy, may not also be rather hence deriv'd.

Let the Drink be midling Ale, mild and clear, and also let it be altered with Antiscorbutick Ingredients without an un­grateful favour: Let it not be thick and sweet, nor also too old and turning sharp: Let this be taken in a moderate quantity, and in a manner only at the set hours of Dinner and Supper: The custom which has prevail'd with many, viz. that assoon as they are out of their Beds, they presently indulge themselves to drink a large Mornings Draught (as they call it) seems very pernicious: For by this means the Blood Vessels are too much fill'd, a store of new Chyle being almost continually sent into them, and Crudities and Filthy Morbifick Dregs are engendred in the Blood, and the office of Sanguification is greatly debi­litated: Truly it is better for most Men (unless it be those whose Ventricle, as long as it is empty, is wont to be plainfully contracted and corrugated) to keep themselves fasting till Din­ner time: Nor is that vulgar custom less contrary to Health, to swill themselves with much Drink presently after Meat: Wines and Ciders, so they are mellow, pure, and not adulterated, being taken in a moderate quantity, do not offend: But the same being counterfeit, musty, austere, or turning sharp, there is nothing more hurtful or injurious to our Health

Exercises and Labour are so notably conducing both to the cure and prevention of the Scurvy, that many by this sole Re­medy, either preserve or recover an entire Health: For the Blood [Page 373]and Nervous Liquour of persons that lead an idle and sedentary Life, (like Stagnating Waters) contract a clamminess and mouldiness: But upon the assiduous and much motion of the Body, the Humours and Spirits become clear, and get a vigour, the Excrementitious and Heterogeneous Particles evaporate, the stuffings of the Bowels are purg'd, and their Tone is corroborated.

CHAP. VI. Some Stories and rare Cases of Persons troubled with the Scurvy.

A Woman of Renown, tall and graceful, about the twenty fifth year of her Age, had contracted a Scorbutick Taint, by reason of various errours committed in Diet. The signs of which were a Spontaneous Lassitude, a difficult Breathing, Pains and Spots in the Legs, and her Gums likewise swoll'n, and full of Blood; in the Spring time after an Abortion, falling into a Tertian Ague, she soon became in a languishing and weak condition, from which Disease nevertheless, first being Methodi­cally proceeded with in Physick, she had soon recovered, but that indulging her self to eat Flesh and other improper things, she soon had a Relaps; and then being a weary of Physick, she took only Empirical Remedies, with which sometimes the Fits of the Ague were driven away, but often presently return'd, mean while the Diseas'd being pale, unable for motion, and wanting Breath, continued swol'n and blown up about the Ven­tricle and Hypochondres. About the third Month of her being sick, she began to have Gripes and bitter Tortures in her Belly; with which shooting sometimes to the Back, sometimes to the Stomach she was afflicted almost continually day and night: Moreover she was affected with a frequent Vertigo, and some­times with Fits as it were, Hysterical: Also being troubled with a frequent Vomiting, she daily threw up a viscous and froathy Phlegm: Within a Months space this Disease passing to its highest [Page 374]pitch, rais'd pains in the Back and Loins, and so afterward in all the parts of the Body: Besides, at this time she complain'd of a mighty straitness of her Brest, and a great contraction of the Viscera: Mean while the habit of the Body fell away to a mighty Leanness, so that the Bones being destitute of Flesh, scarce stuck to the Skin; the Urine was little and very ruddy; on the surface of which grew a little thin Film garnish'd with various colours like the Tail of a Peacock: A short while after this, a Numness and Formication was perceiv'd sometimes in the Belly, sometimes in the Limbs, and afterward the Gripes and Pains began to remit; nevertheless in their stead, a Palsey succeeded, which within a weeks space so pervaded all the Members of the whole Body, that she was not able to bend, or any way to stir from its place either Hand or Foot, or any other part.

It is obvious that those severe Symptoms proceeded from a Scorbutick Root, for by reason of the taint principally fixt on the Blood, the Spontaneous Latssiude, the difficult Breathing, nay, and the intermitting Fever hapning at random, and often returning, and the Bickerings of other Symptoms previous, as it were, and light, were caus'd: Again the Lixivial Urine, and that diversified colour of it plainly shew'd the Blood to be seis'd with a Sulphureo-saline Discrasie; which kind of Urine I have ob­serv'd to be so mark't in many others, affected with the like Disease: Moreover when in this sick Lady, the Morbid Seminal Root being increast in its store, and flowing into the Mass of Blood, came to spread it self on the Confines of the Brain and Genus Nervosum, the other more violent affects arose.

This Lady living far hence, by the advice of a Neighbouring Physitian took Medicines usual against the Collick; which doing no good, and the Disease growing worse, the Patient being brought to Oxford, tryed a great many Remedies both Antiscor­butick and Antiparalyticks almost of every kind and form, though without any benefit: Since therefore any ordinary Method of healing seem'd not sufficient for this Disease, it was thought good to proceed to great Remedies, and truly such as were not wholly void of danger: Wherefore we gave this sick person, as weak and worn away as she was, a Mercurial Medi­cine for raising a Salivation, which effect ensued according to our desire, for a Flux arising within two days, and gently con­tinuing for many days without any ill Symptom, gave a very great relief to the noble Lady: For the Pains being mitigated, [Page 375]she began in some measure to move her Limbs, to have a bet­ter Stomach, and to digest here Food better, and to enjoy a quiet Sleep: The Salivation being over, she took a Decoction of Sarza and China, with Antiparalytick Ingredients for a few days: Afterward being carried to Bathe, and having there us'd the temperate hot Baths, for some time she recover'd an indif­ferent state of Health. The whole Winter she constantly took Medicines against the Scurvy and the Palsey: And upon her renewing the use of the hot Baths the year following, she grew perfectly well; and since is become the joyful Mother of many Children.

A Man forty years of Age, of a Melancholick Temperament, troubled with the Scurvy for many years, is wont to find at various times of the year manifold and diversified Symptoms of it: About his Legs, spots and large black marks, like those caus'd by a stroke, appear, Belly-achs, and a Looseness frequent­ly trouble him, his Urine for the most part appears Lixivial, a Spontaneous Lassitude, a languishing of the Strength, a want of Appetite almost constantly attend him; besides these ordi­nary as it were accustomed evils, he lives moreover obnoxious to violent Fits of sickness, and those of various kinds. Above two years since, when I first went to see him, he sorely com­plain'd of a difficult Breathing, as though he were in danger of being choak't, with a Trembling of the Heart, failings of the Spirits, and a frequent danger of Swooning: Moreover of any thing of these passions in the Praecordia a little remitted, for the most part he was assail'd with a cruel Scotomia and a Ver­tigo; he seem'd to have perfectly recover'd of these affects, af­ter that he had taken for sometime Anticonvulsive Remedies, com­plicated with Antiscorbuticks: Butafterwrad within a few weeks he was affected with a Nauseousness and a Heart-burning, and with an Inflation of the Hypochondres: His Urine was little and very lixivial, his Belly swel'd in a short time, moreover his Feet and Legs growing mighty oedematous, shew'd the marks of an invading Dropsie: Afterward the like kind of Tumour seis'd the Thighs, also the Flesh of the Back and Arms; which affect nevertheless, though it seem'd without hope, was easily cur'd with Antiscorbutick Remedies, Catharticks and Diureticks being join'd with them: Notwithstanding, this worthy Man, though restor'd to his Health, did not continue so long: For half a year being scarce over, he began to complain of a vio­lent Head-ach, with a Vertigo, and an obstinate Watching; af­terward without any evident cause, he was seis'd with a horrible [Page 376]Vomiting: In a short time after the Asthmatick Fits return'd, with a trembling of the Heart, and failings of the Spirits: At this time also, when he seem'd almost past hope, he recover'd again in a short while by the use of Antiscorbutick Remedies: From this case it clearly appears how great evils the Scorbutick Miasm, lying hid like a ferment, both in the Blood and in the Nervous Juice, and displaying its Venom according to occasion, may cause. Which kinds of affects nevertheless, how dread­ful and terrible soever they seem, so they depend only of the Humours being vitiated in their Crasis, and not on the Viscera injur'd in the whole, or in their conformation, for the most part they are wont to be Cur'd with little ado, viz. by an Antiscor­butick Method aptly ordered according to the condition of the Patient as well as of the Disease.

A Renowned Lady, about Twenty five years of Age, of a San­guine Temperament, and a thin habit of Body, fresh colour'd and handsome, had been ill of a Scorbutick Affect of a long time: For besides broad Spots and red Pushes breaking forth in divers parts of the Body, she had been wont to undergo for a long time Pains and bitter Tortures, chiefly infesting her by night, one while in the Shins, another while in the Arms: In regard she was with Child, she had been forc't to leave off a course of Physick, often begun in order to its Cure. After he last Child­birth, her Lochia flowing plentifully, she continued for many days faint and weak, with a difficult Respiration, and being out of Breath upon any motion: A Month after being deliver'd, be­ing taken out of Bed, and attempting to walk, she fell into a most severe difficulty of Breathing, with a Trembling of the Heart, and a frequent Fainting of the Spirits: Being presently put to Bed, she continued almost for a whole day still Trembling, and continually Panting: Moreover the lower Limbs, as though Death were at hand, being quite chill'd, waxed not warm by any Frictions or Applications of warm'd Cloaths: At length, after near four and twenty hours, upon the frequent giving of strong Cordials, she was better about the Praecordia, though there followed near the right Groin, in the top of the Thigh, a very acute Pain, reaching even to the Leg, and within a few hours a pretty hard swelling, resisting the touch, possest all that space: Being call'd at this time, the Diseas'd still fetch­ing her Breath short and with difficulty, presently having or­der'd a Clyster to be forthwith injected, I gave her twelve drops of Spirit of Hearts-horn in a spoonful of the following Julape.

Take Water of Snails, six ounces, Hysterick Water four ounces, Water of Wall-nuts, simple, and of Pennyroyal, of each three ounces, Sugar one ounce, Castoreum tyed in a Rag, and hung in the Glass, a Dram. These Medicines were repeated every sixth Hour.

I ordered a large vesicatory to be applyed to the inward part of the Thigh; then in the Evening, in regard during this whole Fit she had continued without Sleep, I gave her of Laudanum a grain, Pearls powdred six grains, confection of Alkermes without Musk half a dram: she slept quietly, and there next Morning she was much relieved, the pain and swelling of the Thigh somewhat abated, also while she lay quiet in her Bed, she was well about the Precordia, but sitting upright, or turning on one side, presently she seem'd almost ready to dye through straitness of Breath; she continued the use of the Spirit of Harts-horn and of the Julep, to be repeated every sixth hour for many days. More­over, because she was press'd with Thirst, and made water always in a small quantity, ruddy, and filled with contents, she took twice a day a Dose of the following Julep to six Drams.

Take roots of Grass, Chervil, preserv'd Eringos, of each six drams, sha­vings of Ivory and Harts-horn, of each two Drams, burnt Harts-horn a dram and a half, Raisins two ounces, one Apple slic'd, Licorish two drams and a half, being slic'd and bruised, let them boyle in three pounds of Fountain Water; till a third part be consumed: then four ounces of White­wine being added to it, let it be strained into a Flagon, to which put Leaves of Scurvy-grass, and Brooklimes, of each a Handful; Salt of Wormwood two drams, make a close and warm infusion for three Hours, let the strain­ing be kept in Vessels close stopt. Sometimes every day, sometimes every other day a Clister was administred: By the use of these things she seemed to grow better daily, so that within a weeks space arising from her Bed, she was able to sit up two or three Hours by the fire in her Chair: but if she kept from her Bed, or walkt a little more than was fitting, she was presently wont to fall into a straitness of Breathing, or a fit of the Asthma, so that on a certain day having stayed out of Bed too long, she underwent a violent fit of the Disease, and was affected with a difficult Breathing, a trembling of the whole Body, and frequent Swoonings: Being called again by reason of this Relaps of the sick Lady, I gave her Spirit of Harts-horn to twenty drops, with the Julep above prescribed, and in the Evening a dose of our Laudanum: and as thereby she found her self better about the Precordia, Pains and Swellings succeeded in the right Thigh and Legg, such as before had paned in the left. I ordered also vesicatories to be ap­plyed to that Thigh; and besides the Remedies hitherto mention­ed, she took twice a day of our Wine of the Juice of Scurvy-grass four ounces, with two ounces of the Magistral Antiscorbutick Water: Moreover, I ordered her to be purged with our Solutive Syrup, above prescri­bed; which doing well, I ordered it to be repeated within three [Page 368]or four dayes. By these Remedies she grew well within a Month.

A Noble man about the thirty third year of his Age, seeming to be of a sanguine Temperament, tall and slender, of a very acute Wit, and quick understanidng, tho he had used himself for a long time to immoderate and excessive Studies, together with a disorderly way of Diet, yet being still sprightly and full of vigour, he seem'd to enjoy a sound Mind in a sound Body: a little more than two years since, when he had greatly tired himself by dancing a whole Night with Friends, and in the Morning being put in a cold Bed in a Room that was too moist, and having slept a little, he began to be sick; for upon his awake he fell into a mighty troublous Passion about the Precordia, with terrible Swoonings as though he were ready to dye. After a draught of Wine and some cordial Remedies taken, he was a little better, but he often relaps'd, so that all that day both himself and his Friends dreaded either a swoon without returning to himself, or an imminent Apoplexy: Moreover, after that this Fit of the Disease was past, yet still he lived obnoxious to daily passions of the Heart, and upon any great Error committed in Diet, he was wont to be afflicted again with a violent fit. Notwithstanding the use of Remedies, the Disease growing worse within a few Months, did not only infest the Precordia, but in the whole habit of the Body Expansions sometimes of heat, sometimes of cold, moreover in the Limbs a numbness or formication, or light Convul­sions, and sudden contractions were raised; but of late, besides the Sym­toms hitherto mentioned, which still greatly molest the Noble Person, he is moreover sorely afflicted with a frequent Vertigo, and with Di­stractions and Failings of the Spirits residing in the Fore-brain, inso­much that he is forc'd to abstain from the Studies and Politick Employs (to which he has been always addicted) and even from any strong inten­tion of the Mind; for otherwise he feels both in the Head and in the genus nerevosum these troublous Passions, that he may fear either an invasion of the Apoplexy, or horrible Convulsive Affects: a great fit of this Dis­ease pressing upon him, the Ventricle also for the most part is disturbed: Moreover, he has often found ease after a Vomit, either hapning of its own accord, or raised by the help of an Emetick Medicine: Hence some have judged the cause of the Disease to be seated wholly about the Stomach, or Hypochondres: Nevertheless Cathartick Medicines, Emeticks, Dige­stives, Cephalicks, Antiscorbuticks, Chalybeats, and others almost of every kind, prescribed to this Person for two years by famous Physi­cians, and also by Empiricks and Mountebanks, have not effect­ed a cure: he lately tryed Astrop VVaters, but finding himself the worse by them, he presently left them off, and is now advised to drink the Sulphureous VVaters at Knaresborough in York-shire: But what success he finds in them I know not at present.

This case in regard by reason of the concourse of the various Symp­toms, it does not belong to any peculiar kind of Disease else, is justly re­ferred [Page 369]to the Scurvy. As to the Method of Cure to be used in this and the like cases, there are two Intentions on which we must chief­ly insist: viz. First, we must cleanse the Mass of Blood, and withdraw the offensive Ferments conveyed to it from the Stomach, Spleen, and haply other of the Viscera. Secondly, the Brain and Genus Nervosum ought to be strengthned, lest they admit extraneous Particles: and the nervous juice that lyes in those Parts, degenerating from its due Crisis to a sharp and otherwise morbid Nature, ought to be restor'd and re­ctified: the first of these is perform'd by Catharticks, Emeticks, bleeding, and especially specifick Medicines, correcting or wholly taking away the scorbutick taint of the Blood. Now that the Iron or vitriolick Spaws, that famous cleanser of the Blood, did rather injury than give help to this Person, the reason seems to be, both that the Brain being become weak by reason of Cephalick Affects, with difficulty throws off the filthy glut of Waters sent into the Blood, nay, and is in danger of being overwhelmed by it, as it violently makes to its con­fines: and likewise, because when the nervous Liquor degenerating from its Crasis inclines to a sharpish Nature, it is wont to be more per­verted by the fluid Salt of the Spaw Waters. Wherefore we gene­rally observe that in the Rheumatism and Gout the morbid Disposition is increast by the drinking of those Waters. The second Intent is ex­cellently performed by Cephalick Remedies, and especially such as are endowed with a volatile Salt, of which kind are Spirit and Salt of Blood, of Soot, of Harts-horn, the roots and Seeds of Peony, leaves of Mi­stletow of the Oak, &c. with which Antiscorbuticks are mixt.

CHAP. I. Instructions and Prescripts for the Cure of the Head-ach.

SInce all Pain is an Action violated, or an irksom Sensation de­pending on the contraction or corrugation of the Nervous Fibres, the subject of the Head-ach must be the parts of the Head that are most nervous, that is, the Nerves themselves, also the Fibres and Membranes, whereof it has many, plac'd both upon and under the Scull; and those parts which are affected with pain are chiefly the two Meminges and their various Processes, the Tunicles of the Nerves, the Pericranium, and other Periostia; the Muscles, the Panniculus carnosus, and lastly, the Skin it self: As to the Brain and Cerebellum, and their medullary appendixes, we con­clude that these Bodies, in regard they want sensible Fibres, apt to be corrugated and distended, continue free from pain; and so the same is also to be said of the Scull.

Now whenever a pain is rais'd any where about the nervous parts of the Head, its formal cause consists in this, that the animal Spirits being sever'd from each other, and put to flight, cause the Bodies that contain them to be withal convuls'd and corrigated, and so raise that troublesome sensation: And that which so distracts the Spirits, that a troublesome sensation thence arises, is somewhat disproportio­nate, rushing against the Spirits themselves, or the Bodies that contain them, which entring the Pores or Interstices of the Fibres, severs them from each other, and withal forces the Spirits there residing to Irregularities.

As to the Prognostick of this Disease; in case the morbid disposi­tion be inveterate, so that Fits for many years have often return'd of their own accord, and likewise upon any slight occasion, we predict that the diseas'd, though not much in danger of life, will not easily be cur'd: Moreover, that the Cure will be yet more difficult, if hy­pochondriacal, or hysterick affects often troubling them, are wont at frequent times to raise the Head-ach, or if the corrupted taint of an inveterate Venereal distemper be radicated in the Part affected.

And if the Head-ach be not only inveterate, but almost continual, that we may justly suspect it to arise from a phlegmonous or schirrous Tumour, an Erysipela, Abscesses, or Worms, there remains but small or no hope of Cure.

A Head-ach, whether continual or periodical, if it be violent, and has a Vertigo, Vomiting, and other affects, either convulsive or sleepy joyn'd with it, gives suspicion of great danger; forasmuch as it frequently passes into a mortal Apoplexy, and often into an Epilepsy, Palsey, Blindness, Deasness, and other Diseases, either very severe or incurable.

The Therapeutick method of the Head-ach comprehends many Indications, and those of various kinds, according to the manifold species, causes, and differences of this Disease, which it will not be easie to digest, and place all here in an exact order.

An accidental, or occasional Head-ach, viz. such as is wont to arise from an evident cause alone, without any Procatarxis, or pre­vious disposition, as when it happens upon drinking Wine, Surfeit­ing, being in the Sun, or through a vehement exercise, also in fits of Feavers, this for the most part ceases of its own accord, upon the removal of the evident cause, and its consequences; or at leastwise is taken away by bleeding, rest, and sweating.

In every habitual Head-ach, whether continual or intermittent, two chief scopes of curing occurr; to which all the other Therapeu­tick intentions ought to level, and with which provision is made against each cause of the morbid origine.

1. viz. In the first place, for the cutting off all the fewel of the Disease, we must endeavour, both that the matter flowing, or often­times [Page 372]apt to flow to the affected or ill dispos'd places of the Head, be either stopt, or withdrawn thence to some other place: and likewise that the Convulsions rais'd in other places, and thence wont to be propagated to the Head be prevented.

2. Then Secondly, in order to the eradicating of the Disease it self, or (if it may be) of its conjunct Cause, we must endeavour, that the places of the Head predispos'd for Aches (whether only weak, or injur'd in their conformation) being fortified against the frequent incursions of the offensive matter, recover their ancient state and vigour; which In­dication, though it be seldom ever perform'd on a sudden, or through­ly, yet sometimes by a long and diligent care, the morbid root, how fix'd and radicated soever it be, it consum'd.

As to the first scope of Curing, which we must first and chiefly have respect to, we say that the matter, or Humours, that are wont to be heap'd together about the parts of the Head predispos'd for a Head-ach, and to raise the fits of the Disease, are the Blood, or its Serum, or the nutritive or nervous juice. Moreover, with all these, vapours and effluvia, also excrements, sometimes bilous, sometimes melancholick, sometimes acid, salt, sulphureous, and others of va­rious kinds being receiv'd into the Blood from the Viscera, sometimes these, sometimes others, are convey'd along with it to the Head; against the salleys and incursions of all which, let Physical defensa­tives be ordered.

1. And first, if the Procatarxis, or disposition for pains being plac'd about the Membranes of the Head, the Blood, as being hot, and apt for turgescencies, rushes now and then all of a sudden into the Membranes of the Head, and upon its not easily passing them, stretches the Vessels above measure, and severs from each other the nervous Fibres, and so raises fits of this disease: (a sign of which are a sanguine temperament, heat, and a suffusion of redness in the Head about the Face, also a high and vibrating Pulse, with Veins stroutting with Blood; we must presently endeavour both that the Blood being rendred more calm, be not so readily put upon turgescencies; and also that when stirr'd and boyling, it be not carried with a greater salley to the Head than to other Parts, nor be not forc'd there to stag­nate, by reason of the Sinus's of the Meninges being too much fill'd: Wherefore, if the fit continues long, let the Person be blooded in the Arm, or in the Jugular Vein; out of the Fits it is sometimes proper to draw Blood from the Vessels of the Fundament by Leeches; to wit, that by this means the Blood haply boyling, may be drawn down­ward towards that place, whither it often tends of its own accord: Let Oxyrhodinums, or other Epithems be applied to the Head; more­over, let Juleps, Emulsions or Decoctions, which allay the fervour or fury of the Blood be taken: Let the Belly be cooled and kept so­luble by the use of Clysters: Morever, for prevention, Whey or [Page 373]the use of Spaw-waters is convenient; also drinking of Water, a thin and cooling dyet do good: You must order a forbearance of Wine, Spices, Bathing, Venery, any violent motion of the Body or Mind, and all hot things: Moreover, for fixing the Blood, and preventing its effervescencies, let distilled Waters, expressions of Heerbs, or Decoctions, Electuaries, Powders, and especially Crystal Mineral be frequently us'd: It will not be needful to subjoyn here a method, or particular forms of Medicines, because in this case almost every Person that is ill, being taught by frequent experience from things that do him good or hurt, is wont to be his own Physician.

2. It is seldom that the Blood is in the fault alone, or only by it self: Other Humours oftner, being carried to the Head by the con­veyance of the Blood, and there depos'd, cause the Evil: If at any time therefore a filthy glut of Serum breaking forth in abundance from the Blood, causes frequent Head-achs (the signs whereof are Catarrhs at the same time infesting the other parts, viz. the No­strils, Mouth, or Trachaea) then abstinence and rest being com­manded, and the Belly being emptied by a Clyster, let the fluxion of the Serum be permitted to appease it self, and the matter dis­charg'd on the Membranes of the Head to evaporate: Which if they do not follow of their own accord, and in a short time, in a hot constitution Bleeding often is proper; viz. inasmuch as the Vessels being emptied of Blood, suck in again the extravasated Serum: But in cold Persons Vesicatories applied to the Neck, or behind the Ears, are of excellent use: Then after that the Belly is emptied by a Clyster, let the fluxion be appeas'd by the use of an Anodyne, or gentle Opiat: and that being appeas'd, it is proper to give a gentle Ca­thartick, and then Medicines that operate by Urine, or Sweat, or together by both, and so gently evacuate the superfluous Serosities.

Medicines fit for these ends are every where to be found in Books, which nevertheless may not be us'd rashly and indifferently by Em­piricks, but they ought to be chosen, compounded, or altered, nay, and sometimes to be prepared Extempore, as occasion requires, according to the judgement and discretion of a prudent Physician, respect being always had to the Constitution, Temperament, Idiocrasis, and other accidents and circumstances of the Patient. Wherefore, in regard it would be superfluous to heap together here a great many Receipts, I have rather thought fit to rpopose here only a form or two of the Medicines of each kind, viz. of such as regard the chief Intents.

Take Pills of Amber half a dram, Rosin of Jalap four grains, Bal­sam of Peru what suffices, make four Pills; let three be taken going to Bed, and the next morning, if the former do not work enough.

Or, Take Scammony sulphurated half a Scruple, Ceruse of Antimony fifteen grains, Cream of Tartar eight grains, make a Powder, let it be taken in a spoonful of Panada early in the morning.

Take Sulphur of Antimony four grains, Rosin of Jalap five grains, Cream of Tartar six grains, let them be bruis'd together, and with a sufficient quantity of Conserve of Violets make a Bolus to be taken early in the morn­ing with Governance.

Take roots of Butchers-broom, the great Bur-dock, Chervill, Avens, of each an ounce; preserv'd Eringo's an ounce and a half, Florentine Orris three drachms, the lesser Galingal a drachm and a half, Bur-dock-seeds three drachms, dryed leaves of Betony, Sage, Vervain, Fluellin, of each half a handful, Raisins ston'd two ounces, boyl them in four pounds of Fountain Water, will a third part of it be consum'd; then add of White­wine half a pound, strain it, let it be sweeten'd (if need be) with Syrup of the five roots two ounces, let six ounces be taken warm twice or thrice a day a good while after meat.

For such as have a Cold and Flegmatick constitution, let a Decocti­on be prepar'd of the Wood Guiacum, Sassafras, Sarzapar: With the addition of the foresaid Ingredients make an Apozeme, where­of let six or eight ounces be taken twice or thrice a day warm.

For Poor People, and often to the Rich, I use to prescribe, with good Success, a Decoction of the dryed Leaves sometimes of Sage, some­times of Betony, Vervain, or of Rosemary, made in fountain Water, and then impregnated with the Tincture of the Powder of Coffee-berries, to be taken twice a day warm to six or eight Ounces.

3. But, if with the abounding Serum, Particles also saline, acid, bilous, or otherwise infesting, are violently carried into the Mem­brances of the Head, either wholly from the Mass of Blood, or by the Mediation of this, as receiv'd from the Viscera, and there being fix'd, cause more acute and lasting Pains; then it will be proper some­times to repeat a spare Bleeding, and also a gentle Purging: to ap­ply Anodyne, and mitigating Epithemes to the Places affected, and al­so often to give gentle Hypnoticks by frequent changes, Apozemes al­so, and Juices, and Expressions of Herbs, that allay the Fervour of the Choler, and gently carry it off by Seige and Urine, are of excel­lent use: but in the mean time, let smart or strong Medicines, whe­ther they operate by Seige, Urine, or Sweat, in regard they too much fuse, and exagitate the Blood and Humours, be carefully avoided. I have often observ'd in Persons troubled with an acute and obstinate Pain of the Head, that the Serum swimming on the Blood, when let forth, have been ting'd with a Yellowness, or with bilous excrements incocated in it: and that also in this Case a spare and frequent Bleed­ing, and afterward a free drinking of Whey and Spaw-Waters, have given a notable Relief, and beyond other Remedies.

4. Moreover, if the Parts of the Head suster through the Fault of some one of the Viscera, as of the Stomach, Liver, Spleen, Womb, or any other, (by reason of the Transmission of the ill Ferment) then in the Cure of the Disease, let such Remedies as regard the Viscera be [Page 375]administred together with Cephalicks: hence, to certain Persons trou­bled with the Head-ach, whose Stomach also is in a Fault, Elixir Pro­prietatis, Mynsichts Elixir of Vitrol, Tinctura sacra, Vitriolum martis, the compound powder of Aron Roots, and other things vulgarly account­ed for Stomachals, often do good; to others whose Heads participate of the evils of the Spleen, Chalybeats often give help: Some Women sometime find ease of their Head-ach by hysterick Remedies; in like manner, when the Faults of other Parts contribute to the Head-ach, let the coindicated things taken from those Parts, be joyned with the first things indicated.

5. Sometimes the nutritive Juice is the Cause of a periodical Head-ach; viz. in as much as being mix'd with the Blood, and not duely assimilated, it causes a Turgescency in it by reason of its disagreeing Particles; so that the Blood boyling to the Head, throws off its Re­fuse in its Meninges, or certain Parts of them predispos'd for it; and so irritates the Fibres to painful Convulsions. For this Reason, I have known many to have been obnoxious to a daily Head-ach after the Measles, Small-Pox, and other Fevers or Sicknesses, with which the Mass of Blood is wont to be vitiated; viz. so many Hours after Meals, sometimes sooner, sometimes later, first a flushing of Blood in the Face, then a Plentiude and Pain in the Head infested them: more­over, after drinking of Wine, or eating of turgid Food, they were more severely punish'd. The Access of the Distemper is wont to hap­pen sooner or later after they have eat or drunk according as the Chyle begins to grow turgid either a little after its first entrance into the Blood, or after it has stay'd some while in it.

This affect is free from Danger, and for the most part is easily enough cur'd. After a Provision being made for the whole, a gentle Purge, and sometimes blooding being ordered, Remedies which re­store the Crasis of the Blood, such as are chiefly antiscorbuticks, and Chalybeats, prove mighty beneficial.

Take Conserve of Fumitory, Tansey, Wood Sorrel, of each two Ounces, compound Powder of Aron Roots three Drams, Ivoy, Crabs Eyes, Coral prepar'd, of each a Dram and a half, powder of yellow Saunders, Lig­num Aloes of each half a Dram, Vitriol of Mars a Dram, salt of Worm­wood a Dram and a half, syrup of the five Roots what suffices, make an Electuary: let the Quantity of a Chesnut be taken in the Morning, and at five a Clock in the Afternoon, drinking after it three ounces of the following Liquor.

Take Water of the Leaves of Aron, Vervain, and of the Flowers of El­der of each six Ounces, magistral Water of Snails, and Earth-worms of each two Ounces, Sugar on Ounce, mix them.

Various Medicines, wont to be us'd against the scorbutick Diseases of the Blood, may be rang'd here, and giv'n with good Success; for Head-aches, which are so familiar in the Scurvy, oftentimes proceed from [Page 376]the Fault of the Blood perverting the nutritive Humour, and dischar­ging its Recrements in the Membranes of the Head: wherefore, the Remedies mention'd by me elsewhere against that affect, claim a place also here.

6. There remains yet another Humour, to wit, the nervous Li­quor, which being carried into the Fibres of the Meninges and other parts of the Head, sometimes becomes disproportionate to the Fibres by its own disagreeing nature, as it is sharp or otherwise degene­rate, sometimes twitches the containing Parts and irritates them into Convulsions or painful Distentions, as it strongly ferments with some other humour, viz. the nutritious or serous Humour flowing thi­ther.

The nervous Humour, where it is thus morbifick, either being vi­tiated in its whole Mass, brings a very great Injury on the Brain pre­dispos'd for it, or being faultless of it self, is perverted within the Fibres affected, and so becomes morbifick secondarily; the Cure of which then depends on the Restitution of the containing Parts; viz. If the Weaknesses of the Fibres, or their injur'd Conformations be amended, the Humour irrigating them, will presently be free from Fault, With what Remedies the Defaults of the Parts predis­posed for Head-achs are remov'd, we shall presently acquaint you.

Mean while, if the nervous Humour, being degenerate in its whole Mass, causes a great Offence to the Head predispos'd for Pain, let those kinds of Medicines, and that method be us'd, with which be­ing reduc'd to its due Crasis, and gently passing through those Fibres, it may irritate them little, or not at all: for which end, neither strong Purging, nor large or frequent Blooding are proper, in regard they exagitate the Blood and Humours, and impair the Strength, and consequently give a greater Acrimony and Rage to the nervous Hu­mour which was faulty before. But gentle Loosners, and a spare Bleeding, will now and then be of use; whereby the Viscera may be cleans'd, and the Mass of Blood be somewhat purg'd, and a way be prepar'd for other Medicines which will succeed the better after­wards.

Now the Medicines that render the nervous Liquor more friendly and benign to the Membranes of the Head, which are wont to be offended by it, are those which are vulgarly call'd Cephalicks, viz. whose Particles, being active enough, and withall fine and subtle, pass the Blood without any Turgescency or Tumult; and then insi­nuating themselves into the nervous Liquor, gently actuate it, and cause the Ductus's of the Nerves so to open themselves, that there­by the animal Spirits more freely irradiate all Bodies both sensible and motive, and inspire them without Swoonings, Convulsions, or anomalous Distentions.

These kinds of Remedies, tho not always efficacious, nevertheless often remove some Head-achs that are not very inveterate, and in others, tho never so obstinate, they frequently do good: moreover, those things that are prescribed against Pains of the Head, are also given against Affects of the Brain and Genus Nervosum, and on the contrary, the things that are prescrib'd in these are also given with good Success against those; viz. the Vertue of them being display'd within the Brain, does good against the Apoplexy, Palsie, Lethargy, and other Diseases allied to them, also within are moving Fibres against Cramps and Convulsive Motions; and likewise exert­ing their Forces within the sensible Fibres, they often relieve Pains.

Great stores of these Medicines are vulgarly set forth in Physical Books, but so, that their Plenty has brought either a Poorness or Con­fusion to the method of healing; those things which would do most good, often lying hid, or being concealed amon gst that confus'd heap of Remedies; even as Wheat is with more difficulty separated from much Chaff, than it is first gotten clean from the Ear. Therefore in this Case Provision being made for the whole, and then those things being given both by Dyet and Physick, which put a stop to or present­ly appease the Turgecencies of the Blood, let the Medicines call'd Cephalicks, or such as remove the Disorders of the nervous Juice, be prescribed to be carefully taken: I shall set down some few Forms of these.

Take Conserve of Flowers of Betony, and Clovegillyflowers of each three ounces, Powder of male Peony Roots half an ounce, bastard Dittany a dram, lignum Aloes, yellow Saunders of each a dram, red Coral prepared, Pearl, Ivory, of each an ounce and a half, Salt of Vervain a dram and a half, syrup of Peony flowers what suffices, make an Opiate; let the quan­tity of a Chesnut be taken, drinking after it of the following Julep, three ounces.

Take Water of Black-Cherries, Wallnuts simple, Vervain, of each four ounces, Water of Cowslip-flowers three ounces, compound Water of Peony three ounces, Sugar six drams:

Or, Take Leaves of Vervain, Mistletow growing on Apple-trees, of each ten handfuls, male Peony Roots two pounds, Mace, Nutmegs, of each half an ounce, Coriander Seeds an ounce, being slic'd and bruised, pour to them of fresh Milk eight pounds, (or of Milk seven pounds, Malaga Wine one pound) distill them with common Organs, let the whole Liquor be mixt. Let three Ounces be taken at a time.

Take Powder of male Peony Roots half an ounce, red Coral prepared two drams, Ivory, Pearl prepared, of each a dram, make a fine Powder of them all, add of Sugar dissolv'd, and boyl'd to a Consistency for Tablets in a sufficient quantity of Black-cherry Water, six ounces, Tincture of Co­tal a dram, make Tablets according to Art weighing half a dram, let [Page 378]three or four be eaten in the Morning, and at five a clock in the Afternoon, drinking after it a little draught of Tea.

Or, Take Tincture of Coral an ounce, take from fifteen drops to twen­ty twice a day in a little Draught of the Julep or distill'd Water.

Those that are of a cold or flegmatick Temperament, may take twice a day a Dose either of the Tincture of Antimony, or of Spirit of Ar­moniack impregnated with Amber or Coral, or of Spirit of Harts-horn, or of Soot in an appropriated Vehicle.

The use of Millepedes ought not here to be omitted, or set lightly by, in regard that their express'd Juice, distill'd Water, and also the Powder prepar'd of them, often contribute egregiously to the Cure of ancient and obstinate Head-achs. I might here propose many other Medicines of various kinds; nay, transfer hither, the forms in a man­ner, of all those which I have formerly heap'd together against con­vulsive Affects. But the most difficult thing of all concerning the Cure of the Head-ach, yet remains; viz. How the Conjunct, and fixt Cause of this Disease, consisting in the Weakness or injured Con­formation of the Fibres, may be heal'd or remov'd.

Now this, though it will be sometimes incurable, as when a schir­rous, or callous, or some other ancient and fix'd tumour, has possest the Meninges; nevertheless, since the Diagnostick of this is uncertain, and the Procatarxis of a Disease, how unconquerable soever it may seem, sometimes by a continued method of Cure is overcome; there­fore in every kind of Head-ach, as long as the Patient will admit of Remedies, let not a Physician be backward in prescribing those things that shall seem most proper.

Therefore in the first place, as we hinted even now, we must di­ligently endeavour, that the Fuel of the Disease being out off, and intercepted, the frequent Accesses of the Fits be stopt; for so the indisposed Fibres, whilst they are no longer molested, sometimes re­cover their sound state, Nature alone effecting the Cure.

The helps of the Art of Physick, indicated in this Case, are taken from Chirurgery rather than from Pharmacy; for whatsoever is ta­ken by the Mouth, passing through long Circuits, spends all its Vir­tue before it reaches the Membranes of the Head.

Amonst Chirurgical things, first Topical Remedies occur, and of those, Plaisters are of most advantagious use, and often prove very be­neficial. Let not these be extreamly hot, which may draw the Hu­mours more to the place affected, but moderately discussing and cor­roborative. I use to prescribe, Emplastrum de Minio, or Diasaponis, with a half quantity of Paracelsus's Plaister, to be applyed to the Place grieved after it is shaved, and to be worn for some time. As to the Ancients frequent use of Phenigms and Sinapisms, and to the present Practice of applying Vesicatories against violent Head-aches, sometimes to the whole hinder part of the Head, sometimes to the [Page 379] Sinciput: if at any time ease has ensued these not Topicks, it was for this reason, Because by those Administrations a mighty store of sharp Serum was voided from the Part affected.

Liniments of Oyls, and Unguents, tho freuently us'd, do little; because (as I gess) in case they penetrate deep, they render more lax the Tones of the Fibres, whereby they lye more readily open to the Incursions of the morbifick Matter; moreover, they stuff the Pores of the Skin, that the Effluvia do not evaporate: for the same Reason, in a manner, it is, that warm Fomentations, prepar'd of Aromatick, or other cephalick Decoctions, oftner do Hurt than Good, because they draw Humours towards the Parts affected, and withall, open the Pores and Passages, whereby they are more readily admitted; and therefore also it is, that bathing of the Head, by pumping Water on it in hot Baths, is used to Persons troubled with the Head-ach with no better Success: whereas, on the contrary, it would be good for many to wash their Temples, Fore-head, and Sinciput, every Morning and Evening, with cold Water: nay, to bath their Heads every Morning by pumping cold Water on it, or at leastwise, to dip it in a deep Ves­sel or Well.

Another Chirurgical help cryed up for the Head-ach, especially if violent and inveterate, is wont to be a burning or cutting of Issues in several parts of the Body: It's a thing without doubt, that these be­ing made in the Arms or Leggs, are both less troublesome, and prove somewhat beneficial; viz. inasmuch as they withdraw the fuel from the Part, and lead it far away from the place affected: Moreover, an Issue in the Nucha, and a Setaceum in the Neck, also in the lap of the Ear, or near it; and likewise a pellet of the Roots of Wild Black Hellebore stuck in the lap of the Ear perforated, inasmuch as they evacuate much serosity, and cause more to pass towards the emuncto­ries, viz. the Glands are often us'd with benefit. But there is a great deal of talk and a greater reputation concerning Cauteries ap­plied to the place griev'd, or near it, so that large Issues are made in the crown of the Head, or near the Commissures of the Sutures. If we measure the fruit of this practice from the success, it will ap­pear to be little and seldom beneficial, but often unfortunate; for I have not known any person cur'd by these kind of Cauteries, but ma­ny aking Heads to have grown worse thereby. And truly Reason dictates it; for wheresoever an Issue is burnt, a serous humour flows to that place from the whole mass of Blood, and consequently from the whole Body; and it is often heap'd together there in too great a store, that it may be constantly voided by that emissary: Wherefore about Issues, Inflamed swellings, pustules, and various humours eve­ry where arise: What therefore can we suspect less, than that Caute­ries being applied near the place griev'd of the Head, but they will cause the Morbifick matter to be more heap'd together there.

There remains yet another Chirurgical operation, extoll'd by many for an obstinate Head-ach, but tryed as yet by none (that I know) to wit, the opening of the Scull with a trepand Iron near the place of the pain: Our famous Harvey endeavour'd to perswade a Lady of great quality to this, who was troubled with a terrible and inveterate Head-ach, promising her a Cure thereby; but neither she nor any other has been content to admit of the administration: Truly it does not appear to me what certainty we may expect from the Sculls being opened where it pains; if an Abscess lay hid there, this were the only way of Cure; but that is wont to cause the sleepy, or mortal Convul­sive affects, rather than to take away the Head-ach: if an inflamed Swelling, or Pustules, or an Erysipela has seized the Diplois, I know not whether those tumours exposed to the naked Air will evaporate more easily, or whether remedies applied to them, when bare, will do any thing or not: And in case the pains arise by reason of the Me­ninges being beset with tubercles, or a schirrous, or callous Tu­mour, I judge the opening of the Scull will turn to little or no benefit.

But this being past by till it comes in practice, let us proceed to other things: And now let us consider whether Salivation be to be used for curing old and confirmed Head-achs; in truth if the pains arise from the Venereous Disease, I make no question but this way ought to be taken; but those that have tryed that kind of remedy, in Head-achs proceeding fro other causes, have not reaped a Harvest answerable to so laborious a cultivation; I confess the examples of certain persons have scared me from trying that method in those kinds of cases. A certain Lady of great quality (whose distemper I shall set forth beneath) for curing a violent and long continued Head-ach, has undergone three copious Salivations, viz. first by a Mercury Ointment directed by Sir Theodore Mayern, and afterward twic by ta­king the late famous Powder of Charles Huis, and this without any relief, (and I wish it were not with some detriment to her) for since for many years, even to this day, she has given ground to the cruel Tyranny of this distemper growing by degrees upon her. It fell out somewhat worse than this with that excellent man. D.G.D. for the cure of whose ancient Head-ach, when a Mercury Ointment was ap­plied to his Head pained, the Salivation raised thereby, made him blind, without curing the disease. Truly every man, duly considering the operation of Mercury in the Body of man, ought to dread these kinds of effects from the rash giving of it: For, not to ay that Mer­cury is malignant, or wholly venemous, viz. inasmuch as from its united Particles little or no hurt is caused; so that often a great quan­tity of Quick-silver is taken with safety enough; nevertheless, the Mercurial Corpuscles being divided, and separated from each other, (whether it be done by Chymical Salts, as in sublimated and preci­pitated [Page 381]Mercuries, or by percolation through the Pores of the Skin, when an unction is made) they presently become exorbitant and ma­sterless, and raise more turbulent commotions in the Body of Man than any Medicines besides: they sometimes infest the Ner­vous Parts first, wherefore by reason of the Fibres of the Ventricle, Intestines, and other of the Viscera being fretted, Gripes, horrible Vomitings, most sharp and often Bloody Stools, Cardialgias, Swoon­ings, and other terrible affects frequently happen soon after the Medi­cine is given: But sometimes the Particles of the Mercury, when they are not presently dissolv'd, without offending much the Viscera, scarce exert their forces before they are conveyed into the mass of Blood: Therefore being mighty active, and displaying themselves every way, they readily enter this, and presently infecting the whole, exa­gitate it, and often (when they are more fully dissolv'd) stir it to a great effervescency: then the Blood, to clear it self of the disagreeing Particles, beginning to ferment, delivers them that way it may, to the humours contained within it self, viz. the Serum, and Nutritious Juice, and throughly mixes them in it, and withal endeavours to discharge it elf of those, being imbued with so preternatural a mix­ture. Now this is not done easily, or plentifully enough by Urine, or Sweat, for the Liquamina of the Blood being become more viscid and gross, from the Particles of the Mercury incocted in it, than that they may pass the small colatories of the Reins or Skin, sometimes breaking forth (unless they are stopt) by the Caeliak Arteries, pass away upon raising a Diarrhoea or Dysentery, the intent of Salivation being thus letted or frustrated; but ostner the Latex being imbued with Mercury remaining within the Blood, which is also somewhat infected, and being carried violently with it hither and thither by the Veins or Arteries, butts against various Parts, and a way being made, either breaks forth outwardly, or is hurl'd into the Viscera, Membranes, and other Parts, often with great prejudice. Moreover, some Mercurial Particles also seem to penetrate the Brain, and insinu­ating themselves into the Nervous Juice, t be diffused not only through all the inward parts of the Head, but through all the Ner­vous Parts, and so in some sort to ferment the nervous liquor.

But in the mean while the Mercurial Serosities remaining in the Blood, are depos'd for the greatest part in the Glands, which are the proper emunctories of the Arteries: Wherefore, since about the parts of the mouth both a great many, and very great Glands are plac'd (to which a mighty store of Serum is sent for Spittle) and from those the open Ductus's by the excretory Vessels gape into the cavity of the mouth, certainly by this way chiefly, the envenom'd Latex of the Blood will find its passage forth, which it cannot readily do elsewhere. Wherefore, upon a Salivation being rais'd, the Blood long fermenting, like Wine or Beer purging it self, throws off by [Page 382]the Ductus Salivales, and the innumerable Meatus every where ga­ping into the Mouth, whatsoever extraneous and degenerate sub­stance it may either contain within it self, or can drink up, or receive from elsewhere, be it from the Viscera, or solid Parts, or from other humours. Moreover, it is likely, that as the off-scowrings of the Blood, so also those of the Liquor that irrigates the Brain, and Ner­vous Appendix, being stirr'd upon the entrance of the Mercury, are voided forth also this way, viz. by the Ductus Salvales.

Therefore a Salivation caus'd by Mercury, if haply it succeeds well, removes sometimes difficult and indeed Herculean distempers, and such as will not be mastered by any other Remedies, viz. foras­much as this operation, by a long expurgation, throughly cleanses the Blood and nervous Juice, and other humours, destroys all exotick serments, quells the enormities of Salts and Sulphurs, and also exagi­tates the morbifick matter sticking any where, or stagnating, and often leads it forth.

Nevertheless, this Medicine is not always free from danger, viz. because the Mercury being become exorbitant, and carrying with it a mighty store of most sharp, and as it were, envenom'd Serum, and rushing violently into the noble Parts, and especially the Brain; with the appendixes, both medullary and nervous, or into the Lungs and Praecordia, brings upon them an indelibel, and sometimes a mortal prejudice: Wherefore, in an ancient and fore Head-ach there is dan­ger lest the indispos'd Fibres be more irritated by the Mercury per­vading them with much and Corrosive Serum, and be put upon greater Convulsions and painful Corrugations: And also, lest upon the mighty recourse of Humours to the Head, the Brain be invaded, and consequently (which happens too often) lest the sleepy or Convulsive affects be caused: I would have discoursed more concerning these things, because it is of a great concern, but that we daily expect an exact method of Salivation, and a full account of it, as to its ways and effects, advantages or disadvantages, to be set forth by the Leanred Physician, Dr. Needham.

From Chirurgery there remains yet another famous remedy for cu­ring inveterate Head-achs, viz. the opening of an Artery: Some of the moderns use this, and very much extoll it, it being greatly account­ed of amongst the Ancients: Nevertheless, as far as it has appeared to our observation, success has often been wanting to that so much cryed up operation: Nor is it a wonder, because that ground on which the Ancients relying, blam'd the Arterious Blood, as differing from that of the Veins, and more exorbitant, and therefore advised it to be let forth, does not hold good: Nor indeed is thereany other reason, wherefore Blood drawn from an Artery rather than from a Vein near the place grieved, should give ease, but rather on the contrary we may expect a greater help from the opening of a Vein; because an [Page 383]Artery being emptied, receives and draws away nothing from the part affected; but a Vein being opened, in the place of the Blood issued forth, draws from the whole Neighbourhood, and often drinks in again, and restores to circulation the Blood, and other humours heaped together, and Stagnating near the seat of the Disease. How­ever, lest we recede too far from the practice of the Ancients, attribu­ting nothing to Arteriotomy, we grant that sometimes haply it gives help tho, not immediately and causally, but only by way of consequent, and per accidents, viz. forasmuch as the ends of a cut Artery grow together, so that the passage for the Blood that way is stopt for the time to come; hence in regard somewhat a less store of Blood is brought towards the place by the Arteries, and an equal quantity is still carried away by the Veins, therefore it sometimes happens that the fuel of the morbifick matter is diminished, and that its flock is consumed by degrees. For this reason that administration has often succeeded well in distempers of the Eyes. Moreover, Farriers use a practice not unlike this for curing malignant tumours in Horses Legs; to wit, they take and bind the Artery by which the matter flows to the part affected; mean while that which was there sticking, partly evaporates, and partly is drunk up again by the Vein. I have heard that in a manner the same method was successfully tryed by our Har­vey, for curing strumous and schirrhous tumours also in the Body of man. I might here set down many other kinds of Remedies, and also Prescripts and forms of Medicines which are wont to be used both by Physicians and by Empiricks, for curing Head-achet; but the Books of Physicians abound too much with these. I shall now give you some rare cases of Persons troubled with the Head-ach, and first some examples of a most severe continual Head-ach, which also, the cause being invincible, has often proved fatal.

A Woman, fifty years of age, after that she had been ill for about six months with a very great pain of her Head, troubling her almost continually under the Sagittale Suture, and yielding to no Method or Medicines, fell at length into a Lethargy, with a Partial resolution of her Limbs, from which nevertheless being in a short time reco­vered by remedies seasonably administred, she had again the violent pain in her Head as before, and afterward within a fortnight or three weeks falling into a sleepy affect, she departed this life: The Scull being opened, on the side of the third Sinus, a schirrhous tumour three fingers broad grew to the Membranes, by the mediation of which, the Dura Menix also for some space grew to the Pla; and the Blood Vessels which ought there to open into the cavity of the Sinus, were stopt; moreover, both the outward Anfractus of the Brain, and [...]its inward cavity, were filled with clear water. From these observations the invincible, and at length mortal cause of that Disease may plainly appear. I remember formerly to have observed [Page 384]by Anatomy a case like to this, in a certain other Person. Moreover, in regard I judge that in many Persons troubled with the Head-ach, the Disease depends on such an invincible cause, I shall here give you one instance that is quite fresh of that kind of affect.

Some few years since I was called to see a Lady of Quality, troubled for above twenty years with a Head-ach, which at first was intermit­tent, but of lat eis almost continual. She was endowed with admi­rable gifts both of body and mind, so that she was excellently skilled in the Liberal Sciences, and all Learning, above the condition of her Sex; but (as tho Nature thought it too much for her to enjoy so great endowments without some affliction) she has suffered very sore­ly from this disease: Before she was eight years of age, upon her recovery from a dangerous Fever, she became obnoxious to pains of her Head, which were wont to arise sometimes of their own accord, but oftner on some light occasion offered; the disease being not li­mited to one place or part of the Head, sometimes infested the right side, sometimes the lest, and often its whole circuit. During the ac­cess (which seldom ending within the space of twenty four hours, often infested her for two, three, or four days) she could not endure light, speech, sound, or any motion; but sitting upright in her Bed in a darkned room, she was able to speak with none, nor to take any rest, or food: at length, as the Fit declined, she used to fall into a deep and troubled sleep; from which awaking, she was wont to be better, and then by degrees to recover, and during the time of inter­mission to be indifferently well. Formerly the Fit being raised only occasionally, seldom returned within twenty days, or a month, and then afterwards much more frequently; but of late she is seldom free from them. Moreover, through many occasions, or rather evident causes (such as are the changes of the Year, and of the Air, the great Aspects of the Sun and Moon, violent passions, and errours in diet) she is sorely tormented with them. Now tho this affect having sorely afflicted this noble Lady (when I went to see her) above twenty years, and pitching its Camp near the Confines of the Brain, had so long besieged its Royal Fort, however it had not yet gotten possession of it: But the diseased being free from a Vertigo, Scotomia, Convulsive affects and any sleepy symptom, had still the chief Faculties of her Soul whole and sound.

In order to the obtaining, or rather endeavouring a Cure, through­out the whole progress of the Disease, a great many Remedies, pre­scribed by most skilful physicians, as well of our Country, as Fo­reigners, were used without any success, or ease: She tryed all the Great Remedies of every kind and form, but always in vain: a great many years since she underwent a long-continued, and most trouble­some Salivation, by a Mercury Ointment, so that she incurred a great danger of Life. Afterward a Cure was twice undertaken by a Flux, [Page 385]tho to no effect, by a Mercury Powder, (which the famous Empirick Charles Huis generally gave): She tryed hot Baths, and drank Spaw­waters almost of every Country and Nature, with the like success as the rest: She was frequently blooded, and once in an Artery; she went with many Issues, made sometimes in the Sinciput, sometimes in the hinder part of the Head: She took the Air in divers Countreys, viz. besides her Native, that of Ireland and France: She took Medicines of all kinds what­soever; to wit, Cephalicks, Antiscorbuticks, Hystericks, all famous Speci­ficks, nay, and Empirical Remedies, given both by the learned and un­learned, by Mountebanks and old Women; yet she declared that she had not received any where from any remedy, or method of Cure, the least help or relief: But the refractory and obstinate Disease, be­ing deaf to all inchantments of Medicines, would not be mastered. Moreover, having possessed so long the precincts of the Brain, tho it could not enter its recesses, yet when I went to see her, extending its limits into certain other parts of the Genus Nervosum, it began to raise violent pains in the Limbs, also in the Loyns and Abdomen, such as are usual in a Rheumatism, and in a Scorbutick Cholick.

A worthy man, about forty years of age, robust, and sound, when, upon riding a whole day in the rain, he had gotten cold, by reason of the hinder part of his Head being continually wet, soon began to feel a pain in that Part, which in a short time being very much en­creased, miserably afflicted the Diseased both day and night, and kept him in a manner, always without sleep. Blooding, Purging, Cly­sters, Vesicatories, Hypnoticks; nay, and a great many Remedies of all kinds, diligently administred by the joint advice of a great many Physicians, did little or nothing towards the Cure of this affect: When the Disease, notwithstanding all these, daily grew worse, after six weeks, Glands, preternaturally swoln and painful, arose all over the Neck, the Hemicrania in the mean while abating nothing: Moreover, the Tendons of the Neck being very much distended, and stiff, pro­ved very tedious to him; to which in a short time, Convulsive mo­tions, and leaping of the Tendons succeeded in various Parts, with a Delirium; and at length the Diseased being worn out with pains and watchings, yielded to Death.

As in the foregoing cases, the Head-aches proceeded from Nodes and tubercles of the Meninges, so sometimes mortal and incurable Head-achs arise from a Phlegmon and Abscess. A while since, a University Scholar, after he had complained for a fortnight of a very great Head-ach, afflicting him almost constantly; at length the Fever becoming stronger, presently Watchings, Convulsive motions, and a talking light-headed ensued; at which time a Physician being called, Blood­ing, Clysters, Playsters, Revulsives, Vesicatories, also inward Reme­dies for withdrawing the course of the Blood and Humours from the Head, being carefully administred, he could do no good, but Death [Page 386]in a short time followed. The Scull being opened, the Vessels spread over the Meninges were filled with Blood, and very much distended, as tho the whole mass of Blood had flown thither; so that the Sinus's being dissected and opened, above half a pound of Blood flowed forth: Moreover, the Membranes themselves being affected through­out with a Phlegmonous tumour, appeared discoloured: These cover­ings being taken away, all the Anfractus of the Brain, and its Ven­tricles were full of clear water; and its substance being too much irrigated, was moist throughout, and nothing firm: For the Blood being there heaped together, when it could not circulate, threw off from it self a plentyof Serum, by which the whole Head was soon floated; so that the Disease, curable haply at the beginning by Phlebo­tomy, afterward became mortal.

I remember another University Scholar, who after being constantly, and very sorely afflicted with a Hemi [...]ania under the temporal Suture for three weeks, fell at last into a fatal Apoplexy. The Head being opened, a Phlegmon had grown in the Meninges near the place pain­ing, from which at length suppurated and broken, the Sanies falling on the Brain, had affected its substance with a lividness and cor­ruption.

But tho a continual Head-ach (especially if it be drawn in length for many weeks without intermission) be not without danger, never­theless we must not presently despair of its Cure, because the cause of this, how fixed and immovable soever it may seem, is often cured by a long use of Remedies, nay, sometimes without them, by Time and Nature; tho in a case that is almost desperate, there is need of some Physick, lest the present affect pass into a worse, viiz. into a sleepy or Convulsive distemper. So much of the continual Head-ach; it now remains for us to propose some Examples, and some rare Instances of an intermittent Head-ach.

Therefore, not to set forth here cases of the Head-ach, whose Fits being erring and uncertain, proceed from the Blood or Serum rushing into the places affected, in regard that these are very frequent, and vulgarly known. I shall now set before you certain choice Ob­servations of this Disease, being either periodical, or seeming to arise from some one of the Viscera, per Consensum. As to the Former, the period [...] invasions of the Head-ach are produced either from the nu­tritive Humour, or from the nervous Juice; I shall now give you example of both.

A venerable Matron, in the forty fifth year of her age, being of a thin habit of Body, and a bilous temperament, after having liv'd for a long time obnoxious to Head-achs wont to be occasionally rais'd; about the beginning of Autumn she began to be troubled with a peri­odical Head-ach: This affect seizing her about four a clock in the Afternoon, was wont to hold her almost till midnight, till the diseased [Page 387]being tired with watchings and tortures, was forced to fall asleep; then after a pretty prosound sleep, upon her awaking in the morning she was well. The Diseased having undergone daily Fits of this Disease for three weeks after this manner, delay'd the use of Physick, which she very much abhorr'd; but at length her appetite being dejected, and her strength worn away, she was forc'd to desire a method of Cure, and after a gentle Purge and blooding, she took twice a day, for a week or a fortnight, the quantity of a Chestnut of the following Electua­ry, and grew perfectly well.

Take Conserve of the Flowers of Cichory and Fumitory, of each three ounces, compound powder of Aron Roots two drams and a half, Ivory a dram and a half, yellow Saunders, Lignum aloes, of each half a dram; Salt of Wormwood a dram and a half, Vitriol of Mars a dram, Syrup of the five Roots what suffices; make an Electuary.

The cause of this periodical Head-ach doubtless was, that the as­similation of the Chyme, or nutritive Humour into Blood was hin­dred. For when its store received into the mass of Blood could not be overcome, it was wont, after a little stay, to fall at odds, and fer­ment with its particles: Therefore presently the Blood falling into a turgescency, that it might shake off that incongruous mixture, depos'd its recrements, as on other Parts, so chiefly, and with a greater sence of offence on the Fibres of the Meninges, being before weak, or injur'd in their conformation, so that the pain lasted till the heterogeneous particles, boyling by their mutual congress, either were subdued, or did exhale

A handsome, tall, and slender Woman, long and sorely obnoxious to cephalick affects, was wont to be infested sometimes for many days, nay weeks, with a violent Head-ach, which seiz'd her daily at her awake early in the morning, and afflicted her for three or four hours: In the mean space she was also affected with a heaviness of the whole Head, a deadness of the Senses, and a stupidity of Mind: which affects va­nishing together with the pain before Noon, like Clouds disperst, left all things calm and serene: Till the next morning they possest again the Brain like a sogg and dark mist: For curing these distempers, I pre­scribed parging Pills, a spare Bleeding, Vesicatories also, and the use of Spirit of Harts-horn, or of Soot, with Cephalick Juleps, or Waters.

In this Gentlewoman the pains of the Head rather followed sleep than was cur'd by it; because in this morning Head-ach the morbifick matter resided in the nervous Juice, whose greatest curdity, and ag­gravation about the Head, happen presently after sleep; but the other evening fit of this disease, in regard it depended on the plenitude and turgescency of the nutritive liquor within the mass of Blood, therefore hapned so many hours after dinner, and was not mittigated but after sleep, which appeases the disorders of the Blood.

Tho the Experience and Complaints of sick Persons manifestly shew that Fits of the Head-ach sometimes arise by consent from the other Parts, viz. the Womb, Spleen, Stomach, &c. Nevertheless it as clearly appears from the accounts of them, and the Phoenomena being duely considered, that this is done by another means than by Vapours rais'd from the Viscera affected to the Head. And first, as to the pains of the Head seeming to be rais'd from a Womb, nothing occurs more frequently than for violent Head-achs to ensue upon the suppres­sion of the menses or lochia: moreover, tho the menses observe their due course, yet some Women are wont to be afflicted with a violent pain of the Head just as they are coming, others as soon as they are past: But yet, tho at the same time that the Head is affected, the Womb is also, yet it does not follow that the Injury is convey'd immediately from this to that: but it is the Blood it self which fixes the morbifick matter on the Head; viz. it sometimes perversly conveys it, being en­gendred within its own bosom, and design'd for the Womb, into the Meninges of the Brain: and sometimes withdrawing it from the Parts of the Womb, it delivers it to the Head with a greater mischief. This Aetiology agrees also with the Head-ach, vulgarly imputed to the Sto­mach, Spleen, and other Parts.

A beautiful young Woman, of a thin habit of Body, and a hot Blood, having been obnoxious to an hereditary Head-ach, was wont to undergo frequent Fits of it, and those coming at random, to wit, some happening on a light occasion, and others arising of their own accord, that is, without any evident cause. On the day before the spontaneous access of the Disease, being very hungry in the Evening, she greedily eat a plentiful Supper, with a hunger-starv'd, not to say Canine appetite, most certainly fore-knowing by this sign that a pain of the Head would seize her next morning, which sign never fail'd of Event; for as soon as she awak'd, being afflicted with a most cruel torture throughout the Sinciput, she was affected likewise with a vo­miting of a humour, sometimes acid, and as it were vitriolick, some­times bilous, and extremely bitter; it hence seeming to appear that that Head-ach had its rise from the fault of the Stomach.

To undertake to give the reason of this, in the first place it is known that a vomiting ensues upon the Head's being injur'd, viz. after a stroak, Wound, or a fall from an high place; nevertheless, a pain of the Head seldom or never follows a vomiting, Cardialgia, or the Sto­machs being otherwise troubled, unless an effervescency of the Blood happens. Wherefore, in the foresaid case of the Person diseas'd, since it plainly appear'd that the Meninges of the Brain were predispos'd for Head-aches, and that its Fits had raised an agitation of the Blood; hence it will be obvious to conceive, when the heterogeneous Parti­cles by reason of the fault of Chylification, were heap'd together in the mass of Blood to a fulness, presently upon its beginning to flow in [Page 389]order to the expulsion of that which was offensive, they being severed from the blood, as disagreeing with it, and partly being sent from the Arteries into the Ventricle, stirr'd up its ferment, and so produc'd hun­ger, and partly rush'd into the predispos'd Meninges of the Brain, and there depos'd the fuel, or rather incentive of the Head-ach which was presently to ensue. This Patient loathing all Medicines, and refu­sing undergo any method of Cure, became at length also obnoxious to paralitical and convulsive affects. From what is said it will be ea­sie to give the Aetiology of any other Head-ach; viz. hypochondria­cal, hepatical, or otherwise sympithical, so that it will not be needful to add here more Hystories or Observations.

CHAP. II. Instructions and Prescripts for curing the Le­thargy.

HItherto we have described with what Disease chiefly, and how diversly the precincts of the Head, or the Coverings of the Brain are wont to be affected: Now, descending to its inward Parts, and to its cortical Substance, which immediately lyes under those Coverings, let us see to what affects chiefly this Part is found to be obnoxious. We have shewn elsewhere that the Cortex of the Brain is the Seat of Memory, and the Entry of Sleep; wherefore we justly ascribe to the cortical part of the Brain that Disease which is wont to cause an excess of Sleep, and a defect, or eclipse of the Memory, to wit, the Lethargy.

The word Lethargy is wont to signifie two kinds of affects, which are only the act and disposition of this Disease; for those that are said to be troubled with a Lethargy, either altogether keeping their Beds, through a very great Invasion of it, are so far overwhelm'd with Sleep, that they are scarce able to be rais'd by any impression of a sensible Ob­ject: nay, and if hapy they open their Eyes, or raise their Limbs up­on pricking, or a smart stroak, presently becoming insensible again, they sink down, and often, when they are left to themselves, falling into a perpetual Sleep they dye out right: which kind of Fit has very often a Fever joyn'd with it, though when the diseased awake, and come perfectly to themselves, for the most part it ceases of its own ac­cord. Or secondly, those are accounted for Lethargical, who being opprest with an immoderate deadness of the Senses, are in a manner [Page 390]always prone to sleep: so that in walking, nay whilst they are eating or doing any other thing, they now and then fall into a dead Sleep: and since there are divers degrees of this Sleepiness, and various manners of affecting, hence also there are made many Species of the Lethargick Disposition. at present we shall speak of the former Lethargy, and so properly called, and afterward of the continual Sleepiness, also of the Coma, Carus, and other sleepy affects allyed to them: and likewise of continual Watching.

Mean while you may observe, that almost in every kind of Lethargy, a Drowsiness or Sleepiness, and Forgetfulness are always present, as Pathognomick Signs, and equally attend it. Wherefore, that the for­mal Nature and Causes of the Lethargy may the better be known, We must first enquire here concerning Sleep and Oblivion, what they are, and for what causes they are rais'd.

The Essence of Sleep consists in this, that the corporeal Soul with­drawing it self a little, and contracting the Sphere of its Irradiation, in the first place renders destitute the outward part of the Brain or its Cortex, and then all the outward Organs of Sense and Motion of the Emanation of the Spirits, and closes the Doors as it were; so that they being called in for refreshment sake, lye down, and indulge them­selves to rest: mean while the pores and passages of the outward part of the Brain being free, and void of the Excursions of the Spirits af­ford a passage to the Nervous Liquor distilled from the Blood for new Stores of Spirits. In natural and usuall Sleep, these two concauses conspire and happen together as it were by some mutual compact of Nature: viz. at the same time the Spirits recede, and that nervous Humour enters: but in nonnatural, or extraordinary Sleep, sometimes this cause, sometimes that is first: for either the Spirits being weary or called away withdraw themselves first, and afford an entrance to the Nervous humour heaped together in a readiness for it: or a plenty of Nervous humour coming to those Places, and making a way by force as it were, repells the Spirits, and entring their Passages, floats them as it were. Concerning Oblivion, or the Eclips or defect of Me­mory, the cause of this is wholly the same as of immoderate Sleep, viz. an Exclusion of the animal Spirits from the passages of the outward part of the Brain, which are filled with some Humour, and their return prohibited for a time.

Preternatural Sleep or insatiable Sleepiness (which is the chief Symp­tom in the Lethargy and in the sleepy Effects) seems to arise wholly from the same causes as non-natural Sleep, rais'd to a greater Energy, viz. either the animal Spirits being first affected leave the outward part of the Brain, and yeild an entrance not only to the Nervous, but like­wise to the Serous, or otherwise vitious Humour, or the serous and excrementitious Humours together with the Nervous force open the cortical Gates of the Brain, and floating as it were its Pores and Passages, [Page 391]repell and drive away the Spirits thence: sometimes this Cause, some­times that is the first and chief, and sometimes both happen toge­ther.

Therefore the conjunct Causes of the Lethargy are, 1. a heaping together of a redundant or incongruous Humour within the Pores of the cortical part of the Brain; which depends on other, both proca­tarctick and evident causes: As to the former, both the Blood uses to be in fault, in that it sends morbifick matter to the Part affected, and the Brain it self, in that it admits it too easily. The evident causes which joyn with these are chiefly, Over-eating, Drunkenness, and espe­cially immoderate drinking of Wine and hot Waters, then upon such an Excess to sit up all night, or to sleep in the open Air: Moreover, a long suppression of an usual evacuation of Serum by other ways; Also if Spaw-waters, drank in a large quantity, are not presently discharg'd again by Urine, they threaten a Lethargy; the same also is caused by the recrements of other Diseases, coming to an ill or no Crisis, convey'd to the Head: so that a Lethargy happens upon acute, or long continued Fevers, and other Cronick Diseases, and very often upon a Head-ach, Frensie, Empyema, and Cholick.

2. In regard, as non-natural, so sometimes preternatural sleep be­gins from the Spirits being first dejected; therefore the other Conjunct cause of the Lethargy consists in a stupefaction inflicted on the Spirits, which proceeds either from Opiats taken inwardly, or from narcotick particles engendred in the Body.

The sum of what is said concerning the Lethargy, is this, that the animal Spirits residing in the outward part of the Brain being stop'd from their wonted motion and emanation, yield to a profound and in­satiable Sleep; Now they are stop'd either through their own fault, in as much as being spent, or affected with a stupefactive force, they are congeal'd as it were; or because their Paths or tracts are obstruct­ed in the outward part of the Brain, and are possess'd by a strange guest, so that they have not a space granted them fit for their ex­panson.

The chief Symptoms of this Disease, are Sleep and Forgetfulness; a cessation of every other knowing, or spontaneous function, an uneven and slow respiration, a Fever, and often the affect growing worse, Cramps, leapings of the Tendons, and lastly, universal and mortal Con­vulsions.

The prognostick of the Lethargy is included in very narrow bounds; for the Fit of the Disease being for the most part acute, is soon termi­nated in Death, or a Recovery, and most commonly is wont to give more cause of fear than hope.

If it happens upon a Fever that is malignant, or of a difficult deter­minations, or if upon other cephalick or convulsive Diseases, as the Head-ach, Frensy, Mania, Epilepsy, or also if on a long continued or [Page 392]severe Cholick or Gout, the Physician can prognostick nothing but ill, nor is it less to be fear'd, if it happens in a cacochymical Body, or in one long subject to sickness, and in old age.

In like manner, it is an ill Omen, if the Diseas'd being presently overwhelm'd with a great deadness, and becoming almost Apoplecti­cal, cannot be awak'd, if he breaths unevenly and flowly, or with great snoarings: Moreover, if the Disease growing worse and worse, the sick Person be affected with Tremblings, Cramps, leapings of the Tendons, and lastly, with convulsive motions, he is to be look'd up­on as in a desperate condition.

But if the affect without any great Procatarxis, be rais'd by an evi­dent Cause alone, as from over-eating, drunkenness, the use of Nar­coticks, or from a stroak or wound of the Head that are not very dan­gerous, we may expect a less fatal event. Moreover, if the affect ari­sing on such an occasion, happens to a Body which was sound and robust before, if at the first invasion it does not wholly take away the Sense and Memory, and after a little time the symptoms begin to remit, we may not despair of such a sick Person.

In any Lethargy, if the cause of the Disease seems somewhat to be shaken and mov'd, so as plentiful and laudable evacuations by Sweat, Urine, or Seige happen by the help of Medicines, or by the instinct of Nature, and give ease; if upon the application of Vesicatories, a great glut of filthy Waters flows forth; if inflamed swellings, or great pushes arise behind the Ears, or in the Neck; if a great sneezing with a dropping at the Eyes or Nose shall happen, we may thence conceive some hope of recovery. And sometimes an Empyema hapning upon a Lethargy, puts an end to it, viz. inasmuch as the morbifick matter which was fix'd in the Head, and first caus'd the Lethargy, being af­terward drank up again by the Blood, and depos'd in the Breast, pro­duces the Empyema: In the description of the Epidemical sleepy Fe­ver, which reign'd An. 1661. we have observed that this hapned to many.

Concerning the Cure of this Disease, since it allows no truce, we must not be long deliberating: After the injection of a smart clyster, presently let a Vein be open'd; for the Vessels being emptied of Blood, more readily drink up again the Serum, or other humours de­pos'd in the Brain: Moreover, I advise in this case the Jugular Vein to be open'd, rather than a Vein of the Arm, because by this means the Blood very much heap'd together, and haply stagnating within the Sinus's of the Head, will be more easily reduc'd to an even circu­lation.

After Bleeding, other Remedies of every kind are presently to be applied to use; let large Visicatories be applied to the Neck and Legs; the Faces and Temples are to be anointed with Oyl of Amber, or Ce­phalick Balsams; let Cataplasms of Rue, Pepperwort, or Crowfoot, well [Page 393]pounded together with black Soap and Sea-Salt be applyed all over the Feet, let smart frictions be us'd to the Limbs, let Salt of Ʋrine, or Spirit of Sal Armoniack be frequently held to the Nostrils.

In the mean while let Cephalick Remedies be now and then taken.

Take Water of Peony Flowers, Black Cherries, Rue, Walnuts sim­ple, of each three ounces, compound Peony Water two ounces, Ca­storeum tyed in a Nodulus and hung in the Glass, two drams, Su­gar three drams, mix them, make a Julep; let four or five spoon­fuls be taken every third or fourth hour; moreover, to each dose of this add from twelve to fifteen drops of Spirit of Harts-horn, Amber, or Sal Armoniack, or a paper of the following Powder.

Take Powder of Male Peony Roots, Mans Scull, Roots of Virginia Ser­pentary, Contrayerva, of each a dram; Bezoar, Pearl, of each half a dram; Coral prepar'd a dram, make a Powder, divide it into twelve parts.

Moreover, it is here to be considered, whether a purging by Vo­mit or Seige ought not to be ordered just at the beginning. I know that this is variously controverted amongst Authors, and I have known it us'd in practice with a various success: which being considered, and compared betwixt themselves, I shall briefly declare what is my opinion.

If a Lethargy has arose from a fresh over-eating, or being drunk, or if from taking improper and narcotick things, presently let a vomit be raised: Wherefore, let Salt of Vitriol be given, with Wine and oximel of Squils; or in robust Persons, an infusion of Crocus Methallorum, or Mer­curius Vitae, with Black-Cherry Water: and afterward, unless it works of its own accord, let a Vomit be provoked, by thrusting a Quill into the Throat.

But if the invasion of the Disease happens upon a Feaver, or other Cephalick affects; or if it be raised primairly, or per se, by reason of a Procatarxis first laid in the Blood, or in the Brain, Vomits and Purges given presently at the beginning, whilst the matter is flowing, are wont oftner to do more hurt than good: to wit, inasmuch as whilst the humours are in motion, those Medicines more exagitate them; and since they are not yet able to subdue them, and lead them forth, they drive them into the part affected.

On the second day, if the dead sleepiness be not yet remitted, let bleeding, in case the Pulse indicates it, be repeated, or in its stead let Blood be taken away in the Shoulder-blades by Cupping-glasses af­ter Scarification: Then a little afterward let an Emetick Medicine (if nothing prohibits it) or a Cathartick, be given.

Take Sulphur of Antimony five grains, Scammony sulphurated eight grains, Cream of Tartar six grains; mix them, make a Powder, let it be given in a spoonful of the Julep prescribed.

Or, Take Scammony sulphurated twelve grains, Cream of Tartar fifteen grains, Castoreum, three grains, make a Powder: give it after the same manner: Mean while let the same, or the like altering or deriving Remedies be still continued.

On the third day, and afterward, those things which at the begin­ning of the Disease were forbidden for fear of a new fluxion, viz. Err­hines, Sneezers, and Apophlegmatisms ought to be us'd. Moreover, then it will be sometimes profitable to apply the warm Viscera of a fresh kill'd Animal to the Sinciput, after that the Hair is shav'd or cut, and now and then to change it; and sometimes also to foment those pla­ces with a cephalick and discussing Decoction: But beyond other To­picks, I have known great relief given by a large Vesicatory, raising Sores that ran very much all over the Head: I saw two Lethargical Persons cured chiefly by this Remedy, after that the Disease was protracted in length, and therein having lost not only the memory, but even all knowledge: for in both, the excoriated places, in regard they could not easily be covered with an Eschar, discharg'd a vast quantity of a thin Ichor, to wit, daily about half a pound. It will not be needful for us to describe or set down other Medicines of this kind, they being vulgarly and every where to be found, what remains, for the illu­strating of what is said before, I shall give you some Histories of sick Persons.

A Husbandman about thirty years of age, of a phlegmatick tempe­rament, inclining to a sanguine, being long obnoxious to requent Head-aches, about the beginning of Winter became very sleepy and drowsy; afterward, on a certain day when he was tilling a field, he laid himself on the ground, and fell into a profound Sleep; and when he could not be awak'd by a Servant, and other Persons call'd, being carried home he was put to bed: his Friends in the mean while expecting that the Sleep being at length ended, he would awake of his own ac­cord. After the space of twenty four hours was past, when they were not able to awake him by pinching, pricking, making a noise, and other wayes, they call me; when I came, I applied a large Vesica­tory presently to all the hinder part of his Neck, then Blood being drawn to sixteen ounces, I ordered a smart Clyster to be given, his Face and Temples to be anointed with Oyl of Amber, Frictions, and painful Ligatures to be used to his Legs: Moreover, I prescribed Spirit of Soot to be taken often in a day with a cephalick Julep: notwith­standing he lay stupid all that day, without any sense, if, being irrita­ted by hard pinching, he raised himself a little, and opened his Eyes, presently falling down and closing them, he yielded again to his Le­thargy. About the Evening I ordered Cupping-glasses with much flame to be applied to his Shoulder-blades, which being done, he began to become a little awake; and as about that time he purg'd freely by Seige, and the Plaisters being taken off, a great deal of Serum flowed from [Page 395]the little bladders, we had thence a great hope of his Recovery. There­fore Remedies being frequently used afterward that night, awaking the morning following, he knew his Friends, and answered well to what was askt him: but the whole cloud did not yet vanish, for he continued sleepy and forgetful for many dayes, till being twice purg'd he perfect­ly recovered.

An Oxford Gardener, sick of a putrid Fever, and about the height of the Disease, instead of a Crisis falling into a Lethargy, was overwhelmed with a drowsie evil for three or four Dayes afterward, that he could not be so roused from his Sleep by the use of any Remedy, as to become perfectly awake: but at length, when his Head being shaved, and Vesica­tories being applied almost all over it, had raised a grea many Sores that flowed plentifully, awaking from his Sleep, he recovered some sort of Sense: nevertheless his Memory being almost wholly abolisht, he was so stupid, that remembring no ones Name, or Words, he had scarce more apprehension than a Brute. When he had lain after this manner for almost two Months void of Understanding, and full of Sleep, the cloud began by degrees to be disperst; and he at length re­turning to his wonted Labours became indifferently well, though he never got again the same Vigour of Mind, and former quickness of Sence, which he enjoyed before the Disease.

As for a Lethargy arising from the use of Opiats, I remembr I for­merly observ'd a good exact type of it in a Country Village, in which I was sorc'd to stay a night, my Journey being stopt by reason of bad Weather: For as I was just a going to bed, my Host intreated me that I would go and see two poor People in the Neighbourhood, who were affected after such a strange and miserable manner; which Of­fice being induc'd to perform, not only through Charity but also Cu­riosity, I was willingly led to a very small and low Cottage, where I found an aged Father and his Daughter (in two little Beds plac'd here and there in the same Cell) overwhelm'd with a most profound Sleep, which had oppress'd them the day before, after they had eaten Henbane-roots, then freshly dugg up in their little Garden, which they mistook for Parsneps.

To both these, after a Vomiting plentifully rais'd by pouring Oyle and Oximel into their Mouths; and thrusting a Feather into their Throats, I prescribed tincture of Castoreum to be given frequently during the whole Night in a Spoonful of treackle-Water (which Remedies I then casually had by me); moreover that their Temples and Nostrils should be anointed with the same Tincture, and if it could be done, that a smart Clister should be injected: the day following, first the old man, and afterward the Daughter, awaking, came to themselves, the dead sleep being wholly shaken off, in these Persons, after the remainder of the Narcotick being cast up by Vomit, lest it did farther mischeif, it was only needful that [Page 396]the Spirits being raised up by fit Remedies (in the number of which Castoreum is justly accounted against the Poysons of Opiats) they should be freed from the Stupefaction inflicted on them.

CHAP. III. Instructions and Prescripts for curing certain other sleepy affects, viz. the continual Sleepiness, the Coma, and the Carus.

TO begin with the first; many Authors call this not a Disease, but a drawsie Disposition; for the affected as to other things are well enough, they eat and drink well, they walk abroad, they take care indifferently of their houshold Affairs, but in speaking, or walking, or eating, nay their Mouths being full of Meat, they now and then nod, and unless they are stirred by others, they are presently over­whelmed with Sleep: and after this manner they Sleep almost a con­tinual Sleep, not only for some Dayes or Months, but for many years (as it is reported of Epimenides.) Wherefore we judge this Affect by which we are defrauded of more than half of our Life, to be really a Disease and to deserve a cure.

The seat of sleepiness, as of the Lethargy, is to be plac'd in the out­ward part of the Brain, but with this difference, that the material or conjunct cause of this Disease, tho always pressing at the entrances of the Brain, does not penetrate so deep as it is wont to do in the Lethar­gy; but affects in a manner only the surface of the Brain, or the meer cortical substances of the Anfractus, the medullary part within being as it were untouched; in which regard it differs not only from the Le­thargy, but also from the Coma, for in the affect which we describe, tho Sleep be continually pressing, yet it is easily broken off: and more­over being perfectly awak'd the diseased remember a great many things, discourse with the Friends, being presently ready to fall again into their sleepiness: whence it appears that the cause of the Disease sticks only in the outward border of the Brain, nor does it enter deeply its substance, as in other sleepy affects.

This affect, as I have observed in many, is not very dangerous; for either (as it is often done) it is perfectly cured, or at leastwise conti­nuing for many years, without a Carus or Apoplexy (which are wont to be feared) it does not presently become mortal or terrible: the re­lease of this affect often happens upon the change of the seat of the [Page 397]Disease: to wit, the Brain becoming clear, the morbifick matter is con­veyed to the Cerebellum, where lying, it produces Tremblings of the Heart, the Asthma, Faintings of the Spirits, and other troublesome Symptoms accounted for Hypochondriacal.

The Therapeutick method suggests chiefly these intentions, viz. that after a provision being made for the whole by bleeding (if it be pro­per) and by purging, these Remedies may be afterward carefully given, with which the Blood and Brain may be freed from their watery filth, and the later may be corroborated, that it may not for the future re­ceive and retain serous Superfluities. For these ends let the Pilulae de Succino, or Cochiae, be given with Rosin of Jalap once or twice a Week: at other times going to bed, and early in the Morning, let a dose of a Cephalick Electuary, or of the Spirit, or Tincture of Sal Armoniack, Amber, Soot be daily taken, with a Cephalick Julep. The Forms of which may be chosen from those before written: At eight a Clock in the Morn­ing, and at five in the Afternoon, let a draught of Coffee be taken, first boyling in the Liquour of which it is prepar'd, Leaves of Sage or Rose­mary, till it acquires a green Tincture: for ordinary Drink let a Decocti­on of Guaiacum be taken, adding about the end, Leaves of Sage, Betony, and other Cephalicks. Moreover it will be profitable to make two large Issues betwixt the Shoulder blades, and likewise frequently to apply Vesicatories about the Neck; the Hair of the Head being cut off, let a little Cap of Cephalicks and Armoaticks be worn. Let a Vessel filled with Salt of Ʋrine, or Spirit of Sal Armoniack, be now and then held to the Nostrils. Moreover an exact form of dyet being ordered, let some Servants, attending the Diseased, not only stir him up now and then as he falls asleep, but keep him waking daily for some set Hours.

A certain Gentleman, of a sanguine temperament, and, whilst he was young, of an acute and subtle understanding; afterward, in his decli­ning age, being given to Idleness and Drunkenness, became dull and torpid, and likewise Hydropical with a great Paunch, and swellings of the Thighs and Leggs: but from these Diseases (into which he fre­quently fell) if at any time he abstained for some while from his drinking, and applyed himself to Physick, he both often and soon re­covered: but at length tho free from his Dropsy, he was opprest with so great and almost perpetual Sleep, that he would be sleeping in all places, and doing any thing; moreover, being awak'd by his Servants or Friends, he was wont to be present enough to himself, and to discourse well enough for some Minutes of an Hour, of things proposed, falling presently again into his Sleep: To this Person, after many Medicines tryed almost to no purpose, I prescribed at length that he should take every Morning and Evening a Spoonful of the Powder of the Leaves of Betony dried in the Summer Sun, and kept in a Glass, in a little Draught of Water distilled from the Flowers of Lavender: by which Remedy re­ceiving ease within a few days, he was perfectly cured within a Months space, and enjoyed an entire Health for four years from that time. Af­terward [Page 398]when by reason of an ill course of Diet the same evils re­turned, he repeated the same Remedy, tho not with so great success. But besides there being need also of other Medicines, he took sometimes Spirit of Harts-horn or of Soot, with an appropriate Julep; sometimes Electuaries of Cephalick Conserves and Powders, adding sometimes steel. As often as he would indulge himself to his wonted genius of drinking, instead of Wine or Beer, he drank Coffee: moreover for his ordinary drink, he had some­times Ale with the Leaves of Scurvy-grass, Sage and Aromaticks infused in it, sometimes a Decoction made physical with Woods, Spices and Cephalick Herbs, for many years. Afterward, being in a Manner always intemperate and cacochymical, yet he lived free from the Lethargy; at length a Cachexia seizing his Breast, being cast down by degrees by a Cough with an Asthma, he dyed.

The next sleepy affect, viz. somewhat greater than the former, and less than the Lethargy, is that which is vulgarly called the sleepy Co­ma: those that are obnoxious to this, for the most part are opprest with a great sleepiness, to which in a manner always giving themselves over, they lye with the mouth open, and the lower Jaw fallen, more like to Persons dead than living: being stirr'd up by hard pinching or pricking, they look about them, speak to the standers by, answer to things askt, but presently sleeping again, they seem very much trou­bled to be hindred or disturbed from Sleep, thus pleasingly stealing up­on them: and being indispos'd after this manner, they continue in a sleepiness for many dayes, nay, and sometimes Months, without a Fe­ver accompanying it, or following it, or an injur'd respiration, and being easie to be awak'd, and not very forgetful, in which things they differ from Lethargical Persons: mean while they differ no less from others troubled with the affect even now described: for as much as those that have the Coma, keeping for the most part to their Bed, or a Chair, do not walk abroad, or take care of domestical Concerns, as the others. They answer appositely to some short Questions, but are not able to hold a Discourse, or deliberate of things to be done.

The cause of this doubtless is of the same kind as of the former Diseases, but of a middle degree betwixt both before described. For we may conjecture that in this affect the morbifick matter penetrates the Brain a little farther than in the continual Sleepiness, viz. that it invades the outward parts of the Anfractus or Gyri, together with the lesser Branches of the Medulla inclosed: but that it does not reach to the greater Sinus's of the Medulla joyning to the Corpus Callosum, and which are wont to be possest in the Lethargy.

The Coma sometimes beginning primarily and of it self, as the Le­thargy, either proceeds from a serous filth discharged from the Blood on the Cortex of the Brain, or from a stupefaction inflicted on the Spirits there residing: and then this affect, by how much less it is than the Le­thargy, by so much is it accounted less dangerous, but more commonly [Page 399]this Disease ensues upon other Cronick or acute distempers, viz. the Head-ach, Convulsions, and most frequently upon Fevers of an ill crisis, especially in Children, old, and phlegmatick people. Some years since, in an Epidemick Fever, hapning through the affect of the Nerves (which we have elsewhere describ'd) as I observed some to be Lethargical, so many to be troubled with the Coma: of whom a great many recover'd, the morbifick matter being conveyed from the Head into the Breast: Moreover, in other cases this affect being of a doubt­ful event, betwixt hope and fear, requires the sedulous care of a pru­dent Physician.

In a Primary Coma the Therapeutick method suggests to us the like, and in a manner the same intentions of healing as in the Lethargy: As to the morbifick matter, we must endeavour, both that its new afflux to the Brain, and that which is already sticking in it, be discuss'd, or drawn away: Moreover, the Animal Spirits ought to be raised up, and all drowsiness or stupefaction ought to be shaken off from them. For this end we must order Purging, Blooding, Cupping-glasses, Vesica­tories, Revulsing and discussing Topicks, give Cephalick Medicines, and especially such as are endowed with a Volatile Salt, and use many other ways of administrations before-mentioned.

But if this Disease ensuing upon other affects, happens to any Person whose Body is much worn away, the Blood vitiated, or greatly de­pauperated, we must seriously deliberate concerning letting Blood; and Purging before we order them, nay, and for the most part we must abstain from them: tho sometimes, that the conjunct cause of the Disease, or the matter sticking in the Brain may be put in motion, it may be convenient to draw Blood in a small quantity from the Fore­head, or from the Temples by Leeches, or from the Shoulder-blades by Cupping glasses, with a Scarification: Vesicatories have a chief place here, not only to be applied to the Neck or Head, but to the Legs and Arms, and to other parts of the Body by turns. Moreover, let Spirit of Harts-horn, of Soot, or of Sal Armoniack, impregnated with Amber, Mans Scull, Coral, and other Cephalick things be frequently given, with an appropriated Julep, or other Liquor. Forms of these, and of other Medicines usual in these cases, together with stories of sick Persons, and examples of their Cures, are to be found in the description of the fore­said sleepy Fever; so that I need not here again inculcate the same, or the like.

There remains yet another sleepy affect, or kind of the Lethargy, vulgarly called a Carus, which being greater than the Lethargy, and somewhat less than the Apoplexy, is so allyed to this, that it often passes into it, but is wont to be distinguished from both: for those that have the Carus for the most part breath well, if at any time they are hard pinched, they move their members, sometimes raise up themselves, open their Eyes, and often speak, which Apo­plectical [Page 400]Persons do not do; but the same, tho stirred or roused up, scarce understand, or plainly discern any thing, in which respect they are distinguished from those that have the Lethargy.

From what is said it seems to be manifest, that the conjunct cause, or morbifick matter of the Carus, penetrates somewhat more deep toward the middle of the Brain, and to have its seat at least in the out­ward border of the Corpus callosum; and sometimes, as that matter gra­dually advances from one part to another, the Diseases before-menti­oned successively arise, and each last is only the encrease of the other.

But sometimes the morbifick cause, without a gradual progress through those Parts, at the first assault affects the middle part of the Brain, and there (as it sticks shallower or deeper) causes a Carus, or Apoplexy. In which case it must not be thought that the whole cir­cumference of the Corpus Callosum, as also of the cortical part of the Brain is possest by the soporiferous matter; for it suffices, that rushing into any one place, it has seized some part of the middle, for there­upon presently in all that Region follows an eclipse, or at least a pro­sternation of the Spirits.

The Prognostick of a Carus for the most part is ill, especially if the Disease happens upon a malignant or long continued, or a slow Fever not determined, or on that which happens in Childbirth: Nor is less danger threatned, if it succeeds other Cephalick Diseases, or is rais'd by reason of a wound in the Head; though in these cases some­times there is a Cure.

The event of this Disease either for death or recovery is wont to be various: The Carus often passes into an Apoplexy, which soon kills; so that after the loss first of the animadversive faculty, in a while a depriva­tion of sense and mortion, and then by reason of the taint convey'd to the Cerebellum, alterations of the Pulse and Respiration, and in a short time Death it self follows.

But sometimes the morbifick matter sinking deeper, and falling from the Corpus Callosum into the Corpus Striatum, one, or both toge­ther, the Brain becomes a little clear; so that the Diseas'd look about them, speak and know things; nevertheless, in the whole Body besides, the Palsey, or Hemiplegia ensues: Neither are thus things in safety, as to Life; for often when the Brain begins to be restor'd, the Cerebellum is worse; so that thereupon the Spirits which execute the offices of the Vital, and meer Natural function being there ill affected, either Convulsions in the Viscera and Praecordia, or mortal lettings of the Pulse and respiration are caus'd: tho sometimes when the morbi­fick matter is neither too redundant, nor too malignant, it is partly drank up again into the Blood, and partly discuss'd, so that the Dis­eased perfectly recover.

The Therapeutick method suggests the same intentions of Healing, and indicates altogether the sanie Remedies, which are wont to be [Page 401]used in the Apoplexy: Wherefore it will not be needful to set down here Classes of Indications, or to heap together a mighty mass of Me­dicines, but that which seems more to the purpose: I shall here pro­pose a story or two of Persons diseased, whereof I have a great many ready to relate.

A worthy man, about forty years of age, having lost his health through intemperance, when he had begun to use I know not what Remedies, prescribed by an Empirick, fell into a Carus; haply be­cause the morbifick matter being stirr'd, and agitated by the Medi­cine, rush'd into the Brain. Going to see him the second day, I found him buried in a profound sleep, and almost insensible; for tho upon hard pinching or pricking he opened his Eyes, and mov'd his Limbs, yet presently falling asleep again, he perceiv'd nothing at all of what he did, or endur'd. In this case, tho declaring a sad Prognostick, however I did not forbear to use Physical means; abstaining from Phle­botomy, by reason of his strength being much spent, and his Blood depauperated, I presently ordered a large Vesicatory to be applied to his Neck, and a smart Clyster to be given him, of a decoction of Briony Roots, with Carminative Flowers and Seeds, adding likewise two drams of the species of Hiera: His Temples and Nostrils were anointed with Balsams: Cataplasms of Rue and Briony Roots were applied all over his Feet: Moreover, every other or third hour I gave him a dose of Spirit of Harts-horn, with a Cephalick Julep; and many other admi­nistrations, usual in this case, were carefully put in practice. To which nevertheless the Disease not at all yielding, the day following I prescrib'd him a Purge of Scammony prepar'd, to be taken in a spoonful of Broth: After which, when he had frequently and freely Purg'd, he began to open his Eyes, to speak, and to know standers by, and a little after, coming to himself, he fully awaked. This Disease (as I ghess) was therefore cur'd more easily, and sooner than was hop'd, be­cause that cloud sent haply into the Brain by a Medicine, could the better be drawn thence by the help of another Medicine.

A renowned man, fifty years of age, of a gross Body, and formerly abnoxious to a Vertigo, and asthmatick affects, had lived very sound for two years, having used Physick Spring and Fall, and having a large Issue near both Shoulder-blades: At the beginning of Summer, he living in the Country, and his Issues being neglected for many weeks, the filth which was wont to be purg'd forth, ran much less from them; yet he was still in good health, till about the Solstice, when as he was sitting one morning in a Porch, and talk'd cheerfully with his friends, arising on a sudden he complained that he was ill: going in a doors, and setting himself down in a Chair, he vomited very much, then presently leaning to one side, he fell into a profound sleep, and lay so overwhelmed with it, that he could scarce be raised from it all that day. Coming in the Evening, I ordered Blooding, a Clyster, Vesica­tories, [Page 402]and many other Remedies proper in such a case, carefully to be administred: The next day after, his Brain began to grow a little clear; so that he looked about, and spake distinctly a few words: Seeming to know his Friends, he could tell no ones name; but by reason of this matter sinking deep in the Brain, a Palsey of the whole right side seized him. Moreover, a mighty sleepiness yet persisting, on that day Blood was taken from the other Arm: Other Remedies also being continued as before, on the third day, becoming less drowsie, he began to know many, and to call some by their names, to perceive his illness, and to be sollicitous for Reme­dies: But whilst the Brain grew better, the injury communicated to the Cerebellum and Genus Nervosum discovered it self; for on the fourth day his breathing became uneven and difficult, and his Pulse weaker: Moreover, he was often affected with a shivering, and a Convulsive concussion of the whole Body: On the fifth day, the Cramps and Convulsions becoming more violent, oftner infested him; then the Pulse growing weaker by degrees, on the sixth day, tho more free from sleepiness, he dyed: In this, and other the like cases, it's probable that the morbifick matter invades the Brain and Cerebellum together; but whilst it sticks in the Cortex of this (contrary to what happens in the Brain) it causes no very sensible injury, because here the parts offended are neither the seats of sleep, nor memory: but afterward, haply about the fourth or fifth day, the matter sinking further to the Medulla of the Ce­rebellum; whilst as to other things the Diseased was better, the Vital function, by reason of the Spirits appointed for it being op­prest in their very source, began to fail, and afterward declining on a sudden, unexpectedly cut off all hope of recovery, which before was great.

CHAP. IV. Instructions and Prescripts for curing the Watch­ing Evil, and the Watching Coma.

AS Light and Darkness, so Sleep and Watching being set toge­ther, excellently illustrate each others natures.

Concerning a continual waking, or the Watching-Evil, we must in the first place here distinguish, that either it is a symptom which happens upon some other Disease, as a Fever, Frensy, Mania, [Page 403]or Colick, Gout, and the like; and then its consideration and cure belong to that affect, whose offspring it is; or else immoderate Watch­ings arising alone with out any other known cause, seems to be a Di­sease as it were of it self, as I have known it in some Persons, and some of these Watchers, tho destitute of Sleep, seem scarce to want it, For the Spirits appear not thereby either torpid, or wearied, or exhausted: but others bearing ill watching, soon become thereupon languid, and lose their Stomacks, and are forc'd to have recourse to Opiats, which sometimes they use daily, and in a large dose without hurt.

We have intimated before, that the cause of natural waking, which has Sleep interlaced with it, consists in these two things, viz. in one of them or both together; To wit, first, that the animal Spirits being suffi­ciently refresht, and freed from the fetters of the Nervous Liquor, vi­gorously exert themselves, and are expanded every way, and especi­ally from the middle part of the Brain to its circumference; then se­condly, tho they enjoy a clear space every where, and especially in the outmost part of the Brain, being then free from the incursions of the Nervous Juice; yet lest this expansion of the Spirits (which is being awake) be any where protracted longer than is fitting, to their too great loss, both the Spirits being now and then weary, flagg, and as it were repose themselves of their own accord, and withall the Ner­vous Liquor coming to overspread the Cortex of the Brain, stuffs and closes their Passages. Hence it follows that preternatural and immode­rate watching depends also on one or both of those two; for either the Spirits being two exhorbitant, and struck as it were with a rage, do not retreat of their own accord, and withall the Nervous Liquor does not so fill and stop the Pores of the outward part of the Brain, that the Spirits may be forc'd thence inward to a repose: Types of both these every where present themselves to be observed.

And first we may observe that the Animal Spirits becoming some­times exhorbitant, and so elastick, or otherwise irregular, cannot only be appeased and repose themselves, but are scarce able to be contained within the proper Sphere of their emanation; Wherefore being ex­panded in a continual watching, they so fill the Brain, and keep it extended, that the nervous Juice, tho heapt together in a great plenty at the entrance, cannot be admitted; and if the Spirits are recall'd in­ward from the Cortex of the Brain, for that to enter, presently being there restained, or making a tumult within the midst of the Brain, they raise a thousand, and often horrible Fantasms, with which Sleep is kept off; or directing farther their Tendency into the Genus Nervosum, they raise there great disorders which continually drive away, and break off Sleep, tho seeming never so much to be stealing on, or to be at hand.

As for the former of these, I have often observed some troubled with watching, who dreaded to begin Sleep, tho it came on according to [Page 404]desire: for as soon as being about to sleep, they closed their Eyes, presently starting up again they cryed out that a confused multitude of Fantasms made them mad, so that they found themselves necessitated to abstain from Sleep.

Secondly, when the Spirits being become exhorbitant, are called from the circumference of the Brain towards the inward parts in order to Sleep, sometimes they convert their Sallies into the Genus Nervosum, and then either rushing in a tumultuous manner into the Nerves that go to the Precordia, or Viscera, they cause disorders in the respective Parts; (hence to such as are so affected, as often as closing their Eyes they invite Sleep, either Tremblings, Leapings, and Constrictions of the Heart, with Failings of the Spirits, and a letted Respiration happen or inflations and Swellings of the Viscera, a Sense of Suffocation, and other Symptoms vulgarly accounted for hysterical) or secondly, the Spirits being called from their Watchings, and converted to the Genus Nervosum, sometimes transfer their Sallies into the spinal Marrow, and thence into the Nerves that pass into all the outward Members: where­fore to some, when being a Bed they betake themselves to sleep, pre­sently in the Arms and Leggs Leapings and Contractions of the Tendons, and so great a Restlessness and Tossings of their Members ensue, that the diseased are no more able to sleep, than if they were in a Place of the greatest Torture. Sometime since I was advised with for a Lady of Quality, who in the day time was wont to be afflicted with a Cardi­algia, and a Vomiting, and in the Night was hindred from Sleep by reason of those spasmodick affects which came upon her as now and then she was upon the point of rest: nor indeed was she able to sleep all Night, unless she took first a pretty good dose of Laudanum: Where­fore of this Medicine which at first was allowed her only twice a Week, she took afterward daily for about three Months, receiving no injury thereby, either in the Brain, or about any other function, and when in the mean while by the use of other Remedies, the discrasies of the Blood and Nervous Juice being corrected, the animal Spirits became more benign and mild, she afterward leaving off wholly the Opium, was able to sleep indifferently well.

As to the cure of the VVatching-evil (which we even now describ'd) because it cannot be long endured, therefore those things are chiefly to be given, which give a present relief: for this end those things are proper which sooth the Spirits, and gently appease their Disor­ders, as the vulgarly called Anodines, viz. distilled waters, Decoctons, Syrups, and Conserves of Flowers of Nymphea, Cowslips, Mallows, Violets, Knapweed, the Leaves of Lettice, Purslan, the Willow, also Emalsions, or juicy Expressions. And if the restles Spirits will not be mitigated by fair means, we must force them to be quiet, by imposing Fetters as it were, and using Severity: their stores ought to be diminish'd, and withall the spaces in which they may freely, and [Page 405]without tumult expand themselves, ought to be dilated, and cleared from the stuffings of other humours, viz. of Blood and Serum: for which ends opening a Vein sometimes is proper, Vesicatories in a manner always have place; moreover let Diacodium and Laudanum, in case they agree well, be frequently taken; and mean while that the Opats give truce from the violence of the Disease, let the cause of it be eradicated by the use of other Remedies, as much as may be: Wherefore day after day, at Physical hours, let things be given that take away the sharpness of the Blood and Nervous Juice, and restore them to sweetness. In which rank we account Testaceous Powders, Apozemes and altering distilled Waters of temperate Antiscorbuticks, gentle preparati­ons of Steel, spirit of Harts-horn, of Soot, and above all things, tincture of Antimony.

There remains another kind of Watching-evil, whose cause consists for some part, if not mostly, in the almost continual opening or too great gaping of the Pores or Passages in the cortical part of the Brain: for besides that the animal Spirits being sharp and somewhat exhorbi­tant, refuse to lye down of their own accord, and to yeild to rest; and that they are not kept down or subjugated by the Nervous Liquor entring the Pores of the Brain, but being free and exempt from all imposed Bur­then, they are expanded also within the outward spaces of the Brain which are every where open for them, for which cause those that have the watching evil perceive no drowsiness or heaviness of the Sinciput, no appulse or desire of Sleep. I have known some affected after this manner, who when they had past many Nights one after the other wholly without Sleep, yet being still chearful and brisk, having a good Stomack, and ready at business, seemed not as yet to have wanted Sleep. The cause of this doubtless is a burnt and melancholy Blood, which supplies the outward part of the Brain with a Nervous Juice, not mild and benign, but too much scorcht and filled with adust Particles, which consequently is neither apt to flay long within the Pores of the Brain, nor kindly to receive and contain the Animal Spirits: Moreover the Spirits themselves ingendred from it become too elastick and restless in their Nature, so that they are neither easily appeased, nor inclin'd for Sleep of their own accord. Never­theless, being of a fixt Nature, they do not readily fly away, nor are soon tired so as to flag, but last a long time and continue vigorous without any great refreshment. Concerning this sleepless Disposition of the animal Spirits, since it is the same as in Persons troubled with melancholy, we shall have a fit place of speaking somewhat more largely of it in the sequele. We may observe that Coffee also on the same account keeps Persons from Sleep, for that Drink insinuates its adust Particles (with which we find it to abound both by the tast and smell) first into the Blood, and then into the Nervous Juice, which thereupon by their Agility and Restlessness both keep the Pores [Page 406]of the Brain still open, and add spurs and a certain rage to the Spirits (all other Combination and Stupefaction being deposed) by which they are stirred up to a longer execution of their Functions. Again, as to what regards the prophylactick cure of this Watching-evil, or the removal of the morbifick cause; we shall give it you in the Sequel, where we shall treat of Melancholy mean while for the immediate removal of that Symptome as often as it sorely presses, we observe that Opiats will not do; for being given in a good large quantity they seldom cause Sleep, and render the affected more faint and weak. It often succeeds better if going to bed they take some gentle and pleasant drink, as es­pecially our Ale being clear and mild, or also posset drink with Cowslip Flowers boyled in it, or an emulsion of the Seeds of Melons and Almonds in a great quantity, viz. to two or three pounds.

I was advis'd with some time since for an old hypochondriacal man, who, besides other symptoms usual in that case, had liv'd for many years obnoxious to a frequent, loud, and very troublesome belching: He was wont every day to fall a belching twice or thrice, for about two hours together, and with so great a noise that he was heard to a great distance: But sometimes for a week or two, and sometimes for a month, that belching was chang'd into a watching; for the former affect becoming much more remiss, the worthy man past often whole nights without sleep; and when sometimes he had been con­stantly waking for three or more days, not yet seeming to want sleep, he complain'd of no drowsiness, dulness, or failing of the Spi­rits. Narcoticks having seldome or never given him relief, he took sometimes in the evening Posset-drink made with Ale, or Canary; at the beginning of the night he drank sometimes Ale, sometimes Distill'd Waters, by the use of which a little sleep often followed; then after­ward the Watching-evil vanishing by degrees, the belching return'd. Whence it may appear that the cause of both was the same, viz. adust and irritating Particles sent from the mass of Blood, sometimes into the Coats of the Stomach, sometimes into the cortical part of the Brain.

2. Besides these distinct affects or exorbitancies of sleep and wa­king, there remain other conjunct or complicated irregularities of them, in which the acts of both functions are perverted together, which we may observe in the affect vulgarly call'd the VVatching Coma; concerning which we shall now speak in short.

Those that are troubled with the VVatching Coma, tho they are always inclin'd to sleep, yet they can scarce sleep at all, but seem, like Tantalus, to stand always up to the Lips in the River Lethe, for sipping of which, whenever they sink themselves deeper, the yielding Waters always subside lower. They feel a very great heaviness of the Head, with a drowsiness of the senses, and all the faculties; so that they are troubled to move themselves any way in their Bed, or to be disturb'd by the [Page 407]speech of standers by, that speak to them, still expecting to fall pre­sently into a quiet sleep: to which nevertheless when they wholly yield up themselves, and endeavour straitly to embrace it, various phantasms presenting themselves to their mind, keep them still waking, nor permit them at all to enjoy that Sleep which seems always to be ready for them. To this often is added a Delirium, so that whilst the Dis­eased lye with their Eyes clos'd, they talk always absurdly and at ran­dom, and throw their Arms and Legs this way and that in a disor­derly manner, and being awak'd, look gastly. It's a usual thing for such as are in Fevers to continue all night overwhelm'd with a sleepi­ness, as it were; but so that in the mean while they are scarce silent for a quarter of an hour, but mutter various things with themselves, nay, sometimes cry out, howl, and leap out of Bed. If the reason of this be enquir'd into, it seems that we ought to say, that the Pores and Passages in the Brain, which are the avenues of the Spirits, are very much possest by a gross and soporiferous matter, sent from the mass of the Blood, so that the Spirits being very much letted from their wont­ed expansion and mutual commerce, a great and invincible Sleep seems presently to be at hand: but in as much as certain sharp and very active Particles stick to those Spirits as so many stings, they are in­cessantly incited to motion, and therefore some of them forcibly pass the wayes, however stopt and beset with fence, and meet against each other directly or obliquely, according as they can find a way: and such their motion, tho it be not able to procure a compleat exercise of the animal function, yet it easily hinders its rest and cessation, so that those that are troubled with this Disease keep betwixt Sleep and wake.

The VVatching-coma is seldom a Disease of it self, but for the most part is a symptom, and happens upon other affects, as a Fever, the Frensy, Lethargy, and the like, wherefore, it does not require a pe­culiar method of Cure; but it seems only to be needful, that to the Remedies primarily indicated, other Cephalicks be joyn'd, which may disperse these meteors, as it were, like Clouds and Lightning; or if both of them cannot be exterminated together, let the Medicine joyn it self to the aid of one affect, by which that being becom su­perior, let it presently overcome the other; so in a sleepy Watching it is proper to procure either a perfect Sleep or a perfect Watching; and in this case I have often given Narcoticks with good success.

CHAP. V. Instructions and Prescripts for curing the Incubus or Night-mare.

SO far of the irregularities, or morbid Exorbitancies of Sleep and Watching, which being proper to, and as it were peculiarly at­tending the Brain, affect the Cerebellum but rarely, and only se­condarily; but there remains an affect (vulgarly call'd the Incubus or Nightmare) which being peculiar to this Region, and in some sort analogous to the soporiferous Diseases; in as much as its Fits arise in a manner from hence, that by reason of the Animal Spirits being bound or supprest in the Cerebellum, an Eclipse or interruption of them (tho short) is caus'd in the exercise of the vital Function.

That the nature of this Disease may be the better known, in the first place let us consider its Phoenomena. A Fit of the Incubus most com­monly, and in a manner only seizing us whilst we are asleep, is wont to be rais'd for the most part after the Stomach's being loaded with food of ill digestion, and a lying on the back in bed: those that are troubled with it seem to perceive themselves chiefly offended with it in the Breast and about the Praecordia: for respiration being supprest or very much hindred, they think themselves opprest with a certain weight lying heavily on the Thorax, which weight cheats their imagi­nations sometimes with one Apparition, sometimes with another; and when they think to shake it off, or put it from them by the motion of their Body or Limbs, they are not able to stir either their Body or any Limb any way; but after a long struggling in the Praecordia, and sometimes almost to the loss of Life, at length they awake, and be­ing fully come to themselves from their sleep, the imaginary weight vanishes on a sudden, and the moving force of the Body is restored, there remaining nevertheless for the most part a trembling of the Heart, and often a very quick and violent vibration of the Dia­phragm; afterwards, the Fit being ended, the deception of the Fancy, apprehending the dreadful species of an Incubus, comes also to be known.

Now, tho we allow the monstrous Species (which is conceiv'd) of the Incubus to be a meer Dream; yet it is manifest that the Praecordia are really affected, and that the motions of the Pulse and Respiration are in a manner supprest or letted, viz. in as much as that oppression of the Breast is plainly perceiv'd by many whilst they are awake, nay, as they are freshly stirr'd from sleep, and when that is remov'd, trem­blings [Page 409]and disorderly motions of the Heart and Diaphragm ensue; whence it follows, that these Parts are cumbred, and undergo a real damage.

Wherefore, whatsoever others may think, I judge that a Fit of the Incubus is caus'd, insomuch as in sleeping a certain incongruous matter is distilled into the Cerebellum together with the nervous juyce, which causing a heaviness or certain stupefaction to the Spirits in their first source, forces them presently to forbear a little from the performance of their Functions; so that by a second Lethargy, as it were, raised within the Cerebellum, the vital actions suffer a short Eclipse; during which, partly from the striving of the overcharg'd Praecordia, and partly from the Blood being very much heapt together and stagnating within them, that oppression, and sense of an incumbent weight, as it were, is caused: moreover, because all the other faculties of the whole Body depend on the motion of the Heart, therefore this be­ing hindred and supprest, those presently fall into faintings and dis­orders.

Tho it be seldom that any Person dyes of this Disease alone, yet those that are frequently obnoxious to it, if at any time they are seis'd with other cephalick affects, as the Lethargy, Carus, Apoplexy or Lethargy, they are in a very dangerous Condition, because the morbifick matter, sent from the Blood into the Brain, easily invades the Cerebellum also, be­ing so predispos'd; so that the Diseased suffering an Eclipse of the vi­tal function together with the animal, are brought into a greater dan­ger of Life: hence its a common observation, that those that are wont to be frequently troubled with the Incubus often dye Apoplectical.

Another Issue of the Incubus is wont to be less pernicious, that it often leads to the passion of the Heart, and other Affects commonly accounted for Hypochondriacal. I have known many troubled with the Incubus in their Youth, who, as they grew farther in years, being free from that, were affected with a Trembling and Panting of the Heart, and with other Griefs about the Precordia, and Hyphochondres, and very sorely with Convulsions; we judge the cause of this morbid change to be, that the morbifick Matter, after having been often wont to beset the circumfe­rence of the Brain, at length, making a violent assault, penetrates deeper into some private Place, and passing its texture, rushes into the Nerves appointed for the Precordia.

As to the Cure of this Disease, for as to its Fits, because they soon pass away of their own accord, there is no need of it: the therapeu­tick Method, after a provision to be made for the whole by blooding (where it is proper) and a gentle Purge, suggests to us the chief use of those Remedies which are vulgarly accounted Cephalicks: therefore the Powders of Amber, Coral, Pearl, Roots of male Peony, bastard Dit­tany, Contrayerva, also Electuaries, Tablets, distill'd waters, Tinctures, Elixirs, and other things wont to be prescrib'd in the Lethargy and [Page 410]Apoplexy, have place here; but in the first place, a due form of Diet being ordered, let food that is gross, and of an ill concoction, Pulse, and horary Fruits be avoided, nor must the Person indulge himself to sleep, studying, or reading presently after eating: let large and late Suppers, and lying on the back be forbidden.

Because Infants and Children are often troubled with this Disease, (a sign of which is, that they are shaken in their Sleep, and upon their awake cry out terribly) and having undergone frequent fits of it, often fall into convulsive affects: therefore as soon as they seem affected with it, let a due method of cure be used to them: let it be enquired con­cerning the Milk they suck, whether of it self being without fault, and landable, it agrees well with their Stomack? let them not be permitted to Sleep presently after having suckt their fill: Let the Nurse, using a good form of Dyet, take also Morning and Evening a Dose of a Cepha­lick Powder or Electuary, drinking after it a draught of Posset-drink, with the Leaves of Sage, or Betony, or the Roots or Seeds of Peony boyled in it: Let the Infant take twice a day a Spoonful of an appropriate distilled Wa­ter: Let it have an Issue in the nape of the Neck, let it lye sometimes on one side, sometimes on the other, but seldom or never on the back. It will not be wholly without benefit, for it to wear about the neck or on the pit of the Stomack, Coral, or Bracelets made of the Seeds or Roots of male Peony: If at any time in sleeping, being often and sorely shaken, they seem to be dangerously affected with this Distemper, let Vesicato­ries be applyed to the Neck, or behind the Ears; Moreover Evening and Morning let a Dose of the Pulvis de Gutteta, or some other that is appropriate, be daily given in a Spoonful of distilled Water, or in Juleps.

CHAP. VI. Instructions and Prescripts for curing the Vertigo.

AFter having viewed the outward circumference of both Brains, and discovered the Diseases that beset the sensitive Soul, about the first beginnings, and the first sources of the Animal Spirits; now descending to the middle of the brain, where the Fancy and com­mon Sense reside, let us see to what affects these Parts are obnoxious. Concerning this, let it be observ'd in the first place, that of the Spirits residing in those places, sometimes Troops, or rather mighty Armies, sometimes also small handfuls are affected; and then that the same, whe­ther [Page 411]many of them together, or a few only are affected, either from their heterogeneous combination are made elastick, and consequently are forced into disorderly, or rather explosive motions, as in a Fit of the Epilepsie; or undergoing an Eclipse, as in the Apoplexy, are de­priv'd of all motion: We have discours'd amply enough before of the former spasmodick affect of the Spitits; and concerning the Apoplexy we shall treat in the sequel. At present we shall speak of a certain Passi­on belonging to these Parts, viz. the Vertigo, in which some Files of the Spirits are affected, and their motions seem partly to be perverted and partly to be suppress'd.

The Vertigo is thus described, viz. that it is an Affect in which visible Objects seem to turn round, and those that are affected with it find a great trouble or confusion of the Animal Spirits in the Brain, so that they do not duly influence the Nerves: wherefore the seeing and loco­motive Faculties often somewhat waver, so that the Diseased fall down and are often offuscated with Darkness.

In a fit of this, it is to be observed that the Imagination and common Sense are in some sort deceived: whilst they think the Objects that stand still do move, but the rational judgment holds good, for we know our Errour.

That the morbifick cause of the Vertigo, and the preternatural way of its hapning may be known, we must enquire after what manner the same affect, how suddenly soever it comes upon us, is wont to be raised by non-natural things, for by a long turning round of the Body, by looking from an high place, passing over a Bridge, by sailing in a Ship, or going in a Coach, by Drunkenness, or taking Tobacco, and certain other ways, Persons every where become Vertiginous, or contract a Gid­diness: which Affect those occasions produce, in as much as the animal Spirits being greatly disturbed in their set Series and orders, are both moved loosely and in a disorderly manner this way and that within the Passages of the Brain, and break off certain Lines or Threads, as it were, of their wonted irradiation into the genus Nervosum; for those two things being in a manner always reciprocal, mutually succeed and depend on each other, viz. the Perturbation of the Spirits within the middle of the Brain, and their letted emanation into the genus Nervosum: On whatever cause either affect is produc'd, presently the other follows. A turning round of the Body, being carried in a Coach, or Ship, also Drunkenness, an unusual taking of Tobacco, force the Spirits to fluctuate or to reel disorderly in the Brain, which thereupon are presently hin­dred from their due emanation into the Nerves, so that the Persons affected are scarce able to stand or go; In like manner, a looking from an high place, passing over a Bridge, a Fainting or Swoon seizing us, recall the Spirits from their wonted emanation into the genus Nervosum, which therefore falling in a tumult, or being disorderly mov'd within the Brain, cause a Scotomia or a running round of Objects.

these things being thus premitted concerning the Vertigo, rais'd by reason of some accident, or by some evident, solemn, and non-natural cause; we must now enquire how, and after how many ways it is wont to be produc'd by an intrinsecal and preternatural cause.

Concerning this you may observe, that the Vertigo is sometimes a symptom depending on some other affect, seated sometimes within the Brain, sometimes without it; but that sometimes it is a Disease by it self, which being raised within the middle of the Brain, is very trou­blesome, and often terrible, and difficult to be cured.

As to the former, many Diseases of the Head, viz. an acute Pain, the Lethargy, Epilepsy, Carus, Apoplexy, with many others, have often a Vertigo joyned with them, viz. inasmuch as an even expansion of the Spirits in the Brain, and their irradication thence into the Ge­nus Nervosum, is lightly disturbed from those various morbifick causes.

Moreover, this symptom is wont sometimes to be produced by reason of other affects seated far from the Brain, and that chiefly after two manners; For first, it is usual for a Scotomia to arise by reason of the afflux of Blood call'd on a sudden from the Brain, as in a swoon, and great fainting, in great hunger, hard labour, a very great hemorrhagy, long fastings, violent passions of fear or sadness; nay, through other occasions, if at any time the motion of the Blood fails or faulters in the Heart, so that the affected are ready to fall into a fainting of the Spirits, presently because the supply of the Vital Liquor is withdrawn, the Animal Spirits also failing in the Brain, withdraw their irradiati­on from the Genus Nervosum: For their Head-spring being cut off, those that remain flying back from their emanation, run to and fro confusedly in the Brain, and raise vertiginous, and often delirous affects.

Secondly, a disorderly retreat of the Animal Spirits from some one of the Viscera, or some outward member into the Brain, often causes a Vertigo, viz. inasmuch as the Spirits being troubled in a long series from the Part affected by the Ductus's of the Nerves, at length trou­ble others inhabiting the middle part of the Brain, and force them into the like disorders: for this cause it is, that sharp humours twitching the Fibres of the Stomach, and that often an offensive and irritative matter stirr'd in the Spleen, Pancreas, or Intestines, and an acute pain, Ulcers, &c. in the Foot or Arm, often cause light Scotomias in the Brain.

But the Vertigo is not only a symptom, but sometimes is a disease primarily, and of it self: for the through understanding of the na­ture of which, we must enquire into its subject, formal state, and causes.

The Immediate Subject of the Vertigo are doubtless the Animal Spirits, which every person troubled with this affect perceives to be [Page 413]very much troubled, and to move about in a confused manner; but the mediate subject are those parts of the Brain in which Imagination and common sense reside, and whence the next way leads into the Genus Nervosum: Now these are the Corpora Callosa, and Striata.

For the Animal Spirits love to expatiate themselves within these medullous Bodies; and when they smoothly flow in one series from the two extremes attending the Corpus Callosum ( viz. from the Cor­pora Striata, and Gyri of the Brain) towards its middle part, they re­present pleasant imaginations and fancies: and when in another series and haply by other Pores, they flow from the midst of the Corpus Cal­losum into the Gyri of the Brain, they carry thither the signatures of notions for the memory; and when they direct themselves thence in­to the Corpora striata, and origines of the Nerves, they actuate all the moving parts, and as often as there is occasion, convey to them the Instincts of setting upon motions.

Now in a Vertigo those even emanations of the Spirits seem to be intercepted in various places, and to be diversly perverted, for some files of the Spirits are rendred obscure, others are wrested another way, and are driven this way and that into Gyri and Vortex's, and often are forcibly drawn cross-wise; wherefore by reason of the Spirits being so troubled in the Brain, confus'd fancies, erring and unconstant spe­cies of sensible things or turnings round of them are represented: And then, according as the Irradiation into the Genus Nervosum is lessen'd or stopt, a Scotomia, and sailings and faulterings of the locomotive fun­ction ensue.

It seems probable that such disorders of the Spirits depend on two causes, viz first, that some exorbitant and extraneous particles being entred the Brain deeply together with the Nervous Juice, cleave to the Spirits, and force them into irregular motions; it being manifest to vulgar experience, that this happens to some persons after immo­derate drinking of Wine, or Strong Waters, unusual smoaking To­bacco, the eating of certain Vegetables, an anointing with Mercury, &c. Secondly, we may imagine that sometimes a serous glut of filth gets by degrees into the Brain, together with the Nervous Juice, and when at length it has penetrated deeply into it, it defiles these pure Medullae, and greatly stuffs its Pores: So that the Animal Spirits do not display their beams with a light that is clear and full, but such as is weak and broken, with many little Clouds, as it were, scattered here and there.

In an habitual and inveterate Vertigo, the conjunct cause compre­hends both these, as it appears from the things that give relief, or prove offensive. For I observe that that affect is altered for the better or worse, on two kinds of occasions: For whatsoever things inwardly taken engender turgid Particles, and such as are too exorbi­tant and apt to be troubled, as Wines, Strong Waters, pepper'd and [Page 414]flatulent meats, in a manner always affect vertiginous Persons: nor do they find less injury by reason of occasions by which the Brain is fill'd and stuffed, as are surfeiting, sleeping at Noon, or too long in the morning, a Southerly Wind, a moist, misty, and thick Air; a low seated and marshy habitation: and on the contrary, the same are very much relieved by a thin and light Diet, a clear Air, and an open Coun­try exposed to the Winds.

If we enquire into the procatarctick Cause of this Evil, viz. for what morbid predisposition this double evil is wont to be brought on the Spirits residing in the middle part of the Brain; we find that here both the Brain with the nervous Liquor, and the Blood with the Humours residing in it are in the fault.

It is a common fault of the latter, that degenerating from its due Crasis into a sharp or otherwise vitious temper, it perverts the nutritive juyce, and likewise heaps together within it a Serum, and filthy dregs of various kinds, which it is ready to discharge on the Head.

The fault of the Brain is, that its temper is moist and weak, its texture loose and not firm, and has its Pores more open than they ought, and too much gaping, so that any heterogeneous and elastick Particles, and likewise serous, or otherwise morbid recrements, being sent from the Blood into the Head, are easily admitted into the Brain together with the nervous juyce, and by reason of its passages being too open, descend without obstacle into the midst of it, viz. the Corpo­ra callosa and striata. Moreover, such as are of a tender Constituti­on, easily contract this vertiginous disposition; for the Spirits of the Brain being weak, and unable to resist foreign incursions, yield a pas­sage to any matter coming thither: Again, to others, tho robust Per­sons, a disorderly Diet, a sedentary Life, frequent surfeiting, also im­moderate Sleep and Studies, likewise the Scurvy, an inveterate Ca­chexia, Fevers of long continuance, and other Cephalick Diseases, of­ten bring this ill habit of the Brain.

As to the prognostick of this Disease, every new Vertigo for the most part is void of danger; but being habitual and continual, tho it sel­dom threatens a great or imminent danger, yet because it admits not but a long and very difficult Cure, it most commonly so tires both the Diseas'd and the Physician, that before the Disease can be cur'd, one grows weary of the other.

A primary Vertigo seated in the fore-part of the Head, which scarce at all causes a dizziness or falling on the ground, being more safe and curable, is often chang'd into a Head-ach; sometimes also it goes off of its own accord, by a bleeding at the Nose, or a Flux of the Hemor­rhoids, and is often removed by Physick.

A vertiginous affect arising in the hinder part of the Head, and in­tercepting the irradiations of the Spirits into the Nerves, being far [Page 415]more dangerous, often passes into an Apoplexy, or Palsey, or into Con­vulsive Diseases.

A Therapeutick Method does not properly belong to a Symptomatick Vertigo. It will only be necessary that certain Cephalick Remedies for discussing the Clouds of the Brain, and appeasing the disorders of the Spirits be joyn'd to the first things indicated; or rather, to speak according to the capacity of the vulgar (which we must sometimes, tho only for shew) that certain Medicines against vapours be added to them.

An Accidental Vertigo, or any other that is new, for the most part is cur'd only by Blooding and a gentle Purge, sometimes repeated: Ne­vertheless, for the more certain extirpation of the disease, let Cephalick Remedies likewise, such as shall presently be written, be carefully administred.

For the Cure of an Habitual Vertigo, and such as is become inveterate, in a manner the like method ought to be ordered as against most other Cephalick Diseases, Which suggests these three chief intents of Heal­ing: viz. first, we must endeavour that all fuel of that Disease being cut off, the Brain may continue free from any new afflux of morbifick matter; for which end, a due form of dyet being ordered, some­times bleeding, and very often a gentle Purge given at due intervals of time will conduce: Let a dry and well ventilated Air be chosen, let immoderate and unseasonable sleep and studies be shunn'd; let morning and evening draughts be wholly forborn: Instead of the for­mer, let a draught of Coffee or Tea be given, with the Leaves of Sage boyl'd in them; let an Issue be made in the Leg or Arm; and some­times let the Hemorrhoid Vessels be open'd by Leeches: Let the Person affected always rise early in the morning, and wash his Temples and Sinciput with cold Water, and rub them with a course Cloth.

The second Therapeutick Intention will be to remove the Proca­tarctick cause of the Vertigo; wherefore let it be endeavoured, both that the Cacochymical dyscrasy of the Blood be taken away, and that the weak and over-lax constitution of the Brain be corrected. In or­der to the former, Remedies powerfully altering, as temperate Anti­scorbuticks, Chabyleats, and sometimes Spaw-waters, or Whey are pro­per: To which, always by reason of the latter thing indicated, let Ce­phalick Medicines, viz. such as are prepar'd of Coral, Amber, man's skull, the root of male Peony, Mistletoe, Peacocks dung, and the like, forms of which we shall presently give you, be added.

The third Intention, and which is properly curatory, attempts the taking away of the conjunct Cause of this Disease, tho it ceases for the most part of its own accord, upon the removal of the procatarctick Causes. For if the passage of every extraneous matter into the Brain be cut off, nothing will hinder, but that the Spirits being as pure as may be, and having gotten free and open spaces within the Corpus cal­losum, may flow thence every way. However, that we may prosecute [Page 416]this scope of curing together with the former, we must also inter­changeably use Medicines endow'd with a volatile Salt, whose Particles being very subtle and active, refresh the animal Spirits; of which kind chiefly are the Spirits of Harts-horn, Soot, Sal Armoniack impregnated with Amber, man's skull, &c. the tinctures of Coral, Amber, Antimony, the Elixir of Peony, &c.

These things being thus premitted concerning the Vertigo in gene­ral, it seems likewise proper for us to delineate a therapeutick me­thod more particularly, and to give an orderly process of it: And first, it shall be shewn what is to be done in the Fit for curing it, and then what out of the Fit for preservation.

1. As to the former, tho an invasion of the Vertigo, how violent so­ever it may seem, for the most part is free from danger, and often pas­ses off easily of its own accord; yet because those that are affected with it, fearing themselves a dying, desire Physical Aid; in such a case, if the Pulse indicates it, a Clyster being premitted, let bleeding be ordered; then a Vesicatory being applied to the Neck, let strong-smelling things, as Castoreum, Spirit or volatile Salt of Harts-horn, Ʋrine, or Sal Armoni­ack be presently held to the Nostrils: moreover, let those Spirits be given twice or thrice a day, with a convenient dose of a Cephalick Julep; going to bed let a bolus of Mithridate with powder of Castoreum be taken: the day following, if the affect be not yet gone, let a gentle Purge be given; or if the Diseas'd be inclined, or easie to vomit, let an Emetick be taken, than which there is scarce any Remedy more excellent.

Take Pillulae de Succino twenty five grains, Rosm of Jalap six grains, Tartar vitriolat seven grains, Balsam of Peru what suffices, make four Pills to be taken going to bed, or early in the morning: or,

Take Sulphur of Antimony five grains, Cream of Tartar half a scruple, Castoreum two grains, make a powder, to be taken with governance, ex­pecting a vomiting.

That Vomits often do good in the Vertigo, besides the testimony of Authors, it sufficiently appears also by common observation; and since vertiginous Persons vomit often of their own accord, hence an opinion has grown amongst many, that the cause of this Disease lies hid in a manner alwayes in the Stomach, but we have shewn elsewhere that this is otherwise, and that the vomiting frequently happens by reason of the Spirits being troubled in the Brain. Now the reason why Eme­ticks do good in this Disease, is, that by this kind of Medicine, both a very great Revulsion is made of Humours from the Brain, and that the Spirits there being in a tumult, are presently restrain'd. When the Membranes and Fibres of the Ventricle and the Viscera placed near it are twitcht, various Humours, viz. the nervous, serous, lymphick, pan­creatick and bilous, are drawn into those Parts, and so dreined that the Brain continues free from their Incursions, nay, and easily throws [Page 417]off a great many then sticking in it; Then, as to the animal Spirits, we have shewn elsewhere that there is alwayes a very great communicati­on and intimate accord betwixt those that reside in the Stomach and those of the Brain; so that a grateful or ingrateful affect of the Sto­mach from things taken, causes erections or dejections of the Spirits re­siding in the Brain. Opiats, whilst remaining in the Stomach, bring a sleepi­ness, so in the Vertigo and other Cephalick Diseases, it will not conduce a little to the redressing and regulating of the Spirits in the Brain, when all in confusion, and mightily agitated, if their consociates or relations be put in a consternation within the Ventricle by an irritating Medicine; for whilst for the aid of these, a great many are call'd from the Brain, the others remaining remit of their disorders, and resume their ancient Offices; doubtless it is chiefly for this reason, that Emeticks often give great Relief in affects of the Mania, insomuch that certain Empiricks use in a manner those alone.

2. But returning from this small digression, let us consider what is to be done for curing an inveterate, and almost continual Vertigo, out of the Fit: therefore in the first place a method being ordered concer­ning blooding and purging to be us'd, and repeated at fit intervals of time according to the Constitution and strength of the Patient; I also use to advise that a Vomit (if nothing indicates the contrary) be ta­ken once a Month; for which end, to weak Persons, after the Stomack's being fill'd with light food, let Wine and Oximel of Squills be given, to two or three ounces, and afterwards let posset-drink with Carduus leaves boyl'd in it be drank in a great quantity, and let it presently be thrown up again with a spontaneous or forced vomiting: To others, let an Emetick be given of Salt of Vitriol, or of the Infusion of crocus Metallo­rum: Concerning Issues, Vesicatories, the opening of the hemorrhades, also of a Plaister or Cap to be worn on the Head, and of topicks to be apply'd to the soles of the Feet, or to the Wrists, for revulsion or derivation, let a Physician deliberate.

Take Conserve of the Flowers of male Peony six ounces, powder of its Roots an ounce, Peony seeds powdered two drams; Amber, Coral, Pearl pow­dered of each two drams and a half, Salt of Coral a dram, Syrup of coral what suffices, make an Electuary. The Dose is a dram and a half, or two drams in the evening, and early in the morning, drinking after it three oun­ces of the following distilled Water.

Take fresh leaves of Mistletow six handfuls, roots of male Peony, Angeli­ca, of each a pound and half; the white dung of Peacocks two pounds, Car­damum bruised two ounces, Castoreum three Drams, all being slic'd small, and mixt together, pour to them of White wine, or of Whey prepar'd of it, eight pounds, distill it with common Organs, let the whole Liquor be mix'd.

Take powder of the root of male Peony half an ounce, red Coral prepar'd, Species Diambroe of each a dram and half, powder of male Peony flowers [Page 418]fresh bruised and dried in the Sun, a dram, make a powder, to which add of double resin'd Sugar dissolved in Peony water, and boyled to a consistency for Tablets ten ounces, make Tablets according to Art, weighing half a dram, let one or two be taken often in a day.

Because all things do not agree with all Persons, but a Physician ought to assay divers Medicaments, and insisting on a various Method, at one time to try these Medicines, another those, therefore I shall here set down certain forms of another kind.

Take our Syrup of Steel six ounces, let a spoonful be taken in the Morn­ing and at five of the Clock, with three ounces either of the distilled Water even now described, or of some other Cephalick Water: or take from fifteen to twenty drops of our Syrup of Steel with a draught of the same distilled Water twice a day, I have known these things to have given great Relief to many.

Sometimes let doses of the Spirits of Soot, Harts-horn, or Sal Armoni­ack, impregnated with Amber, Coral, or Mans Scull, or let tincture of Amber, Antimony, or Coral be daily given after the same manner.

Take Powder of the Roots of male Peony an ounce and a half, Peony Seeds, Coral prepared, white Amber of each three Drams; Pearl prepared, Pow­der of male Peony Flowers fresh bruised, and dryed in the Sun, of each two Drams, Sugar-candy one Ounce, make a Powder, let a Dram be taken twice a day, with a draught of Tea or Coffee, or a Decoction of Sage or Rosemary.

For poor People let a Powder be prescribed of the Leaves of Misteltow growing on Apple Trees, dryed in the Sun and powdred, to a dram, to be taken twice a day: or take the white Dung of a Peacock six Ounces, pow­der of the Flowers of male Peony an ounce, Sugar two Ounces, make a Powder, let a Spoonful be taken twice a day in a convenient Liquour.

Let vertiginous Persons use for their ordinary Drink small Ale with the Leaves of Mistletow growing on Apple Trees boyled in it instead of Hops, and in a Vessel of four Gallons let a Bag be hung, in which put of Pea­cocks Dung half a pound, and of Cloves bruised three Drams.

So frequent and daily Examples of Persons troubled with the Verti­go occur, that it seems but to little purpose to give here any instances of them: however that the Types of this Disease may be known, I shall relate here some few and rare Cases.

A Divine sixty years of Age, after that he had been troubled for about three Months with a slight Vertigo, or a frequent Coruscation as it were of the Spirits in the Sinciput, at length the Disease increasing, he be­came affected also with a dizziness and a falling-Evil; in so much that in walking sometimes he would fall flat on the Ground; Being called to cure him, I prescribed blooding, with a gentle purge to be repeated at fit intervals of Time, moreover I diligently gave Electuaries and mixtures, such as above-written, Vesicatories and other Administrati­ons being not neglected: after a fortnight no relief being found from [Page 419]these things, I gave him a vomit of Salt of Vitriol, and an infusion of Crocus Metallorum; upon which having ten easie vomits, he presently from thenceforth was better, and Cephalick alteratives being used for about a fortnight longer, he grew perfectly well, and from that time he took yearly Spring and Fall for six years a vomit, with certain other Medicines, and even at this time is in perfect Health,

A certain Gentleman sixty six years old, after that he had lived for a long time obnoxious to a light Vertigo, and which was wont to be rai­sed as it were only occasionally, about the end of Autumn being more severely troubled with that affect, became also forgetful: going to see him after he had been ill about three Weeks, I found him very much changed in his Countenance and Aspect, the vigour of both being very much broken. To this Person, who had every Evening a smart Feaver, with a high and strongly vibrating Pulse, in the first place I ordered Blood to be drawn from the Arm, and after six or seven dayes from the hemorrhoide Veins; moreover I had Vesicatories presently applyed to his Neck and incontinently after behind his Ears, and Cauteries be­twixt his Shoulder-Blades for two large Issues to be there made: he took daily inwardly at Physical Hours Cephalick Remedies almost of every kind. Within a Months space seeming to recover, he began to walk abroad and to take care of his domestick Affairs and other Concerns. But at the beginning of the Winter, upon taking cold, as he went daily abroad, he fell into a small Feaver with a great Perturbation of the Spirits within the Brain: for every day towards the Evening being light-headed, he scarce knew what he did, or said, nevertheless within seven or eight dayes, the Feaver vanishing after blooding and a thin dyet, the affect of the Brain was changed from its former state. For the Vertigo wholly ceasing he became very forgetful, and withall Paralytical in the whole right side. Being often askt concerning his Head, whether it was clear, and free from a Scotomia and confused Phantasms, he answered, that as to those things it was never better: for he understood well his Infirmi­ty, knew his Friends, Relations, and others that came to visit him, but could scarce call to mind any of their Names: and when he went about to discourse of any thing, he wanted words to express the Sense of his Mind: Moreover as to the side affected, in the right Arm and Thigh, there was not only a total Resolution and Immobility, but likewise in both a very great aedematous Tumour grew, insomuch that not only almost all hope of cure was laid a side, but even of keeping him long alive; nay, others were already solliciting for the State Offices and Em­ploys he enjoyed.

However, I desisted not from proceeding with a Method of cure, and prescribed him loosning Pills to be taken by intervals: and on other dayes, at physical Hours, Cephalick, Antiscorbutick, and Antiparalytick Remedies: I ordered a Plaister of Gums and Balsoms to be applyed to his Head shaved, the parts resolved to be anointed and strongly [Page 420]chafed with Oyles and Balsoms: whilst these things were done with some kind of success, as to the greater clearing of his Understanding; I know not through what cause, in the midst of Winter he fell into a Feaver, so that he was greatly troubled every Night with a heat, and mighty drought, and an interrupted Sleep, his Tongue was parch'd and rough, his Pulse high, his Urine ruddy, and full of contents; we abstained from blooding by reason of his old Age, and Palsie, and chiefly by reason of a Dropsie began in the side affected: nevertheless a thin dyet and Barly and Oat Broths being commanded, we gave him day after day Juleps, Apozemes, and other Remedies moving Sweat and Ʋrine: and as at this time the Issues made by his shoulder Blades ran plentifully, the diseased began to be better as to his Memory and Palsie, and thence­forward recovering by degrees from both these affects, and withall from his Feaver, and daily growing better; within six Months he was re­stored to his perfect health, and at this time is very well.

Being tired of late with the almost daily complaints of a certain im­portunate Person, troubled with the Vertigo, after a great many Reme­dies us'd to no purpose, I prescribed at length that for a Months space he should take every day twice about a spoonful of the following Pow­der, drinking after it a draught of a Decoction of Sage or Rosemary, im­pregnated with the Tincture of Coffee.

Take powder of the roots of male Peony two ounces, flowers of the same bruised and dried in the Sun, one ounce; the white dung of a Peacock half a pound, double refin'd Sugar, two ounces, make a powder.

It is scarce credible how great a Relief he found by this Remedy. Coming to see me again a Month afterwards, he seem'd to be a new, and another man; being freed from his Vertigo, he did not only walk about with confidence, but was able to take care of his Houshold af­fairs, and to manage other difficult Concerns, of which before he was wholly incapable.

CHAP. VII. Instructions and Prescripts for curing the Apo­plexy.

THE seat of the Apoplexy seems to be within the same inward portion of the Brain, viz. The Corpus Callosum, as that of the Vertigo; to wit, in as much as in both affects the Imagina­tion, common Sense, tho in a far differing degree, are affected, viz. in the former the irradiation of the Spirits, is wont to be obscur'd in [Page 421]some places, and to be inetrrupted with little Clouds, as it were, scattered here and there, but in the latter, the same is forthwith wholly darkned, and undergoes a total Eclips.

The Apoplexy, according to the import of the Word, denotes a striking, and by reason of the stupendous Nature of the affect, as tho it contain'd somewhat Divine, it is called a sideration: for those that are seized with it, as tho they were Planet-struck, or smitten by an invisible Deity, fall on the Ground on a sudden, and being deprived of Sense and Mo­tion, and the whole animal function (unless that they breath) ceasing, they lye dead as it were for some time, and sometimes dye out-right: and if they revive again, they are oftentimes affected with a general Palsie or an Hemiplegia.

Tho it may seem a Paradox, it is not disagreeing with Reason to say that the Apoplexy is two-fold, and that one of them belongs to the Cere­bellum, and that the other has its seat in the midst of the Brain: the former happens by reason of the animal Spirits design'd for the vital function, being supprest in their very source, viz. within the Cerebellum, the motion of the Heart being often thereby letted or supprest, as we have intimated before that this happens in some sort in the Incubus: and doubtless to this cause ought to be attributed what I have observed in some, that after a great heaviness in the Occiput, a Swooning with a sudden privation of all the animal function ensues: in which the disea­sed lye without Motion or Sense, with a Pulse and Respiration greatly diminish'd, and scarce perceivable, and being all over cold for many Hours, nay, often a Day or two, more resembling Persons dead, than living: We have sometimes known Persons so affected, who have grown cold and stiff, their Pulse and Respiration seeming wholly to be ceased, and who have been really taken for dead, and put in their Cof­fins, yet after two or three dayes to have come to life again.

To enquire into the causes of the other, and the wayes of its coming to pass, we must first distinguish concerning the various Invasion of this Disease; to wit, how sometimes being raised from a sudden, solemn, and invincible cause, without any previous Disposition or Procatarxis, it is for the most part mortal; against this no Procatarctick or preservatory Method can be ordered; and the method of curing it, which is ordina­rily entred upon, for the most part becomes ineffications: or secondly an Apoplectick Fit, having an antecedent Cause, or a previous Procatarxis is brought into act through various Occasions or evident Causes.

As to the seisure of the former kind, viz. being sudden and unawares, its conjunct, and immediate cause is either a great Solution of Continu­ity hapning some where within or near the middle of the Brain; through which its Pores and Passages being obstructed, or comprest, all ema­nation of the Spirits is supprest, or it is a great and sudden putting to flight, or extinction of the Spirits residing in the Brain.

The things which are wont to cause a great solution of Continuity within the Brain, are, Blood extravasated, an Abscess suppurated and broken, and an inundation of a serous humour; and tho this latter sel­dom or never happens of it self, yet sometimes, by reason of strong evident causes, such a glut of serous filth rushes into the Brain, that pre­sently filling and stuffing all its medullary Pores, it renders the Person speechless, which I have known to have hapned to some upon sleeping presently after having drank too largely of small Wine and Spaw Waters; I have observed the like affect upon a total and long continued sup­pression of Urine. And in malignant Fevers the serous recrements by a critical Metastasis being conveyed to the Brain have often caused a loss of Speech with Death.

Of the evident Causes by which an extemporary Apoplexy is wont to be procured, the other kind consists in a sudden profligation, or extincti­on of the Spirits: which strong Narcoticks, and an immoderate drinking of hot-Waters often effect.

Thus much concerning the Causes of the accidental and extemporary Apoplexy, which bring a fit of it on all Persons indifferently, tho not predispos'd; and wherefore there can be no Prophylaxis ordered, and it is seldom that a Cure succeeds. But we observe besides, that this Disease sometimes is habitual, viz. That there remains in certain men a constant Disposition, by reason of which first slight Bickerings trouble them, afterward by short intervals greater accesses come upon them: of which for the most part they dye at last.

As to the conjunct cause of this Disease, it consists in the sudden fil­ling of the Pores of the Corpus Callosum, and the destroying of the Spi­rits by the approach of a malignant matter.

Its procatarctick Causes are the like as in most other affects of the Brain, viz. both the Blood is in fault, that either engendring of it self, or ta­king from elsewhere extraneous Particles, and such as are very adverse to the texture, or constitution of the animal Spirits, and as it were ex­tinctory of them, it sends them to the Brain: and moreover, the fault of the Brain is, that being weak in its Crasis, and too lax and loosned in its Pores and Passages, it always admits so easily and without resistance the morbifick matter obtruded from the Blood.

The Subject of this Disease being the Brain, or the Cerebellum, or both together; the Brain is shewn to be most obnoxious to it, by pre­vious and frequent Scotomias, and vertiginous Affects: the Cerebellum is argued to be ill-disposed by a frequent Incubus, an intermitting Pulse, a Swooning, and frequent Fainting.

The Prognostick of this Disease is never declar'd but fatal and dubious: for an Apoplexy is never without danger either present, or to come, but the worst is, in which, besides all the spontaneous Functions being abo­lish'd, the Pulse also and Respiration either fail, or are carried on with much adoe, and then for the most part it happens with a foaming at [Page 423]Mouth, and a Swooning, to which at length a sweat (which most com­monly is colliquative) supervening, foreshews that Death will happen very suddenly.

Those who being seized with the Apoplexy are deprived of Pulse and Respiration, and a little after growing cold, seem to be dead, ought not presently to be taken forth of Bed, or to be left without Physi­cal Administrations: moreover, tho no hope of Life appears, let them not be buried till after three or four dayes: for such, either of their own accord, or by the use of Remedies sometimes revive: which hap­pens not by reason of the vital heat being raised up again in the Heart, (for it was not wholly destroyed here) but for that the morbifick mat­ter being discuss'd, or evaporated from the Cerebellum, the motion of the Heart is renewed, as that of a Clock upon hanging on Weights.

In an Apoplectick Fit, if after letting Blood relief follows, some hope of well-doing appears: but if after this and other Remedies the affect continues above four and twenty hours without remitting, or grows worse, all hope is over concerning the diseased.

If after the first seisure of a speechlesness being well over, the dis­eased afterward becoming more drowsie and dull, is affected with a Scotomia, and a frequent Vertigo, it is a sign that he will be obnoxious to other accesses of the Apoplexy: for the foresaid affects proceed from the morbifick matter at that time deposed in the circumference of the Brain, and there floating here and there, and now and then descend­ing by small parts only, into the midst of it, which matter, whether it be Vitriolick or Narcotick, after that it is gathered together to a ful­ness, brings the Apoplexy.

The Therapeutick method either is curatory, for removing the fit, after it has seized, or preservatory for preventing it from returning: the former regards every Apoplexy, the other only that which is habi­tual.

A fit of the Disease hapning (if it does not proceed from an outward or violent hurt of the Head) tho it be unknown whether it be raised by an invisible cause (such as are an extravasating of the Blood in the Brain, or an Abscess broken) or not: however we ought diligently to endeavour its cure. And because the Blood being too turgid is wont to induce the morbifick cause, or at leastwise to increase it, and when it subsides and becomes more calm is wont sometimes to remove the same: therefore in the first place we ought to deliberate concern­ing the moderating of its course. And here a question arises con­cerning the site of the diseased, viz. Whether he ought not presently to be put to bed, or rather to be kept out of it for some time? some religiously observe the latter, nor is it without reason, because in Bed there is a greater propension to sleep, and the Blood boyling more, and burning more freely by reason of the ambient hear of the Bed, sends more of the recrementitious matter into the head affected: on [Page 424]the contrary, when the diseased being thinly cloathed, is plac'd in a Chair, the Blood flows more slowly, and the subsiding Vessels seem more fit rather for drinking up humours sent from the Brain, then for sending them thither. Wherefore, if the Patient be strong enough, it may haply be better for him to stay out of Bed for six or eight Hours, till the Fluxion of the morbifick Matter be past, and the course of the Blood be made more calm by blooding, and other Re­medies carefully administred. But let those that are weak, and of a tender Constitution, be put presently to Bed as soon as they are seiz'd. Let the site of the diseased, whether he be in Bed, or out of it, not be on his Back, but the Head somewhat raised, and learning sometimes to one side, sometimes to the other.

Blooding, being necessary almost in all Apoplectical Persons, may not be delayed: but a smart Clyster being injected, let Blood be taken in a plentiful quantity. In the Clyster let there be dissolved Species Hierae Diacolycinth: and a thick infusion of Crocus Metallorum: let a large Vesicatory be applyed to the Neck, and others to the Leggs, and drawing Cataplasmes to the feet: let the Temples and Nostrils be anointed with appropriate Oyles and Balsoms, and let painful Frictions be used to the Limbs, nay to the whole Body: meanwhile let those things be now and then given, which raise up the animal Spirits, and free them from their Fetters, viz. Spirit of Harts-horn, Soot, and the like, with a Cephalick Julep.

Afterward, the diseased being put to Bed (if he seems easie and able enough to bear a Vomit) let a vomitory of Salt of Vitriol, Oxymel of Squils, or an infusion of Crocus Metallorum be given: and now and then a Quill being thrust into his Throat, let a vomiting be raised four or five times, Posset-drink by intervals being poured into him.

The vomiting being over, let comforting things, as Quercitans Elixir of Life, Spirit of Lavender, or of Treacle camphorated, Tincture of Peony, or of Amber, or Coral, be given in a fit dose, with Apoplectick and other appropriate Waters, and as occasion requires let them be repeated.

On the second day the same Remedies being still continued, let dry Cupping-glasses or with a scarification, also be applyed about the Shoul­der-blades, or in the Neck: or if more Blood ought to be drawn, let the Jugular Vein be opened; let the Clyster be repeated; Let Spirit of Sal Armoniack, or a steam of Galbanum boyled in sharp Vinegar be held to the Nostrils: Moreover, let Errhins, and Apophlegmatisms be used: afterward in the Evening let a purge of Pilulae Rudii, or the Electuary of Roses so­lutive dissolved in some Liquour be given.

These things doing no good, tho there be small or no hope, let either a burning hot Iron, or a large Vesicatory be applyed to the Crown of the Head shaved; let the remaining part of it, and chiefly the Forehead, and Sinciput be somented with Bezoardick Vinegar: [Page 425]Let Leeches be applyed to the Temples, or behind the Ears; Let Spi­rit of Harts-horn, or of Soot be given him in a large dose, and often; we must insist on these and other ways of adminstrations till death seems to be at hand, which (as Celsus has it) those kind of Remedies often only delay, and in the mean while prove troublesome to life.

The Prophylactick Method regards both those, who have been for­merly set upon with one or more Invasions, and those who seem prone to them, as being born from Apoplectick Parents, or being obnoxious to the Vertigo, Incubus, or frequent Faintings, and such as have the Neck short and thick grown.

Spring and Fall let purging and blooding (where it is proper) be used; as to the former let those that are easie to vomit, take first a vomitory of the Infusion of Crocus Metallorum, with Salt of Vitriol, or of Sulphur of Antimony, and then after three or four dayes, let a dose of Pilulae Rudii, or of Amber be given; and afterward by due intervals let it is be repeated three or four times: let two large Issues be raised near the Shoulder-blades, or if those Places do not please some, let them have one in the Arm, and another in the opposite Leg.

On other dayes free from purging, let altering and cephalick Me­dicines be taken twice a day.

Take Conserve of the Flowers of Lillies of the valley (or of male Peo­ny) six ounces, powder of the roots of male Peony half an ounce, mans skull prepar'd three drams, seeds and flowers of male Peony powdered, of each two drams, red Coral prepar'd, Pearl and white Amber of each a dram, Salt of Coral four scruples, syrup of the flowers of male Peony what suffices, make an Electuary: the dose is two drams morning and evening, drinking after it of the following water two or three ounces.

Take roots of male Peony, Angelica, Master-wort, of each half a pound, roots of Zedoary, the lesser Galingal, of each an ounce, leaves of Mistletoe of Apple-trees, Rue, Sage, Betony, of each four handfuls, the outward coats of ten Oranges and eight Lemmons, Cardamums, Cloves, Nutmegs, of each half an ounce; all being slic'd and bruised, pour to them of White-wine (in which two pounds of Peacocks dung hath been infused for a day) ten pounds: let there be a close infusion for three dayes, then distill it according to art, let the whole Liquor be mixt.

Take species Diambroe two drams, powder of the roots of male Peony, choice Zedoary of each a dram and a half, Pearl a dram, Oyle of pure Amber half a dram, double refined Sugar dissolved in Peony Water, and boyled to a Consistency, for Tablets, six ounces, make Tablets according to art, weighing half a dram; let the Patient eat one or two often in a day at pleasure.

Within fifteen or twenty dayes, the Remedies, that they may be less loathsome and more advantageous ought to be changed; therefore instead of the Electuary, give for a fortnight or three weeks sometimes Spirit of Sal Armoniack saccinated, or coralliated, or impregnated with Mans [Page 426]Scull, or Castoreum; sometimes the Elixir of Peony, or the tincture of Amber, or Coral, or Quercitans Elixir of Life, mixtura simplex: Also, instead of the compound Waters let them take either the Water of black Cherries, or of Walnuts, or of Rosemary, or of Lavender simple, sometimes a draught of Posset-drink with the Flowers of male Peony, or of Lillies of the Vallies boyled in it, or a draught of Tea or Coffee, in the Morning (those Ingre­dients being first boyled in the Water of which it is prepared) or let a Confection of Chocolate be made after this manner.

Take powder of the Roots of male Peony, mans Scull prepared of each half an ounce, Species Diambrae two drams, make a Powder, to every paper of which add Cocao-nut-Kernels a pound, Sugar what suffices, make a Confection, let half an ounce or six drams of this be taken every Morning in a draught of a decoction of Sage, of Peony Flowers, or the like.

Take Powder of the Roots of male Peony, mans Scull prepared of each an ounce and a half, Roots of choice Zedoary, bastard Dittany, Angelica, Contrayerva of each two drams, make a subtle Powder of all of them, add the yellow Coats of Oranges and Limons preserv'd of each two ounces, let them be bruised together to a Powder, let about half a dram, or a dram be taken an Hour before and after meals.

For ordinary Drink, let a Vessel of four Gallons be filled with midling Ale, in which boyle the Leaves of white sweet-smelling Hore-hound dryed six handfuls, Anacardiums, Cardamums, of each an ounce and a half, be­ing slic'd and bruised, make a Bag.

But especially, let an exact form of Dyet be observ'd: Let a tempe­rate, dry, and well ventilated Air be chosen; let food only of an easie concoction, and light, be eaten; let the Supper be spare, or none at all; let sleeping at noon, drinkings, and other ill accustomances about nonnatural things be shunned.

I might here instance several stories of Apoplectical persons, viz. of some, who, tho seiz'd once or twice, are still living; and of others kill'd by the first, or second, or afterward at the third Invasion. The Right Reverend Father in Christ, Gilbert Lord Arch-bishop of Canter­bury, lives still, who escap'd above six years since from a severe Apo­plectick fit, (God, to whom ever be praise, giving success to Physical endeavours,) and from that time, tho he has now and then under­gone light touches of the Disease, yet he has never been so prostrated by it as to become speechless, or insensible: But it's to no purpose to dwell long in setting forth this and other examples, in regard they contain nothing very rare, whence the Aetiology of the Disease may be illustrated. I have dissected some dead Bodies, but they were in a manner only of such Persons as were seiz'd Apoplectical after the Head being greatly hurt, as by a stroke, or a fall, in all which the Blood extravasated, or an Abscess was the cause of Death: As to the opening of Persons dead of an habitual Apoplexy, we are most com­monly hindred by Friends, who expecting their revival, both delay [Page 427]the Interrment, and wholly forbid Anatomy. But I shall give you here one notable Anatomical Observation made about five years since at Oxford.

An ancient Divine, an honest and pious man, of a gross Body, and ha­ving a short and full grown Neck, being long ill-dispos'd in his health, and leading a sedentary life, had contracted a very Scorbutick Cacochymia; being affected with a difficult and pursy breathing, and with an unwonted heaviness and drowsiness of his Head, he was scarce able to perform any thing of labour or exercise, but to go and come daily from his Chamber to the Chappel, and Refectory: On a certain morning, entring the Chap­pel a little before Prayers, as he set himself on his knees, being struck on a sudden, and presently becoming speechless and insensible, he fell on the ground; but being forthwith rais'd up, and his Cloaths taken off, he was put into a warm Bed: My self and other Physicians being call'd, and coming as quick as might be, we found him not only with­out Sence, Pulse and Respiration, but cold and absolutely stift through­out his whole Body: Nor could he be brought to life, or to a heat by any Remedies, or ways of administration, tho applied with all dili­gence for some time: Whence we imagin'd, that from his first be­ing struck, the beat of the Heart was wholly stopp'd, and its flame being extinct, that presently all motion of the Blood was sup­pressed.

The next day after we opened the Body, it appearing to be quite dead and stiff; nothing doubting but very clear footstepts of an affect so suddenly mortal, left within the Brain, would shew themselves to the eye; but neither there, or in any other part, was there remain­ing so much as any shadow of the Disease, tho very violent: the ves­sels irrigating the Meninges were indifferently fill'd with blood, but without any inflammation or extravasation: the Brain, Cerebellum, and medulla oblongata, with all their processes and prominences, ap­pear'd every where firm and well-coloured throughout, both within and without: neither was there Serum nor extravasated Blood heapt together any where within their Pores and Passages, nor also within the greater Ventricles: nay, and the plexus choroeides plac'd both within the Cavity of the Brain, and behind the Cerebellum, seemed free from all fault, so that the morbifick matter being as fine and subtle as the Spirits which it affected, remained wholly inconspicuous, and we could only argue its presence there from the effect.

Nevertheless, lest it should lye hid elsewhere without the Head, after having accurately inspected all the Contents of the Brain, we came to the Thorax, where the Lungs being discoloured, and stufft throughout with a frothy Ichor, shew'd manifestly enough the cause of the difficult and pursy breathing; but the Heart being sound and firm enough, was wholly free from any obstructions, or polipous con­cretions. Moreover, neither near it, nor in other adjacent Viscera [Page 428]was any Abscess or Impostume found, by whose contact or ill favour the Heart could so be opprest, or the Vital Spirit (in case this be possi­ble) on a sudden be suffocated.

Wherefore in this case we could imagine nothing else, but that the Animal Spirits residing within the middle of the Brain were on a sud­den put to flight, and extinguished as it were by certain malignant, or narcotick, or otherwise infesting Particles; so that the motion of the Heart, as of the first mover in a machine, failing on a sudden, pre­sently all the other Functions, their impulses being taken away, whol­ly ceas'd.

CHAP. VIII. Instructions and Prescripts for curing the Palsey.

THE middle of the Brain, or the Corpus callosum, where we have assign'd the Seats of the Vertigo and Apoplexy, seems al­so to be the place primarily affected in the Epilepsy; but of this, as also of convulsive Diseases, we have treated elsewhere: where­fore let us descend to other lower Regions of the Brain, and its Ap­pendix, and next let us describe the affects that belong to the Cor­pora striata, medalla oblongata, and also to the nerves and nervous Fi­bres.

These Parts execute all the Functions that regard motion and sense, wherefore the failings or enormities of these must be affects of those Bodies, or of the Spirits residing in them: now sense and motion are injur'd chiefly two ways; for both are wont to be perverted, or stop­ped; when motion is perverted, Cramps and Convulsions; when Sense, pains arise; when either Function or both of them together are letted or abolish, the Affect thence rais'd is call'd the Palsey; of which we must treat at present.

The Palsey is described after this manner, viz. That it is a Resolution, or Relaxation of the Nervous parts from their due Tention; by reason of which Motion and Sense, to wit, either one of them alone, or both of them together cannot be exercised in the whole Body, or in certain parts of it after a due manner.

The Nervous Parts are resolved because the animal Spirits doe not sufficiently irradiate, raise, and actuate them with vigour: The cause of which defect is, either an obstruction of the Ductus's, whereby their passage or conveyance is hindred; or an impotency of the Animal Spi­rits, [Page 429]inasmuch as being affected with a stupefaction, or being but few, they do not display themselves vigorcusly enough: By reason of these various ways of affecting, divers kinds of the Palsey arise: For first, as to motion by it self, this spontaneous faculty (which chiefly, and in a manner only, is obnoxious to the Palsey) sometimes in the whole Body, or in certain parts, is wholly abolish'd; but sometimes it being only letted, is diminish'd or deprav'd. Secondly, in like manner we observe as to Sense by it self, that either one Sense, or many together, sometimes wholly are taken away, and that sometimes they are very much diminished or vitiated. Thirdly, sometimes it happens that both powers are injur'd together; we shall speak of each of these in order, and in the first place of the Palsey, in which spontaneous motion is abolished; which we conclude to happen chiefly for two causes, to wit, by reason of the Ductus's being obstructed, or of the Animal Spi­rits being struck with a stupefaction, or, as it were, with a certain malignant blast.

As to the former, the Interception of the Spirits from the Parts re­solved by reason of the Pores being obstructed, it being always above the Parts, is wont to happen in various places, and for divers causes; but especially either in the primum sensorium, viz. in the Corpora Stri­ata, or somewhere about the Caudices Medullares; or lastly, in the Nerves themselves; and so lightly it happens either in their origines, or in the middle of their Processes, or in their extream parts, viz. the Nervous Fibres. When the Injury happens to the Corpora Stri­ata, or Medulla oblongata, or Spinalis, it either obstructs the whole running of the marrow of the Back-bone, whence a universal Palsey arises beneath the place affected; or one half of it, whence a Hemi­plegia: or it affects the heads of some certain Nerves either in one side, or in both together, whence resolutions are caus'd in this or that member separately from the others.

There are many ways, by which the passages of the Animal Spi­rits in the foresaid bodies are obstructed; viz. either, first, their Ductus's are fill'd with an extraneous matter forc'd into them; or se­condly, they are compress'd by extravasated Blood, a glut of serous filth, or some tumour lying on them; or thirdly, there is a solution of their continuity, as by a wound, stroak, concussion, also by an ex­cess of heat or cold.

As often as a Ʋniversal Palsey, or Hemiplegia (as is usual) ensues up­on a Lethargy, Carus, or Apoplexy, it is obvious to conceive that such a change of the Disease happens by reason of the removal of the matter, viz. inasmuch as this passing at length from the pores and passages of the Corpus Callosum (which if first possest, and falling a little lower,) enters into the medullary tracts of one Corpus Striatum, or haply of both.

If it be askt why Sense is not always hindred as well as Motion in the Palsey, since both are performed by the same Nerves and Fibres, and as it seems, within the same medullary tracts, so that one faculty is only the inversion of the other; it seems here to be said, that, as Light passes through Glass where the Wind is excluded, so also Sense continuing en­tire, Motion often is abolisht: Moreover, Sense is only a Passion, and sensi­ble impression, which is propagated by the continuity of the nervous pro­cess, from the Organ to the sensorium commune, without any effort or force of the Spirits, which might be done, tho the Sensorium Commu­ne be somewhere obstructed, and the Spirits residing in it are grown dull; But Motion is a difficult and laborious Action, to which it is re­quired that the Spirits display themselves vigorously, and make as it were explosive affects, not only in the moving Organs, but especially about the parts where the principle of Motion and its first Impetus is, also in the whole passage through the Nervous parts. Wherefore, whereas a few Spirits, and those disabled, suffice for Sense, many are required for Motion, and those free and prompt as to their Expansions.

I have observed in many that when they were first affected with an Indisposition of the Brain, a Dulness of the Mind, and a Forgetfulness; and afterward with a Stupidity and Dotishness, they fell afterward (as I was wont to predict) into a Palsey; viz. the morbifick matter be­ing fallen by degrees, and at length heap'd together to an opilative plenitude somewhere within the Caudex Medullaris, where the medul­lary Tracts are more straitned than in the Corpus Striatum.

What before we said in the Apoplexy, we affirm now in the Palsey, that the morbid Particles are not only opilative, but sometimes narco­tick, and extinguish the Spirits; thus the steams of Antimony, Mercury, and Auripigment, cause weaknesses, tremblings, and often, resolutions of the Members to some using amongst furnaces of Metals. In like man­ner we may imagine, that in certain scorbutical and very cacochymical Persons, heterogeneous Particles, and seemingly of a vitriolick nature, enter the Ductus's of the Nerves, and subvert certain files of the Spirits, or suppress their motion; hence stupors or resolutions sud­denly arise in the Members or Muscles, sometimes in these, and some­times in those, they often removing from place to place, and some­times a fixt Palsey is settled: And in every Palsey caused by obstructi­on, the morbifick matter is not a gross and viscous phlegm, (as Galen and many Physicians affirm) for such does not pervade the Brain, much less the Ductus's of the Nerves; but seems to consist of subtle and very active particles, tho injurious to the animal oeconomy, for the Palsey happens to men, as a blight or rust does to Plants; for some Winds endued with Vapours more than cold, viz. of a vi­tious or vitriolick Spirit, when they blow upon young tender Plants presently cause them to wither; viz. in as much as the tender stami­na interwoven every where like Nerves in the Leaves and Branches [Page 431]are so throughly constring'd by the blast of the malignant Air, that they no longer admit the Juice sent from the Trunk and Root, through defect of which they wither: after the like manner extraneous, and as it were, vitriolick Particles admitted within the Organs of Sense and Motion, in as much as at the same time they stop the Pores, and de­ject the animal Spirits, or restrain them from Motion, bring as it were a blast on the respective Parts.

As to the evident causes of an habitual Palsey, viz. through what occasions those that are disposed to this Disease contract it sooner, or being already seized with it, are more severely troubled with it: I say all such things make for this, which add to the vitiating of the Blood, also which fill the Brain, and its nervous Appendix, or raise suffusions of a morbifick matter in it, those things likewise wich affect the Spi­rits with a Stupefaction, or diminish their Stores: in the number of these first occur disorders in the six non natural things, an ill form of Dyer, a drinking of strong Wines, or hot Waters, too much or unseasona­ble Sleep, Idleness, and a sedentary Life, immoderate Venery, too great losses of Blood, a moist and marshy Air, houses fresh plaistred, metallick Fumes and Vapours, frequent use of Narcoticks, or To­bacco, an excess of Cold, Heat, or Moisture, vehement and long con­tinued Passions of Sadness and Fear, with many other things, which I shall not here stand to relate.

There is another kind of this Disease depending on the scarcity and fewness of the Spirits, in which tho motion fails wholly in no Part or Member, yet it is performed but weakly only, or depravedly by any: to wit, the affected, tho not become without Motion, yet they are not able to move their Members, or to sustain any Burthen with strength; moreover in any moving effort they are troubled with a trembling of the Limbs, which is only the effect of Weakness, or a broken strength in the moving Faculty.

Persons become subject to this affect by reason of an extream or va­letudinary old age, also through immoderate losses of Blood or Seed; and likewise by reason of being very scorbutical, or cacochymical: and many recovering with difficulty and slowly from a chronick di­stemper are troubled with a languishing of the Limbs, and a great re­solution of the Members from their due Vigour and Strength; so that tho their Stomack holds good, and their Pulse and Urine be well dis­posed, yet being enervated, as it were, and without Strength, they scarce dare to set upon any local motion, and if they begin it, they cannot hold it long: nay some, without any considerable sickness, keep their Beds for a long time, as Persons ready to dye; whilst they lye undisturbed they discourse with their Friends, and are chearful, but they neither will, nor dare be raised up, or walk about, nay they ab­hor all motion as some dreadful thing. Doubtless in these, tho the ani­mal spirits in some sort actuate and irradiate the whole Genus Ner­vosum; [Page 432]yet their Stores are so slender and loosly set together, that when many Spirits ought to be gathered together somewhere in it for motion, there is great danger lest presently in the Neighbourhood their Conti­nuity be broken off, and consequently the tension in the Nervous Parts ber esolv'd. Wherefore, in regard the Spirits residing in the Brain are conscious of the Weakness of the others plac'd in the Members, they refuse to impose local motion on their Companions, as being a task too difficult for them; for which cause the affected are scarce led by any perswasion to try whether they are able to go or not: but those who being troubled with a scarcity of Spirits, will force them as much as they may to local Motions, are able at their first rising in the Morning to walk, move their Arms this way and that, or to lift up a weight with strength; but before Noon the store of the Spirits which influ­enc'd the Muscles being almost spent, they are scarce able to move Hand or Foot. I have now a prudent and honest Woman in cure, who for many years has been obnoxious to this kind of bastard Palsey, not only in the Limbs, but likewise in her Tongue; This Person for some time speaks freely and readily enough, but after long, hasty, or labo­rous speaking, presently she becomes as mute as a fish, and cannot bring forth a word, nay, and does not recover the use of her Voice till after an hour or two.

In a certain species of the Palsey the sensitive faculty is hurt by it self, motion being still entire; this is obvious enough concerning the Organs whose Nerves are only relating to Sense, as of the Sight, Hear­ing, Tast, and Smell, and the Reason is plain enough. But that in the uttermost habit of the Body, or the Members, sometimes the touch perishes, the locomotive Power being without hurt; as it is every where seen in Persons affected with the Leprosie, Elephantiasis, and in some troubled with the Mania who are wont to go naked, and to lye on the Ground, and who are become so insensible in the Skin and the Flesh of the Muscles, that they do not feel the cuts of a Pen­knife, or Needles any where thrust into them. This I say is very dif­ficult to be explained; But concerning this it must be said, that the same Nerves haply convey forward and backward the instincts of Mo­tions, and the Impressions of sensible things; but that the same Fibres which are locomotive are not alway, or chiefly sensible: We have shewn elsewhere that the muscular and tendinous Fibers execute the former Power, but the sensible Species is received in a manner only by the membranous Fibres; wherefore the outward Skin is the primary Organ of the touch; after this the Membrancs that cover the Muscles, and lastly, those that compose the Viscera are in the same sort affected by the tangible Object, wherefore the hurt or loss of the touch happens by reason of an Injury offered the outward Membranes; viz. when the Fibres of these are obstructed with a Vitriolick Matter, or are very much constipated by an excess of Cold, so that the animal Spirits which [Page 433]ought to receive their Impressions, are excluded from their Organs, and that these Inhabitants of the outward Members are only affected it thence appears, because the Members deprived of Sense do not wither as those deprived of Motion, but continue full and fleshy; which is a sign that the animal Spirits still entring the Nerves and carneous Fibres give their vertue to the Function of Nutrition: but when Motion being abolish'd, the Spirits are in a manner wholly banish'd from those parts, the Flesh withers away, because the nutritive Matter tho brought to them by the Arteries, is not assimilated.

As to the Prognostick of the Palsey, 1. Any Palsey that happens, the knowing and vital faculties being unhurt, ought not to be judged an acute Disease; but being free from sudden danger, admits of a cure at long run, or at leastwise of an endeavour for it.

2. This disease hapning through an evident cause alone, as by a stroke, a fall from an high Place, a wound, &c. or coming upon an Apoplexy, Carus, Convulsion, Colick, or other affects of the Brain, or Systema Nervosum, if it be not altered for the better, or yeilds to Medicines in in a short time, for the most part proves incurable.

3. If upon the origine of the medulla oblongata being wholly ob­structed, or through the Spine's being vehemently hurt, a total resolu­tion follows and takes away Sense and Motion, the affect is cured with difficulty, or scarce at all.

4. A Palsey hapning to men that are Aged, Cacochymical, greatly Scorbutical, or intemperate, tho the affect be not great, is cur'd with difficulty.

As the Types of the Palsey are many fold, and its causes divers, so its cure ought to be undertaken not always after one manner, but by a various method, viz. appropriate to each species of that Disease: for the most part there will be these three kinds of it, or rather there will be three wayes of healing, whereof sometimes this, sometimes that, or the other, ought to be entred upon in order to the cure of this Disease, to wit, according as the resolution (of what kind soever, and in what place soever it be) is either first caused on a sudden by an outward accident, viz. a stroke, a fall from an high Place, a wound, an excess of cold, or the like; or secondly, succeeds some other affect, viz. The Apoplexy, Carus, Colick, or a long continued Fever; or thirdly, being a Disease primarily, and of it self, depending of a Proca­tarxis, or previous apparatus, is raised by degrees: we shall speak of each of these particularly.

1. When therefore a Palsey is caused by reason of some accident, with a violent hurt, there will not be many Intentions of curing, but only that the part injured may recover its ancient confirmation; and first, left the Blood and other humours flowing to it, as being af­fected and weak, and there staying, increase the evil, let Phlebotomy, which most commonly is requisite in this case, be presently put in [Page 434]practice; afterward a thin dyet, if the case requires it, or a dyet of easie concoction being ordered, we must insist chiefly on moderate Hydroticks; to wit, that whilst the diseased, put to bed, is kept in a gentle sweat, all sorts of Superfluities withdrawn from the part injured may plentifully exhale, and that the Spirits being gently agi­tated within the Pores and Passages of it, so opened by the warm ef­fluvia, may recover their former Paths and Tracts.

For this end, let the Powder for a fall, described in the Pharmacopoea August and be given to the quantity of about a dram in a draught of White­wine, or of Posset-drink made with it, (it being usual amongst us to give to the like quantity of Irish-slat,) and let it be repeated every six or eight Hours: Moreover let a Traumatick Decoction, if it may readily be had, either of the Roots of Madder, or Butter-burr, or of the Flowers of St. Johns wort in Posset-drink be frequently given.

Moreover, let the place affected in the mean time be diligently search'd after, which will easily be known, partly from the hurt in­flicted on it, and partly from the member resolv'd. If any thing be dislocated in it, we must endeavour that it be presently put in its place: If a tumour, contusion, or wound be made, let relief be given them by balsas, liniments, fomentations, or cataplasms: But if no­thing preternatural appears outwardly, let as much as suffices of the Oxycroceum and Red Lead Plaisters, mixed together in an equal quan­tity, be applied to the part hurt, and let the Diseased by kept at rest, and in a moderate warmth for three or four days: if the resolution continues obstinate, and an afflux of new matter be not feared, let more resolving and discussing Remedies be applied about the places affected; wherefore let fomentations, and hot liniments, nay, and natural hot Baths, if it be convenient, or at leastwise artificial ones, be used: Sometimes it is good to put the members affected in warm Horse-dung, or Grains, and to keep them there for some time: and now and then to interlace Clysters and gentle Purges with the use of these things. But if no relief follows these Administrations, this af­fect ought afterward to be handled with the like Method, and the same Remedies with which an habitual Palsey, or any other that is confirmed, or follows upon other Diseases is dealt with: which way of cure we shall give you beneath, in regard it is common to every Palsey deeply rooted.

2. When a Palsey, hapning upon a Fever, Apoplexy, Carus, or other Cephalick or Convulsive affects is great, and comes on a sudden; we must chiefly use a Physical means for the removal of its Conjunct cause, which has its seat in a manner always in the Medulla oblongata, or Spinalis: Wherefore in the beginning of the Disease let Blooding and Purging (if nothing indicates the contrary) Clysters, Vesicatories, Cupping-glasses, Sneezers, Liniments, and other administrations usual in Cephalick Diseases, viz. such as some way drive out, or with­draw [Page 435]the morbid matter sticking in the Caudex Medullaris, or the little Heads of the Nerves proceeding from it, be us'd: And if the first effort of Physick does nothing within fifteen or twenty days, the affect afterward, in regard it is firmly rooted, and become habitual, is to be overcome by a long method, and by Preservatory, as well as Curatory Indications; of which we shall presently speak.

3. An Habitual Palsey, depending of a Procatarxis, is either in fieri, or in its disposition, or in facto, or in its habit; both require a peculiar way of Cure.

Of the former there are two chief cases, in both of which the The­rapeutick method, regarding only the Procatarctick causes, is ordered af­ter the like manner: to wit, whether any Person be in danger of being seiz'd with the Palsey, or recovering from it, be in hazard of a relapse, we must insist in a manner on the same Medicines.

Therefore the Intentious of Curing must be, first, that the functions of Chylification and Sanguification being duly perform'd, a laudable matter for the generation of Animal Spirits be sent to the Brain in a sufficient plenty: and then, secondly, that the Brain being still firm and of a due conformation, admits into it, and duly exalts into Ani­mal Spirits all apt particles, excluding such as are heterogeneous; for these ends we have thought good to propose the following method, which ought to be varied according to the various constitutions of the Diseased.

Spring and Fall, let solemn courses of Physick be entred upon, nay, and the whole year besides, let some Remedies be constantly used: Bleeding is not generally proper for all Persons: and if we forbid this, it is not for the same reason with the Ancients, supposing the Palsey to be a cold Disease; but because the Animal Spirits are both engendred from the Blood, and become elastick within the moving Fibres, by reason of a sanguineous combination; therefore if the store of this be lessened too much, they will fail and flag. Which truly I have observed in many, and that for the most part in the Arm, from which the Blood was drawn, languishings and tremblings have begun. Nevertheless, a spare and moderate Bleeding sometimes agrees with some that are endued with a Blood that is hot and sharp, and apt to too great effervescencies, tho they are disposed to the Palsey.

About the Equinoxes, purging ought to be ordered, and to be re­peated by due Intervals three or four times; but in the first place let a Vomit, if nothing indicates the contrary, be given of Salt of Vitriol, Sulphur of Antimony, or an Infusion of crocus metallorum, or Mercurius vitae; afterward let Pillulae de succino or Aloephanginae be taken by them­selves, or with Rosm of Jalap, every seventh or eighth day: At other times let Cephalick Remedies, such as we have prescribed for the sleepy affects, viz; Electuaries, Powders, Spirits and volatile Salts, Tinctures, [Page 436]Elixirs, with distill'd Waters or Apozemes, viz. sometimes these, some­times those, or others be frequently used. Let Issues be burnt in the Arm or Leg, nay, in gross and cachectical Persons together in both, or near the Shoulder-blades. Let a Physick-drink of Sage, Betony, Stoechas, the wood Sassafras, Winters bark &c. be drank the whole year. Wine and Venus ought either to be forbidden, or to be allowed only spa­ringly.

But if the Palsey, after a previous disposition in the whole, or in one side, or in certain members, throughly seises, and, notwithstand­ing the first encounter of Physick, comes on again; for its cure a long and complicated method, which is alwayes requisite, often times does not suffice; for not only the Disease, or its conjunct or procatarctick Cause severally, but all together, must be assaulted: for which ends, blooding for the most part being forbidden, only a gentle purge, and that but now and then, is proper. Again, and indeed chiefly, against the Proca­tarxis of the Disease, Cephali [...] and Antiscorbutick Medicines are wont to do good: but not all of these kinds agree with all Persons, but, as we have observed in the Scurvey, according to the various Constitu­tions of the Diseas'd, the Remedies also must be of a differing kind and vertue: for with bilous paralyticks, in whose sharp and hot blood there is much Salt and Sulphur, and very little Serum, hot Medicines, and such as are endowed with very active Particles, do not agree, nay often prove offensive to them; which nevertheless prove greatly beneficial to phlegmatick persons, whose blood is colder and contains a great deal of Serum, and a few active Elements. Wherefore, accor­ding to this two-fold state of the Diseased, it seems fit for us to pro­pose here a double method of Cure, and two Classes of Medicines, whereof this will do well to be given to cold paralyticks, and the other to such as are hot.

In the former case, for the removal of the procatarctick Cause, after a Vomit and a Purge duely ordered, I advise to be prescribed according to the following forms.

Take Conserve of the leaves of Garden Scurvy-grass, and of Rochet made with an equal part of Sugar, of each three ounces, Ginger condited in the Indies an ounce, the yellow coats of Oranges and Limons preserv'd of each six drams, powder of the Claws and Eyes of Crabs of each four Scruples, species diambroe two drams, winters-bark a dram and a half, roots of Ze­doary, the lesser Galingal, Cubebs, the seeds of Garden-cresses, rochet, of each a dram, Spirit of Scurvy-grass, and of Lavender, of each two drams, Syrup of the conditure of Ginger what suffices, make an Electuary: Let the quantity of a Walnut be taken at eight a clock in the Morning, and at five in the Af­ternoon, drinking after it a pound of the following decoction, or six ounces of the Tincture of Coffee, with the Leaves of Sage boyled in it, or three ounces of Viper-wine.

Take Raspings of Guaiacum six ounces, Sarzaparilla, Sassafras of each four ounces, red and yellow Saunders, shavings of Ivory and Harts-horn of each half an ounce, infuse them according to art, and boyle them in sixteen pounds of fountain-Water, to a half, adding Crude Antimony, powdred and tyed in a Nodulus, four ounces, roots of Calamus Aromaticus, the lesser Galingal of each half an ounce, Florentine Orris an ounce, Cardamum six drams, Co­riander seeds half an ounce, six Dates, make a Decoction, and let it be used for ordinary drink.

Going to Bed, and early in the Morning, let a dose be taken either of the Spirit of Soot, or of Harts-horn, of Sal Armoniack succinated, of Blood, &c. with three ounces of the following distilled Water.

Take of the Leaves or Roots of Aron a pound, Leaves of Garden Scurvy-grass, the greater Rochet, Rosemary, Sage, Savory, Time, four handfuls, Flowers of Lavender three handfuls, the outward rinds of ten Oranges and six Limons, Winters bark three Ounces, Roots of the lesser Galingal, Cala­mus Aromaticus, Florentine Orris of each two ounces, Cubebs, Cloves, Nutmegs, of each an ounce, all being slic'd and bridsed, pour to them of White-wine and Brunswick Beer of each four pounds, let them be distilled with common Organs, and let the whole Liquour be mixt.

Sometimes instead of the Electuary, for fifteen or twenty dayes let a dose of the Tincture of Sulphur terebinthinated, or the Tincture of Antimony, or of Amber: sometimes also let the Elixir Proprietatis, or of Peony be taken in a spoonful of the distilled Water, drinking after it three ounces of the same.

Sometimes also let the following Powders or Tablets have their turns in the course of Phyfick.

Take powder of Vipers Flesh prepar'd at Montpellier an ounce, Hearts and Livers of the same half an ounce, Species Diambroe two ounces, make a Powder, let a dram be taken twice a day, with three ounces of the di­stilled Water, or with Viper Wine, with a decoction of the Leaves of Sage, of the Roots and Seeds of the great Bur-dock, and Eringo roots condited made in a sufficient quantity of Fountain-Water to a half, to the quantity of six or eight ounces warm in the morning, expecting a sweat.

Take Solar Mineral Bezoar half an ounce, Cloves powdred two drams, mix them, make a powder, to be divided into twelve parts; let one part be taken twice a day after the same manner; with the use of these kinds of Remedies, let gentle Catharticks be pretty ften interlac'd.

Take powder of choice Roots of Zedoary, and the lesser Galingal of each a dram and a half, Species Diambror a dram, powder of the Seeds of Mustard, Rochet, Scurvy-grass, Water-cresses, of each half a dram, make a subtle powder of all: add pure Oyle of Amber half a dram, with six ounces of white Sugar dissolved in compound Peony Water, and boyled to a Consistency for Tablets, make Tablets according to Art, each weighing half a dram, let three or four be eaten twice a day, drinking after it a dose of some one of the Liquors even now mentioned.

Take powder of the roots of Virginia Serpentary two drams, of the lesser Galingal a dram, of the Gummous extract from the residency of the distilla­tion of Quercitans Elixir of Life a dram, Flowers of Sal Armoniack (or of pure volatile salt of Soot, or of Harts-horn) a dram, Balsam of Peru a scruple, Balsamum Capivi what suffises, make a Mass, let it be made into little Pills, rowling them in species Diambrae, the dose is half a dram evening and morning. (or)

Take Rosin, or Gum of Guaiacum three drams, species Diambrae a dram, Chymical Oyle of Guaiacum excellently rectified a dram and a half, liquid Amber what suffices, make a mass, let it be formed into Pills, to be taken after the same manner.

But if a Palsey, hapning in a bilous Temperament, or in young Per­sons, admits only mild Medicines, being wont to be exaspirated by any that are hot and elastick, the following forms will be of use for removing its Procatarxis.

Take Conserve of the Flowers of Betony, Fumitory, Primrose Flowers of each two ounces, species Diambrae a dram, Ivory, Crabs Eyes, Crabs Claws of each four scruples, Powder of Peony Flowers two drams, Lignum Aloes, yellow Saunders, of each a dram, Salt of Wormwood, a dram and a half, with a sufficient quantity of Syrup of Peony Flowers make an Electuary, the dose is two drams a day, drinking after it either of the simple Water of the Leaves of Aron, or of the following compound Water three ounces, or of a Decoction of Sage, with the Leaves of Tea infused in it four or six Ounces.

Take Rots of Aron, male Peony, Angelica, Masterwort, of each half a pound, Leaves of Sage, Rosemary, Marjoram, Booklimes, Water-cresses of each four handfuls, the Flowers of Primroses, Cowslips, Marygolds, of each three handfuls, the yellow coats of six Oranges, and four Limons, all being slic'd and bruised pour to them of new Milk six pounds, Malaga-wine two pounds, distill them with common Organs, let the whole Liquour be mixt.

Instead of the Electuary sometimes for fourteen or fifteen dayes, let the use of the Syrup of Steel be interlaced, wherefore let a spoonful be taken in three ounces of the distilled Water, it may be made after this manner. Take double refined Sugar dissolved in black Cherry Water, and boyled to a Con­sistency for Tablets eight ounces, adding of our Steel powdred three drams; let them be stirred together on the Fire, and then pour to them by degrees, Rose­mary Water warmed twelve ounces, let them seeth gently for a quarter of an hour, taking off the froth, and pour it out warm through a hair Strai­ner.

Chalybeat Tablets also may be made after this manner; viz. To the Sugar sufficiently boyled with the Steel add Oyle of Amber, or Chymical Oyle of Rosemary half a dram, and presently pour it forth that it may run abroad into a Consistency for Tablets, the dose is two drams twice a day, drinking after it of the distilled Water, or of the following Apozome six ounces.

Take China Roots an ounce, shavings of Ivory and Harts-horn of each half an ounce, white and yellow Saunders, Mastick-wood of each half an ounce, let there be a warm and close infusion for a Night, in six pounds of Fountain-water, in the Morning add Roots of Chervil, Avens, Butchers-broom stone-Parsley of each an ounce and a half, dryed Leaves of Ground-Ivy, Sage, Germander, Betony, of each a handful, Coriander Seeds three drams, let them boyle to a half, then add of White-wine half a pound, and strain it into a Bottle on two handfuls of Leaves of Water-cresses bruised: make a warm and close infusion for two hours, strain it again, and keep it in a stopt Vessel.

In a scorbutick Palsey Juices and Expressions of Herbs often give an excellent relief.

Take fresh Leaves of Brooklimes, Water-cresses, Plantain, of each four handfuls, being bruised together, pour to them of the distilled Water even now described eight ounces, express it strongly, keeping it in a Glass, and let three or four ounces be given twice or thrice a day.

At the earliest and latest physical Hours, viz. in the Evening and early in the Morning, let the following Pills be taken.

Take Millepedes prepared three drams and a half, Pearl a dram and a half, Roots of bastard Dittany a dram, Venice Turpentine what suffises, make a mass, form it into small Pills, the dose is half a dram, drinking after it a little draught of the distilled water.

For ordinary drink let either a Bochet be prescribed of Sarsa, China, yellow Saunders, &c. or small Ale, with the dryed Leaves of Ground-Ivy boyled in it, and of Sage, with the wood Sassafras infused.

While these things are done for removing the Procatarxis of the Disease, no less a curatory endeavour is required for its conjunct Cause, viz. that any places obstructed, being again opened, may admit and give a free passage to the animal Spirits, freed from stupefaction.

There are two chief kinds of Remedies which conduce much for these ends; viz. the one particular and special, to be applied to the Places affected, to wit, that by Fomentations, Liniments, Plaisters, and other outward Applications the stupified Spirits may be raised up again, and their Ductus's be opened: the other universal, to wit, that the Blood and Spirits, and the other humours (and the active particles abounding in the whole Body) being very much agitated and put in a more rapid Motion, making as it were a swift current, may force from before them and remove damms, or Obstacles any where sticking, by which the Spirits are obstructed.

The Administrations to be used to the outward Parts, are so gene­rally and vulgarly known, that it would be superfluous to insist here in describing them at large. First, let Liniments of Oyles, Unguents, and Balsams, more or less hot according to the temperament of the diseased, be applied twice a day with Frictions. Let Fomentations of a Decoction of Cephalick Herbs and Aromaticks in Fountain-wa­ter [Page 440]be sometimes us'd before these; adding sometimes hot Waters, Wine or Beer, or their Lees: moreover, it is proper sometimes to apply Vesica ories, Cupping-glasses, a Pication, or Urtication about the places affected. Bags, and Playsters oft do good. Again, if the case admits it, it is profitable for the resolv'd Members to be put into Grains, or the Dregs of Grapes remaining after pressing, or to be thrust into the Belly or Thorax of a Beast fresh killed, or also be bath'd in an artificial Bath, or natural hot Baths, and to be kept in any of these for a long time.

But if these things do no good, we must come to the Universal or great Remedies: such as chiefly are Diaphoreticks, Mercurials raising a Sali­vation, and strong Vomitories: of each of which we shall speak in short.

There is no one of the Vulgar but every where observes that Dia­phoreticks sometimes do great good in the cure of the Palsey, and that sometimes they prove very prejudicial. Wherefore it much concerns us that the reasons of so different an effect should be explicated; to the end that Indications may be thence taken concerning the use, or rejecting of them.

Therefore a copious sweating is wont sometimes to prove very ad­vantageous to Paralyticks, chiefly for two reasons; to wit, that it may plentifully drive forth the impurities of the Blood, and nervous Juice, which are apt to exhale, so that the morbifick Matter may no longer flow to the Brain, and the Parts affected, and that that which has alrea­dy flown to them may in part be conveyed forth. And then secondly, that the effluvia of heat passing from the boyling Blood very much open the Ductus's of the Nerves before obstructed, as they pass through them in evaporating, and open wayes for the Spirits. Wherefore this Ad­ministration agrees chiefly and in a manner only with those, whose Blood, being not filled with a fixt Salt and Sulphur, is diluted with a limpid and insipid Serum: for on the contrary, Paralyticks, whose Blood and Humours are greatly stor'd with wild, Exotick, and fixt Particles of exorbitant Salts and Sulphurs, and such as are unfit for exhaling, often receive a great damage from a sweat violently raised, of which effect we assign these two Causes, to wit, that the morbifick Particles being too much exalted by reason of their Agitation, become more exorbi­tant: and then secondly, that being driven plentifully into the Brain, and Genus Nervosum, they often increase the ancient Obstructions, and not unfrequently produce new.

For raising a plentiful and easy Sweat, both inward Medicines and outward Administrations are wont to be used: the former stir the Blood or Serum to effervescencies, or stimulate the Heart to quicker Motions, and thence (whether one of them, or both be performed) when the Liquor of the Blood, being rapidly circulated through the Heart and Vessels, is put into a frothy Turgescency, it cannot but [Page 441]discharge from it self a great many Effluvia, which are the matter of Sweat: for this end Medicines of various kinds are recommended to Paralyticks, of which those of chief note are, a decoction of Guaiacum, Sarsaparilla, &c. Spirit, and Oyl of Guaiacum, mixtura simpelx, Flowers and Spirit of Sal Armoniack, Aurum Diaphoreticum, Salt, Powder, and Wine of Vipers, mineral solar Bezoar, Tincture of Antimony, &c.

Outward Administrations promote a Sweating, for as much as they raise and keep a moderate heat in the whole circumference of the Bo­dy, and then the Blood being heated, is forc'd to move more swiftly, and to evaporate more, and withall, the pores of the Skin being open'd, more readily let forth all Particles apt to exhale; for this end, besides Bed-coverings (which only keep the Effluvia of heat emitted from the Body in its circumference) a Cradle likewise with Charcoal, or Spirit of Wine, kindled, a Hot-house, and Baths of various kinds and forms, and natural Hot Baths are wont to be used; but above all, our Hot Baths at Bathe, than which (if they agree well with the tem­perament of the Patient) no more excellent Remedy can be imagin'd, which is sufficiently shewn by the Crutches of a great many Persons cur'd of resolved Members, hung up as so many Trophies of the Con­quest of this Disease.

Nevertheless, as generous Medicines, if they do not prove Alexi­pharmicks, often pass into Poysons, so the use of hot Baths, when it has not cur'd some Paralyticks, has rendred them much worse; so that more Members, and such as were before affected, being more re­solv'd, there has been no other occasion for the Diseas'd for leaving their Crutches there, but that being rendred more weak they could use them no longer: we have hinted the cause of this before, to wit, that bathing exagitating the Blood and all the Humours, exalts more all Morbifick and heterogeneous Particles, and being rendred more exorbi­ant, drives them from the Viscera into the Mass of Blood: whence (in regard they cannot easily evaporate) entring the Brain, and Genus Ner­vosum, they increase the Paralytick affect, and often bring a Convulsion with it: for this reason Bathing sometimes first actuates a Nephritick, and Gouty Disposition, moreover, it brings to many a Blood-spitting Asthma, or Consumption, where no Disposition was; wherefore hot Baths ought not to be tryed without the advise of a Physician, and being try'd, if they seem not to agree, they ought soon to be left.

I have it sufficiently confirmed both by my own Experience, and that of some other Physicians, that some Paralyticks are cured by a Saliva­tion raised by Mercury, but I judge that this kind of Remedy is to be us'd only in an habitual Palsey, viz. which has a Procatarxis in the Blood and Brain readily enough to be moved, and a conjunct Cause in the nervous Appendix, which is not very fix'd: but when that affect is caused by an outward and great hurt, or happens upon a Carus, Apo­plexy, or Convulsions, Salivation is attempted in a manner always in [Page 442]vain, and sometimes not without a mighty Prejudice; and let not those who, having a weak or over-lax Brain, are frequently subject to a Vertigo, drowsiness, and convulsive Motions, use Mercurial Medicines inconsiderately. But sometimes a Salivation does mighty good in an habitual Palsey, and which is not very fix'd, for as much as by taking away the Impurities of the Blood, it cuts off all the fuel of the Disease; and in as much as some Mercurial Particles, whilst having past the Brain, they enter the Ductus's of the Nerves, divide the Morbifick matter sticking in them, and severing its parts one from another, disperse them several ways, some forward and some backward. Whereas it is a common fault of other Medicines, that often they press forward only the damm that obstructs the ways of the Spirits, and therefore if they do not force it asunder, they drive it more firmly into the places obstructed.

And it is in some sort for this reason that Vomitories often do egre­gious service in Curing the Palsey: to wit, that they withdraw the fuel of the Conjunct Cause, and do not drive only forward the matter sticking in the Nerves, but revulse it, mightily shake it, and often break it into minute parts, so that when the Continuity of the damm is broken, the animal spirits themselves easily dissipate the Particles of the Morbi­fick matter sever'd from each other; we have intimated before another reason concerning the relief of Emeticks in the sleepy affects, which has also in some sort place in the Palsey.

So very many Examples and Instances of Paralyticks daily happen every where, that the various Types and Histories of them (if they were described) would fill a mighty Volume, wherefore I shall only set down here some of the more rare, viz. one or two, with which each chief species of that Disease may be illustrated, and since it would be to little or no purpose to give a Relation of Resolutions of Mem­bers hapning by reason of some outward Accident, as a fall from an high Place, a Wound, or a Stroke, I shall insist only in describing those Cases, where the Palsey arises either by it self after a previous Dispo­sition, or follows upon some other Disease.

Some time since, a certain Gentleman, Robust, well in Flesh, and above forty years of Age, having been in a manner always in health, at length giving himself to a sedentary Life and Idleness, and after­ward becoming more dull than usual, refused any exercise and vi­gorous motion of the Body: moreover, being melancholy and sad, on any light occasion, nay, sometimes without any manifest cause, he was wont to break forth into a weeping and tears: this Person a short while after (which I have also observed of many others) was affected with a Weakness and a Trembling of all the Members, and afterward with a Resolution of the lower Parts, by which Disease (being me­lancholy and soon a weary of Physick) yielding himself overcome, and growing weaker by degrees, he dyed within six months.

I remember many others, but especially two committed to our care, being as to the first part of their Life mighty Ingenious, and well Learned, who afterward in their declining Age, partly by reason of a Cacochymia of the Body, and partly through a trouble of mind growing dull and forgetful, at length (notwithstanding the use of Remedies in the beginning of the Disease) became Paralytical.

A young man of a sanguine temperament, clear spirited, and for the most part Healthy, sitting in a Chair after a plentiful Supper, and an immoderate Drinking of Wine, was so affected with a stupidity in his right Hand, that his Glove, which he happened to hold, fell down against his will; afterwards standing up and endeavouring to go, he perceived a resolution in the Leg and Thigh of the same side, fal­ling a little afterward into a certain dulness of Mind, and a stupidness, tho without an Apoplexy, for he was always present to himself, an­swering aptly enough, tho slowly, and with some trouble, to things asked, and doing things that were commanded him; a very skilful Physician being presently called, Blooding, Vomiting, Purging, were used in order, Cupping-Glasses, a Scarification, Liniments, Frictions, and other fit Administrations were diligently applyed: nevertheless the Palsey increas'd, so that besides Motion almost taken away from the Members of the right side, he lost also the sight of that Eye: yet, tho dull and sleepy, being still Compos mentis, he knew his Friends, and being conscious of his Infirmity, and sollicitous for the recovery of his Health, he took all Remedies offered, but notwithstanding this, the animal functions daily fail'd more and more, and through a consent with them, at last the vital, so that about the seventh or eighth day falling ever and anon, sometimes into a Delirium, sometimes into Convulsions, and other distractions of the Spirits, at length his strength being gone, he yielded to Death.

A certain Noble-mans Bayliff, about forty years of age, having a sharp Blood and a bilous temperament, and long obnoxious to a Vertigo, as he rode through a certain Village in the Country, being seiz'd on a sudden with a Scotomia, fell head-long on the ground; where being presently ta­ken up by the Inhabitants, and put to Bed, he lay for many hours insen­sible, and dead as it were; but afterward awaking, he found all the members of both sides resolv'd into a Ʋniversal Palsey: going to see him the next day after, I presently drew about twelve ounces of Blood, and forthwith prescribed other Remedies, both as to out­ward administrations, and inward Medicines to be diligently us'd, and indeed with good success; for after five or six days he began to stretch forth, or bend his feet, nay, to move them from their place this way and that, tho slowly; afterward, by the constant use of Re­medies, he was able within two months to raise himself, stand on his feet, and go a little with Crutches, then having us'd at his house an artificial Bath for some time, he daily gain'd in the motion of his [Page 444]members, and his strength; at length, assoon as the season of the year was fit, going to Bathe, and by the use of the hot Baths perfectly re­covering within six weeks, he returned sound, leaving there his Crutches.

The following Relation will manifestly shew that the Palsey does not only follow upon Cephalick affects, but also on the Colick and Scurvy.

A handsome Woman, and young, after Child-birth fell into a Tertian Ague, this afterward becoming a Quotidian, and the cure protracted, brought a very violent Cholick, and of long continuance. Pains first raged only in the Abdomen, with a vomiting and most bitter tortures: being long tormented, and almost worn away with these, at length she began to be troubled with a stupor, and a sense of pricking, such as arises in members lain on. Nor was it long after but a Palsey (which that other affect very often fore-runs) followed in the whole Body. In this state being brought to Oxford, she was committed to our care; another famous Physician, D. D. Lydall, being called to joyn with me. Not only all the greater Members of this Diseased, but even the lesser of each Limb were so wholly resolved, that she was not able to stir from its place either Hand or Foot, or any finger of either hand. Moreover, she was so far affected with an Atrophia, that the flesh being wholly vanished, the Skin scarce stuck to the Bones, yet she still had a good Pulse and vivid Aspect, from which alone we gathered some­what of hope.

After that we had given this Person for many Weeks the choicest Medicines both Antiparaliticks, and Antiscorbuticks, almost of every kind, and according to various Methods, without any success, at length we proposed to her self and her Friends a Salivation, as a Remedy more powerfull than any others, but withall dangerous: not delibera­ting long concerning this, they resolve rather to try a doubtful Medicine than none, or which is the same, one wholly ineffectual. Therefore we gave her Precipitatum ex Mercurio cum sole in a small Dose, and re­peated it the next day after: on the third day, an easy and gentle Sali­vation beginning, went on fairly for a Week without any malign Symp­tome; but then the Diseased complaining of a great Head-ach and Ver­tigo, begun to be affected with Convulsive Motions, so that we were forced presently to let fall the Salivation, and to break off this Course as soon as we could, withdrawing the fluxion of the serous latex from the head towards the other parts, which frequent Clysters, Epispastick and Revulsive Plaisters applyed in various places, together with Cor­dials and Opiats inwardly given, soon effected; and presently upon it the noble Lady being somewhat better, begun to stretch forth and bend the Joints of her Hands and Feet, and to move sometimes those members or these from their place, the Spitting ceasing: being gently purged, she took for many days a decoction of China, Sarsa, red Sannders, Ivory, &c. with the addition of the dryed leaves of Sage, [Page 445]Betony, Speedwell, &c. with which she was wont to interlace the use of Spirit of Harts-horn, or of Soot, of a Cephalick and Cordiack confection, also of an appropriate Powder and Julep: within a Months space she was able to stand on her Feet, and to walk a little in her Chamber being support­ed by Servants: moreover, getting Sleep, and taking Food in­differently, the bulk of her Flesh and her strength daily increas'd, and at length using the temperate hot Baths at Bath she grew well.

But that hot Baths do not do good to all Paralyticks, nay (as we have intimated before) that they do great hurt to some, the follow­ing relation will plainly shew: A London Merchant after a Luxation of a Joynt of the Foot, became lame in that part, being otherwise sound enough, and robust: when Topick Remedies of various kinds, tryed for some, time did not do, at length by the advice of a Physician go­ing to Bathe, he began to try the temperate hot Baths, from the farther use of which (becoming forthwith worse upon it, the Palsey presently beginning in other Members) he had abstained, but the Physician be­ing then present, assuring him that he would be better afterward, ad­vised him to persist: wherefore he took the hot Baths again for about thirty dayes, till all the lower Members, to wit, from the Os sacrum to the Feet being wholly resolv'd, were withered, and that in the Thorax a very great and as it were Asthmatical dyspnaea was raised: for the Muscles imployed in Respiration (being as it seem'd affected also with the Palsey) the brest was not able to be dilated for drawing the Breath deep enough, wherefore, being always out of Breath, he labour'd under continual affects of those Parts, and an Agitation of the whole Thorax. In this state departing from Bathe, he is commanded by his Physician to abstain for a whole Month from any Remedies taken from Pharmacy: which when he had religiously observed, through hope as it were of a Resurrection, that time being past, all deliberation was now late concerning the use of Medicines: for besides the Paralytick and withered Members, his Belly swelled, his Respiration was yet more difficult and letted, that the diseased was scarce able to draw his Breath: his Pulse being very weak, with frequent Swoonings, and Faintings hapning upon any Motion of his Body: so that hereby scarce any place at all being left for Catharticks, he must insist only on Car­diack and Paralytick Remedies: notwithstanding the use of which, the diseased within six weeks labouring under a very great dyspnaea for many hours, at length dyed: the immediate cause of whose decease I conceive to be Polypous Concretions of Blood in the Heart, for in regard the Motion of the Praecordia was greatly letted for a long time, nothing seems more probable than that those kinds of carneous lumps as it were, were concreted within the Ventricles of the Heart.

For illustrating a little farther the Theories of the Palsey, and also of the Lethargy and Carus, I shall here give you another Example, with Anatomical Observations, which hapned whilst the precedent things were printing.

A child, little more than three years of Age, of a moist Brain, as it appear'd by sore Inflammations of his Eyes, and watery pushes of his Face (to which he had been sometimes obnoxious) at the beginning of Autumn being ill, with a slow Fever and a dejected Appetite, became very drowsie and sleepy, so that he slept almost continually day and night; but being awak'd, he knew the standers by, and answer'd aptly enough to things ask'd: meet Remedies, viz. Clysters, Vesicatories, Catharticks, also Juleps, Spirit of Harts-horn, Powders, with many other things usual in this case, being forthwith, and carefully given him, did so much good, that within six or seven dayes the diseased being free from his Feaver, waking sufficiently, and desiring Food, seem'd to recover, and scarce to have any more need of Physical help, But in a short while after (I know not on what occasion) undergoing a relaps, and being drowsie again, he was presently affected with a great Stupefaction, so that being with difficulty to be awak'd, he scarce knew any thing, or did any thing with Knowledge; the next day after, being utterly stupid, tho being pinch'd hard, he would open his Eyes, and roul them this way, and that, he saw nothing: and within a day or two a Palsey of the whole right side followed: The former Remedies repeated to him, and likewise Sneezers, Apophlegma­tisms, drawing of Blood, Cataplasms to be applyed to the Feet, and Epispasticks to the whole Head shaved, with other Medicines and wayes of Administrations prescribed in order, did nothing; but the diseased, after he had lai so for three or four dayes insensible, the Pulse and Respiration at length failing, he dyed.

The Scull being opened, the formost Region of the Brain, almost as far as the Insertion of the fourth Sinus, was swollen, being covered with a limpid Water shining through the Membranes, which upon the dissection of the Meninges presently flowed forth; Moreover, at that place the portions of the Brain cut off by piece-meal appear'd too moist, and almost without red or bloody specks; but in the hindmost part of the Brain the Vessels were red with Blood, and the cortical Sub­stance appeared more low and firm without a Tumour, or being floated with Water: from these things (as we have concluded before) it will manifestly appear that the Cause of the Lethargy depends on a watery glut of filth in the outward part of the Brain.

The Brain being cut off piece-meal, and a hole being made into the foremost cavity, strouting with a lympha, the limped water sprung forth as tho it had been pent up in too narrow a space before: whose mighty store had filled all the Ventricles to the top, and (as it seem'd) by compressing the Thalami Optici had caused the blindness, and by entring or compressing one Corpus Striatum, or its Pores, had brought the Palsey.

The Plexus Choroeides appear'd as parboyled, somewhat white, and almost without Blood, its probable that all the Lympha, or the great­est part of it, wherewith the Ventricles of the Brain were floated, [Page 447]distilled from those Vessels; tho in this case if (as some think) the watery latex sinking lower from the cortex of the Brain, at length ha­ving wholly pass'd the Brain, could fall into those Sinus's, a reason may not uneasily be thence taken wherefore the Lethargy seeming first to be cured, by and by being more violent, return'd again, with a Blindness and Palsey joyn'd with it, to wit, as at first the store of soporiferous matter fell from the Cortex of the Brain into its cavity, the animal Function grew a little clear; but afterward, when a new matter sprung in the Cortex of the Brain, and this falling into the Sinus's, was gathered together to a fulness, thereupon a Relapse of the former Dis­ease happened with the addition of a blindness and Palsey.

Now tho the Dropsy of the inner part of the Brain, or an inunda­tion of its Ventricles, by compressing the corpora striata or thalami optici causes a Palsey, or blindness, or by twitching the Origines of the Nerves, Convulsive affects; yet it most evidently appear'd by a late observation, that the Lethargy does not arise from such a Cause, but only from the outward part of the Brain being floated or compress'd.

A certain Gentleman, long sickly, after that he had been troubled almost for five Months with a Colick, or rather with a most violent scorbutick and running Gout, (in which not only the Viscera and Fi­bers were affected with great Gripes, but likewise the Membranes, and all the Muscles of the whole Body almost with continual Tortures) and at length suffer'd in his Members sometimes horrible Convulsions, sometimes Apoplectick Invasions as it were, or an offuscation of the Sight, at last his Strength being spent, and the Stores of his Spirits wholly exhausted, he dyed. For seven dayes before his decease (ex­cepting only the last save one) being more lively as to his Sense and Understanding, he lay almost continually awake: a little before this long waking, upon a Vesicatory's being applyed to his Neck, a vast quantity of water flowed to it; and thence-forward flowed forth daily, even to his death, that I may hence suspect he continued thus with­out sleep, by reason of the watery humour withdrawn from the Brain in too great a plenty.

The Head of the defunct being open'd, the inward Cavities of the Brain, or all its Ventricles appear'd fill'd to the top, and strouting as it were with a limpid water, nay about the top of the Spine the Funis medullaris it self seem'd to be surrounded with, and immerg'd as it were in Waters there heapt together. Without doubt for this reason such violent pains and cramps infested him in his Loyns and Members, and in the whole Habit of the Body; and by reason of the deluge in the Ventricles, he became obnoxious to frequent offuseations of the Sight, and resolutions of the Limbs: nevertheless there was no Lethargy here, tho the long watching was caus'd by reason of the waters deriv'd in too great a plenty by the Vesicatories from the circumference of the [Page 448]Brain. This Person had also gotten a Dropsie in his Breast, by reason of the Lungs being much vitiated: the Liver being of a vast bigness, appear'd every where with white spots, and almost without blood; so that the depravations of the blood and nervous juyce ought to be as­crib'd in some sort to these faults of the Viscera.

CHAP. IX. Instructions and Prescripts for the cure of the Deli­rium and Phrensy.

SO far of Cephalick Diseases, by which the Animal Functions by themselves, and as they are Corporeal, are wont to be letted or perverted, without respect to the rational Soul; in some of them, viz. in the Vertigo and Palsey, the Understanding for the most part continues clear and lively: and in the rest, as an Eye plac'd in an ob­scure place, it beholds either no Species at all, or a few only set before it with a gross appearance, but is not easily carried into a great Errour, or a Fury: which kind of Symptoms are generally caused by other affects of the Brain, and of the Spirits residing in it, of which we shall now treat, for if at any time the Imagination be so troubled, or per­verted, that it either conceives amiss, or ill compounds, or divides the Species and Notions presented by the Sense or Memory: thereupon presently the Understanding descryes, or frames only deform Concep­tions and Thoughts, distracted from each other, and greatly confus'd, which are represented to it by the Brain ill affected, as erroneous ap­pearances by a variegated, and distorted Glass: there being many ways with which the Imagination, and consequently the Mind and Will, and other Powers of the superiour Soul are wont to be pervert­ed or deprav'd, they all are denoted by the common word Desipi­entia. Now this Affect is distinguish'd into a short one, which is cal­led a Delirium, and a long or continual one, which is either joyn'd with a Fever and is called a Frensy, or happens without a Fever, and to it either a Rage, or Sadness, or Stupidity is joyned; and therefore it is divided into a Mania, Melancholy, and Fatuity. We shall speak of each of these in order, and at present of the Delirium and Frensy.

Tho the Delirium be not a Disease by it self, but is only a Symptom, proceeding from other affects: yet because in the cure of these on which it happens, it is usual to obviate it for the most part with appropriate Remedies; Therefore it seems to concern us to inquire somewhat strictly into its Nature and Causes. That word taken properly is the [Page 449]same as Dementia, and denotes such an annoyance of the animal Functi­on, as arising in the fits of Fevers, Drunkenness, and sometimes in the Passions called Hysterical, induces men to think, speak, or do absurd things, ( viz. some of these or all of them together) for a short time.

A Delirium is raised in as much as the Animal Spirits either being too much irritated, or put in Confusion, are carried hither and thi­ther within the globous frame of the Brain (where the Fansie and Memory have their Seats) in a disorderly and tumultuous manner, for so whilst the various species of the Imagination and Memory be­ing rais'd together, are confounded with each other, only absur'd and incongruous Phantasms are presented to the Rational Soul, and therefore the Acts of the Understanding and Will are wrought only irregularly. But reason of the Animal Spirits being irregularly mov'd within the Meditullium of the Brain, or the Corpus Callosum, incongruous conceptions and confused thoughts are presented to the Rational Soul, it hapning in like manner, as when the Species of vi­sible things are brought to the common sense after a long turning round of the Body, whence all things seem to run round, sometimes to be raised on high, sometimes to be depress'd low; so that nothing is seen fix'd and settl'd in its due site and position. In a Brain rightly disposed, the motion of the Animal Spirits is perform'd in cer­tain numbers and measures, as it were in a Dance; while certain Spi­rits are moved in these tracts, others lye still in those, afterward these maintain those with a supply in motion, and the several Acts of each Faculty become as so many distinct undulations of Waters in a River, but in a Delirium all the Spirits skip about together, and meeting each other in a tumultuous manner, or taking several ways, dance about like People distracted: Moreover, even as these being struck with such a Rage within the frame of the Brain, raise manifold and very troubled thoughts: so while they are carried beyond the confines of it into the Nervous Origine, they produce an Idle talking, absur'd Gestures of the Body and Members, and often Convulsive motions, yet since such a wild motion of the Spirits (otherwise than in the Frensy or Mania) soon ceases, and after that that tumult is over, no deviating tracts are made in the Brain, the Delirium soon passes off, and the affected in a little time come to themselves again, no foot-steps of the distraction remaining.

If it be ask'd, whence this short Fury is given the Spirits residing in the Brain, that shaking off the Reins of the Mind, they are so all in confusion in their Oeconomy; we say, that they enter upon this dis­order for a double reason, viz. this Rage is either immediately com­municated to them from the Blood irrigating the compages of the Brain; or certain animal Spirits residing in some outward part within the Genus Nervosum, first begin a certain disorderly Motion; and after­ward the same disorder being communicated to the Brain by the Ner­vous [Page 450]Ductus's, and affecting in like manner the Spirits there residing, causes the Delirium. There are various kinds and causes of both these, wherefore we shall here briefly touch the cheif; and first, it shall be shewn how and on what occasions the Blood, either swelling with too great an effervescency, or being full of a venemous matter, becomes the Parent of the Delirium: in as much as it insinuates into the Pores and Passages of the Brain, either exorbitant and masterless Particles, or such as are malignant, and subverting the animal oeconomy,

1. As to the former, in the Fits of intermittent Fevers, and the height of such as are continual: the Blood being troubled with an im­moderate burning, sometimes raises a Delirium by the meer Impetus of its Ebullition; viz. in as much as being very turgid, while it passes the small Branches of the Arteries spread all over the outward circumfe­rence of the Brain, it greatly puffs them up, and stretches them: and therefore compressing the substance of the Brain, it drives the Spirits several wayes, and forces them into very confused crowds as it were. Moreover, from the Blood's growing thus turpid through a frothy Ra­refaction, Effluvia of heat, and Heterogeneous Particles with them entring the Pores and Passages of the Brain, exagitate the Spirits, and carry them violently hither and thither in a tumultuous manner.

2. For a like reason in a manner to this, Drunkenness causes a deep Sleep or a Delirium: viz. In as much as the mass of Blood insinuates into the Pores and Passages of the Brain, the spirituous Particles of the Wine, which causes it to boyl, and by which the Spirits residing in them, are either overwhelmed, or put into disorderly or confused Motions.

3. Nor does the Blood only ministring febrile and turgid, or vinous and masterless Particles, but sometimes such as are malign and vene­mous as it were, cause a Delirium with or without a Fever. As to the former, in the Plague, small-Pox, malignant Fevers, (tho the heat be moderate) the malignant matter conveyed to the Head produces abrupt, incoherent, and at length distracted Notions, in as much as it dissipates the stores of the Spirits, rather than by driving them into a tumult.

4. For a like reason to this some Poysons, and venemous things in­wardly taken, and (as some say) outwardly applyed, soon bring a Deli­rium: this is vulgarly said of Solunum furiosum, Mandrake, and cer­tain other Plants: the thing is most notorious concerning the Roots of the wild Parsnip. An intimate Friend of mine, and a Man worthy of credit, and also very learned, told me once, that he went into the House of a certain Gentleman, where the Lady, her Daughters, and all the maid Servants (one only excepted) being all delirous at the same time, ran about the House leaping and talking incongruous and absurd things; he thinking them plainly distracted, was given to un­derstand by the Maid, who was well in her Wits, that all this hapned from eating Parsnip Roots, which she alone had not touched; and the [Page 451]event also confirmed it; for after, being tired, they had slept, all of them awak'd sober.

5. But moreover, we observe that a Delirium is sometimes raised by a scarcity of the animal Spirits, and their great dissipation; for when their Orders are broken and discomposed, they minister confused and in­congruous Notions, as well as when tumultuarily hudled together. Hence we observe, that some have grown delirous after great Hemorrhagies, or long Watchings, and a long Fasting: for this Reason many dying Persons speak light-headed and incongruously.

There remains the other kind of Delirium, in which the Blood be­ing without fault, the animal Spirits residing somewhere in the Genus Nervosum, first begin to fall in disorder, and afterward the same affect creeping to the Brain by the Ductus's of the Nerves, moves the Spirits residing in its Meditullium to a Delirium: this is obvious in the Passions called Hysterical, to wit, that after a rising of the Belly, and an Op­pression of the Heart, at length sometimes a privation of Sense, some­times a talking idly, with a Weeping and a Laughter ensues. In like manner, I have observed in a violent Colick, that sometimes extream Tortures about the Viscera or Loins have presently past into a Delirium, then a little after this ceasing, that the Tortures returned. I knew a Girl, who after taking an Emetick Medicine was wont constantly to be delirous till it wrought: for this also makes what I often observe, that a Delirium is raised by a Gangreen, beginning in some outward Mem­ber: and this is generally accounted for a mortal sign in a Wound, or Ʋlcer; because it denotes the animal Spirits to be generally a killing in the part affected.

Nor does that Symptom afford a better Prognostick to such as have been long valetudinary, and are almost worn away: in the Fits of intermittent Fevers, its in a manner alwayes safe, but in continual Fe­vers it's of a doubtful and somewhat a suspected event; in malignant Fevers it commonly threatens ill: in Convulsive Diseases, the first in­vasions of a Delirium for the most part are without danger, but a fre­quent access of it often begets a disposition to a Carus, Apoplexy, or Palsey.

This affect, as often as it seems safe, does not require a Cure, for the Fit soon and easily passes off: but because some, whose Brain is weak and lax, and whose animal Spirits, being too dissipable, are apt to a flight and confusion being troubled on any light occasion, are wont presently to act or speak delirously; therefore there is need of Physick for these, tho not of Hellebore, but of Cephalick Remedies for corroborating the Brain, and fortifying it against the incursions of the morbifick Matter; also for strengthning the animal Spirits, and rendring them more fixt and stronger to resist. We have given the Forms and wayes of Administration of these Medicines before, they being profitable for removing the Procatarxis of any other Cephalick Disease.

A Delirium hapning upon continual and malignant Fevers, requires a peculiar way of cure, for it particularly indicates that the morbi­fick matter, dangerously convey'd toward the Head, ought to be re­vuls'd thence some way or other; for which end, let Vesicatories be ap­plied to the Neck, Plaisters or Cataplasms, or the Flesh or warm Vis­cera of Animals to the Feet: Inwardly, let Temperate Cephalicks be given, as Powders of Coral and Pearl, the Waters of Black Cherries, of the flowers of Cowslips and Poppies, and other things refreshing and soothing the Spirits.

These things being thus premitted concerning the first and lightest manner of Raving, let us ascend to a higher degree of it, viz. the Frenzy, which is far greater, and more durable than the former affect. In a Delirium the perturbation rais'd in the Spirits, residing in the Brain, seems like an undulation of Waters in a River, upon throwing in a stone; but in a Phrensy their commotion seems as the troublous motion of the Sea-waves raging upon a tempest.

The Phrensy is defin'd, That it is a continual raving, or a depravation of the chief faculties of the Brain, arising from an inflammation of the Me­ninges with a continual Fever. With this Disease another allied to it is rank'd, viz. the Paraphrenesis; and its cause is said to be not the In­flammation of the Membranes that cover the Brain, but of the Dia­phragm; moreover, in both affects the Fever, as tho it were only symptomatical, is said (as also in the Pleurisie tho falsely) to arise from the same Conjunct Cause, viz. a Phlegmon of some Part: but that the Phrensy rather succeeds the Fever, both Hippocrates heretofore, and now every Vulgar Person observes, and that it is produc'd because the boyling Blood conveys its adust recrements to the Head; viz. forasmuch as the Urine of a Feverish Person being changed from being troubled and thick, to be thin and watery, indicates an imminent Phrensy: of which affect therefore the cause is gathered to be the removal of the febrile matter into the Brain.

But as to the Conjunct Causes of the Phrensy and Paraphrenitis, it will be easie to shew, that the former does not alwayes proceed from the inflammation of the Meninges, and the latter never from that of the Septum: in Anatomical Diffections I have commonly seen the Me­ninges, nay sometimes also the outward circumference of the Brain beset with a Phlegmonous tumour; but the diseas'd being not affected with a Phrensy, but on the contrary with a drowsiness, dyed of a Carus or other sleepy diseases. And indeed Reason plainly dictates the thing to be thus, for inflam'd Meninges, and much more swollen, greatly compress the Brain, and stop the passages of the Spirits, which causes a Lethargy; whereas in a Phrensy the Spirits are dilated above mea­sure, the Pores of the Brain being all open'd tho it may happen by a long continuance of that Disease, that the Blood being heaped toge­ther too much within the Veslels of the Meninges, and there stagnating, [Page 453]at length begets a Phlegmon in them; but then we suspect for that cause (by reason it frequently falls out so) that the Phrensy pas­ses into a Carus or Lethargy, of which such as have the Phrensy often dye.

Nor do we less reject the inflammation of the Diaphragm, which Galen with others have assign'd for the cause of the Paraphrenitis: Anatomical observations plainly make out the contrary: some time since, opening the Body of a Girl dying of a sudden Leipothymia, we found in the fleshy part of the Diaphragm, a great Abscess with a bagg, full of a gore and little bladders of Water, yet she was never wont to be troubled with a delirium or phrensy. And heretofore, when we dissected the Body of a Renowned Person of the University, who dyed of a bastard and long continued Pleurisie, it manifestly appear'd that a great Abscess in the Pleura and intercostal Muscles, being suppu­rated and broken inwardly, had pour'd a mighty quantity of Pus into the cavity of the Thorax, which corroding the subjacent Diaphragm, had made a mighty hole in it; and yet this Person in all his sickness had neither the Phrensy, nor was delirous; wherefore I judge that this affect is scarce ever produced by such a Cause: but that opinion seems to have risen thence, that oftentimes in a true Phrensy, toge­ther with a continual Raving, the motion of the Diaphragm is wont to be hindred or perverted: as may be gathered from the uneven and difficult Respiration, viz. sometimes being painful and suspended, as it were, sometimes thick and swiftly repeated with an Inspiration, sometimes doubled, which kind of symptoms, and withall the alienati­on of the mind are said to proceed from the Septum being inflamed, and therefore convuls'd: wherefore the Ancients called the Diaphragm Phrenas: tho they need not have done it, if they had considered that all the action of the Diaphragm depends on the efflux of the animal Spirits from the Cerebellum, and therefore, if when the Phrenetick matter invades the Brain, some part of it withall rushes into the Cerebellum, besides the raving, the motion also of the Septum, tho in it self being without fault, will be altered.

Therefore the formal nature of the Phrensy seems to consist in this, that the animal Spirits being very much irritated, chiefly in the whole brain, are driven into disorderly, very confused, and withall impetu­ous Motions; so that the acts of every animal Function are depraved, and variously perverted: the Ideas of things are confounded, &c. More­over the Spirits, not only in the Brain, but likewise in the Cerebellum, and every where in the Genus Nervosum, being struck as it were with a rage, fall in a tumult; wherefore such as have the Phrensy do not only speak ravingly, but breath unevenly, cry out, beat their Fists, throw their Hands and Feet, and exert all their Members with a mighty strength and force: that really the whole Soul seems furiously to fret and rage in the whole Body, or rather being set on fire as it [Page 454]were, to be all in a flame: and indeed the Phrensy cannot be more aptly defin'd, than that it is a Phlogosis or inflammation of the whole sensitive Soul, or of the animal Spirits in their whole Hypostasis; This burning flame always beginning from the Spirits residing in the Brain, and thence passing into the other parts of the sensitive Soul, seems to receive both the matter which first kindles it, and the constant supply of Fuel for it from the Blood, first burning with a feverish blast; for its probable that the Blood, feverishly burning, brings into the Brain sometimes sulphurous Particles together with the spirituous; which being half kindled, and in a manner on light fire, if they have pene­trated together with the others, thence presently entring all the me­dullary and nervous Ductus's, every where cleaved to the Spirits, and render them, being so inflamed, mightily exorbitant and implacable. Certainly it is more likely that the Phrensy is caused after this manner by the inflammation of the Spirits, than by that of the Meninges of the Brain, which (as I have found by frequent dissections) will more certainly bring the Head-ach or Lethargy, than a Fury.

As to the Procatarctick Causes of the Phrensy, we shall find them partly in the Blood, and partly in the Brain, and in what resides in it.

The previous disposition of the Blood disposing to a Frensy, some­times is simple, and sometimes two-fold: the former is its hot and sharp or bilous constitution, to wit, that it contains a great many sul­phureous particles in it self, which being kindled more than they ought in a Fever, are apt to inflame the Blood more, and to insinu­ate ills burning flame into the Brain: this disposition, when it is pow­erful and mightily actuated, often produces that Disease by it self; but for the most part there is another disposition of the Blood, which aids the former, and renders it more efficacious, to wit, that besides sulphureous and inflamable particles, there are others sharp and pe­netrative, which enter the Pores and open them, and so more readi­ly introduce the others: Saline Corpuscles joyned with sulphureous in some sort effect this; hence Cholerick and melancholy Persons that are in a Fever, are more inclin'd to Phrensies: but much rather heterogeneous Particles, when they are in the Blood, being stirr'd by a Fever, open the entries of the Brain, and let in all such Particles as are inflamable: wherefore the Phrensy frequently happens upon the small Pox, and malignant and pestilential Fevers.

The other Preparation for a Frensy, belonging to the Brain, con­sists partly in the temper and conformation of it, and partly in the disposition of the Spirits residing in it: as to the former, those that have a hot and dry Brain are found more prone to a Frensy; not that that Constitution is more obnoxious to an inflammation, or Phleg­mon, (for it is less apt to this) but because in such a Brain, otherwise than in a hot and moist, or a cold and dry, the pores and passages [Page 455]are more open, and gaping too much, afford a passage to the incen­tive matter minitred by the Feaver: Whih likewise will much more easily be admitted, if the Spirits being very apt to be put to slight, and pathetick, on any light occasion are prone to the passions of sadness, fear, anger, or hatred; so that they less withstand the in­cursions of the extraneous matter, and more readily take fire them­selves.

The evident causes of the Frensy are either remote, viz. whatsoever things are wont to raise the febrile distemper; as Surfeiting, Drun­kenness, a violent perturbation of the body or mind, solemn evacua­tions supprest, with many others; or immediate, as a Fever, and its little appendixes and adjuncts; viz. if it be pestilent, malignant, or ill disposed; if it arises by surfeiting with meats or drinks which are very disagreeing; or if it follows upon violent passions of love, hatred, envy, indignation, or sadness, or immoderate studies: for these kinds of occasions render the Blood and Spirits severishly boyl­ing, very much inclined to the affect of the Frensy.

This Disease, according to the temperament of the Diseased, is said to be sanguine, bilous, phlegmatick, or melancholly; and this not improperly, for the Animal Spirits, according to their various dispositions, are wont to rage after a different manner in this Disease.

The Prognostick in this distemper is always dubious, and to be made with the suspicion of an ill event: For the Frensy is a most acute and dangerous Disease of it self; moreover, if it happens upon a pestilent, malignant, or ill disposed Fever, we may expect none but a fatal event.

If a Frensy happens to a sound Body, well in flesh, a sanguine temperament, and in youth, there is a greater hope of doing well, than if the Diseased be elderly, lean, bilous, and subject to violent passions.

If a Frensy frequently remitting, has lucid intervals, it is better than if the fury be without discontinuation: but if the Diseased seem­ing sometimes to be better, after moderate sleep always awake fran­tick, it is a sign that the Disease will be obstinate, and consequently dangerous; viz. inasmuch as a new store of incentive matter is often ministred to the Brain, which we have shewn elsewhere to be done much more plentifully during sleep, than whilst waking.

The Frensy is either terminated in a short time with a Fever, by a Recovery, or Death; or being long protracted, and remaining after the Fever, it is either cur'd at long run, or passes into other Diseases, viz. a Lethargy, or Mania, or Melancholy.

If a Fever having a laudable crisis, by a plentiful sweating or ma­king water be throughly solv'd, the Frensy also for the most part will wholly cease; but if the Fever being not determined, still sends the [Page 456]morbifick matter into the Brain; so that besides the animal functi­ons being deprav'd, the vital begin to fail (which will plainly ap­pear from the Pulse and respiration altered for the worse) if the Urine be pale, if frequent droppings of Blood from the Nose, if Vomitings, and Convulsions happen, the Physician may conclude that Death is at hand.

Sometimes a Fever, tho it be not determined at once and per­fectly, yet afterward passing off by degrees and leisurely, leaves the Frensy or raving behind; which if by its long stay it has not defac'd the former tracts of the Spirits in the Brain, afterward it either ceases by degrees of its own accord, or is cur'd by the help of Me­dicines.

But if by reason of the Frensy being long protracted, the Me­ninges, or Cortex of the Brain are at length possest with a phlegmo­nous tumour, or a serous glut of filth hapning from the Blood or Serum there heaped together and stagnating, the Lethargy, or the sleepy affects ensue; whose Cure is often difficult, or none at all: But if after a long Frensy, either the Animal Spirits (tho their burn­ing ceases) contract a vicious disposition, or if the Pores and passages of the Brain are perverted, often a perpetual raving (the former Disease passing into a Mania, or Melancholy, or Fatuity) ensues: Wherefore it is vulgarly said of Franticks, not soon cured, that the Brain is crackt; so that afterward they always are mad, or become delirous.

In the Cure of the Frensy, we must have regard both to the Fever and to the fury: The feverish burning, or immoderate effervescence of the Blood, which for the most part is the antecedent cause of the other affect, ought in the first place to be restrained and appeased, and withall the Animal Spirits ought to be pacified and freed from any violent excandescence. If a Frensy happens about the begin­ning or middle of a Fever, in a manner the same remedies and me­thod of Curing conduce for both ends: But if that affect happens upon this whilst it is in its greatest force or height, the ways of curing often are contrary to each other; and there is need of great caution, lest while we give help to one disease, we increase the other; in this case the vital indication concerning the preservation of the strength has the first place, and let not Blooding or Purging be used rashly, and in a large measure.

In the former case, when the Fever and Frensy are almost of the same standing, let Phlebotomy, which is seldom or never to be omitted, presently be used; and if the strength bears it, let it be sometimes repeated for nothing depresses and diminishes the immoderate flame of the Blood as much as this Remedy, and nothing more removes or withdraws its burning flame from the Animal oeconomy: Where­fore, if the case requires it, let a Vein be opened sometimes in the [Page 457]Arm or Hand, sometimes in the Leg or Foot, sometimes in the Neck or Forehead; sometimes haply it may be expedient to open the Artery of the Temples; and sometimes also to draw Blood from other places by Leeches or Cupping-glasses, for this is the chiefest re­lief: And according to Galen, this being the first and greatest of all Remedies, is wont to satisfie a great many indications in the Frensy.

Moreover, to prevent the violent recourse of the febrile matter from the Viscera to the Head, Clysters will be of chief use; with which, if need be, let the Belly always be kept soluble: Vemits and Purges, unless only such as are lenitive, have seldome place here: Let Cataplasms of Rue, Cammomil, Vervain, Briony Roots, Red Poppy­flowers, with Soap be applied all over the Feet: or in their place let Pidgeons slit in two be applied whilst they are warm. Mean while Juleps, Apozemes, Powders, Confections; by which both the boylings of the Blood, and the excandescence of the Spirits are appeased, ought to be prescribed according to occasion.

Take the waters of Apples, Black Cherries, Cowslips, of each four ounces; of whole Citrons two ounces, Pearl powdred a dram, Syrup of the juice of Citrons an ounce, mix them, make a Julep, let three ounces be taken three or four times a day.

Take Roots of Grass, Leaves of Wood-Sorrel, Burnet, of each a hand­ful, Barley half an ounce; Apples slic'd, Corinths, or Strawberries, or Rasberries, a handful; let them boyl in four pounds of Fountain-water to the consumption of a third part, to the clear straining add Syrup of Violets an ounce, Sal Prunella a dram and a half.

Take fresh and tender leaves of Borage four handfuls, Wood-Sorrel two handfuls, two Apples pounded to a mash, Sal Prunella two drams, the pulp of one Orange, double refin'd Sugar an ounce, being bruis'd together pour to them of Fountain-water two or three pounds, make a strong ex­pression, keep it in a glass to be clarified by setling: Let six or seven ounces be taken at pleasure often in a day. For quenching thirst, drink at plea­sure the divine drink of Palmarius, viz. Fountain Water with Sugar, and the Juice of a Limon, or Water, or Whey with the leaves of Meadow­sweet, or Burnet infus'd, or boyl'd in them; emulsions of a decoction of the roots and flowers of Nymphaea, with the seeds of Melons, or fountain, or distill'd Water, with the pulp of boyled Apples dissolved in them.

Hypnoticks are often necessary in this Disease, but such as are strong are not proper presently at the beginning, nor may they be frequent­ly used, because sleep caused by opiats brings the matter more to the Brain, and fixes it there more deeply.

Take Water of Cowslip flowers four ounces, Syrup of Maeconium half an ounce, Pearl a scruple, make a draught to be taken late at night.

Take white Poppy-seeds two drams, Sugar-candy a dram and a half, [Page 458]being bruis'd together, pour to them of white Poppy-water six ounces, wring it forth, and take it after the same manner.

Let Narcoticks, consisting of meer cold things, be given with cauti­on; because they do not agree with some, whose Stomachs have their fibres very tender and sensible. I have often observ'd that these kinds of Hypnoticks have caus'd a great oppression in the Ventricle, and that then presently its inflation, and a little afterward distracti­ons and disorderings of the Spirits in the Brain, nay, in the whole Body followed: So that not only a frustration of sleep, but a mighty restlesness was caus'd.

Let a dose of liuqid Laudanum, prepared with Salt of Tartar, or the Juice of Quinces, be given in a convenient liquor.

Epithemes also, which provoke Sleep, are often applied to the Temples, Forehead, and Sinciput, with success: of which kind are Oxyrrhodinum, an Embrocation of Water or Milk, liniments of the Oyl of Nutmegs by expression, and unguentum populneum; to which sometimes let five or six grains of Opium be added; or a cake of Roses, or of Poppy­flowers, with Vinegar and Nutmeg, &c.

Again, on this account, rather than for removing the inflammation of the meninx, the warm lungs of a Lamb or Weather, also Pidgeons or Chickens cut in two, often give an excellent relief. For this use the great Burr-dock bruised and mixt with Womans Milk, and applied to the Sinciput shaved is greatly commended. Also Penotus's Epitheme of twelve grains of Musk, half a scruple of Camphire, and twenty ounces of Rose­water, impregnated with the Tincture of Red Saunders, is commended by some.

Moreover, not only to the Head, but likewise to the Heart, Liver, and other parts, Epithemes are wont to be applied: Let a Sacculus of fine Linnen, with lays of cordial Species and Cotton stuck in it, and irriga­ted with the distilled Water or Vinegar of Roses be applied to the Praecor­dia; also let Linnen Cloaths dipt in Vinegar of Roses be laid on the Testles: Let the Feet be bathed with a decoction of the leaves of Willow, Lettice, and the heads of the white Poppy: But let these kinds of cooling and mitigating topicks be us'd only about the beginning of the Disease; in its greatest height let Resolvents, and Emollients, as the flowers of Cammomil, Melilot, Elder, &c. also the leaves of Mallows, Arach, Marjoram, Hyssop, and the like be added: In the declination of the Disease let Resolvents only, and those sparingly be used.

In the mean while a very great regard ought to be had of the Strength, for this being too much broken, all hope of Cure is lost: Now the strength is wont to be soon consumed by reason of great watchings, perpetual agitations of the body and mind, a thin dyet, and Blooding sometimes, it being often needful. Wherefore we must take a great care, lest whilst we go about to eradicate the Dis­case by Purging, and frequent Bleeding, we on a sudden weaken the [Page 459] Vital function; if this begins to waver, neglecting the Frensy, and al­lowing a more nourishable Food, we must cheifly use Cardiacks.

Take Tincture of Coral half an ounce, let twenty grains be taken twice or thrice a day, with a dose of a Cephalick or cordial Julep, or let the milkly so­lution of Coral, made with the Juice of Oranges be given to a spoonful often in a day.

Take Rob, or Conserve of Rasberryes, and Barberryes an ounce, Pearl prepared, Magistery of Coral, of each a dram, Confection of Hyacinth two drams, Syrup of the Juice of Kermes what suffises, make a Confection: let the quantity of a Nutmeg be taken three or four times a day, drinking after of the following Julep three ounces.

Take Waters of the Flowers of Nymphaea, red Roses, and of the Leaves of Medow-sweet, of each three ounces, Syrup of Coral two ounces, Aqua Cor­dialis Saxoniae a dram, mix them.

Take Conserve of the Flowers of Nymphaea, of Violets of each an ounce, Lettice Stems condited half an ounce, Powder of red Coral ground on a Marble with the Juice of Oranges, and dryed, two drams, Species Diamar­gariti frigidi a dram, white Poppey Seeds a dram and a half, with a suf­ficient quantity of Syrup of the Juice of Wood-sorrel, make an Electuary, let the quantity of a Nutmeg be taken often in a day.

In the Phrensy not only the Belly, but likewise the Bladder, when unmindful of its Office, ought frequently to be moved or irritated to it. Wherefore the diseased are to be admonisht, and a Chamber-pot be­ing presented, to be entreated to make water; which if they do not obey, Let the Region of the Share be fomented with a Decoctionof Pellitory of the Wall, Elder Flowers, the Seeds of Parsly and wild Carrots with a Spunge, and after the Fomentation let it be anointed with Oyle of Scorpions and Ʋnguentum Dialthaea: in a long Suppression of Ʋrine you must put a wax Candle into the Ʋrethra.

So many and so various Cases and Stories of Persons troubled with the Frensy are written by Hippocrates in lib. Epidem: that it may seem to little purpose to add others here: especially because it would be a thing of an immense Labour and Tediousness to relate the various Con­ditions, and Gestures of Franticks: mean while, as to the event of the Disease no great diversity occurs. For, for the most part either, the Fever being determined, the Frensy ceases by degrees, or that having no Crisis or an ill one, either death or a long raving ensues: Neverthe­less for the Illustration of our Hypothesis concerning the Inflammation of the Spirits, I shall here set before you one rare instance.

Soime time since I was called to cure a robust Maid servant, who be­ing in a Fever, and very much distracted, was continually kept bound in her Bed: to this Person I ordered Blood to be drawn in a plentiful manner, and afterward the blooding to be repeated, the Belly to be frequently loosned by a Clyster, and all other Administrations usual in this case to be performed in order; mean while I gave her Emuslions, [Page 460]Juleps, Hypnoticks: but these doing little or no good, she continued still for seven or eight dayes without Sleep, and extreamly raving, howling, and crying out contintually for cold Drink: wherefore it be­ing allowed her to drink her fill of cold Water, she became not at all the more appeased or less dry; Therefore (it being Summer) I or­dered, that in the midst of the night, being taken up by Women and led forth, she should be put into a Boat, then her Cloaths being ta­ken off, and the Cords with which she was bound being untyed, she should be dipt in the deepest part of the River, only a Cord being bound about her middle to keep her from drowning: but there was no need of that support; for she swam of her own accord almost as well as a man that had well learned: after the third or fourth part of an hour, she was taken out of the Water sound and sober, then being put to bed she slept, and sweated freely, and afterward grew well without any other Remedy. This Cure hapned so suddenly and suc­cessfully, in as much as the excesses both of the vital and animal flame being increased to a vast height together, were taken away by the proper Remedy of an intense Fire, viz. a Humectation and In­frigidation.

CHAP. X. Instructions and Prescripts for the curing of Me­lancholy.

AS the Frensie arises from the burning of the animal Spirits, or from the inflammation of their Substance; so other affects of raving proceed from their Substance being altered after other manners, and its being changed from its genuine disposition, viz. spirituo-saline, into an acetous or sharp nature, resembling aqua stygia, or into a flatness or deadness; which therefore are either Melancholly, or a Mania or Madness, or a Morosis or fatuity: of which we shall now speak ion order, and in the first place of Melancholy.

Melancholy is commonly defined, a Raving without a Fever or Fury, joyn'd with fear and sadness; whence it follows to be a complicated affect of the Brain and Heart; for, that melancholick Persons rave, it proceeds from the fault of the Brain, and the disorder of the animal Spirits residing in it; but that they are sad and timorous, this is attri­buted to the Passion of the Heart.

There are various and sundry kinds of the Imagination'sbeing de­praved in Melancholly, concerning which we may observe in general, that the affected either rave concerning all things, or at leaswise concerning most, so that they pass a right judgment in a manner con­cerning no subject; or they imagine amiss only in one or two parti­cular cases, but of most others form notions not altogether absurd. First, we shall enquire concerning this affect, as it is more Universal, how the Imagination is prevaricated concerning most things, to wit, for what Causes, and with what difference of Symptoms this is wont to be done, afterward we shall speak of the particular raving.

Tho the delirous affect of universal Melancholy contains manifold symptoms, yet they consist chiefly in these three things; first, that the affected are almost continually occupied in thinking, so that their Fancy is scarce ever idle, and at rest. Secondly, in thinking they com­prehend fewer things in their mind than they were wont before, so that they often roul in their mind the same Object day and night, being nothing follicitous of other things, which sometimes are of far greater moment. Thirdly, the Ideas of Objects or Conceptions appear often deform'd, and like frightful Apparitions as it were, and they are al­wayes represented in a greater Species, so that every small thing seems to them great and most difficult, and by reason of this hor­rid and unusual appearance, the Image once conceived is not easily, nor soon let go.

The Indisposition of the animal Spirits in this affect is wont com­monly to be described after this manner, to wit, that whereas they ought to be transparent, subtle and light, in Melancholy they become obscure, opake and darkish, so that they represent the Images of things covered as it were with a Shadow or obscurity. But I conceive the state of the animal Spirits in raving is most aptly explicated according to the Analogy they bear with certain chymical Spirits, as it will ap­pear from what follows.

1. Liquours chymically distilled are of divers kinds, according as the active Elements are combin'd in them after various manners; the most excellent of these, by the consent of all, is said to be, in which the Spirit united to the Sal [...]olatizes it, and is again acuated, and re­cieves somewhat of a firmness from it: of this nature are conceived to be the great Elixir and the Liquour Alkahest: and in truth, in some sort are the Spirits of Blood, of Harts-horn, of Soot, and the like, they being very subtle, volatile and penetrating, and yet not inflamable, or apt to be soon dissipated. And indeed the animal Spirits enjoying a sound and meet disposition, seem in some sort to be as the spirituous Liquour filled with a volatile Salt, which is distilled from the Blood: unless it be that to this a mighty Acrimony and Empyeuma are caus'd by the Fire, of which the Liquour which is in the Brain and Nerves is wholly free.

2. Other Chymical Liquours are too sulphureous and burning, as Spirit of Wine and of Turpentine, which consisting of Spirit and Sulphur combin'd together, are easily inflamed and readily separate from others, and take this way and that, as they find a Passage: of which kind of nature the animal Spirits in some sort participate in the Phrensy.

3. Some Liquours or Spirits are produc'd by Chymistry, in which the fixt salt being raised to a flowing has the Dominion: of which kind are those which are distilled from Vinegar, ponderous Woods, and certain Minerals by a gentle Fire; whose particles are very movable and restless, but of a shorter activity, so that the effluvia do not flow far from them, and if they are distilled in Baleno, nothing but an in­sipid Phlegm is raised into the Alembick: And indeed we conjecture that the animal Spirits have such a kind of acetous Nature with the do­minion of the fluid Salt in melancholy Affects, as we shall by and by shew more at large.

4. Some Liquours spagyrically drawn are sometimes extreamly sharp, in which the wild Particles of a fluid Salt, and of an arsenical Sulphur combin'd together are exalted, as are the Stygian Waters distilled from Nitre, Vitriol, Antimony, Arsenick, Verdigrease, and the like; all which are of a wild, very penetrative and invincible Nature, so that their diffuse themselves to a great wideness: and these kinds of Liquours aptly enough resemble the Disposition of the animal Spirits acquir'd in a Mania, as we shall declare beneath.

But at present, that we may deliver the formal nature and Causes of Melancholy, we may opine, that the Liquour distilled from the Blood into the Brain (which filling and irrigating all the Pores and Passages of the Brain, and its nervous appendix is both the Vehicle and Vincu­lum of the animal Spirits) has degenerated from its mild, benign, and subtle Nature, into an acetous and corrosive Disposition, such as that of the Liquours drawn from Vinegar, Box and Vitriol, and that the animal Spirits, which dispersing their Rayes from the Meditullium of the Brain, both into its globous Substance, and into the Systema Ner­vosum, produce all the Functions of Sense and Motion both inward and outward, are disposed in like manner as the Effluvia passing from those acetous Chymical Liquours. Concerning which we may observe these three things, viz. First, that they are in perpetual Motion, secondly, that they do not flow far; thirdly, that they are not only carryed by open Passages, but make new prosities in neighbouring Bodies, and insinuate themselves into them. From the Analogy of these Conditi­ons concerning the animal Spirits it happens, that melancholy Per­sons are always thoughtful, that they comprehend only a few things, that they form their Notions concerning them amiss. [ you may find this fuller explained in Dr. Willis at large.]

So much of the primary melancholy Affect, viz. a Delirium raised through the faults of the Spirits residing in the Brain: whose beginnings tho cheifly, and often in a manner only proceed from the acetous Disposition of the Spirits; yet afterward the conformation of the Brain it self is frequently taken in as a part of the cause. viz. In as much as the Recrements of the melancholy Blood, continually sent into it, ren­ders its substance more gross and opake, and the primary Tracts or Paths of the animal Spirits being almost defac'd, new oblique and de­vious Tracts are made, so that tho there be a supply of the better sort of Spirits, they cannot easily irradiate the Brain, or presently recover their former Passages.

Melancholy is not only an affect of the Brain, and Spirits residing in it, but likewise of the Praecordia, and of the Blood there kindled, and thence sent forth into the whole Body: and as it produces in the for­mer a Delirium, so here a Fear and Sadness: but after what manner let us now see.

In Sadness, in the first place the flamy or vital part of the Soul is straitned as to its circuit, and is restrained within a less space; and then consequently the animalor lucid part of the Soul contracts its Sphere, and has less vigour: but in Fear both are suddenly represt, and made to stagger as it were, and to contain themselves within very small spaces: in both affects the Blood does not circulate and burn live­ly and with a full flame, but being apt to be heapt together and to stagnate about the Precordia, it causes there an oppression, or fainting; and in the mean while the Head and Members being destitute of its plentiful efflux, languish.

Now that those Passions become habitual in melancholy Persons, the cause is partly in the Blood, and partly in the animal Action of the Heart: for the Blood, by reason of saline Particles exalted, becomes less inflamable: whence it is neither sufficiently kindled in the Lungs, nor does it burn within the Ductus's of the Heart and Vessels with a flame sufficiently clear and plentiful, but such as is apt to be represt, and almost blown out by any puff of Wind: hence in regard the vital Flame is so slender and languishing, that it staggers and trembles at all Motion, it is no wonder if a melancholy Person, the Soul as it were subfiding and being half overwhelmed, is always sad and tlmorous. By reason of this saline discrasie of the Blood, melancholy Persons are seldom troubled with a Fever, but being seised with it, they are more dangerously ill by reason of the irregular burning of the Blood.

Nor does it happen less through the fault of the Heart, that melan­choly Persons by reason of the course of the Blood being retarded, or often drawn back, become sad and timorous: for since that Muscle is not actuated but by the influence of weak and irregular Spirits, it is not able to perform its Contractions with Strength and Constancy enough, whereby the Blood may be driven forward throughout the whole Body [Page 464]without stop, or flying back. Therefore the Blood and animal Spirits mutually affect each other with a reciprocal injury, and bring dam­mage on each other: the melancholy blood, that is, consisting of sa­line Particles exalted, together with such as are sulphureous, engenders animal Spirits of an acetous nature, as we have shewn: and these Spi­rits performing the vital Function amiss, cause such a dyscrasy of the Blood to be encreas'd.

So far of Melancholy in genera, viz. of its Essence, conjunct Causes, and chief Symptoms: before we proceed to the kinds and differences of this Disease, we ought to explicate from what causes both procatar­ctick, and evident, it is wont to arise and be fomented: and first, whence both parts of the Soul. viz. both animal and vital acquire their mor­bid Dispositions.

Of these we have shewn the former to be acetous, resembling Spirit of Vitriol, or of Vinegar, and the other to be Salino-Sulphureous, or Atrabilarious; moreover, and that as they both soment each other, so that they first engender each other: for sometimes melancholy begin­ning from the animal Spirits being troubled and put in a certain confusi­on, and persisting some time, brings a melancholy habit to the Blood; sometimes also the Blood, contracting first that discrasy, perverts the Na­ture of the Spirits.

That Melancholy oftentimes begins from the animal oeconomy, its easi­ly seen in excessive Love, extream Sadness, pannick Terrours, Envy, Cares, and immoderate Studies, for on these occasions the animal Spi­rits being driven out of the wonted Paths of their Expansions, and persisting in their errour through the assiduity of their Passion, at length fall into devious Tracts, which afterward keeping to, they are with difficulty reduced into the ancient and right again. Moreover, since thereupon the Motion and Vigour of the Heart are diminish'd, there­fore the Blood falls from its due Crasis and Pneumatosis, and thereby being rendred more fixt and salino-sulphureous, furnishes only animal spirits degenerated to a sourness; and so the Blood being depraved a posteriori, gives a Fuel to the melancholy disposition begun by the Spirits.

Nor does it happen less frequently that the seeds of melancholy first laid in the Blood, give at length that taint to the Spirits: for this reason some hereditarily become obnoxious to that Disease. Moreover, a disorderly dyet, the intermission of an exercise long us'd, solemn Evacuations, as of the Menses or Hemmorhoids, also of the Seed, or serous Ichor suddenly supprest, and many other occasions, easily defile the Blood, and render it melancholick, whose evil Disposition will af­terward of necessity be communicated to the Spirits.

As to what a great many Physicians think, that melancholy rises from a melancholick Humour engendred somewhere primarily and per se and assign particular Places for its Generation; viz: the Brain, Spleen, [Page 465]Womb, and the whole Habit of the Body, we do not easily grant all this: for besides that no secret Stores of such a humour, lying any where, appear, unless haply in the Spleen, it is indeed the Blood it self which first conceives per se the melancholick Distemper, or any other, and afterward deposes recrements of that Nature in proper Emunctories or Receptacles: nor would the yellow Choler be stor'd up in the Gall-Bladder, or the black, so call'd, in the Spleen, unless the mass of Blood first engendred those Humours. If at any time these, or other recre­mentitious humours, some where depos'd, be receiv'd by the mass of Blood, they produce its effervescence, but not presently, or easily its distemperature.

1. As to that therefore, that the origine of Melancholy is sometimes as­crib'd to the Head, and the distemperature of the Brain is accus'd by some as too hot, and by others as cold: I think we ought rather to say that the affect sometimes first begins from the Brain, and from the Soul residing in it.

2. As for the Origine of this affect being sometimes drawn from the Womb, it must not be thought that the melancholy Humour is there first engendred, but that the occasion of melancholy proceeds thence: ei­ther because by reason of the Menses supprest, the whole Blood being defil'd and become degenerate, afterwards falls into a melancholy dis­crasy, or for that by reason of the Stimuli of Venery restrain'd with a great reluctation of the corporeal Soul, the animal Spirits being long contained and kept in, at length become fixt and melancholick.

3. That melancholy is sometimes either primarily raised, or very much fomented by the Spleen being ill affected, and thereupon by a peculiar word called Hypocondriacal, it is both the common and our own Opinion; but the Blood being first in the fault, engendring in it self filthy melancholy Dregs at the beginning, deposes them in the Spleen, which afterward receiving again, being exalted into the nature of an evil ferment, it is vitiated more in its Crasis by their defilement.

4. As to that that besides, another species of melancholy, distinct from the Hypocondriacal and the former, is said to be engendred to­gether in the whole Body, it is nothing else than that the whole mass of Blood becoming degenerate from its right Nature, by reason of errours in the six non-natural things, and on many other occasions, ac­quires a melancholick Discrasy (that is, where the Spirit being depress'd the sulphureous Particles together with the saline, and some also that are terrene are exalted) this melancholy disposition of the Blood be­ing very much allyed to that sulphureo-saline Habit, which we have shewn to be often prevalent in a certain kind of Scurvy.

The Prognostick of Melancholy, tho, as to Life or Death, it be for the most part safe, yet, in reference to the event, it is very uncertain: for some recover soon, others are not cur'd but after a long time, and others not at all.

This affect, rais'd on a sudden from some solemn evident cause, as from a vehement passion, is much safer than invading by degrees after a long Procatarixs: for if the evident cause be presently re­mov'd, that often ceases of its own accord, or is cur'd with little ado; but in this, in regard both the mass of Blood, and the whole troop of Animal Spirits have fallen from their due crasis, and often the conformation of the Brain, as to the tracts of the Spirits, is altered, a Cure does not happen but with great difficulty, and not but after a long time.

Melancholy long protracted often passes into a Fatuity, and some­times also into a Mania, or Madness: Moreover, sometimes it brings Convulsive affects, or a Palsey, or Apoplexy, nay, sometimes a vio­lent Death.

There is little or no hope of a Cure, if the affected, being very stubborn and refractory, refuse all Medicines, and any method of management: Moreover, scarce any thing better may be expected from those, who being sick of Diseases in a manner only imaginary, take any Remedies, nad often require many, and of divers kinds, to be given them.

The Cure of Melancholy, as it is always difficult, and long, so it is wont to be very intricate and perplex'd; seeing that in respect of the causes of every kind, evident, procatarctick and conjunct; also by rea­son of the symptoms daily energing, it ought to be diversly taken in hand, and often to be varied: Nor must we only change the Reme­dies and method of Cure, but variously intermix with them ad­vices, deceptions, flatteries, entreaties, and punishments.

But in the first place let the evident cause of the Disease, if any no­table one has preceded, be search'd out; and if it may be, let it either be presently remov'd, or let the removal of it be some way coun­rais'd, either be appeas'd, or be subdued by others that are opposite. Wherefore in an excessive passion of Love, Indignation and Hatred come in as a relief; to Sadness, let baits of Pleasures, Musick, the desire of vain Glory, be oppos'd, or also a pannick terrour: In like manner you may proceed with other Passions, either for curbing, or cluding them.

The Therapeutick Method, fitted to the Cure of Melancholy, suggests many other Indications: Whereof the chief, and to which the rest may be best reduc'd, are those three so vulgarly known, viz. the Curatory, which regards immediately the disease, and its Conjunct cause; the Preservatory, which regards the procatarctick and evi­dent causes; and the Vital, which is occupied in preserving the strength.

As to the first Indication, the Physical Intentions will be, so far to raise, volatize and corroborate the Animal Spirits, being become fixt, [Page 467]or dejected also, and apt to act overthwartly, or go astray, that af­terward being more freely expanded, they may irradiate the whole Brain with a full and stedfast beam of Light, for the acts of the Imagi­nation, Judgment, and the other chief Faculties; and may so vigo­rously actuate the Praecordia, and make them vibrate so strongly, that the Blood being plentifully kindled may thence spring forward with­out stop or restagnation throughout the whole Body.

Therefore, for the cure of the Spirits, let it be chiefly procur'd, that the Soul be withdrawn from the troublesome and forc'd Passion, viz. from excessive Love, Jealousie, Sadness, Commiseration, Hatred, Fear, and the like, and be compos'd to a Cheerfulness and delight: let a merry or jocose Discourse, Singing, Musick, Painting, Dancing, Hunting, Fishing, and other pleasant Exercises be brought in ure: those to whom Delights, or Sports are not pleasing (for these are always ungrate­ful to some melancholy Persons) may be put upon some light Employs; mathematical or chymical Studies, sometimes also travelling does great good; moreover it is often profitable to change the Places of their Habitation in their native Soyl. Those, who must always stay at home, should be advised to look after their houshold Affairs, and govern their Families; to cultivate and order their Houses, Gardens, Orchards and Fields: for a Mind, employed in necessary Cares and Offices, more readily deposes vain or mad Thoughts, and at length quits them: Let melancholy Persons be seldom left alone, for if at any time they. are permitted to follow and dwell long on their Phantasms, and aereal Speculations, the Soul subsides within, and leaving the Body, and undergoing a certain Metamorphosis, indues a new species, and often contrary to the state of Man; wherefore the affected ought to be con­tinually disturbed by the discourses of their Friends and Acquaintance, to wit, that they animal Spirits being call'd outward from their bye wayes, be brought again into their former and usual Tracts. But if the diseased, being seduc'd by fantastical Illusions, imagine and firmly belived certain prodigious things of themselves; the Mind is to be withdrawn from those things by artificial Inventions, of which man­ner of Cures there are many Cases and Examples to be found in Books, and a prudent Physician may invent the like as occasion requires.

Tho a melancholy new contracted is sometimes cur'd by a meer or­dering and management of the Mind and the animal Spirits, yet in a lopng continued to inveterate melancholy, where the Spirits have con­tracted an acetous Disposition, and the Blood an atrabilarious dyscrasy, and that the Conformation of the Brain, as to its Pores and Passages is injured, and other indications, called preservatory, are required for removing the procatarctick Causes of the Disease. Concerning this thing, the Physical intentions must be in the first place to reduce the Blood to a better and genuine, to wit, a spirituo-saline Crasis; and then to give a vigour to the Brain, and, its Pores being opened, to render it [Page 468]clear and diaphanous, and withall to strengthen the animal Spirits, and to stir them up to a vigorous Emanation: for which ends I propose the following Method, which nevertheless ought to be varied according to the various Constitutions of the diseased.

Blood-letting has place in a manner in every melancholy, and some­times it is often to be repeated, for the adust and effaete Blood being withdrawn at times, a new and more sprituous Blood springs up in its place. Concerning the Quantity, Place, and Wayes of administring this Remedy, Authors are of various Opinions; but the Motion and Affects of the Blood being duely weighed, it may suffice first to draw an indifferent quantity of it from the Arm, and afterward, if need be, a less, either from thence, or from the Vessels of the Fundament by Leeches: how the opening of the Slavatella Vein should give so nota­ble a releif, as is said, I confess is unknown to me: if melancholy Per­sons are strongly perswaded that blooding there will cure them before any where else, haply it may do them good: a frequent opening of the Hemorrhoid Vessels afterward to endeavour that eva­cuation, which spontaneously hapning (as Hippocrates tells us) often cures this disease.

Purging ought to be used from the beginning, and to be repeated by intervals, in regard it withdraws the fewel of the disease from the first Passages, and removes the impediments of other Remedies: as to what some judge, that for the speedy eradicating of the Disease, we must chiefly use Hellebore, or the Spurges, and quote Hippocrates their Author, those things, if the success be look'd upon, are not found so generally to agree; but that they often very much injure the Diseased: for strong purgers do not take away the cause of the Disease, to wit, the dyscrasy of the Blood, but rather encrease it: moreover, they far­ther weaken and prostrate the animal Spirits before dejected. Helle­bore is so frequently prescribed by Hippocrates, because scarce any other Catharticks were then known, at least wise they were not in common use; but now it is far better to draw gently from the receptacles of the Humours by such as are mild and without roughness, and to cleanse the Viscera and first Passages without troubling much the Blood and Spirits.

Vomitories (as in most Cephalick Diseases, free from a Fever) are wont to give relief after a peculiar manner in any sorts of Distractions; the reason of this partly consists herein, that the viscous load of the Ventricle, which (as we have shewn elsewhere) greatly oppresses the mind, being cleans'd forth, the Spirits thereupon being more free, expand themselves more vigorously and cheerfully. Moreover, in as much as vomiting compresses and evacuates the neighbouring Re­ceptacles of the Humours, to wit, the Gall-bladder, the Ductus of the Pancreas, and the Glands of the Mesentery, it keeps their Contents from being conveyed to the Head.

CHAP. XI. Instructions and Prescripts for curing Madness, or the Mania.

AFter Melancholy, it remains for us to treat of Mdness, which is so far ally'd to the other, that these affect often change turns, and each passes into the other; for A melancholy disposition growing worse brings a Fury, adn a Fury coming to abate, often ends in a melancholy disposition.

Since Madness, raised withot a Fever, and with [...]ighty annoy­ance of the animal Function, is wont to be continual and long-lasting, its next and immediate subject must be the animal Spirits; which be­ing affected not per consensum, nor by another thing forcibly moving them, but per se, and habitually, fall from their proper and genuine Dissposition, viz. salino-spirituous, into a salino-sulphureous nature, resem­bling Aqua Stygia, as we have hinted before: and consequently they exert none but disorderly Actions, and continue so acting amiss for a long time: to this their Fault haply the Brain, the Blood, or other parts contribute something, but the Spirits themselves are first, and chiefly in the fault.

Concerning Maniacal Persons we must observe, that thefe three things are in a manner common to them all, viz. First, that their Fancies or Imaginations are perpetually occupied with the raging of impetuous Thoughts, so that mumbling to themselves, or crying out and yelling, they talk aloud various things both Day and Night. Secondly, that their Motions, or Conceptions are either incongruous, or are repre­sented under a false or erroneous Species to them. Thirdly, that with their raving a Boldness and Fury are most commonly joyned, contra­ry to what it is in melancholy Persons, who are always astected with a Fear and Sadness.

The Depravation or maniacal Disposition of the animal Spirits, to­gether with the Juice irrigating the Brain, is wont to arise after vari­ous manners, and for divers causes; but for the most part that affect (as we have observed in Melancholy) begins either from the Spirits themselves, or from the Blood.

1. A madness beginning from the Spirits, sometimes arises from a solemn evident cause, as from a violent Passion, sometimes also it pro­ceeds from a Procatarxis laid in the Brain, as when it happens upon Melancholy or a Frensy; Let us confer a little the Cases, Reasons, and the various wayes of the coming to pass of both.

1. As to the former, when a vehement Passion turns any one from his right mind, that so happens to be done either because the Ani­mal Spirits are too much cast down, and driven into confusion, or because they are raised above measure, and endeavour to expand themselves beyond their Sphere.

1. The Spirits are wont to be cast down by a violent and terrible Passion; so it many times happens, that some upon areal or imagina­ry seeing of a Ghost, presently being struch with a pannick terour, fall into a perpetual madness. Moreover, some, by reason of some great disgrace, or reproach, others by reason of the hope of an excessive Love being frustrated on a sudden and unexpectedly, and others by reason of Vows rashly broken, and their Conscience being violated, first being mightily disturbed in Mind, become shortly after mad: the reason whereof is, that the animal spirits being driven out of their ranks and usual Passages, and put in a Confusion, frame new and bye wayes for themselves, which entring, they presently form delirous Phantasms: mean while the sline Partcles of the nervous Juice fall from their volatility, the spirituous being depress'd, and coming to flow, take to them the sulphureous Corpuscles sent from the Blood into the Brain, being then weak and open; whence this Liquour presently becomes most sharp like Aqua fortis, and the animal Spirits exorbitant, and very much troubled.

Secondly, the animal Spirits, sometimes, whilst they are raised too much, almost after the like manner, bring both to themselves, and the nervous Juice, a Disposition to Madness; hence Ambition, Pride and Emulation have made some run and; the reason whereof is, that whilst the coproreal Soul, swelling through the Opinion and Pride of its own excellency, raises and endeavours to expand it self every way as far as may be beyond the limits of the Body, the animal Spirits tu­multuarily call'd into the Brian, are not able to be contain'd within their wonted Treacts, but being there refracted, and diversly reflected by reason of their too great exertion, are forc'd into new and wholly devious Tracts; wherefore, both themselves being disturbed from the course of their proper Emanation, and the nervous Liquour, soon ac­quire a sharp and irritating disposition, and consequently a madness ensues.

So far of Madness raised by reason of a solemn evident cause alone: but this disease also arises often by reason of a Procatarxis praeexisting in the Brain, and chiefly by reason of a preceding Melancholy or Phrensy: in that the animal Spirits being exalted a little too much with the nervous Juice, and in this being a little too much depress'd, acquire the Disposition to madness.

2. The Disposition to madness no less frequently has its roots in the mass of Blood, and at length is produc'd into act, to wit, when the Blood being mightily depraved, and nitrosulphureous, either perverts [Page 480]the nervous Liquour together with the animal Spirits, or furnishes such as are evil, which kind of taint of the Blood is eiter hereditary or acquir'd.

First, its a common observation, that men born of Parents that are sometimes wont to be mad, will be obnoxious to the same disease: and tho often they have lived prudently and soberly above thirty or forty years, yet afterward without any occasion or evident cause will fall mad. The reason whereof is, that the Blood at that time being fal­len from its due crasis by degrees to be nitrosulphureous, furnishes the Brain with animal Spirits, and a nervous Juice of a most sharp Nature. We heave formerly shewn that the Elementary Particles in our Body persist during Life, separately from those that are scondary, supplyed by Nutrition, and that they have times of their Crudity, Maturity, and Decay: wherefore we judge also, that the morbid Seminia come to a ripeness also according to the periods of ages: Moreover, we ob­serve, that often these mobid Fruits being ripend, continue a good while, or during Life, and that sometimes they wither away again as it were of their own accord, and then that afterward, after some tract of time, new Fruits spring forth again from the miasm left behind, and rises by degrees to their height; wherefore an hereditary Madness sometimes is continual, sometimes interrmittent, and its Fits sometimes are wont to return after shorter intervals, sometimes after longer.

2. As the Procatarxis of the Mania, sticking in the Blood, is often innate or originally in it, so the same sometimes is engendred by degrees, either by an ill form of dyet, or by a suppression of solemn Evacuati­ons, by reason of a precedent Feaver, or for other causes, and at length being brought to a maturity, breaks forth into a madness. It's usual in a great dearth for certain poor People who are forc'd to love only on disagreeing Food, or such as is of an ill digestion, at first to become sad, with a staring and wan aspect, and in a short time after to turn mad: the Flux of the Hemorrhoids or Menses being restrained, or malignant Ulcers supprest, dispose towards this Disease. Moreover, those who originally or acquiredly are of an eager Temperament, an extravagant Behaviour, and an earnest Countenance, because of being nigh to a nitrosulphureous Disposition of the Blood, are in danger of falling mad upon some strong evident cause.

3. Venemous Ferments insinuated into the Blood and nervous Juice, as especially from the biting of Animals that are mad, or by the taking of some venemous things, are wont to cause Madness. Concerning the reason of the former, we have elsewhere proposed our Conjectures. Of late a noble Lady, and worthy of Credit, related to me of her own Knowledge, that a certain Gentleman after having eaten at Dinner the tender Leaves of Wolf-bane in a Sallet with other Herbs, found him­self ill in the Evening, and complaining of a great agitation and rest­lessness of his Blood and Spirits, entreated his Friends that a Chirur­geon [Page 481]might be called to open a Vein, and said that otherwise he should presently run mad: which indeed happned as he said, for, before he could be let blood, falling mad, he dyed within the space of twenty four hours; which deadly affect hapned so on a sudden, in as much as the Poyson did not only pervert both the Blood and animal Spirits as to their Crasis, but by its malign Ferment presently subverted them utterly.

The reason why mad Persons are bold and very confident, so that they flye no dangers, and set upon the most difficult of things, is, that the animal Spirits being very exorbitant, and vehemently moved, both fortifie the Imagination, that no Object seems greater or more terrible to it than usual, and actuate the Praecordia with Vigour, so that they strongly and swiftly convery the Blood, and briskly drive it into the outmost bounds of the Body. In this affect the Soul strives to outgoe, and to springit self as it were beyond the circumference of the Body, and so making an effort every way, it bears it self undaunted against any incursions of exteriour things.

2. The Reason why mad Persons are strong to a miracle, is, that Par­ticles as it were nitrosulphureous, or otherwise very sharp, or as it were Stygian, ar contained in their Blood and nervous Juice, whence the animal Spirits excell in a stupendous and incredible elastick, or ex­plosive force, far above the natural.

3. It is to be observed, that mad Persons are hardly ever wearied, for tho by raging and striving they strongly exercise their Limbs for many dayes and Nights, and in the mean while live without eating and sleeping, they scarce at all faulter, nor desist from their strugling through a failure of Strength; which doubless so happens, for as much as the animal Spirits, tho very movable and elastick, yet are not volatile and easily dissipable, but by reason of the saline Particles de­press'd from their volatility into a flowing state, and being combin'd with the sulphureous ones, become firm and fixt, and therefore hold out veryling in their Activity.

4. Almost for the same reason, many Persons, how much soever they suffer or are afflicted, are not hurt: but endure Cold, Heat, Watchings, Fastings, Stripes and Wounds, without any sensible dam­mage, because the Spirits being strong and fixt, do not faulter nor flye away. Moreover, the Blood having got a nitrosulphureous dys­crasy, is incapable of any other change, wherefore, tho insensible trans­piration be stopt, and other solemn evacuations are supprest, or sup­plyes of te nutritive Juice are deny'd, neither a Catarrh, nor Feaver, nor an Atrophia, or Cacochymia lightly ensue upon Madness, for in this affect, tho the Particles of the Blood are grown very turgid, yet by reason of the store of Salt, they do not take to a feverish Flame.

As to the prognostick of Madness, since the affected are never ob­noxious to a Fever, nor to oter Diseases besides, nor are easily hurt by outward Accidents, it is not a mortal Disease of it self: but is very [Page 482]of Cure, because a great alteration is to be made in the Blood and Spirits, and the Diseased are refractory to any method of Cure, being Enemies both to the Physicians, and themselves.

If the Madness be inveterate or hereditary, or be caus'd by the bite of a mad Dog, it admits of a perfect Cure with difficulty, or not at all; that which is rais'd through some occasion, whether it be from an evident cause alone, or comes upon a Fever, also on which the Itch, Small Pox, Hemorrhoids, or Varix's happen, is more easily Cured.

Those that are obnoxious to this Disease at times, are very much in danger about the Summer Solstice, or in the Dog days; also in great changes of the Air, as when long colds or heats are changed into op­posite constitutions of the Heavens.

Since there are two kinds of Madness, to with, a continual and intermittent one; the method of Curing also ought to be two­fold.

1. The Therapeutick method to be used in a continual Mania, sug­gests to us the three primary Indications so vulgarly known: viz. the first Curatory, which, regarding the Disease if self, endeavours to cor­rect or appease the furies and exorbitancies of the Aniaml Spirits: The second preservatory, which, levelling at the causes of the Disease, undertakes to remove or amend the sharp and nitrosulphureous Dyserasies of the Blood and the Nervous juice, and the Stygian dispo­sition, as it were, of the Spirit. The third Vital, which directs such a way of Dyet and resumptive nourishment, that both the nutritive and vital functions may be able to be carried on and maintain'd as is barely necessary in this Disease.

The first Indication, viz. Curatory, requires Discipline, viz. threats, bindings, or stripes, as well as Physick; and therefore the mad Person, being put into a House fit for that purpose, let him be so ma­naged both by the Physician, and prudent attendants, that he be kept in a manner always in his due behaviour, and in meet gestures and motions, either by advice, chiding, or by punishments now and then inflicted on him; and indeed there is nothing more efficacious or necessary for curing mad Persons, than that they always dread and stand in awe of certain Tortures, as it were; for by this means the Corporeal Soul, being somewhat deprest and restrained, is forced to remit of its haughtiness and exorbitancy; and therefore afterward grows mild by degrees, and is reduced to order. Wherefore mad men are sometimes sooner and more certainly cured by punish­ments and tortures, in a pent up room, than by Physick, or Me­dicines.

But withal, such a course of Physick also ought to be us'd, which may restrain and bring down the haughtiness of the Corporeal Soul: Wherefore in this Disease Blooding, Vomitories and Catharticks, how [Page 483]strong soever they are, and given at rovers and boldly, very often do good. Which indeed manisestly apperars, because Empyricks, only with this kind of Physick, together with governanace, and a severe discipline, often successfully cure Mad-men. Tho this rough way of handling, does not so well agree with all mad persons, but chiefly with such as are raving mad, oters being more remissly mad, are often cured by fair usage and gentle Medicines.

But in most mad persons, it is both the common voice and general practice to bleed plentifully about the beginning of the Disease; and in­deed it will be good now and then to repeat it as far as the strength will bear, and sometimes to perform the operation in the Arm, some­times in the Jugular Vein, Forehead, or Foot; and sometimes to open the Hemorrhoid Vessels by Leeches: For these evacuations being sea­sonably made, both the exorbitancies of the Spirits, and te haugh­tiness of the Soul are excellently supprest; and likewise the Dyscrasies of the Blood are corrected, in regard that a new and more mild springs up in the place of that which was taken away, being sharp and corrosive.

That Vomits also do great good in curing mad persons, it is past even into a Proverb, so that all Hellebore, nay, all Anticyra is assign'd to them: After what manner Emeticks often do good in Cephalick Dis­eases, we have shewn before: Quacks in this case giving a large dose of Stibium, tho it be rashly and dangerously, yet have often success. In truth, Chymical things best agree here, both because they move more powerfull, and because the Disased may be deceived more easily by them.

Take sulphur of Antimony from eight grains to ten, Cream of Tartar half a scruple, mix them, by grinding them together, make a Powder, let it be given in a spoonful of Panada, or if it must be given craftily, and the Per­son not knowing of it, let it be put in a crust of white Bread, to be taken in Broath or Milk: let this vomitory be frequently repeated, viz. once within four dayes.

Take Mercurius Vitae six or seven grains, make a Powder, let it be given after the same manner. The Emetick Tartar of Mynsicht, Hercules, Bovii, and other various preparations of Mercury, may begiven after the sme man­ner. Aurum Vitae, or the Solar, and also the Lunar precipitate are ac­counted by Chymists specifick Remedies against against Madness, and indeed Mercurial Medicines, in as much as they work by Vomit, and Seige, and often also by Sweat, Ʋrine, or Salivation, prove egregiously benefici­al: a copious Spitting, and of long continuance has perfectly cru'd some mad persons.

Strong Pruges (where the strength and constitution will bear them) in as much as they depress the exorbitances of the Blood and spirits, and much evacuate the emunctories for receiving the recrements of the Rlood and Nervous juice, often give relief also in this Disease. [Page 484]For this use, preparations of black Hellebore, as especially its extract, and the Wine of the infusion of its Fibres, or the pap of an Apple boyled with the Roots of it sticking in it, are very much commended.

Take extract of black Hellebore, Calamelanos, of each a scruple; make; a Bolus.

Take Calamelanos a scruple, Diagridium from twelve grains to fifteen, make a Powder.

Take Confectio Hamec, or the Electuary of the Juice of Roses from half an ounce to six drams, let it be given in Broth.

Take Gereons Decoction of Senna, or the Decoction of Epithymum (with two drams of the roots of Black Hellebore) six ounces, make a draught.

The Pulvis Diasennae two drams, let it be taken in Whey.

In the mean while that these things are done, let the preservatory Indication take care of the Cause of the Disease. Wherefore with these frequent Purges and Bloodings let alterig Remedies be interlac'd, for tempering the Blood and nervous Juice, and for reducing them to their due Crases; if haply the diseased, being obsequious and tracta­ble, do not refuse to take such things methodically.

Take crystal Mineral, or Nitre excellently purified two ounces, Pearl powdred two drams, Sugar-Candy two drams and a half, Camphire half a Scruple, let them all be ground into a subtle Powder; let two drams of this be put in a Glass-bottle holding a quart, with Fountain-water, or small or mild Beer for ordinary Drink, wich may be given at pleasure.

Let boyling Whey be poured to the Flowers of Violets or Nymphea, after an infusion for two hours let it be drank off plentifully: Spaw-waters also drank regularly and in a plentiful manner, are proper for mad Per­sons.

Take fresh and tender tops of Borrage and Bugloss of each four handfuls, three mash'd Apples, Sal Prunella two drams, Sugar half an ounce, being bruised together, pour to them three pounds of Rountain-water, express it strongly, let half a pound be taken thrice a day or oftner.

Take Conserve of the Flowers of Borrage and Violets of each three drams,. Confection of Hyacinth, Alchermes of each two drams, Coral prepared a dram and a half, Pearl powdred a dram, Salt of Coral a dram, Syrup of red Poppyes what suffices, make an Electuary, wherefore let two drams be taken twice or thrice a day drinking after it of the following Liquour four ounces.

Take Water of Nymphea, Borrage, Bugloss, black Cherryes, of each four ounces, of red Poppyes six ounces, red Rose-water two ounces, Camphire tyed in a Nodulus and hung in a Glass half a dram, Syrup of Coral an ounce and a half, mix them, make a Julep.

Take the yellow Flowers of a Willow what suffises, distill them with common Organs, repeat the distillation, pouring the Water on fresh Flowers by three Cohobations, let it be given to four ounces twice or thrice a day, sweet­ning it with Syrup of Nymphaea.

Take leaves of the Willow, Meadow-sweet, Burnet, Borrage, Baum, of each six handfuls, Flowers of Nymphaea, tops of St. Johns Wort of each four handfuls, Camphire powdred three drams, all being slic'd together pour to them of fresh Milk eight pounds, distill it with common Organs.

Let Sheeps Brains be distilled with milk, and let the Water be given to three or four ounces, thrice a day.

Moreover, let specifick Remedies be applyed to use, of which kind the Decoction of Pimpernell with a purple Flower is famous, also the tops of St. Johns Wort, and other Decoctions, Opiats, and powders against Madness, well known by all famous Empiricks.

As to the cure of Madness caused by the biting of venemous or mad Ani­mals, since it is in a manner only Empirial, and vulgarly known, there is no need for us to discourse of it in this place, we having also pro­pos'd our Conjectures concerning it elsewhere: Again, the Decoction or infusion of Apples either crude or boyled in fountain Water; the Liquour Tea, Emulsions, with many other things, forms of which we have given in the cure of Melancholy, are proper in this case.

Moreover, many other helps besides Blooding are wont to be afford­ed from Cbirurgery for curing this Disease: Cupping-glasses, with a Scarification often do good; Vesicatories, Cauteries, both actual and potential, are commended by many. Some commend Arteriotomy, others trepanning, and others Salivation: But these kinds of admini­strations, besides that they are of a doubtful effect, cannot easily, and searce with safety, come in practice, by reason of the intractable disposition of the Diseased. Wherefore it would be superfluous here to enquire into the reasons of the relief or Cure to be expected from those things. It is good sometimes, the Head being shav'd, to apply the warm Lungs of a Lamb or Sheep, and other fomentations to the Sinciput, and now and then to change them. But these Epithemes also, in regard they cannot be methodically applied and repeated to the Diseased, who admit them with reluctancy, often do more hury than good.

30. The Vital Indication directs how mad persons ought to be han­dled, as to their Government, Diet and Sleep. In this Disease, other­wise than in many others, there is no need of restoring: for neither ought the strength to be restor'd with Resumptives, nor the Spirits with Cordials; but on the contrary, a suppression, or as it were, a certain extlnction is to be us'd to both, being too exorbitant of themselves, resembling a flame, as it were, burning above measure: Therefore let the Dyet be thin and not delicate, the cloathing course, the lodg­ing hard, the dealing with them severe and rigid. But Sleep, be­cause it is very necessary, if it be wholly wanting, ought sometimes to be caus'd by giving Remedies; for which end, the Hypnotick Medi­cines prescribed before for Melancholy, are proper also in this disease, those who have an inveterate habitual Madness are seldom put to a [Page 486]Physical cure, but being committed to Hospitals for mad Persons, by the ordinary discipline of that Place, either return at length to themselves, or are kept there from doing hurt to themselves or others.

It is not needful to illustrate the nature of this Disease with Histories and Examples, and to set forth many Types of it; but rather address your selves to the Hospitals of mad People, where, not withour a great admiration, you may behold as it were a new and monstrous Genera­tion of Men, viz. contrary to such as are rational, and as it were our Antipodes; who, if they could all be gathered together into one place, and all the Fools and senseless Persons be joyned with them, I know not whether they would not make an equal division of the whole Earth with the sober and prudent.

So far of the cure of a continual Madness. But the intermittent has perfectly lucid intervals, in which the diseased return to a sound Mind, or the Fury only ceases, the Delirium still remaining, so that the affected become gentle and tractable: yet continuing still to err as to their Imagination and Judgment, they speak and do a great many absurd or incongruous things, and afterward become mad again at times.

The remedy of both these affects, as to the curatory Indication, is the same as in a continual Madness, that it will not be needful to fet down here any other Method or Medicines: but as to what regards the Pro­phylaxis, or preservatory Indicatin, to wit, whereby the way of cu­ring to be used out of the Fits for preventing or lessenging them is order'd, in which the Fury only intermits, the Delirium remaining, the very same physical Method and Remedies, which we have prescribed for removing the Procatarxis of Melancholy are proper. pa In a madness which intermits perfectly, as to all smptoms; at the most fit seasons, to wit, Spring and Fall, solemn courses of Physick ought to be entred upon; and also there is always need of a care and governance of the Diseased; both that as to his diet, and way of Life, lie be kept always in an even and moderate Temper; and that as soon as the signs of an imminent Fit appear, blooding and purging being pre­sently used, its access be kept off.

Therefore, at the approach of the Equinoxes, let Blood be drawn from the Arm, and then after seven, or eight dayes from the Hemorr­hoid Veins by Leeches: Let Purges and Vomits by due intervals be gi­ven twice or thrice: moreover on intermitting dayes, let altering Re­medies be orderly taken at physical Hours: forms of these are deliver'd both in this Chapter and in the foregoing for the cure of Melancholy: let the diet be thin and of good digestion; as to Sleep, Motion, and other non-natural things, let all be maderate: If at any time aperson seems to be threatned with an access of Madness, constantly before the Summer solstice, let blooding with vomiting, and a thin diet be used.

CHAP. IX. Instructions and Prescripts for the cure of Stupidity or Folly.

STuidity or Folly, tho it chiefly belongs to the rational Soul, and signifies the defect of the Undertanding and Judgment, ne­vertheless it is not improperly placed among the Diseases of the Head, or of the Brain; to wit, in as much as that Eclips of the superiour Soul proceeds from the Imagination and Memory in­jured; and the failings of thofe depend on the saults of the animal Spi­rits and of the Brain it self.

1. As to the Animal Spirits, how they ought to be qualified of their proper and genuine Nature, and what they are by reason of a preter­natural dispositio in the Frensy, Melancholy, and Madness we have suf­ficiently declared; but besides, sometimes the animal Spirits being in a manner destitute of active Particles become as it were dead and essaete, to wit, whereas the spirituous Particles ought to predominate and ga­ther to them the saline volatiz'd; in a Stupidity as well both these as the sulphureous, being too much depress'd, are almost drown'd and overwhelm'd in such as are watery and earthy.

2. As to the fault of the Brain, first, its a vulgar Observation that the Wit and towardly Disposition depends somewhat on the greatness and figure of the Head, and consequently of its Brain, for as to its bulk, it is a Proverb, that too little or too much Brain argues Folly: And tho this does not always happen so, yet it does frequently, the reason of which is, that in a little Brain only a few Spirits are engen­dred and exercised: and a great Brain, consisting for the most part of a course texture, is not fit for any acuteness of Wit.

Secondly, the genuine and best figure of the Brain ought to be glo­bous, to wit, for this end, that the Spirits may be diffus'd with an even efflux from the midst of it on every side to its circumference, and may be thence retorted every where with equal Agles of Reflex­ions, but those who have a flat Head, or too copped, or otherwise dispro­portionate, for the most part have some notable failing in the animal Faculty.

3. The Substance of the Brain ought to be well tempered and of a laudable texture, nor only as to the qualities of Heat and cold, drought and moisture; but ist Constitution should be sublte and aereal, con­sistig of a plenty of volatile Salt and Spirit, with a moderate propor­tion of the other things, that the Spirits may readily pass the whole, [Page 490]and frame Tracts for themsnlves; and withall it should be indifferently firm and compact, that the Tracts and Passages may remain when made, nor presently be defac'd by the subsiding of Parts too tender. But in Persons that are stupid we may imagine, sometimes an excess of some manifest quality in the Brain, as cheifly of moisture and cold, for which reason Children and aged Persons are often wont to be affected with a Dulness of the Senses; sometimes a Texture too gross and ear­thy, so that the Spirits cannot easily irradiate it, or make Tracts for themselves. To this gross Texture of the Brain some, born of Rusticks, are frequently obnoxious, so that in some Families, looking back up­on many Generations, you will scarce find one wise or witty Man.

4. Sometimes the evil conformation of the Brain as to its Pores and Passages, acquired by reason of some Disorders, is the cause that the animal Function is not duely performed: for sometimes these Pores are either wanting, or perverted, that the animal Spirits cannot duely operate.

So far of the conjunct Causes of Folly, as to the procatarctick and evident Causes, there are many Occasions by reason of which the fore­said blemishes are brought on the Brain, or Spirits, or both of them.

For first, Stupidity is sometimes originary, or born with a man; and so either it is hereditary, as when Fools beget Fools, the same effaete Particles concurring to frame the Animal Organs in the Son which were in the Father; or the Connate Stupidity is acciden­tal, as it were, to wit, it frequently happens that wise and mighty ingenious men beget meer Sots, which sometimes so falls out for these reasons, either that the Parents spend their Spirits in Study and too much thinking, or weaken and enervate the Body through intemperance, luxury, and ill living: Whereas we see in other Animals, as in a good breed of Horses and Cocks, that their young ones do certainly patri­zare, so that presently they are sold at a great rate, their Vertues, in regard they are not broken by a disorderly and preternatural way of living, descending in a long series to their posterity.

Secondly, there are many evident causes, by which Stupidity is brought on such as are originally sound: Some at first being witty and ingenious, in their declining years grow dull and doltish; on the contrary, some at first being dull and incapable of Learning, as they grow further in years, become very witty.

Thirdly, sometimes a great wound, or concussion of the Head, especially which happens by falling headlong from an high place, brings a prejudice and weakness to the animal faculty, dulling the un­derstanding.

Fourthly, frequent drunkenness and surfeiting, especially if men sleep presently on eating and drinking, very much weaken the under­standings of some, and impair the use of Reason; as a frequent use of opiats has shrewdly blunted the edge of the understanding of others.

Fifthly, violent and sudden Passions, such chiefly as an exceeding great terrour coming unawares, or an extream sadness, have rendred some doltish.

Sixthly, We may observe, that some Men by reason of great Diseases of the Brain have turn'd Fools: this frequently happens in a severe and long continued Epilepsie; in as much as this affect possessing the Me­ditullia of the Brain, perverts, and so stuffs with Feculencies, and fills all the Pores and Passages by reason of the Spirits there frequently and vehemently exploded, that the Tracts of the Spirits being close shut, the Acts of the inward Senses and Motions are hindred: Moreover, I have observed Stupidity to accompany and precede the Palsey in many, to wit, the same matter which in the Corpus Striatum brings a Resolution, being gathered together in the Corpus Callosum, if it does not bring an Apoplexy or Carus, often causes Folly.

There are many differences of this Disease, and first, we use to de­stinguish betwixt Folly and Stupidity; that those who are affected with the former, apprehend simple things well and quick enough, and keep them fast in Memory, but for want of Judgment, ill compound, or divie Notions, and far worse inferr one thing from another: Moreover, by fooling, and doing, and speaking a great many things unhappily or ridiculously, they move Laughter in the Standers by: on the contrary, those that are stupid by reason of the defects of the Imagination, Memory, and Judgment, neither apprehend well, nor nimbly, nor argue well: moreover, they do not behave themselves as the former, in making Sports and Gestures, but blockishly and unfeatly, and as it were, like Apes, and consequently the simplicity of these is more, who so carry their Disease in their Countenance and Gesture. In Folly, it seems that the animal Spirits being somewhat nimble, but unstedfast, and having only short and oblique Tracts, do not pass the Brain with an even and constant irradiation, but making excursions this way and that after a desultory manner, kexercise only slight or ridiculous Acts of animal Functions: but in Stupidity, the Spirits of their own nature being dull and obtuse, and residing in a gross and unpervious Brain, are not able to exert themselves for duly performing the Offices of the ani­mal oeconomy.

There are many degrees of stupidity, for some Persons are account­ed unfit as to the comprehension of all things, others only as to some: some being wholly unfit for Learning, and the liberal Sciences, are apt enough to mechanical Arts: others, tho incapable of both these, yet readily comprehend Apriculture, and Country Affairs: others, being incapable in a manner of all business, can be taught only those things that regard eating and drinking, and the common way of living, others being meer Dolts, scarce understand any thing as all, or do any thing with Knowledge.

As to the Prognostick, Stupidity contracted by birth, or hereditary, or hapning through some unknown causes, if it continues to the time of Puberty, is scarce ever cured: tho sometimes it happens that lit­tle Children, at first dull, and almost senseless, when the Crases of the Brain and Spirits come afterward to a maturation, become ingenious, and apt enough to Iearn.

The Disease raised through some sole evident Cause, as by a hurt of the Head, or a violent Passion, also hapning upon an inveterate Epi­lepsy, if it persevers some time, is afterward incurable.

That, which ensuing upon other sleepy Affects, depends chiefly on the hurt of the Memory, sometimes those affects being cured, vanishes of its own accord: if at any time therefore in these Cases the cure of Stupidity is ordered, in a manner the same method of healing and Remedies which we have prescribed for the preservatory indication of the Lethargy will be proper here: whereof the chief intents must be, that the animal Spirits being free from any Deadness and Stupefaction, make Pores and Passages within the translucid Brain, and duely ex­pand themselves in them.

Sometimes a Fever has cur'd some Fools and stupid Persons, and has rendred them more acute, Huartus relates, that a certain Fool in the Court of Corduba, being affected with a malignant Fever, arriv'd in the height of the Disease to so great an acuteness of Judgment and Discretion, that he put the whole Court in Admiration, and for the whole remainder of his Life continued a very prudent Person: and we have known a certain Person of a dull, and indeed Boeotian Understan­ding, who raving in a Fever, was very quick at breaking smart Jests, and season'd with much Salt: the Reason of which things seems to be, that the Febrile heat sometimes rarefies and disperses the mist investing the Brain.

Therefore, as to the cure of this Disease, Stupidity, whether innate, or acquir'd (if it be not a plain senselesness, and doltishness incapable of all Erudition) tho it be not usually cur'd, yet it is wont to be amen­ded. Wherefore the cares both of a Physician and Tutor must be us'd for polishing somewhat the Understanding of such as are so affected, and that being brought to the use of at least some little Reason, they may be exempted from the rank of Brutes.

For this end, because Bards, or such as are very blockish, learn not the Notions of things more readily than Children their A. B. C. there­fore they are to be instructed in all things by an assiduous and very diligent Master, and the same things are to be incultated again and again; For by this means the Spirits, tho dull and torpid, will in some measure be actuated by perpetual Exercise; and being continually stirred up, will make at length for their Expansion some Tracts or Passa­ges, tho imperfect, in the Brain, how gross soever. For the better and more easie effecting of these things, physical Remedies also ought to be gi­ven [Page 493]for purifying and volatizing the Blood and nervous Liquour, toge­ther with the animal Spirits; and also for clarifying the Brain, and ren­dering it as it were diaphanous.

For purifying the Blood, let a gentle purge sometimes, and letting blood in a small quantity, if the strength will bear it, frequently be used; for the same pursose, and likewise for deriving Faeculencies from the Brain, Issues are proper in the Arm, or in the Leg, or toge­ther in both: in gross Bodies, and such as have a moist Brain, it is good sometimes to cut two by the Shoulder blades. Moreover, it is on this account that some mightily extoll trepanning, (to wit, whereby the Brain may transpire and evaporate the more freely) let the diet belight and attenuating, the Habitation in a free and dry Air; the Sleep moderate.

After that these things have been used for some time, and in a so­lemn manner, if there be found no change, it will be in vain to waste any more physical Oyle and Labour; but if after the use of those things, signs of benefit, or some hope appear, sometimes it seems pro­per to add altering Remedies, to be taken daily at Physical hours for a long time: Forms of these may be taken from our curatory part of Phy­sick before delivered for removing the Procatarxes of most Cephalick Diseases: Moreover, I have thought good to add here besides some Magistral Receipts which particularly regard this case.

Take Spirit of Armoniack succinated six drams, give from fifteen drops to twenty in the Evening, and early in the Morning in three spoon­fuls of the following distilled water, drinking after it seven spoonfuls of the same.

Take fresh leaves of mistletoe growing on Apple-trees six handfuls, Sage, Rosemary, Savory, Wild-time, Calamint, Penny-royal, Marjoyam, the great­er Rochet, of each four handfuls, roots of Angelica, Master-wort, of each six ounces, Zedoary, the lesser Galingal, Calamus Aromaticus, Winters bark of each two ounces; Cloves, Nutinegs, Mace, Cinnamon, Ginger of each an ounce; Cubebs, Cardamums, Grains of Paradise of each six drams; all being slic'd small and bruised, pour to them of the best Canary wine twelve pounds, let them digest cold and in a close Vessel for three dayes, then distill them according to Art, let the whole Liquor be mixt, and sweeten it with Sugar as you use it, the Dose is two or three ounces.

After the use of Spirit of Armoniack for fifteen or twenty dayes, let other Medicines have their turns for about the same space of time, such as are the Spirits of Soot, Harts-horn, mans skull, the tincture of Coral, Antimony, Castoreum, Amber, Quercitan's Elixir of Life, Elixir Pro­prietatis, Spirit of Lavender, &c. Or,

Take Conserve of the flowers of Lillies of the Valley six ounces, roots of Aromatick-reed preserv'd six drams, Ginger condited in the Indies, Nut­megs condited of each half an ounce, Species Diambrae two drams, Lig­num Aloes, yellow Saunders, roots of choice Zedoary, Cubebs, Jamaica Pepper of each a dram and half, Coral prepar'd two drams, Syrup of the [Page 494]Preserve of Ginger what suffices, make an Electuary; the Dose is two drams morning and evening, drinking after it three ounces of the distill'd Water.

Let those, whose Brains abound with too much moisture, drink eve­ry morning a draught of Coffee with the leaves of Sage first boyled in it, to those whose animal Spirits are effaete and depauperated, the drink of Chocolate, such as before describ'd, seems profitable. For ordinary drink prepare small Ale, or Beer, and in a Vessel of three or four Gal­lons let the following Bag be put after it has wrought. Take leaves of Salvia acuta dried four handfuls, Cubebs an ounce, Cloves, Nutmegs, being slic'd and bruis'd, mix them according to art.

Outward Applications have place here, or which kind are, a Cucu­pha, or Cap, Plaisters, and Liniments, and sometimes let these, some­times those, or the others be us'd.

Take Flowers of Lillies of the Valley, Rofemary, and Staechas of each a handful, Celtick spike two drams, Roots of Cyperus, the lesser Galingal, Flo­rentine orris of each three drams, Labdanum, Benzoin, Balsam of Tolu, Amber of each two drams, Nutmegs, Colves, Mace, Cinnamon, of each a dram and a half, make of all a jubtle powder, and sew it into a cap in­terlacing it with Cotton.

Take of the Plaister call'd Flos Ʋnguentorum two ounces, Tachama­hacha, Ceranna, Balsam of Tolu of each three drams, powder of Amber and Myrrhe of each two drams, Cloves, Nutmegs, Mace, of each a dram, being melted together, let them be made into a mass, of which let a Plaister be made, to be spread on Leather, and to be apply'd to the Head shav'd.

Take Oyle of Palm half an ounce, oleum Capivii three drams, Balsam of Peru a dram, oyl of Nutmegs by expression two drams, oyl of Amber half a dram, make a liniment for the Head.

I could add here many other Medicines and wayes of Administra­tions; but let these suffice in a Case almost desperate, where most com­monly no Remedies do good, and the Cure is never perfected.

CHAP. XIII. Instructions and Prescripts for curing the Gout.

AMong the Diseases of the Head and Genus nervosum, we justly rank also certain Affects which are wont chiefly to infest the Feet and Belly, to wit, the Gout and Colick. For we may con­clude from the primary symptom, viz. Pain, that the Seats of both are in the nervous parts. I shall speak in the first place of the for mer.

The Gout most commonly is wont to arise about the Internodia of the Bones of the Feet; tho often it happens in the Joynts of the Hip, Knee, Elbow, Shoulder, Wrist, Ancle, and of other Parts.

The Fits of this Affect (which in a manner is always intermittent) either seize at random, or periodically; which ending sometimes soon­er, sometimes later, good lucid Intervals ensue; presently, upon the first invasion, Pains for the most part arise without any swelling; tho afterward, about the height of the Disease, the Part affected often swells; the Pains about the beinning scarce yield to any Remedies, but are wont to be very much exasperated by Catharticks, and not presently to be driven away, or asswag'd by Topicks; the Fits most commonly seize on a sudden, and without a precious affect, tho sometimes it has a fore-running effervescence in the Blood, or a little Fever. The Disposition to this Disease sometimes is Hereditary, some­times acquir'd through an ill Diet: the Occasions or Causes, which being wont to actuate the Disposition, raise the Arthritick Pains, are some violent alterations, or Passions inflicted on the Humours and Spi­rits. Hence Surfeiting, immoderate drinking, especially of acid and thin Wines, Transpiration letted, Anger, immoderate Venery, Sad­ness, also the Revolutions and great changes of the Year and Air, eve­ry where bring Fits of this Disease: those that are obnoxious to this, are also in danger of being sometimes troubled with the Stone or Gra­vel in the Kidneys, and on the contrary: moreover, the Gout increa­sing gathers together every where about its chief Seats, to wit, the Joynts, a calculous matter, and there raises a tophous mass.

The Parts affected, upon the twitching of whose Fibres the Pains are raised, for the most part are the Periostia, or the Membranes co­vering the heads of the Bones, also the Tendons, and haply the Liga­ments there plac'd: but since the Pain in those Parts depends wholly on the solution of continuity, and this proceeds from a certain matter sticking in, or lying on those Bodies we must enquire, first, of what kind that morbifick matter is; secondly, whence it is brought thither, and thirdly, after what manner, by solving unity in them, it causes such periodical Fits of the Gout.

As to the morbifick matter, it seems in the first place that it is nei­ther the Blood nor the nervous Juyce by themselves; nor also one sin­gle Humour depos'd by either of them, but that in the chief Seat of this Disease many fermentative Juyces, and not easily miscible, meet; and then that from their contest and effervescency painful twitchings of the nervous Fibres arise.

Therefore a saline or tartarous matter, depos'd from the arterious Blood about the spaces betwixt the Bowels, is as it were the feminine Seed of this Disease; which nevertheless, tho heap'd together in a great plenty, is wholly unfruitful of it self, till the nervous Liquour growing turgid, sends acetous Recrements, falling from it, to the seat of [Page 496]the former, which, as the masculine Seed, presently renders the other prolifick: for, in as much as those two particles, which are of a differ­ing state and origine, meet, and mutually contest, they twitch the Fi­bres of the Membranes and Tendons, and so cause the Fit of the Gout, the appeasing of which depends wholly on the mutuall subduing and dissipation of the sharp Particles of both kinds.

As to the evident causes for which the nutritive liquor, brought from the Blood to the Joynts, is too much stored with a fixt Salt, and by reason of which these Parts become over-ready and easie to receive what is disproportion'd to them, in regard they are various and ma­nifold, we shall here briefly touch the chief of them.

1. And first, an hereditary disposition is wont to produce both the failures: for Gouty Persons for the most part engender Gouty Children; and this Disease, descending from Parents to Children, is wont to have in both not only the like fruit, and to be brought to a ripe­ness about the same terms of age; but for the most part it fixes its first roots in the same members, and every where observes the like progress.

2. But nevertheless, the Arthritical disposition, without an original taint, is often caused by reason of an ill dyet, and errours in the six nonnatural things; for those who being given to feasting and good fellowship, delight themselves in eating and drinking much and dis­orderly, and especially if they feed on salt and sumptuous provisions, and drink, Wine plentifully, easily contract this Disease. For by this means none but an indigested Chyle, and such as is endowed with wild and unmeet Particles is prepared in the Viscera; moreover, after much drinking of Wine, Salt dregs and heterogeneous filth, which otherwise would stay in the first passages, being too much exalted, are conveyed into the Blood: To which irregularities in Dyet, if a sedentary Life, Idleness, and much sleeping are joyned, so that neither the superfluities exhale, nor the saline Impurities are blown off by exercise that they do not subside about the Joints; certainly a great store of this Alchalisate seed will be sown for produ­cing this Disease of the Joynts.

The weakness and Arthritick disposition of the Joints is not only hereditary, but is frequently caused on several occasions; the falling down of the morbifick matter often brings it: for if by chance it happens that the firs fit of the Gout be in this or that Part, the pec­cant humour will afterward more readily fall on that member; and in a short time will make there, as it were, its nest, where it will con­tinually lodge its brood: Moreover, solution of Continuity also, or an injury hapning to some Joint by cold or moisture, a wound or luxati­on often cause a Gouty disposition.

The evident Causes, which in respect of the Nervous Liquor, cause Fits of the Gout, either pervert the particles and Portions [Page 497]into an acetous nature, or being before degenerated, stir them to fluxious.

1. Many acid Liquors and small Wines ought to be avoided, and ex­perience teaches us that Cyder and stale Beer ought of all things to be shunn'd by Arthritical persons, for those kinds of drinks do not only bring into act the latent cause of the Disease, but by filling the Brain and Nerves with a great many acetous particles, they contribute to its fuel, and encrease the morbifick matter.

2. Immoderate or unseasonable exercise of the Body, Violent pas­sions, immoderate Venery, and a disorderly Diet, and likewise what­soever things greatly trouble or exagitate the Spirits and Humours, and consequently raise fluxions of the nervous Juice, or of its Recre­ments cause Arthritick pains.

3. Solemn Evacuations supprest, also an admittance of cold and moi­sture, forasmuch as by this means the Blood, and consequently the Nervous Liquor fall into effervescencies and fluxions, bring fits of that Disease.

4. For the same reason changes of the places of aboad, also the revolutions of the year are wont to bring pains of the Gout, that it is become a Proverb, that Couty persons carry their Almanack in thier Bones, and from their pains draw most certain prognosticks of the seasons; for as often as a moist constitution of the year, and South or North Winds, or Snows are at hand, they are wont to predict those things from the accesses of their pains. Moreover, at each quarter of the year, especially Spring and Fall, they are more sorely tormented; wherefore the Aequinoxes are always religiously observ'd by them: The reason of these things partly consists in this, that in­sensible transpiration is variously altered by reason of the changes of the air and of the year; for which reason, the Effluvia, which were wont to transpire, being restrain'd, ferment the Blood and Ner­vous humour, and easily stir them to Arthritick flucions. Moreover, the humours of our Bodies, as the Juices of Vegetables, and other natural or artificial liquors, diversly ferment according to the changes of the seasons, and fall into various states, sometimes of fixation, sometimes of volatility, sometimes of flowing.

The chief differences of this Disease are taken from the places af­fected, and therefore they are made, as it were, the distinct species of the same, viz. to wit, the Hand Gout, the Hip Gout, the Knee Gout, the Foot Gout: Mean while, pains usually rais'd in any other Members, go by the common name of the Gout: Whether the Tooth-ach, the pain in the Loins, and pains of other Parts ought to be referr'd to this, I have not now leisure to enquire.

A long continued Gout very often joyns to it s Scurvy, and some Scorbutick affects so plainly counterfeit the Gout, that they cannot easily be distinguish'd: The reason of the former is both a like Dyscra­sy [Page 498]of the Blood, in both affects depending on the fixt Salt; and likewise that the Scorbutical disposition easily comes upon Gouty persons; for that keeping long to their Bed or a Chair, they use no exercise. Secondly, the Scorbutick affects which initate the Gout, are a Rheu­matism, and the Arthritis vaga Scorbutica, concerning which we have written in our Tract of the Scurvy.

The Gout has so near a Relation to the Stone in the Reyne, that both affects, as tho they were of the same Origine, most common­ly concur: for scarce any Person is troubled with that Disease, but he is found obnoxious to this; Moreover an inveterate Gout is wont to cause strong concretions in the Joints, such as the Nephritick Disease in the Reins: hence I think it very likely that the ach in the Reins ar­rises from a like, or wholly the same cause which we have assign'd for the Gout to wit, that the Salino-fixt-matter depos'd by the Blood in the Reins ferments with the acid humour often sent thither by the Ner­vous Ductus's; and that therefore Nephritick Pains are frequently caused; and that afterward the Stone is form'd by both matters coagulated af­ter fermenting.

As to the Prognostick of the Gout, every man knows it to be a Di­sease that is safe enough, but extreamly difficult to be cured. 1. As to the former, this Disease is not only void of danger as to it self, but is a prevention against most other Diseases: for gouty Persons by reason of a saline-fixt Discrasy of the Blood are not obnoxious to Fevers; More­over they live for the most part free from other affects of the Head or Viscera, in as much as the Recrements both of the Blood and Ner­vous Juice are continually depos'd in the Joynts. 2. But as to the way of its cure, it is so diffcult, that for the removal of the Procatarxis of the Disease there is requir'd both a most perfect amendment of the two Humours, viz. of the Blood and Nervous Juice, to wit, that they en­gender not any Saline-fixt, or acid Particles, and likewise a Restituti­on of the weakned Joints (neither of which can ever easily be done) to which may be added, that the conjunct cause of this Disease lies in parts very remote, where the Vertues of no Medicine reach.

Sometimes it happens by reason of the fluxions of the Arthritick matter being supprest or struck back, that one while gripes of the Belly or Viscera of the Abdomen, another while a Dyspnaea, Asthma, or other affects of the Brest, and sometimes also that the Apolexy, and other sleepy or convulsive Diseases are raised; from which things being observ­ed, it will be obvious to object, that the Minera of the Gout is not such as we even now describedit, because its saline part, in regard it is the same which is appointed for the nourishment of the Joints, cannot be driven thence, or convey'd, or depos'd elsewhere: when as to the other part, to wit, the acid Seminium deposed in its usual place, it seems that that can­not easily be driven back, and being supprest by it self, or in its Passage, or convey'd elsewhere, that it will not much hurt any part; but it may [Page 499]easily be replyed to this, that the acetous Portion of the Arthritick matter flowing in the Ductus's of the Nerves may be repelled or stopt, and that being discharged on other parts, it often causes very sore Diseases, and indeed the nervous Liquour and its Recrements, since they consist of Particles that are very subtle and active, upon any small let or repulse are driven into divers sorts of sallies and fluxions; More­over, when those grow turgid about the noble parts, or within the Ductus's of the Nerves, or meet with Particles of other Humours of ano­ther kind, and ferment with them, they cause various affects either in­ducing pain, or convulsive: and often, in as much as Particles of a dif­fering nature are coagulated together, Tumours, sometimes Strummous, sometimes Cancrous, or otherwise malignant arise.

Whilst I was writing these things, I was called to a renowned Ma­tron, who formerly having been very obnoxious to the Gout, after that she had been ill of late for about three Months of a very great weakness of the Stomack with an Anorexia, a Nauseousness, and almost a continual Vomiting, at length I know not on what occasion, falling into frequent Swoonings, a little after she was often troubled with a Vertigo, with a failing of Memory, and sometimes with a slight De­lirium, and when she had continued so for many dayes, and in the means while being free from the Gout, and having a good Stomack, she eat Broath twice or thrice, and flesh once a day with an Appetite, and disgested it without trouble; this was a plain sign that the Recre­ments of the Nervous Humour which formerly were wont to fall by the spinal Nerves into the feet, to the seat of the Gout, afterward being deposed by the Nerves of the Par vagum and Intercostale in the Ven­tricle, raised continual Troubles in it, which at last partly restagnating in the Brain, and partly being conveyed into the Nerves of the Heart, were followed by those affects of the Leipothymia, Vertigo, and Deli­rium.

The Theraputick method suggests three primary Indications, where­of the first being curatory, is used only in the Fits, for the appeasing, or sooner putting an end to the Pains: The second being preservato­ry, and appointed for the intervals of the accesses, endeavours to re­move the Procatarxis of the Disease, so that the invasions of the Pains may return but seldomj, or more mildely, or not at all. The third be­ing vital, orders by what kind of dyet, and with what Remedies, the strength may be supported among the said Tortures, and Life, notwith­standing the frequent and almost continually troublesome oppressions of the Disease, may be prolong'd, and withall reinvigorated.

The first indication, viz. the appeasing of the Pains, contains these two cheif intents: viz. That the Solution of Continuity be taken away, and in the mean while that the irritation or excandescency of the Fi­bres, or of the Spirits abounding in them, be allayed.

1. To take away the Solution of Continuity in the places affected, both the fluxions of the Humours which are apt to tend thither ought to be stop'd, and the Minera already there sticking ought to be discuss'd or dissipated, and its Particles be restrained from their mutual Efferves­cencies. For these ends evacuating and altering Remedies, and both of them, as well inward as outward, are appointed: we shall-set down certain select Forms and wayes of Administration of these in or­der.

Blooding in a new Gout, or which is not very inveterate, and especial­ly in a hot constitution, being used about the beginning of the Disease, often gives relief: but in an habitual Difease, also in a cold tempera­ment, and in old Age, it is wont to do more hurt than Good, in as much as it depresses the vigour of the Blood and Spirits, which are not too exorbitant, without a diminution of the morbifick matter.

Concerning Purging about the beginning of the Disease, the thing is very much controverted, whilst some Physicians religiously abstain from all Purging, before the declination, or end of the Fit; and others on the contrary constantly give strong Purges about the beginnings of the Disease: the reason of the difference seems chiefly to lye in this, viz. that in some gouty Persons, who are yet firm in the Constitution and Tone of the Humours and the containing Vessels; and whose Joynts are not yet weakned, as often as the Blood and Nervous Liquour are troubled by a medicine, their Superfluities and Recrements are not presently precipitated into the Minera of the Disease, but yielding to the Medicine irritating and stirring them, they are drawn from the Mouths of the Arteries into the Cavities of the Intestines; and mean while the emptied Vessels withdraw or drink up again a part of the morbifick matter. but on the contrary, in tender and weakned con­stitutions, upon the gentlest commotion of a Medicine, the Recrements of both humours fall into the Place troubled with the Gout. To those therefore with whom purging agrees, it ought to be ordered with a strong and exagitating Medicine: for this purpose are vulgarly famous the Electuary Caryocostinum, Syrup of Buckthorn, compound Powder of Her­modacts, Pilul. ex duobus, Pil. Rhasis; which, if we may believe the Au­thour, will make such as are not able to goe, presently to walk about.

Take of the best Aloes half an ounce, red Roses two Scruples, Hermodacts pill'd a dram and a half, Diagridium a dram, Honey of Roses what suf­fises, make Pills. Rodericus a Fonseca wonderfully extolls the roots of black Hellebore, and amongst other things, an Apple with the Fibres of it stuck in it to half a dram, rosted under the Embers and eaten.

Take Calomelanos a Scruple, Rosm of Jalap three grains, or of Scammony three grains, Oyle of Cloves a drop, Balsam of Peru what suffises: make three or four Pills for one dose.

In purging, what Solenander prescribes happily may be of some mo­ment; viz. by putting a Plaister, or some other defensive Medicine on the place, to hinder the falling of the humour to it.

Vomiting, with those with whom it uses to be safe and easie, does well also in this Disease; for which end the Emetick Tartar of Mynsicht, Sulphur of Antimony, its Flowers, Mercurius Vitae, Vinum Emeticum, Gutta Gamba may be given.

Moreover, in a Fit of the Gout, Powder of Stones, Bones, and Shells, and also of smart Vegetables do good, which being said to be the Anti­dotes of this Disease, subdue all Particles, and fermenting with them, mortifie them as it were, and at length being subjugated, send them forth by Urine, or sweat.

Take compound Powder of Crabs Claws two drams, Ivory, Roots of bastard Dittany, Roots of male Peony of each a dram, Lignum Aloes, yellow Saunders of each half a dram, make a Powder, let it be taken from half a dram to a dram, either by it self in a Spoonful of red Poppey water, drinking after it six Spoonfuls of the same, or let it be made into a Bolus, or Pills with Venice Treacle, or Venice Turpentine what suffises; the dose is a dram twice a day, drinking after it of the distilled water beneath prescri­bed, two or three ounces. Or,

Take of the same Powder six drams, conserve of Clove-gilliflowers and Betony Flowers of each an ounce and a half, Diascordium two drams, Syrup of Maeconium what suffises, make an Electuary, the dose is a dram, to two drams Evening and Morning.

Mean while that these things are done for withdrawing elsewhere the morbifick Matter which would flow into the places affected, or for sending it forth, let altering and qualifying Medicines likewise have their turns, which may appease the Turgescencies of the Blood and Nervous Juice, and stop the fluxions of the Recrements falling from them; for this end a thin diet, and a drinking of Water (if it be pro­per) being ordered, let Emulsions, Juleps, Apozemes of mild things and Anodines be prescribed.

As to what concerns the other Scopes of curing, viz. the discussion of the Minera sticking in the Parts, and the mitigating the excandes­cencies of the Fibres and Spirits; we must insist first on this latter, without the performance of which we cannot answer the other intent: for this end therefore it is expedient to use both outward things, viz. Topicks of various kinds, and inward things, viz. Hypnoticks.

There being a vast number of Topicks, they either being only Ano­dines, have regard to the Pain it self; or levelling at this, together with the Tumour, they are either Repercussives, or Resolvents and Discussers; there are various Forms and Wayes of Administrations of every kind of these: but those of cheifest use are wont to be Fomen­tations, Cataplasms and Plaisters; we shall set down some of the most noted of these, and first Anodyne Applications, which moderate the Fibres [Page 502]and appease the Spirits by a certain soothing: for this use, a Cataplasm of Milk and Crum of Bread, or of those things with the poúndings of the Leaves and Roots of Mallows and Althea, and the like, are every where in common Practice with the Vulgar.

Others commend a Cataplasm of fresh Cow-dung applyed warm.

Take Water of Night-shade, or of the Spawn of Frogs, of each six ounces, Saccharum Saturni a dram, mix them, let linnen Cloaths dipt in this be applyed warm.

Take of red Lead three ounces, distilled Vinegar two pounds, digest them for many dayes: let either this Liquour by it self, or a Water drawn from it by distillation be used for a Fomentation.

Also a distilled water made of the Tincture of Verdigrease distilled in Vi­negar, often appeases Pains.

I was told by a Gentleman often troubled with a severe Gout, that he, in the cruel Tortures of that Disease, had always present ease from a Fomentation with a Water distilled from the contents of a Bullocks paunch newly killed.

Against extream Tortures of the Gout outward Narcoticks sometimes ought to be used.

Take Leaves of Henbane, and Hemlock of each three Handfuls, let them be put into boyling Water, and as soon as they grow tender, let them be taken forth; to which, being bruised, add Powder of the Flowers of Cam­momil about two drams, the yolk of one Egg, make a Cataplasm. Or,

Take Tincture of Saffron made in Spirit of Wine four ounces, Camphire and Opium of each a dram, let there be a close and warm digestion till they are dissolved; let the part that pains be anointed with this Liquour: there are innumerable Medicines of this kind every where to be found in Books of Physick, and are every where wont to be prescribed by every vulgar Person; which likewise may suffice for fulfilling the other intent, to wit, the repercussion of the Humours, if at any time it seems to be indicated.

As to what regards resolvent, and discussing Topicks, such are not required, which only open the Pores, that the Serum may evaporate, and the Blood may be restored to Circulation, as in a Phlegmon or Aede­ma, but whose saline Particles being destinated for strongly assaulting the saline Particles of the Arthritick Minera, may either draw them forth by laying hold of them, or, by precipitating them, keep them from their Pain, causing Effervescencies: wherefore, in this Disease, when Fomentations, or Cataplasms of Chammomil, Mallows, Marshmallows, Linseed, and Faenugreek seeds do little or no good, nay often much offend the nervous parts by relaxing them, the Dissolutions, or Stilla­titious Liquours of Sal Armoniack, Sea-salt, Nitre, Vitriol, quick Lime and the like; which in other Humours and Pains are always offensive are wont to prove very beneficial.

Of these kinds of Liquours to be applyed to the part pained in Fits of the Gout, several are prescribed by Quercitan, Crollius, Hartman, and other Chymists; which since other famous Physicians, upon fre­quent tryals have approved off, we conclude them to have given relief for the foresaid reason.

I need not repeat here the forms of these; as I could suggest many other Preparations of the same sort, I shall here only add one or two.

Take Salt of Tartar and Armoniack powdred of each two ounces, dissolve them in four pounds of Rain-water or Fountain-water: let it be used luke­warm with Linnen-Cloaths dipt in them.

Take spirit of Vitriol not rectified a pound, Sea-salt calcin'd and powdred a pound, mix them, and distill them in a Glass Retort with a sand heat; there will come forth a pure spirit of Salt, to wit, which being driven from its seat by the distilled Liquor of the Vitriol, and leaving to it its possession, will easily dscend: to the Caput mortuum pour Spirit of Wine two pounds, make a close and warm digestion, adding of Camphire two drams, let it be applyed warm to the part grieved with Linnen Cloaths.

Take filings of Iron, Flowers of Sal Armoniack of each six ounces, mix them by boyling them together, let it be distilled in a Glass Retort till the Flow­ers are sublimed: to the caput mortuum bruis'd pour spirit of Wine, digest, and keep it for use.

I have heard that some for appeasing Pains of the Gout, put the foot affected in a bag fill'd with Sea-salt calcin'd and powdred, from which they still expect a certain and quick relief.

In the declination of the Fit, to strengthen the part, and to discuss the remainder of the morbifick matter, Plaisters are usefully applyed, which nevertheless do not all agree indifferently with all Persons; but with these more hot, with othérs less hot, tho with most those are wont to be most efficacious, in which are red Lead, Litharge, Mercury, and other mineral or saline things, we use chiefly a Plaister of red Lead, Cerusse, and Soap boyled with Oyle, or take the red Lead Plaister two parts, Paracelsus's Playster one part, mix them and spread them on Leather.

Inward Remedies to be used against Pains of the Gout, are in a manner only Narcoticks, which ought to be given in a cruel and long continued Pain. Of these we most commend Preparations of Opium, with Salt of Tartar or its Tincture. Moreover, for this use Paracelsus's or the London Laudanum, Pilul. de Styrace, de Cynoglosso, Syrup of Meco­nium, Venice Treacle and Diascordium are wont to prove beneficial.

The second indication called preservatory, has respect to the remo­val of the Procatarctick Causes of the Gout; so that the Fits of the Gout may molest with invasions more seldom, and less, or not at all. For this end evacuating, altering, and corroborating Remedies, together with an exact sorm of Dyet are prescribed to be used out of the Fits.

1. Therefore Gouty persons ought to Purge solemnly Spring and Fall. and it will be convenient then to give a Vomit, if nothing in­dicates the contrary, and afterward to repeat it sometimes by inter­vals. Those who have a strong Stomach and Praecordia may take Mi­neral Emeticks, prepar'd of Antimony and Mercury: Those who are of a more tender constitution, after having eaten slippery food, may take Wine of Squills, or Salt of Vitriol with Whey: Afterward, the Sto­mach being filled with warm Water, or plain Posset-drink, or with the leaves of Carduus boyled in it, let a Vomiting be raised twice or thrice, or oftner. For Purging to be used also frequently at fit intervals of time, the forms of Purges above prescribed may be proper enough. Or,

Take threads of black Hellebore cleansed an ounce, lignum aloes, Cloves, of each two drams, being bruised, pour to them of Spirit of Wine not recti­fied, two pounds; let there by a close and warm digestion for many days; the dose is two or three spoonfuls in the morning twice or thrice a week, and let Vomiting and Purging always be begun before the Equinoxes, lest haply the fit, hapning first, may prevent the course of Physick. Blooding, or opening of the hemorrhoid Vessels are sometimes pro­per Spring and Fall to Persons of a hot temperament and a sharp Blood; Cauteries made in the Arms and near the Shoulder-blades are useful in a manner to all that are obnoxious to this Disease.

Moreover, altering Remedies, call'd by the Ancients the Antidotes of the Gout, are of excellent use, and being taken sor a long time, together with an exact governance as to the six nonnatural things, often give great relief: In this rank, Medicines endow'd with a Volatile Salt, or a Balsamick Sulphur; to wit, inasmuch as these exalt the fixt Salt, and those reduce the acetous, are accounted the chief; again, bitter and astringent things, as the Herbs Germander, Groundpine, Centory, Roots of Gentian, and Birthwort, &c. (since they are approv'd of by expe­rience in this Disease) seem to be profitable for this reason that they help the offices of Concoction and Chylification, and keep the saline faeculencies from being carried into the Blood. Let us set down cer­tain forms of each of these.

Take Powder of Groundpine six dram; Crabs-eyes two drams, Venice Turpentine what suffices, make small Pills, let three or four be taken in the evening and morning for thirty or firty days; drinking after it of the fol­lowing distill'd Water two or three ounces.

Take leaves of Cypress, Firr, Misteltoe growing on Apple-trees, of each six handfuls; Roots of Avens, the great Burr-dock of each a pound, the outward rinds of ten Oranges and six Limons; Nutmegs, Mace, of each an ounce, being all slic'd and bruis'd, pour to them of fresh Milk seven pounds, Malaga Sack a pound, let them be distilled according to art; let the whole liquor be mixt.

Or let a plain Water be prepared of the leaves of the great Burr-dock, cohobating it twice or thrice on fresh leaves.

Take Powder of the Seeds of the great Burr-dock six drams, Crabs­eyes two drams, Nutmegs half a dram, Balsamum Capivii what suffices, make a mass, and let it be made into little Pills, let four be taken in the evening and morning for many dayes.

Take Tincture of Antimony an ounce, the Dose is twenty drops to twenty five in the evening and early in the morning, with three ounces of the wa­ter even now describ'd.

To poor People I use to prescribe after this manner. Take powder of the leaves of Sage half a pound, Crabs-eyes, Saccharum Crystallinum of each two ounces: mix them, let it be kept in a glass, let a spoonful be taken twice a day with a draught of the decoction of the leaves of Sage, or of the roots of the great Bur-dock.

Or, let Dornorellus his powder be prescribed to be taken after the same manner.

Take powder of the leaves of Germander, Ground-pine, the lesser Cento­ry, Marjoram, Sage, Betony, roots of Gentian, round Birth-wort, of each an ounce, Sugar a pound, mix them, make a powder.

Or the Powder of Johannes Anglicus, called by him Saracenicus.

Take powder of the Leaves of Ground-pine an ounce, of the Bones of Mans­foot burnt two drams, Licorice three drams, mix them.

For ordinary drink let a Bochet be prepared of Sarsaparilla, Saunders, Lignum Rhodium, shavings of Ivory and Harts-horn, &c. Or, let a small Ale be prepar'd for a Vessel of four Gallons: in which instead of Hops let the leaves of Germander and Ground-pinē be boyl'd: and after it has wrought, put into it of the leaves of dry'd Sage four handfuls, Sassafras two ounces, Roots of Avens eightounces.

Among altering things, a Milk Dyet does not claim the last Place; viz. that the Patient use no other Dyet for three or four Months; Morn­ing and Evening let him drink Milk as it comes from the Cow; about Noon let him Eat of it boyl'd with White-bread, Barley, or Oatmeal. I have known some who by this kind of Dyet have found great Relief; and that others have been much worse after the use of Milk, and the Gout being not cured, to have contracted great Obstructions of the Vis­cera and a Cacochymia. Therefore, let not that Method rashly be entred upon without the advice, and careful observation of a prudent Physi­cian whether it agrees or not.

Not long since, it grew a vulgar Custom for Gouty Persons to drink every Morning their own Urine, which I remember to have done good to some: The reason of which relief seems of be, that the Saline latex of the Urine, passing again through the Blood, carried with it the Salino-fixt Particles, which were wont before to be convey'd to the Joynts: Wherefore this Method, if at any time it give ease in the Gout, for the most part it encreases the Nephritick affect.

A very learned and Pious man, the Glory both of our Nation and of Learning, D. D. H. H. having lived for many years greatly obnoxi­ous [Page 506]to frequent fits of Pains, Vomiting, and pissing Blood, at length, upon the constant use of the following Remedies, becoming almost free from the Nephritick affect, he liv'd above seven years without any very great Fit of it. The Method of Cure which a certain Gentleman had taught him, without any Physick, was thus, Abstaining from Wine and Cyder, he drank for ordinary Drink a small Ale made of Oaten Malt; Moreover, once a week he took in the Morning a draught of the same Ale to about half a pound, with three spoonfuls of the Pow­der of Ossa Senelorum dissolv'd in it: by the use of these things seem­ing to have bid farewel to the Disease of the Stone within four Months, he presently begun to be troubled with the Gout, and was often infested with severe Fits of it during all the time of his being free from the Stone; and at length, upon every little occasion, he became so obnoxi­ous to them, that if presently after Eating he any way exercis'd his Body or Mind, viz. either by walking or study, he certainly expected in­vasions of the Pains; the reason of which was, that the Blood being saturated to a fulness with Salino-fixt Particles, and the Nervous Li­quor with Acetous, when, upon a fresh supply of Nutritive Juice, they were stir'd and grew turgid, presently they deposed their Super­fluities, viz. the morbifick matter of both kinds in the Joynts, as be­ing very weak.

Therefore that Venerable Person, being tired with so srequent and almost continual a Torture, by the Advice of a certain Friend drank his own Urine every Morning, by the use of which, within a Month or two he was tormented somewhat less with his Pains of the Gout, but by an ill change the Nephritick affect begun to come upon him again; for he was often affected with a Pain about the Loins, with a Vomiting, and Dysuria, which being not to be overcome by any Remedies, caus'd the Death of the Renowned Person after about a Fortnight.

The Body being opened, all the Viscera excepting the Reins ap­peared very sound and firm, but the right Kidney seem'd to have been almost consum'd long before, there remaining only a little heap of Glands, all the Vessels and the Ureter growing together, and being wholly stop'd, that no Urine had pass'd there for a long time; The left Kidney being large enough, contain'd a great heap of Gravel-Stones within it's Cavity and Ductus's. Moreover, a round, hard, and whitish little Stone being fallen about three Inches deep into the Ureter, and there sticking, had wholly stop'd the Passage of the Urine, the Membrane of the Ureter, where the Stone stuck, was become so thick and callous, and consequently without Pain, that it could not be stirred thence by any means upward or downward.

It seem'd in this Case, that whereas the Coagulative Particles of the Blood and Nervous Juice, viz. Salino-fixt, and Acetous first meeting together in the Reins, had long caused the Nephritick affect; afterward, by the use of that abovesaid Powder the Saline being still [Page 507]sent into the habit of the Body, and not readily convey'd forth, heap­ed together a Seminium for the Gout in the Joynts, the Reins in the mean time being almost free: but at length, when by drinking his own Water the Saline-miner a was brought back to the Reins, the Disease of the Joynts was changed into a fatal Nephritis.