NOTwithstanding the indefa­tigable labours of so many able men, for more than two thousand years past, to bring the art of physick to a de­gree of perfection the other sciences have attained; notwithstanding the great pro­gress, [Page 2]that has been made in many branches of this art; and how enlightened soever we may have been by the improvements and discoveries of the last century; yet it must be confessed, that the cure of many dis­eases, is not yet arrived to a degree of perfection; or is infallibility ever like to be an attribute of physick. To free a man from pain, and to save him from destruc­tion, is in itself noble and god-like, nor is it to be wondered, that the first physi­cians were deified, or that those, who have excelled in this art since, have been highly esteemed and honoured; for as in natural things, the sun is the author and fountain of life, so the physician who pre­serves life, seems a second origin there­of. ^* Yet happy would it be for mankind, if a more expeditious method of curing some fevers could be discovered, consi­stent with the patients safety? What emo­luments and applauses would that man deserve of his country, whose studies had [Page 3]been so fortunate to discover a medicine, which had the power of checking the exorbitance of a fever, eluding its force, and entirely eradicating the latent cause? How happy, I say, if this could be effect­ed without waiting the tedious course, nature is sometimes observed to take, in fitting and preparing the febrile matter for a separation, and expulsion from the blood, in order to a salutary crisis; or if even those assistances art has hitherto employed, in accelerating these crises, or rendering them unnecessary, could be effected with less danger.

Such a pursuit and study is undoubt­edly laudable and beneficent, and tho' the whole science may be too abstruse, and extensive, for the human mind to comprehend; ^† though, like the philoso­pher's [Page 4]stone, and longitude, it seems at­tended with insuperable difficulties; yet, when discoveries, in particular branches, are offered to us with modesty, candour, and impartiality, abstracted from merce­nary views, or the arts of designing men; they certainly merit our notice, and strong­ly demand our attention: but should we find they want these intrinsic characters, these genuine marks of truth; that they are supported by the sophistry of the artful and designing, or protected by the bigottry of credulous and improper judges; sure it becomes high time to unmask the impostors, and detect the chicanerie; espe­cially in so important a cause as that, wherein our healths and lives are so prin­cipally concerned: for as all ages have abounded with false pretenders, who have deluded the unwary, under the specious appearance of serving the publick, so me­dical impositions have been more noto­rious, and successful: nor indeed is it to be wondered at, that this tribe should be so numerous and prevalent, when such en­couragements are given them; and when [Page 5]we consider how few are qualified to judge properly, either of diseases, or remedies; or to distinguish between the powers of art, and the influence of nature.

These are the chief points we shall endeavour to render more obvious and familiar, for it is neither our design, or intention, to enquire into the causes, which have retarded this wished for perfection; or to point out the obstacles, which by some are thought to have impeded the completion of so noble a fabrick, after so fair a foundation laid by our predecessors of old: we shall therefore first observe, that possibly an invariable method of curing diseases, can never be laid down, so long as different temperaments of the air, climates, seasons, and constitutions, are so frequently introducing new and various diseases; which, tho' often in many res­pects similar to others, which have pre­ceeded them, yet do they differ from them very essentially, and of course require very different treatment. Without having re­course to the authorities of such sagacious [Page 6]writers, as Hippocrates, Sydenham, Boer­haave, Hoffman, &c. whose accurate and faithful observations would be indisputa­ble in such a point; Who is there capa­ble of making proper remarks in practice, to whom this truth has not occurred? And who but from hence must have been convinced, that in the direction of medicine, due attention must be paid to particular symptoms, without being slavishly attached to particular forms?

But as the diligent observers ^§ of nature's laws, ingenuously confess, that in many cases she is her own, and best physician; and that we often attribute effects to wrong causes, by charging that to the re­medy, which is due only to her own efforts; it may be necessary to consider how far nature may be said to cure diseases, un­assisted [Page 7]by art; to point out when it is in her power to relieve herself, and when without the help of art, she would destroy herself; and this will naturally lead us to the true study of the medical art.

As the word nature is variously defined, we desire to be understood by it, the laws of motion, originally implanted in the machine, in order to set it in action, and preserve it so; by this natural mechanism of our bodies, whatever prove injurious to us is often thrown off some way, or other, provided the course of nature be not in­terrupted. This power of nature is so extraordinary in some constitutions, that in spite of all the blunders that are fre­quently committed, men recover even from the most dangerous fevers.

That we may the better judge of the nature of a disease, or fever, it may by some perhaps be thought no useless digressi­on, to enquire wherein health consists, that by a proper definition of the term, we may the better understand, when it is perverted, [Page 8]and by what means, either of nature, or art, it is again restored.

The health then of every animal body depends on a regular, moderate, and equa­ble circulation, of a proper condition'd blood, a due secretion, and execretion, of the juices or humours from it, and a proper degree of elasticity in the solids. This cir­culation once disturbed, and these secreti­ons once perverted, are the cause of almost all diseases. Thus from obstructed per­spiration, or sweats suddenly suppressed, the fluids that should freely flow off through the pores and glands of the skin, recoil on the blood, increase its quantity, and pervert its quality: a redundancy of bile, or an undue secretion of it in the liver, becomes productive of many and various diseases, such as bilious cholics, jaundices, inflam­mations of the liver, St. Anthony's fire, fevers, and many other disorders arising from its acrimony and stimulus. From this specimen, we may judge of the ill effects, which are the consequence of the rest; for whenever these secretions are not [Page 9]regularly carried on, the constitution is sure to be injured; and these humours or juices so amicable before, by being now de­praved, are made capable of producing an infinity of disorders.

We come now to explain, what we mean by nature curing diseases, and how or by what ways she effects this purpose and here among many others she takes, to remove an offending enemy, brought on frequently by a suppression of one, or other, of the above secretions; if the cause be slight, she frequently throws off the load of impure serum, by the glands of the nose and fauces, by coughs, a loose­ness, urine, and sweats; which if untimely suppressed by art, are sure to bring life in danger, or at least foretell a future dis­ease. But her most general method, when the disease is more important, is by raising a fever for her relief, and increasing the motion of the circulating fluids; ^* by this means she removes obstructions, which [Page 10]threaten life; by this the superfluous, impure, and viscid fluids, which choak up the vessels, are attenuated, dispersed, and thrown off by urine, stool, or perspiration: in other cases, when the vessels are too turgid, she often relieves their distending fullness, by bursting open their mouths, and bringing on a salutary bleeding, by those of the nase, uterus, and anus; and thus delivers berself from the oppressive load.

These are some of the ways she takes to relieve herself in acute disorders, as fevers: nor is she sometimes less successful, in the cure of old, stubborn, and chronical dis­eases; Asthma's of long standing have been cured by a St. Anthony's fire thrown out on the surface; epilepsies by scorbutic eruptions; and even melancholy and mad­ness by the piles. However it must be confessed that the power of nature is not so often manifest in the cure of chronic, as acute disorders, which latter are often effected solely by her own means, as the former generally are by art.

After having taken notice of the vari­ous ways nature takes to relieve herself, and observed, that the most greivous diseases are sometimes happily terminated and cured, without medical assistance; few arguments can be thought necessary to inforce this study of nature and her laws, as preferable to any other; for if it is most certain, that nature often prevails over art, which should always be her assistant and imitator, we may justly con­clude, that the method by which nature alone cures diseases should be studied, as worthy our imitation, and more particular regard.

For whoever doth not attend to natures motions in relieving her, will most cer­tainly do her great injury; which is fre­quently the case with those, who before the febrile matter is moveable and dissolved, or prepared for separation, endeavour to ex­pel it untimely, and by ways neither adapt­ed to that purpose, or to which she has any tendency herself. Thus as Hoffman ob­serves [Page 12]* it is to be lamented, that we every day see unskillful physicians, trusting too much to their NOSTRUMS, without having any regard to indications, method, or time, with respect to the disease, and thereby often bring the patient into extreme dan­ger; but if nature be powerful enough to elude the force of the medicine, and triumph over the disease, they then ar­rogantly boast of the importance of the cure, and gain both fame and rewards by their rashness; but such imprudent men are not to be trusted, for sure it is not the least part of the physicians art, to know the course, genius, and salutary ways of nature, that he may not disturb her operations, or assist her improperly.

But notwithstanding this power of na­ture in curing diseases, 'tis evident there are many, where she wants assistance, and would often destroy herself without timely relief, by the very means she endeavours for her preservation; the symptoms brought ⁵ [Page 13]on by her own efforts, being often more dangerous than the disease itself; so that in many diseases, a great part of the physicians work, is to appease her fury, and correct her errors; for being sometimes transported as it were, with a blind and impetuous passion, she unseasonable produces those dangerous, disorders in the body, that demand the succour of art. Thus to what salutary purpose are those violent spasms which arise from some poisons taken inter­nally, but to retain the enemy, she wants to expell? Of what use to her, are those various convulsions, which arise from fla­tulencies and worms in the bowels? To what purpose those direful pains, those vehement, and acute fevers, which arise from the slightest injury, or puncture of nerve, or tendon? Certainly these enor­mous commotions are worse than the cause, for whose sake according the Hel­montians, they were by provident nature appointed for her relief; for unless art soon runs to her assistance, they will most inevitably bring her into great danger, if not destroy her. What succour can nature [Page 14]bring to fixed inflammations of the head, lungs, uterus, &c. without the help of art. The venereal lues was never cured by nature. The dry and bilious cholic, with some others, require the immediate assist­ance of art: inveterate schrophulous, scor­butic, and leprous disorders, nature never removed. The gout, epilepsy, madness, dropsies, gravel and stone, worms, and many other disorders that might be enu­merated, tho' all of them are strong proofs of the little power nature has over them, yet many of them are known to be cured by the efficacy of medicine, and all of them have been alleviated thereby. In short with Mr. Boyle, ^† we may look on a good phy­sician, not properly as a servant to nature, but a counsellor, and a friendly assistant; who in his patients body furthers those motions, and other things, that he judges conducive to the welfare and recovery of it; but as to those he perceives likely to be hurtful, either by encreasing the disease, [Page 15]or otherwise endangering the patient, he thinks it is his part to oppose or hinder, tho' nature manifestly seems to endeavour to increase, or carry on those hurtful mo­tions. Thus many of the miseries, to which human nature is subject, may be relieved by proper assistances, and with Asclepiades we may say, naturam et prodesse & nocere.

It may be necessary to observe here, that tho' art is chiefly instrumental in the cure of chronical diseases, yet it is under the auspices of nature, and effected by a proper imitation of her ways. What else is meant by giving warm, stimulating, pungent, and volatile medicines, with steel and mineral waters, but to encrease the motion of the circulating fluids, and pro­mote a certain degree of fever. Are not the cures of some rheumatisms, palsys, and many other disorders, accomplished by these means; by attenuating and melting down the viscid fluids, and opening their obstructed channels by this accelerated motion. Thus as a certain degree of fever [Page 16]is necessary to remove acute, so also chroni­cal disorders; and as a late writer has ob­served, could a physician certainly raise a fever, and keep it to what height he pleased, many chronic disorders might be thus cured; but tho' this cannot be effected by art, yet nature may be imitated by direct­ing the above medicines, which by ex­perience have been found successful for this purpose, so that in many cases, it may be said, the fever is not the disease, but the remedy, et dolor, est medicina doloris.

From hence then we learn, that though nature often cures diseases, yet she often stands in need of medical help; tho' it is more evidently observed in chronic, than acute cases; for we speak not of those which come under the surgeon's cognisance, where she must often be destroyed, with­out immediate manual assistance.

Nor is it the least part of the physicians skill to know when to give it, and to di­stingush between the force of nature and art, between the effects and bounds of me­dicine. [Page 17]Happy is he then, who has made nature his study, who knows when to re­strain her exorbitant, and when to rouse her languid motions; who foresees when to give her timely succour, and can di­stinguish when he does her most service, by attempting to do least for her; for 'tis a grand mistake to conclude that nature al­ways wants the assistance of art, it being the best remedy sometimes to use none at all But according to Lord Bacon, men com­monly take a view of nature, as from a remote eminence; and are too much a­mused with generalities: whereas if they would descend and approach nearer to par­ticulars, and more exactly and considerate­ly examines into things themselves, they might make more solid and useful disco­veries. No doubt therefore, if physicians, leaving generalities for a while, would advance towards nature; they might be able to vary their art as distempers vary. ^*

This knowledge however can only be attained by experience, and sedulous obser­vation, and a perfect acquaintance with those indefatigable guides, who studied nature carefully, and have left us the fruits of those studies on record: to this end also a man should be well acquainted with natural philosophy, the materia medica, and the animal oeconomy; have a genius, and penetrating sagacity, to be able to di­stinguish the true causes of disease, from effects; the certain powers of medicine, with the bounds of nature and art; for there are in physick, as in the natural and moral world, general laws, universal pro­positions, and a perpetual analogy, between art and nature, that runs through the whole science for that purpose.

Let us therefore, says the great Pitcairn, ^* if we are inclined to deserve well of the re­publick of physick, that is, of all mankind, follow this excellent rule; for it is our duty to compare the observations that have been made by others, and continue to be made [Page 19]every where, upon diseases and their re­medies, without any regard to opinions: which are nothing in comparison to the certain conviction of our senses.

But how few, as Dr. Friend, has taken notice, are qualified to make judicious observations on their experience? ^† For the word is often made use of, when the effects do not plainly appear. He farther observes, that a man may practice and practice all the days of his life, and yet be never the wiser for his experience, if he neglects to make the proper observations, which that expe­rience might suggest to him; and it is not very likely, he should be over nice in his observations, who constantly goes on in his first tract, and has no other scheme, but his own narrow notions in his view: whereas the searcher of authors, has the benefit of other men's experience, together with his own, and it is from the joint con­currence, that we can hope for any con­siderable advancements of knowledge. [Page 20]Were it not for this, the oldest physician would always be the best physician; and there would be little or no difference, even as to the scientific part, between an old nurse, and the most regular professor.

Thus is it plain that practice alone will not teach a man the art; ^* for there are not wanting instances of practitioners, who are grown old in business, but for want of being early instructed in the principles of the art, are almost as absolute strangers to it, as they were at first setting out. The practice of these men has always been, empirical and by receipts, and as their minds have never been sufficiently enlightened with true science, to pursue it properly; so they catch at every new medicine, like drown­ing men at every twig, in hopes of sup­porting a little longer a sinking reputation. Such is the fluctuating state of the mind, unless a man is thoroughly grounded in the rudiments of his art; for like one perplexed in a labyrinth, unless the right path is [Page 21]pursued, he is continually erring and mis­taking his way; treading again and again in the same tract, till he is tired; yet is he often deceived in the mazey round, and frequently flatters himself, with the pursuit of the true path.

This naturally leads us to enquire into the force, and power, of some favourite medicines, which are given in acute fevers; and are supposed now and then, to work such speedy recoveries; when the cure in general, rather depends upon a due regula­tion in diet, and proper regimen in other respects, than any peculiar medicine: but our fondness to such remedies, generally rises in proportion to our credulity, igno­rance, or prejudices; for rather than attri­bute any good change in the distemper, to the power of such regimen; it flatters the vanity of some, to ascribe it to a medicine of his own prescribing, tho' ever so insig­nificant. How often have the most simple things, luckily timed at the crisis of a fever, been applauded for effects, they had no pretensions to; for nature who often [Page 22]triumphs over slight obstacles, little cares to whom the honour is attributed, so that she herself comes off victorious. This might be abundantly exemplified in a great variety of instances, to the conviction of the most sanguine bigot: and indeed im­partial, and competent judges, will readily confess, that nothing is more difficult to ascertain, than the true virtue of medicines: for their effects in general rather take their force, from the judgment of the physician, in their just application, than from any constant and inherent virtue of their own. The learned Dr. Friend ^* hath curiously observed, and shewn, that the different operation of remedies, arises not from any change of virtue in the medicament, which continues always the same; but from the different state of the body, wherein it is applied.

Thus the bark taken in the fever fit, shall often purge, between it, bind; Opium instead of controuling watchings, shall fre­quently [Page 23]increase them; Aloes whose pro­perty is to purge, shall in some cases, tho' given for that purpose, not operate at all; while restringents, shall in other con­stitutions occasion purging. Steel, Antimony, Mercury, &c. might be brought to eluci­date this truth; and prove their different effects on different constitutions; as well as when they are injudiciously directed.

But as it may be necessary, to set this affair in a clearer light, to prevent being misunderstood; and to shew, when nature can do without art, and where the latter is requisite; I must beg leave to explain myself a little farther, on both these heads. Who then, ever so slightly acquaint­ed with acute disorders, but must have ob­served, that fevers in their infancy, are frequently and easily removed, by very simple means; or rather that the FEVER, which is nature's instrument, assisted by di­lution with small liquors, and abstinence from animal diet, seldom wants any other helps; but where bleeding and gentle eva­cuations are joined to these, the end is gene­rally accomplished in a few days; for by [Page 24]this; method, the fluids are diluted, the se­cretions renewed, and the fullness of the vessels abated: and to speak ingenuously, 'tis extremely probable, that fasting, and abstemiousness, would cure many, and prevent most distempers; had men resolu­tion enough to pursue it for a sufficient length of time, under proper regulations.

But when this method has been neglect­ed, and repeated colds, or acts of intempe­rance, are urged on one another; aggrava­ted by a heating regimen, or hotter medi­cines; we must not wonder at the difficul­ties that often attend the removal of such a fever; for the blood and other juices, are now become too viscid or sizey, to circu­late in the finer vessels; hence frequently from such obstructions, arise inflammati­ons in particular parts; which if not soon removed by art, terminate in matter, or fatal gangrenes. In other fevers, the blood is in the reverse state, being too rare, thin, and acrimonious; tending to dissolution, and putrefaction; which by the rapidity of the circulation, is frequently forced thro' [Page 25]the extremities of the small arteries, and are the cause of malignant eruptions, and violent bleedings. Here indeed it is high time for art to interpose, for nature is no longer her own assistant, but will soon de­stroy herself, without timely succour: under these different circumstances, the skillful physician has sufficient opportuni­ties, of distinguishing his prudence, and abilities, for the storm is now raised, the pungent pains are become insupportable; the disturbed functions of the mind, call aloud to be be-calm'd, that reason may re­assume her throne; now is the time to assist her effectually, either by curbing her inordinate transports, or succouring her languishing struggles: Here the cautious prescriber, will guard well against either extream, least by an injudi cious applica­tion, he may aggravate the cause, by adding fuel to a fire which burns but too intensily already, or check that vital flame, that is but too nigh extinguished. Here he who has carefully studied the laws of nature and observed the ways she sometimes takes to relieve herself, will be best able, to give [Page 26]her that assistance, she now so much wants; while he, who is only acquainted with her in speculation, will stand amazed, and affrighted at symptoms he never suspected, and impotently attack the disease, on the strength of some favourite hypothesis, or some darling NOSTRUM.

From this portrait, or description of two different kinds of fevers only, one may rea­sonable inquire how far any one method, or medicine, is like to answer both inten­tions; but before we venture to mention our own thoughts on this head, let us take the opinion of the immortal Sydenham, that candid, and judicious observer; who says, ^* there are various kinds of fevers, most of which require their peculiar method of cure, different from the rest; and that the same individual fever, of whatever kind it be, requires one treatment at the first, and another somewhat different, through all its stages, as long as it continues. Many other similar passages might be extracted [Page 27]from this great man's works. Let us hear also the experienced Baglivi, who says, ^† a great many have such an affection to some one remedy, that they think it alone in­titled to a sovereign virtue, and power, of curing almost all diseases; either by reason of a lucky event, observed now and then to ensue the use of it, or rather by a certain innate propensity that they have, not only of crying up some medicines, but ascribing to them fictitious virtues: but I must observe by the bye, says he, that no physician can cure a fever happily, with­out he informs himself of the febrile state of the blood; whether it is too rapid, thin, or inflammable, &c. or on the other hand, apt to congeal, thick, malignant, &c. For in such different states of the blood, the indications of cure must be diversifyed accordingly. The honourable Mr. BOYLE in his treatise on the usefull­ness of philosophy, observes, that it is much more difficult, than men can imagine, to make an accurate experiment in physic, [Page 28]for often the same disease proceeding, in several persons, from quite different causes, will be increased in one, by the same re­medy, which has cured it in an other and not only the constitutions of patients, may as much alter the effects as the causes of diseases; but even in the same patient, and in the same disease, the single circum­stance of time, may have almost as great an operation upon the success of the medi­cine, as either of the two former particu­lars. The learned FRIEND ^* on this occa­sion also observes, that a man who has the least acquaintance with physic, must be sensible, that a universal medicine must be a cheat; and though it be ever so good and valuable a medicine itself, yet it is utterly impossible it can be equally appli­cable to all persons, in all cases, and at all junctures; and therefore it must be de­termined by the skill of some discerning physician, who is well apprised of the na­ture and symptoms of the disease, where ^† [Page 29]to give it, and where to forbear. We need not go far for a proof of this: we have a convincing one in that great, and perhaps the only specifick, the bark: which if used indifferently, and without judge­ment, even in intermitting cases, has a chance to do as much hurt as good. But I forbear making further quotations, from other writers of equal eminence, that the reader, may not be tired.

If these things be true, if such autho­rities are to be relied on, how absurd is it, to suppose any medicine can be possess'd of the unerring faculty, of removing all fevers; and yet this opinion, however dissonant to reason, and common sense it may be, appears to have it's abettors; and I am sorry to say it, among some few too, who call themselves physician; contrary indeed to the ingenuous declaration of the learned publisher of this remedy, who in the following passages in his dissertation on fevers, as well as in his daily practice, manifestly disavows such a general power in his preparation. I am obliged says [Page 30]he, ^* to own, that as I esteemed life too sacred to be hazarded, for the sake of an experiment, I have never neglected to call in all other medicinal aids, to my assistance, when I thought the case required them, and believed that they would be of service. Again ^† as I would be extreamly cautious of leading any one into error, in an affair of so much importance, as is that of life, I must remark, that when violent inflam­mations of the vital parts threaten imme­diate destruction, I should think it impru­dent to neglect repeated bleedings, purges, clysters, and all other assistances, which the art of medicine can afford.

After such plain and candid concessions, one would think it was impossible, that any but stupid bigots, or superstitious old women, unacquainted with such auxilia­ries, would solely depend upon this reme­dy, and in the most desperate cases. Does it not hence evidently appear that Dr. [Page 31] James himself does not? Do not some of his cases prove it, where we find Bleeding, Nitre, Musk, stimulating Cataplasms, Blisters, and Purges, directed as associates with the medicine. ^*

And who, among such a group of auxi­laries, can pretend to say, what share of merit, becomes due to the powder? The Dr. himself ingenuously confesses, he some­times could not determine how far it was instrumental in the cure; ^† nor indeed how should he.

How absurd then must it appear to every impartial man, who reflects cooly, that a medicine, which it is acknowledged may demand all these occasional assistances, should without restrictions, be thus rashly and universally recommended by some in all fevers; for whatever limitations may be hinted at in the treatise, can it be sup­posed, that those unacquainted with the [Page 32]science of physic, can distinguish, from the rules there laid down, when to employ these auxilaries? Neither can Dr. James, always be at hand to, direct them, and who less acquainted with that medicine, would risk their reputations, by being concerned with it, on such important occasions, where lives are at stake; much less can it be possible, that the promiscuous admini­stration of this remedy, to diseases of such general Names, as are mentioned in the advertisement, can be successful; when the conditions of these diseases, do so perpetu­ally vary.

But if the operation, and effects of this medicine are to be rationally, and not empi­rically accounted for; if it is to be ex­amined by the same tests, that all others are; we shall find, that like them, it must be directed, and given with prudence, and skill, to render it efficacious, and prevent it's being injurious. For example if it has been found successful in thinning and at­tenuating the viscid, sizy blood and fluids, is it not likely to be prejudicial in cases, [Page 33]where the fluids are already too thin and rare? If it has been found useful, in in­creasing the secretions of the glands of the skin, intestines, and kidneys, by pro­moting stools, urine, and sweats, may it not be injurious, in those cases, where these secretions are but too liberal already? That this is evidently the case in some colli­quative fevers, appears by the broken tex­ture of the blood; where the particles being too much dissolved, are daily ex­hausting the patient, by running off too fast, through the pores, by melting sweats, or the bowels by watery stools.

How preposterous, how inconsistent then must be the practice of those, who give it thus indiscriminately; and who thus wan­tonly trifle with lives, they are intrusted with? But surely the folly of such pro­ceedure can want no illustration. Could a man also without horror reflect, on being accessory to the untimely death of a friend, or neighbour, by the vomiting power of an antimonial medicine, given without previous, or proper bleedings, in inflamma­tions [Page 34]of the lungs, or brain, trusting to this medicine solely, in such important diseases, contrary to the express rules of Dr. James? This though a real prostitu­tion of it, yet has been done, and by the direction of some, who ought to know better; for can the most sanguine abettors of this medicine, pretend to pre­vent this operation, as it is one of its gene­ral effects, ^* the continuance of which may depend on the juices it accidentally meets with in the stomach? Under such threat­ning cicumstances, with violent pains in the head, or sides, attended with the ut­most difficulty in breathing; what a truly piteous situation, must be that of the un­fortunate patient, under the vomiting power of this medicine? How must the acute, pungent pangs, be thereby aggra­vated? The turgid and distended vessels stretched, even to bursting? Or at least such a quantity of fluids may thereby be derived [Page 35]on parts, already but too much loaded, so as to fi [...] immoveable obstructions, and occasion fatal gangrenes. These are warn­ings that should be given by somebody, as they are not the result of imaginary specula­tions, but are real facts, which have occurred; and though the farmers loss may not be greatly increased, by the additional expence, attending the purchase of ^* the medicine, for his cows and oxen; yet his family may sustain an irreparable one, by an untimely and injudicious taking of it himself.

But if such be the barrenness of the ma­teria medica. or the incapacity of the phy­sician, in drawing his indications of cure, that this must be the popular, and fashion­able remedy; let us at least have the wisdom and honesty, to treat it, as we do other medicines; for by these means only, can it obtain a just reputation: let us then con­fine it within its proper sphere of action and give it in such cases only, as it appears, calculated for; which from our observa­tions, seems chiefly to be in the beginning of [Page 36]slight fevers, which arise from indigestions, or taking cold; for by its stimulus on the stomach and bowels, those organs may be thus cleansed of their indigested particles, their, feculencys thereby removed, and the sweats it generally procures, assisted by plentiful dilution, may set open the secre­tions; and thus by removing the surcharge early, nature is left at more liberty to re­cover cover herself. Should it on fair trials be found to suit other indications, let it be given with discretion; but if our views are not answered soon, let us not, Sangrado like, obstinately persevere as some do, to the patients destruction; that we may a­void the just reproaches of an injured family, who may be made sufferers by our wanton­ness, and imprudence; and prevent those bitter reflections, that will recoil onour owm minds, by being thus accessory to them.

Medicines of this kind, as generally gi­ven, tis true may save some the trouble of thinking, and searching for indications; which every prudent man thinks absolutely necessary, before, he prescribes; but this compendious method cancels all tyes, or [Page 37]duty of this kind; abjures this slavish at­tachment to the study of nature, and her laws, as delusive, and desultory; reduces the science of physic to a narrower com­pass, and instead of leading, or kindly assisting nature, forces her to be obedient, and follow the ways they choose to pre­scribe her. Such implements however in physic, are like edge tools in the hands of children, or weapons of destruction in those of madmen; the simplicity of the one, converting them to their own prejudice, and the insanity of the other, to the de­struction of those about them: and this observation we apprehend will always hold true, that this or any other valuable medi­cine, can only be of real service, when di­rected with judgment; and that it is the judicious timeing, and adapting the medicine, to the disease, that makes it either a bene­ficial remedy, or a destructive poison.

We desire it may particularly be re­marked, that the violent sweats extorted by sudorisic medicines in fevers, but too often aggravate the disorder, though they [Page 38]seemingly give present relief; ^† for unless this evacuation be critical, i. e. by carrying off the cause of the fever, the blood is there­by defrauded of its thinner, and finer parts, and the remainder left so thickened, that 'tis rendered unfit for circulation in the finer vessels, and often occasions ob­structions, that terminate fatally. This has remarkably been observed to be the case with this medicine, where after having caused profuse sweats, for several days, the blood on examination for that purpose, so far from being attenuated by the medicine, (as is the property generally ascribed to it) hath on the contrary, been found more tenacious, and sizey; and so unfit for circu­lation, as to occasion constant watchings, delirium, &c. which in some cases subsisted till blisters, and more powerful attenuants removed those symptoms; in others till death put an end to them.

Nor is it less necessary, to guard against the promiscuous use of this powder, in eruptive fevers, particularly those called miliary; as it is evident to the observing practitioner, that the eruptions once re­pelled, the patient is thereby often brought into the most eminent danger of his life: and if this has often been found to be the case, by a few slight stools, what conse­quences may we not apprehend from a medicine, whose known effect is acknowledg­ed, sometimes to purge pretty briskly. ^*

As Dr. James seems so sinngular in his no­tions concerning miliary fevers, and suspects them to be entirely the children of art ^† as he has so ludicrously treated this im­portant subject, which has been so accurate­ly described by Sir David Hamilton, Hoffman, Mead, &c. and probably too so far, as to lead some of his pupils into fatal errors; I thought it the more incum­bent [Page 40]on me, to give this caution; and the more particularly, as in his paper instruc­tions, he recommends this powder for miliary fevers, and all others of the erup­tive kind; and says that there is no reason to fear a moderate number of stools, at the latter end of a fever, or at any other time. ^* The latter part of this paragraph, is surely too bold an assertion, especially if relative to this fever; where a very mode­rate number of stools, has frequently pre­cipitated the patients fate, by the sudden repulsion of the eruptions.

From what then has been advanced in relation to the powers of nature and art; in regard to the use of medicine in general, and this powder in particular; we may ob­serve that in many acute disorders, or fevers, nature is often her own, and best physician; that the assistances from art should in general be cautiously directed; al­ways drawn, from such indications, as the symptoms point out, and must be varied [Page 41]in proportion to the nature of the disease: That no one medicine, can ever answer so many different purposes; more especi­ally one whose operations are so precarious; and which we are convinced from the pro­cess of, (which is no secret to the world) that tho' it may be useful in some cases, it must be prejudicial in others; that a pro­miscuous, unlimited power of giving it, according to some, has to our knowledge, been productive of many, and great mis­carriages: How often has nature been di­sturbed, and a favourable crisis prevented by this, and other ill-timed medicines? And how easily distempers slight in themselves, are often converted into important ones, by untimely and injudicious applica­tions, is well known to the careful observer. Cases of this kind have occured where nature tho' feeble, and oppressed, yet labour­ing hard to relieve herself, and depurate the blood by critical swellings, has been most preposterously teized and thwarted with the stools, and sweats, incited by this medicine, till she had nigh sunk under the [Page 42]oppression; yet has she at last happily e­merged, and accomplished her designs, after having obtained a truce with it for a few days. So true is that observation of Dr. James* that some few are so happy in an unextinguishable strength of constituti­on, that they even at last miraculously re­cover, notwithstanding the most absurd treatment. In colliquative cases, where the secretions were too liberal, it has sunk many untimely; and in fevers of several days standing, where the vessels are too tur­gid, the pulse vehement, the blood so gluey and viscid, that it cannot freely pass the finer vessels, or so fused, and broken, that it threatens to escape them; when inflam­mations are also fixed on the nobler parts, foreboding inevitable destruction without speedy relief; surely on such emergencies, it would be madness indeed to trust to this, or any one medicine, without calling in every other help, that reason, and expe­rience dictate on such occasions; and this we are justified in asserting, not from the ²⁶ [Page 43]reason of the thing only, but from the authority likewise of Dr. James himself, in the places above cited.

I cannot conclude without taking notice, of a ridiculous insinuation, advanced by some, as a reason, why the gentlemen of the faculty do not patronize this medicine; which is, that it would be destructive of their private interests, by making such speedy cures. But this objection, the trite, and stale artifice of every empirick to re­commend his NOSTRUM, is as mean, and contemptible, as it is false; 'tis an artful lure, thrown out only as a decoy for the publick, that they may the more readily become their dupes.

For are not the physicians of this nation in general, and of London in particular, men of liberal educations, whose learning, and abilities are equal to any in Europe? Are not many of them, as conspicuous for their humanity, benevolence, and tender­ness, as they are for their independant fortunes? What could induce such men, [Page 44]to procrastinate the cures of those commit­ed to their charge, but a certain conviction of the inefficacy, and incertitude, of general medicines? Is it not then base, and infamous, to insinuate, that these men would sacri­fice all considerations of honour, justice, and compassion, merely to oppose such a universal medicine? Is it not notorious, that many of them in their private practice, as well as by repeated trials in our hospi­tals, have found it was by no means to be relied on? or can it deserve credit from any sensible, and unprejudiced minds, that those few practitioners who do espouse this medicine, have alone monopolized the amiable qualities of truth, disinterestedness, and common honesty? Surely it would be more ingenuous, and candid, to conclude, that nothing but this certain conviction of the incertitude, and inefficacy, of general me­dicines, and of this in particular, (whose virtues like all others, can only arise, by being rationally adapted to particular cir­cumstances, and states of diseases) could be the true and only cause of leading physici­ans, to forbear its general use; whatever [Page 45]bold assertions, ignorant, and designing men may advance to the contrary.

These are some of the observations, that have occured, and 'tis to be apprehended will have some weight with the impartial: for if neither honour, conscience, humanity, and independance, can be thought to have any influence over the conduct, of such pro­fessors of physic; we must be under a ne­cessity of condemning, a body of men, as monsters in nature, who have hitherto been esteemed real ornaments to their country, and respectable, as well as useful members of society.