A Compleat System of the Theory and
Practice of Physic.
All Diseases incident to Men,
Women and Children.
An Account of their Causes, Symptoms, and most approved methods of Cure,
PHYSICAL and CHIRURCICAL.
To which is prefix'd a short View of the Animal and Vital Functions; and the several Vertues and Classes of Med'cines.
Translated from the last Edition of the Works of Michael ETMULLERUS, late Professor of Physic in the University of Leiptsich.
Printed for E. Harris, at the Harrow in Little Britain, F. Hubbard, next Door to the Crown Tavern in Ducz Lane, and A. Bell, at the Cross Keys and [...] in Cornwall, near Stocks-Market. 1699
PUBLISHED FOR E. Harris
PUBLISHED FOR F. Hubbard
PUBLISHED FOR A. Bell
1.1. Sect. XV.
1.1.1. CHAP. V.
Of Malignant Feavers.
A Feaver is call'd Malignant, when 'tis attended by more dismal Symptoms, than its visible Cause is wont to produce. Malignity is not inseparably united to Contagion, there being some contagious Diseases that are not malignant, as the Itch, &c. and e contra. Oft-times it lies latent in the Body for three or four days, 'till the Season of exhibiting Antidotes be over; upon which account, a Physician ought to be very watchful in the Beginnings of Feavers.
The Symptoms which lead us to the discovery of a latent Malignity, are these following; a sudden prostration of strength, and the Appetit dejected, while the other Functions are regularly perform'd, stubborn Watchings without any anxiety if the Head be only affected; but if the [Page 255] Stomac and Breast be disorder'd, they are attended with a great perplexity, tossing to and again, sometimes the whole Body, sometimes only an Arm or a Leg; to which symptom Deliriums and Convulsions frequently succeed. The Urine resembles that of healthy Persons; or, if by vertue of Medicines, or otherwise, it happens to thicken, yet it still continues transparent, and has little or no sediment, unless it be a yellowish Clot of Chyle voided along with it. The Pulse is at first in seeming good order, of a sudden it becomes weak, small, oft-times hard; and towards the height of the Feaver, unequal. At first a gentle shivering may usher in the Feaver; to which succeeds a very moderat heat externally, tho' in the mean while they are burnt up within, which is a fatal sign of internal Inflammations. And notwithstanding the moderation of the Heat, an unquenchable thirst molests 'em, and their Tongue is dry and rough. Or if on the contrary, they be extream hot, and withal insensible of thirst, 'tis likewise a sign of malignity. These are the most common Symptoms. Sometimes the Feaver is attended by violent Headaches; difficult respiration, respecially upon the point of cuticular Eruptions; stinking Excrements, and lastly, eruptions of Spotts, Pushes, Wheals, &c. According to which it undergoes several Denominations. Sometimes the malignity is arriv'd at that height, that the external Parts are corrupted and seiz'd with Gangreens, the Person possess'd with, an invincible aversion to all manner of Liquors, &c.
Malignant Feavers admit of several Degrees. The first is when the occasional sharpness and degeneracy of the febril ferment, converts a benign Feaver into a malign one. 2. When the ferment is not only sharp, but contagious, or epidemical. Now the original of Contagion, is an active spirituous ferment, easily communicable to the Spirits, and capable to propagate it self by a fermentative motion, in matter fit for its purpose; which, in company of Spirits exhal'd from the sick Person, pitch upon those whose Constitution and Pores gives the easiest admission, such as the Relations of the sick Person, weak People, &c: The manner of its reaching and insinuating into such Persons, is either by immediat Contact, or in the Vehicle of Food, Cloaths, &c. or that of the Air convey'd into the Lungs, where it debauches the Spirits circulating that way, and in passing the Mouth, adulterats the Saliva, which immediately affects the most sensible Orifice of the Stomac: Hence the first, [Page 256] and most dismal Scene of tragical Symptoms is laid in the Stomac. 3. When the ferment is become pestilent. And, 4. When 'tis form'd into a direct Plague.
The cause of Malignity, assign'd by Willis, is the coagulation of the Blood; and that by Sylvius, is a sharp volatil lixivious Alcali, destroying the acid Sulphur of the Blood, and consequently, its consistence: But the vicious fluidity of the Blood attending malignity confutes the former; and the natural inactivity of Alcali's, the known power of volatil Acids in extinguishing the animal Spitits, and galling the nervous System; and the Antidotal vertue of Alcali's, both volatil and fix'd, such as Camphyr, Myrrh, and the absorbent Powders, overturns the latter Hypothesis. 'Tis therefore a sharp volatil Acid that causes malignity, partly by dissolving the texture of the Blood, and disposing it for Putrefaction, and generation of Worms, observable by Microscopes; partly by irritating the Stomac, Brain, and nervous Parts, and partly by extinguishing both the vital and animal Spirits.
That the Spirits are immediatly attack'd as well as the Blood and Humors, is made to appear by the symptoms of sudden Weakness, contracted Pulses, Watchings, Deliriums, &c. and by the force of imagination in propagating the Contagion. Nay oft-times the Spirits are principally assaulted, and the Humors only mediatly, thro' their sides. Now it will be of use in malignant Feavers, to distinguish nicely the original trouble of the Animal Spirits and nervous System, from that of the vital Spirits and Mass of Blood. The Symptoms of the former, are an unquenchable Thirst, a rough and dry Tongue, a quick and small Pulse, attended by a moderat Heat, anxiety and unquietness (proceeding from the Stomac) a melting looseness, the rotten smell of Excrements, and the thin fluid consistence of the Blood: Those of the latter are a violent heat of the Forehead; the hardness of the Pulse, without the trouble of any membrane in the Body; or a laudable Pulse attended by extream weakness; the prostration of the Appetit, squeamishness, vomiting, stubborn watchings without any visible Cause, the dryness or roughness of the Skin, and the unaccountable thickness and crudity of the Urin.
The Remote Causes of Epidemical Malignity are: approaching to corrupted things, as Dead Carcases, &c. The Salt Subternanean Fumes; Earthquakes; a preceding famine; eating of corrupt Food, as of putrify'd Summer Fruits, and [Page 257] drinking Rotten Water, &c. Inwardly the prevalent acidity of the Juice of the Pancreas may so exalt the Bile to a rusty sharp quality, that it becomes malignant. Thus Benign Feavers frequently degenerat into malign ones; and Scorbutic or Hypocondriac Persons, who are stuff'd with a fix'd Acid, are not so much oppress'd with malignity or a Volatil Acid, as others.
The prognostics of malignant Feavers are very uncertain, and fallacious. A large and equal Pulse is a good sign. A quick and small creeping Pulse is a bad sign; as also an unequal Pulse; tho' neither the inequality nor intermission, nor smallness are so fatal in malignant as in Benign Feavers. If Doating continue after sleeping and be not attended by Sweats; if the Eye represent false Colours of Objects; if the Urine, after apparent Concoction, become Crude again; if it stink, if it appear Fat, Oily, black, or livid, with a blackish Sediment. If a Looseness happen especially after eruptions upon the Skin; if the Excrements or Urine are Bloody; If the Excrements, Serum, or Blood, send forth a heavy Smell; if a redness of the Face, Heat and Watchings be attended by a dropping at the Nose; if the Tendons start; if a tickling or pricking Pain invade the Palms of the Hands; if the Person attempts to catch Flies, or pick the Bed-Cloaths; if any of these Symptoms appear they threaten Convulsions or Death. Deafness tho' it be look'd upon as a dismal Symptom in the beginning of acute Feavers, meets with a favourable construction about the height of Malignant Feavers. The Eruption of Bubo's and swellings of the Glandules frequently infer the solution of the Disease.
The Cure is either design'd for preservation from imminent danger, or removing the present Illness. Distill'd Vinegar, Camphyr, and alexipharmacal Ingredients are proper Preservatives. As for the proper Cure of Malignant Feavers, 'tis perform'd by expelling the poysonous ferment, and fortifying the Spirits and Humours, in order to promote the expulsion. To this purpose, Sulphur, absorbent Antimonial Powders, Camphyr, Vinegar, and Acid Juices; precipitating Powders such as the friable parts of Animals, mix'd with alexipharmacal Ingredients, such as Zedoary, Ivy-Berries, Juniper and Bayberries, Myrrh, Angelica, Gentian and Saffron, with Opium and Sudorifics, are very proper. But in order to a regular use of 'em, let us mind the following Cautions.
1. Vomits, especially the Infusion of Vitrum Antimonii, are of admirable efficacy in the very beginning of Malignant Feavers; especially when they're attended by Anxieties in the Breast, or proceed from an internal corruption of the Humors. But the Season of exhibiting them must be nicely weigh'd; for if Nature be already endeavouring any other evacuation, especially through the Skin, they are out of season.
2. Sudorifics are justly look'd upon as the basis of the Cure; but they ought to be proportion'd to the malignity of the Disease, and strength of the Patient. If the Malignity be of a moderat Character, 'tis advisable to begin with absorbents at first. Indeed a violent malignity requires powerful Sudorifics; but care must be taken that the Patient be not stifl'd with weight of Cloaths. And those of the sweating Tribe that are Aromatic and Oily, are only proper in the beginning, or during the increase: Towards the height, or when the Heat is violent, 'tis not amiss to exchange 'em with fix'd Powders or, at least, to qualifie 'em with Acids, such as the Spirits of Nitre, the vegetable Acid Juices, &c. Camphyr is a Sudorific never to be omitted, unless it be prohibited by a peculiar Antipathy as in some Women, and studious Men.
3. During the time of sweating, or immediatly after it, let Acid mixtures of the Juice of Citrons, and especially Spirit of Nitre &c. be exhibited. They retrieve the exhausted Spirits, and procure a due consistence to the dissolv'd Blood, and ought always to be imploy'd for a Vehicle to Venice Treacle, and such like hot Compositions.
4. Opiats are of admirable use for promoting Sweat, which is frequently hinder'd by anxiety and unquietness. Let 'em be mix'd both with Sudorifics, and with the Acid mixtures exhibited after sweating; but their proper Season is during the Increase; for towards the Crisis they ought to be avoided.
5. The Cure of malignant Feavers varies according to their respective Causes. If they proceed from external Contagion, fierce Sudorifics are requir'd. If from the internal corruption of the Humours, they ought to be more temperat, and rather absorbent. If the Animal Spirits are the principal seat of the Malignity, subtil, volatil, penetrating Ingredients, mix'd with Narcotics, are proper. If the Blood claim that Character, they ought to be temper'd with Acid Vehicles. The malignity of the Blood is, for the most part, attended by eruptions of Humours at one part or other; that [Page 259] of the Spirits by Deliriums, Watchings, Convulsions, &c. and a tolerable Pulse.
6. Malignant Feavers are frequently complicated continual Burning ones; in which case regard must be had to the boiling heat of the Blood, by insisting most on moder at Acids, and fix'd absorbents, especially those of Antimony, and qualifying the volatil oily Specifics.
7. The above mention'd Symptoms relating to the Tongue, Hands, and Tendons ought always to be inquir'd after; as also the condition of the Eyes, for if they are rutilant and fiery, or fierce, they threaten Deliriums.
8 There is nothing more fatal than a Looseness; and all Artificial Purgations are pernicious, especially if the Disease came by Contagion, or if Nature endeavour Cutaneous Fruptions, or if the force of malignity surpass that of the febrile effervescency. If the first Passages be stuff'd, let temperat Clysters be injected, and even those but very cautiously. In the Declension of the Disease a gentle Laxative is not amiss.
9. Blood-letting is highly Pernicious, especially if the Disease came by Contagion, or tend to cutaneal Eruptions. Sometimes if the malignity be weak, and the Blood boyl high in a Plethoric young Person, accustom'd to Bleeding, it may be allow'd; but with a great deal of Caution and Judgment.
10. Blistering Plaisters are very useful. They're applied to the Legs and Arms, and in case of sleepy Symptoms to the Nap of the Neck. If the Animal Spirits are much afflicted, or if the Eruptions design'd by nature advance but slowly or retire afterwards, they are of singular use. Stephanus advises us not to be over hasty in applying 'em, till Nature have discover'd her design, and then if she be weak to interpose their help. The increase or rather beginning of the Height is a proper time to apply 'em.
11. The Diet must be thin; neither are Victuals to be offer'd unless the appetit require 'em. For Drink, let Water be boyl'd with a third part of Rhenish Wine, and mix'd with the Juice of Citrons and Gelly of Hartshorn. Or let Whey be sharpen'd with the Juice of Citrons, or Spirit of Nitre.
Having premis'd these Cautions, we shall next touch at the Specifics, some of which are volatil, some fix'd. The volatil are either lean and thin, such as the Spirit of Sal-Armoniac, [Page 260] the Spirits and volatil Salts of Hartshorn, of Vipers, of Tartar, of Urine, of Amber, &c. Or Oily and Aromatic, such as Camphyr, Elecampane, Birthwort, Rue, Galangal, Mary-gold, Orange Peel, Germander, Castor, Vipers, Baum, Zedoary, lesser Centory, Rob of Juniper and Elderberries the distill'd Oyls of Amber, Camphyr, Hartshorn, and Tartar; Essence of Triacle; Spirit of Triacle Camphoris'd, and the Essences of Aromatic Herbs. The fix'd are Diaphoretic Antimony, Diaphoretic Gold, native Cinnabar, or that of Antimony, above all the fix'd Sulphur of Antimony, mineral Bezoar both simple and Compound, the Bezoar Stone given to half a dram, or in the room of it the Stone cut out of a Man's Bladder, seal'd Earth, Coral, Hartshorn, Sulphur, and the preparations of Nitre, &c. Some are of a temperat nature, neither properly volatil nor fix'd; such are the Gelly of Hartshorn, the expelling Seeds, viz. Those of Carduus Benedictus, Columbines, Cresses, Citrons, &c. To which we may add Myrrh, which is a baumy Medicine, of excellent use for covering the Spirits from the shocks of the malign ferment.
From these Simples are prepar'd an infinity of compound Medicines, such as Venice Triacle, or Diascordium (which is better) Mithridat, Species of Hyacinth, the Powder call'd Saxonicus &c. As for Venice Triacle and such like hot Compositions, the best way is to exhibit em in Acid Vehicles, and mix 'em with fix'd Specifics.
Take of Rasberry Water, and that of Water Germander, of each an ounce and a half Diaphoretic Antimony, half a dram; Cinnabar of Antimony, fifteen grains; volatil Salt of Hartshorn, twelve grains; Camphyr, two or three grains; (or Laudanum Opiatum, a grain or two) Syrup of Carduus Benedictus, an ounce. Mix for two Doses, in order to Sweat. This is to be given in the beginning or increase of the Disease after the general Premises. As likewise these following.
Take of Rue Water, and that of Vipers-grass Roots, of each an ounce; of the Mixtura Simplex, a dram; rectify'd Spirit of Soot, half a dram; Syrup of Water Germander, half an ounce. Mix for two Doses.
Take of the Cordial Saxony Water, an ounce; Cinnamom Water, half an ounce; Spirit of Venice Triacle camphoris'd, two drams; volatil Salt of Hart-shorn, a scruple; volatil Salt of Amber, half a scruple; Syrup of Clove Gilly [Page 261] Flowers, half an ounce. Mix and give a spoonful frequently, when Delirium's are threaten'd.
Take of the Water of Carduus Benedictus, Water of Goat Rue, and that of Elder Flowers of each six drams; Spirit of Venice Triacle camphoris'd, a dram and a half; volatil Salt of Vipers, a scruple; Diascordium, two drams; Syrup of Carduus Benedictus, six drams. Mix for two Doses.
Take of the Water of Vipers-grass Roots, and that of Water Germander, and Vinegar of Wine, of each an ounce; Venice Triacle two drams; Diaphoretic Antimony, two scruples; Camphyr, six grains: Syrup of Rasberries, an ounce. Mix for two or three Doses. If the Heat be violent exchange the Triacle for Diascordium.
Take of the Water of Carduus Benedictus. and that of Water Germander, of each an ounce and a half; fresh Juice of Citrons, six drams Venice Triacle, a dram and a half; mineral Bezoar, half a dram; Laudanum Opiatum, a grain and a half; Syrup of Mint, dulcify'd Spirit of Nitre, a sufficient quantity. Mix for two Doses.
Take of the Conserve of Citrons, and Conserve of Roses vitriolated, of each an ounce and a half; Rob of Juniper, half an ounce; Diascordium, two drams; Camphyr, a scruple. With Syrup of Citrons make an Electuary.
Take of Venice Triacle, a dram; Diaphoretic Antimony, fifteen grains: Salt of Wormwood, half a scruple. Mix for a Dose or two, to be taken in Vinegar of Wine. This is to be given in case of great Malignity.
When the Disease is further advanc'd towards the height, volatil Sulphureous Medicines must be cautiously us'd. As, take of Fumitory Water, three ounces; Harts-horn prepar'd without Fire, two scruples; mineral Bezoar, a scruple; extract of Treacle, six grains; Syrup of Orange Peel, three drams. Mix for three Doses. Myrrh may also be added.
Take of the simple Mixture, six drams; the Spirit de tribus (distill'd from Antimony, Sulphur, and Nitre) two drams; Flowers of Sulphur, a scruple; Fumitory Water, two drams; Syrup of the Juice of Citrons, an ounce. Make a Potion for one Dose.
Take of Diaphoretic Antimony, Cinnabar of Antimony, of each half a scruple; volatil Salt of Harts-horn, four or five grains; volatil Salt of Amber, two or three grains; Camphyr, two grains. Make a Powder. I have seen the [Page 262] good effects of this Powder in the case of Delirium's, and imminent Convulsions.
Take of Harts-horn prepar'd without Fire, a dram; mineral Bezoar, two scruples; seal'd Earth and mineral Unicorn, of each fifteen grains; Laudanum Opiatum prepar'd by fermentation, four grains. Make a Powder for four Doses. Nitrum Antimoniatum, Poterius's Diaphoretic Gold, solar and Jovial Bezoar, volatil Salt of Vipers and Myrrh, are proper Ingredients for the same purpose.
Take of Sennertus's Bezoardic Powder, prepar'd Unicorn's Horn, of each a scruple; solar and Jovial Bezoar, of each six grains. Mix for two Doses.
Take of the red Powder of Pannonia, fifteen grains; Nitrum Antimoniatum, twelve grains: Poterius's Diaphoretic Gold, five grains. Make a Powder.
During the use of these or suchlike Alexipharmacal Prescriptions, let Acid Mixtures be exhibited for quenching the Thirst, and comforting the Spirits after sweating. As,
Take two fresh Citrons, slice 'em. Add of white Sugar, three ounces; Vipers-grass Roots, two or three drams; Spring Water, six pound. Boyl them till two parts of three be evaporated, and strain it for use.
Take of Mynsicthius his Decoction of Citrons, a pound and a half; Gelly of Harts-horn, an ounce and a half; Syrup of Cherries, and Syrup of Rasberries, of each an ounce: with a sufficient quantity of the Juice of Citrons, make a Julep.
Take of the Decoction of Harts-horn, with the Roots of Vipers-grass, one pound; Tincture of Columbine Flowers, and that of Piony Flowers, of each a dram; Syrup of the Juice of Citrons, an ounce and a half; Syrup of Rasberries, six drams: with a sufficient quantity of the Spirit of Nitre, make a Julep. The Syrup of Poppies in case of violent Heat is added with good success.
Take of the shavings of Sassafras, six drams; boyl them in Water, to a pound and a half of the strain'd Liquor add two ounces of the Juice of Citrons, an ounce and a half of the Syrup of Citrons, and a sufficient quantity of the Spirit of Nitre, to render it grateful.
Take of the Decoction of Tamarinds with Raisins a Pound; Syrup of the Juice of Citrons, Syrup of Rasberries, of each an ounce; with a little of the Spirit of Nitre, make a Potion.
Sometimes the Confection Alkermes, or Diascordium, or Diaphoretic Antimony is dissolv'd in these acid mixtures.
During the time of Swearing some apply a little Loaf hot from the Oven, the under Crust being par'd off, and the Heart excavated and fill'd with Triacle and Wine; thus they apply it to the Navel to attract the Malignity.
If the Patient bleed at Nose, which is a fatal Symptom, apply a dry Toad to the Armpits; or, take of Vervain Water, three ounces; Spirit of Wine Comphoris'd, an ounce; Opium, five grains. Make an Epithema for the Forehead; which is also of use to prevent Head-achs and Delirium's. If the Stomac be much disorder'd, apply to it a Plaister of Tacamphac, Balsam of Peru and Venice Triacle. If the Throat and Palat be dry, without a slimy Crust, make a Gargle of fair Water, Spirit of Wine rectify'd, and Hony.
If a Looseness attend a malignant Feaver, exhibit two scruples of the red Powder of Pannonia; or Venice Triacle mix'd with Opium and fix'd Sudorifics Prepar'd Harts-horn, Bole Armenic, seal'd Earth, mineral Unicorn, are also proper to be added to Alexipharmacal Ingredients.
If a malignant Feaver be attended by Heartburnings, and gnawings of the Stomac, violent Head-achs, Watchings, Deliriums, and a grievous Prunella, 'tis call'd the Hungarian, or Camp Feaver, and is highly Contagious. Vomits commence its Cure; which ought be follow'd by Acid Juleps, and fix'd or meagre Sudorifics. The Hungarians are wont to Cure it by rubbing the Body with a Root of Garlic soak'd in Spirit of Wine, and bruis'd; and then covering up the Person in order to Sweat. The Prunella is accounted for by washing the Mouth with a mixture of Houseleek Water, Juice of House-leek, and Sal-Armoniac.
Some malignant Feavers are accompany'd by Spots in the Skin resembling Flea-bitings. These Spots are also compatible to some Tertian and Scorbutic Feavers that are not tinctur'd with Malignity. When they attend malign Feavers, they are usher'd in by these Symptoms,viz. an universal bruising, tearing Pain, and Weariness, a sudden and unaccountable decay of Strength, and a moderat Heat, with little or no Sickness at first; follow'd by heavy pains of the Back and Head, Watchings, Unquietness and anxiety; towards the Evening they grow worse, and continue so all Night. In the Beginning of the Disease they Sweat easily; during its further progress they Sweat but little or with great difficulty, [Page 264] and in the height of the Disease, none at all, either naturally or artificially. About the fourth, seventh, or tenth Day, the Spots break forth in the Breast and Shoulders, afterwards on the Belly and Legs, and at length in the Arms, the Face being for the most part free. In the Declension or even in the height of the Disease, sometimes there insues a comfortable salivation. The Spots are distinguish'd from fleabitings by this Mark, that these have a red point in their middle, which the Spots have not, and that they disappear by the application of the Meal of Beans with Vinegar.
If these Spots are many, large, broad, and of a high Colour, 'tis a good sign. But if they are few in number, apt to retire, or of a Yellow, Green, Blew, or above all of a Black Colour, 'tis a desperat Case. If they break out before we can discover any signs of Concoction, or after their eruption are follow'd by a bleeding at the Nose, 'tis an ill Omen. If during the first Days of the illness the Person walk'd about and expos'd himself to Cold, 'tis an aggravating circumstance. In general, all spotted Feavers are flow and less acute than others.
The cause is the same, as that of other malignant Feavers, as also the general Cure. What peculiarly belongs to spotted Feavers is couch'd under the following Cautions.
1. Vomits are of excellent use. Purgation and ofttimes injecting of Clysters is noxious, if the Spots are already out. 2. Bloodleting is fatal. 3. In the Beginning and Increase, Venice Triacle, and such like conpositions, may safely be exhibited. But towards the height those of a fix'd Quality are preferable. 4. If the eruption be Symptomatical, it ought not be promoted by Sudorifics, but rather moderated by Acid Antidots. If 'tis Critical, following the signs of Concoction, and affording some relief to the Patient, it ought to be gently incourag'd by Emulsions of the expelling Seeds. 5. A Looseness following the eruption ought to be cautiously handled. 'Tis not fit to stop it directly: but only to persist in the use of sweating Medicines; or if it occasion the retreat of the Spots, then we may adventure to curb it gently. 6. Blistering Plaisters are of Sovereign use, especially if the Spots disappear unseasonably. 7. Wine moderatly taken is not improper.
There is another sort of malignant Feaver, call'd Purpurata, which approaches to the nature of acute Feavers, both in timing its Crisis, and the Symptoms that usher it in. Under the increase of the Disease the Person is seiz'd with a notable [Page 265] Heat, and pricking Pains all round the Breast, Shoulders, Neck, &c. and the Skin becomes rough and red, and sometimes itches, and in the height of the Disease is cover'd with little miliar Eruptions, which are apt to strike in upon the least Cold whatsoever, And in the declension of the Disease fall off like Scales. This Disease frequently attacks Women in Childbed, perhaps by reason of the suppression of their Lochias. It seems to partake much of a Scorbutic nature, and therefore Antiscorbutics mix'd with other Antidors are very proper. In fine, its Cure is the same as that of other malignant Feavers, to which we may add, that all Purgatives, or Clysters, or the least degree of Cold, ought to be nicely avoided.
1.1.2. CHAP. VII.
Of the Plague and Pestilential Feavers.
THE Plague is an exalted pitch of Malignity, compatible with any Disease whatsoever. In this place we take it for an epidemical, catching, and highly malignant Disease, proceeding from poisonous Miasma's in the Air, and attended by fiery Botches, Bubo's, Carbuncles, or malignant Spots. This Miasm is volatil and spirituous, and fir for encountering Mens Spirits, and defiling the vital Spirit of the Air. Perhaps it approaches near to the nature of Arsenic. The Passions of the Mind, Fear, and Apprehension, subterranean Damps let loose by Earthquakes, Famine, corruption of dead Bodies, and such like, are its remote causes. When this poisonous Miasm afflicts Mankind, it joins to the Human Spirits, and disperses it self where these meet with the readiest reception; upon which account, Relations are liable to the Contagion, tho' in distant places; and the Beasts are secure, when Mankind falls an universal Sacrifice.
The Plague is not always accompany'd by a Feaver. When Nature is weak, it yields to the oppression, and makes no Feaverish resistance. The Symptoms are the same as those of Malignant Feavers, rais'd to the highest pitch; to which we may add swellings in the Armpits, Groin, behind the Ears, or in any glandulous place, with a pricking shooting pain in the middle; Botches, and Carbuncles in the Fingers, Nostrils, Eyes and Lips; sometimes fatal Blackspors, or malignant Ulcers all over the Body; a sudden prostration of strength, violent pains of the Head, without any cause, or following the passion of fear, &c. the degeneracy of the Pulse from being large and swift, to a small, languid, intermitting, unequal state; and a burning heat within, but moderat on the external surface of the Body. An imminent [Page 274] Plague is foretold from unwonted swarms of Insects resorting to a Country.
The Prognostics of a Plague are very fallacious: 'Tis an acute Disease, ending sometimes in Twenty four Hours, sometimes in two, three, or seven Days; in general, those who are scabby or Pocky are in least danger, as being defended by their peccant Acid. Preceding Fatigue or Fear are bad Omens. Black livid Spots are a worse Symptom, than Carbuncles, and these worse than Bubo's. Scars or Marks of mortification are always fatal. Many and large Bubo's are a good sign, as also copious Sweats. But cold Sweats, or many Carbuncles; coldness of the extream Parts, especially the Nose; a livid circumference surrounding the swellings; Carbuncles growing upon Bubo's in places full of Tendons; the imperfect eruption or retreat of the Tumors; a Hiccough succeeding to the eruption; the white, blue, or livid Colour of Carbuncles, while the Feaver is not abated; Pains of the Throat, and difficulty of swallowing, attending Bubo's in the Neck, or behind the Ears; are all fatal Symptoms. If blistering Plaisters raise no Blisters, 'tis an infallible sign of Death in all Diseases. If a Cautery applied raise a white Crust after the application, or if the place be dry, or not cover'd with Pushes, and the Botch continue to spread further, or if Issues dry up of a sudden, 'tis a desperat case. Carbuncles in the Stomac, Guts, Bladder, Eyes, and Nostrils, are plain indications of Death. Anxiety of the Breast without a Feaver, frequent sneezing, a Looseness, Hiccough, Vomiting, Convulsions, Hoarseness, a flux of Blood by Urine or Salivation; and in short, all the dismal circumstances of malignant Feavers (related above) are the Companions of fatal Plagues. A continual Costiveness, and numerous Pushes, fill'd with laudable Matter, appearing after the Application of a Cautery to any part, are look'd upon as hopeful Signs.
The Cure divides it self into two Branches. The first is that of preserving from imminent danger; the second rescues from actual Oppression. Preservatives regard either the Air, the common Vehicle of Contagion, or the Bodies of People. As for the former, the Air is purifi'd by the shooting of Cannon, by burning Gun-powder, or Nitre and Sulphur with Amber, Myrrh, Camphyr, Pitch, Benzoin, and Juniper Berries; by throwing the Mineral acid Spirits, or Vinegar in which Vitriol and Verdigrease are infus'd, [Page 275] together with Camphyr, upon hot Bricks; by burning of Goats Horns, and filling the Air with ungrateful Smells, such as that of a House of Office, of Hogs Dung, &c.
The other sort of Preservatives, arm the Body and Spirits against the assaults of the contagious Miasms. For this end, we ought to avoid fasting or going abroad before eating. Butter and Rue Leaves, and a draught of good generous Wine, upon which Camphyr has been kindled, are fit to be taken in a Morning: as also the Mineral acid Spirits, and the acid Juices of Fruits; but above all, Vinegar impregnated with the Vertue of Camphyr, Myrrh, Juniper-Berries, Zedoary, and other aromatic Simples. Next to Vinegar are the sulphureous balmy Ingredients, especially Sulphur, Myrrh, and Amber, which cover the Spirits from the attacks of the morbific Matter, and ought to be taken in acid Vehicles. To these we may add Opium and Diascordium. Venice Treacle, and such like hot Compositions ought to be cautiously us'd, and always dissolv'd in Vinegar. Sugar of Lead also given with Camphyr from four to ten grains, is of excellent use, but 'tis very volatil, and, if indiscreetly us'd, may accelerat the Disease.
Externally, there is nothing equals the cutting of Issues. A Spunge wet with Aromatic Vinegar impregnated with Myrrh and Camphyr, may frequently be applied to the Nostrils. Let Ginger and Zedoary, or Troches made of Myrrh and Camphyr, and Tragacanth dissolv'd in Vinegar, be often chew'd and held in the Mouth. Let the Temples, Wrists, and Breasts be anointed with the Apop ectic Balsam, mix'd with Camphyr; let Sala's magnes Arsenicalis, mix'd with Benzoin dissolv'd in Spirit of Wine, be form'd into Tablets, and hung in a scarlet ClothBag upon the Breast. If the Contagion proceed from subrerranean Damps, let dry'd Toads be hung over the Breast; If it proceed from the Air, let Spiders stand in their room. Some recommend crude Mercury calcin'd by the fumes of Lead for the same purpose.
The direct Cure of the Plague consists in expelling the poisonous Miasma's by Alexipharmacal Medicines. For the regular performance of which, the following Cautions will be of use.
1. Let Sudorisics be repeated every eight Hours even after the eruption of Bubo's or Carbuncles; and after sweating, exhibit a Cordial Draught mix'd with acid Spirits, for thickning the Blood, and rallying the dispers'd Spirits.
2. Avoid sleep in time of sweating, and for that end, apply Vinegar mix'd with Camphyr, or Castor, to the Nostrils.
3. If the Sudorific cannot procure Sweat, let a hot Loaf of Bread be excavated and fill'd with Venice Treacle and Spirit of Wine camphoris'd, and applied to the Stomac, or Navel, the under Crust being taken off.
4. If obstinat Watchings threaten Deliriums, and prevent Swea , let Laudanum Opiatum be added to Sudorifics, in order to procure sleep after sweating.
5. If the fermentation be faint and low, Venice Treacle and Mithridat are proper. But if the Feaver be high, and attended by a violent heat, they are fitly exchang'd with Antimonial Powders, and lixivious Salts.
6. Acids mix'd with Sudorifics are always proper.
7. Blistering Plaisters are appli'd with extraordinary success to the Neck, Legs and Arms. They ought to be very sharp, and after they're remov'd, the Blisters kept open with the Plaister of Melilot, cover'd with the Powder of Cantharides. But if the Bladder be inflam'd, or the Urine hot; if the Patient be very weak, or with Child, or look for her Terms, they are improper.
8. Blood-letting is always pernicious.
9. In the beginning of the Disease Vomits are very useful. They ought to be mix'd with Sudorifics. Purgatives and Clysters are not safe.
10. If the Patient be molested with a vomiting, so that Sudorifics cannot be retain'd in the Stomac, let Sweat be forc'd, by applying a hot Loaf as above, and covering up the Body and Face.
The Specifics that are us'd in this Disease, are Camphyr given in substance, or its Oyl mix'd with Oyl of Amber, and that of Citron Peel, called Heinsius's Oyl; Ivy-Berries, given to a Dram in Vinegar and Wine; Juniper and Elder Berries, and the Rob of either given in Vinegar; Garlic Heads bruis'd and exhibited in Vinegar; the Blood of a Stork, or its volatil Salt; the Spirit of Harts-horn sharpned with its own volatil Salt, and given to a Dram; the volatil Salt of Vipers (above all) sprinkl'd with Oyl of Amber, and mix'd with Camphyr; Man's Ordure applied externally to Bubo's, and given internally with the Patient's own Urine; Sulphur or its Flowers given to a Dram in an acid Vehicle; or rather the fix'd Sulphurs of Antimony, which in this case surpasses all other Medicines; the Oyl [Page 277] and volatil Salt of Amber; and Diascordium given to two drams in Aromatic Vinegar.
Take of the Flowers of Sulphur, half a dram; Cinnabar of Antimony, fifteen Grains; Camphry, six Grains. Make a Powder. The volatil Salt of Vipers, or that of Harts-horn, or prepar'd Amber may be added by turns.
Take of the Rob of Juniper, three ounces; Diascordium and Mithridat, of each an ounce and a half; Venice Treacle, half an ounce; Flowers of Sulphur, two or three ounces; Myrrh, three drams; Frankincense, six drams; Camphyr, two drams; Saffron, half a dram; Juice of Citrons, half an ounce. Make an Electuary. Dose a dram and a half in a convenient Vehicle.
Take of the Water Carduus Benedictus, an Ounce and a half; Vinegar of Wine, six drams; Diascordium, a dram and a half; Camphyr, six grains; Syrup of the Juice of Citrons, half an Ounce. Make a Potion for one or two Doses.
Take of hot Verdigrease a Pound, sprinkle it with three Ounces of distill'd Vinegar; distill through a Retort in Sand, with an intense heat; then add to the Spirit thus distill'd, a double quantity of rectifi'd Spirit of Tartar; and half a dram of Camphyr, and a little Opium for every Ounce of the compound Spirit; and let all stand for digestion. This is call'd Elixyr Antiloimicum, and is of excellent use.
Besides the universal Cure of the Plague, it is requisite also to have a peculiar regard to its incident Symptoms. As for Bubo's, or swellings of Glandules, they require the application of attracting, ripening, and cleansing Ingredients. If they be black and livid, and threaten a Gangrene, they ought to be cut up with a Launce, without waiting for maturation; otherwise 'twere proper to endeavour their maturation, and attract the Poison, by applying roasted Onyons, mix'd with Mustard-seeds; Or in case of great Pain, the Juice of Onyons mix'd with Venice Treacle and Soot. Man's Ordure, or a Melisot Plaister, mix'd with the Powder of dry'd Toads, and that of Amber, from which Spirit of Wine has been thrice evaporated, are much approv'd for the same use. But of all Plaisters, Sala's Magneticum Arsenicale, is the best. 'Tis prepar'd thus,
Take of crude Antimony, yellow Sulphur and white Arsenic, of each two Ounces. Set them in hot Sand in a Phiol 'till they melt and become a dusky Mass. Then [Page 278] take of this Mass, Gum sagapanum, Gum Ammoniac, and Galbanum, of each three Drams; Turpentin, and Wax of each half an Ounce; distill'd Oyl of Amber, two Drams; dulcifi'd Spirit of Vitriol, a Dram. Dissolve the Gums in Vinegar, then strain 'em through a Linnen Cloth, and thicken 'em again. Melt the Turpentin and Wax apart, then add the Gums, and make a Plaister according to Art.
This Plaister will raise a malignant Crust, which ought to be taken off by applying the Ointment of Basilicon, mix'd with Venice Treacle. If the Skin be thick, and the swelling lie so low that the Plaister cannot reach it, let a sharp blistering Plaister be first applied; or, if that be ineffectual, a Cautery of quick Lime, and Spanish Soap, that so the Plaister may operat more freely. If it cause an Inflammation, let foft'ning Cataplasms be applied above the Plaister, 'till the Crust come off. After the swelling is open'd, it ought to be cleans'd by the Infusion of Birthwort, Myrrh, Aloe, and Saffron in Spirit of Wine Tartaris'd; Or Balsam of Peru, and Balsam of Sulphur, mix'd with Treacle; and applying emplastrum Album, mix'd with Oyl of Tobacco. After 'tis sufficiently cleans'd, apply Rulandus's Plaister Diasulphuris for consolidation. In all Compositions relating to pestilent glandulous Swellings, Mercury, Vinegar, Opium and Lead ought to be avoided.
Carbuncles are the beginning of a Mortification, which displays it self with a purple Colour, surrounded with a red or livid Circumference, incroaching gradually upon the adjacent parts, 'till the mortifi'd part fall off. In order to prevent their spreading, let a Circle be drawn round 'em with an Emerald stone, 'till the part become livid; then touch the point or top with Butter of Antimony; and when the Crust appears, apply Sala's Plaister, call'd Magneticum Arsenicale. Some chuse to open it first with an actual Cautery, and then apply either this Plaister, or attracting and emollient Cataplasms of Garlic, Water Germander, Marshmallows, Meal of Lentils, Berries of the Herb Paris, Pigeon's Dung, Black Soap and Hony; or, in case of great pain, the Plaister of Hounds Tongue: But, after all, be sure to avoid fat things. After the Matter is evacuated, apply a Cataplasm of Comfrey Roots boil'd, or the Ointment of Basilicon, with Balsam of Sulphur and Treacle, or a Cataplasm of Comfrey Roots boil'd.
The symptom of Heat is but seldom violent in Malignant Feavers, or at least ought not to be much restrain'd, for fear of repressing the cuticular eruptions. If necessity require that it should be moderated, Antimonial Nitre, and all nitrous Medicines taken inwardly, and applied outwardly with Juice of House-leek and Rosewater to the Wrists, Forehead, and Temples, will answer the Design.
Head-aches, Watchings, and Deliriums are frequently the Companions of pestilential Feavers. If they happen in the beginning, they require a Cure; but if their first appearance be put off 'till towards the time of the Crisis, 'tis not safe to oppose 'em. If the hinder part of the Head be particularly affected, it signifies a peculiar disorder of the Head and Animal Spirits, independent of the Feaver. If the Head-ache seize chiefly the fore part, or be attended by anxiety of the Breast, and unquietness, it proceeds from the Stomac, and ought to be prevented by Vomits, and sometimes Clysters in the beginning of the Disease. However, for mitigating these Symptoms, let Cataplasms of Rue-leaves, Raddish-roots, Salt, Pigeons Dung, and Elder Vinegar be applied to the soles of the Feet, and palms of the Hands; or the Temples and Forehead fomented with the dissolution of Nitre in some convenient Water, or anointed with the Ointment of Alabaster, and express'd Oyl of Poppies, but so as to have a care of stopping the Pores, and hindering transpiration. Inwardly, exhibit the emulsions of the Cold Seeds, Poppy Seeds, &c. An add Opium to the other Specifics, after the first two or three Days are elaps'd.
If a Drousiness and inclination to sleep attend the Pest, let Opium, Treacle, and all Compositions partaking of it, be avoided; let Tincture of Caster and Vinegar be frequently taken inwardly, and applied to the Nose; or Frankincense, Bayberries, and Pepper, beaten up with the Yelk of an Egg, be applied to the Forehead.
A symptomatical bleeding at Nose, is cur'd by applying a Toad under the Arm-pits, washing the Hands and Feet with Vinegar; applying to the Forehead, Neck, and Temples, Cataplasms of Chalk and Potters Clay, beat up with Vinegar; and giving inwardly large quantities of Nitre, Spirit of Vitriol, Spirit of Salt, and Opiats mix'd with astringent Juleps. After the Bleeeding is stop'd, a gentle laxative may be exhibited, if other Circumstances allow of it. Thirst is also abated by Nitre, especially Nitrum [Page 280]Antimoniatum, or clarify'd Whey, with Juice of Citrons mix'd with the Spirit of Salt, and Gelly of Hartshorn. A gnawing at Heart, and vomiting, is cur'd by the following Electuary.
Take of the Conserve of Mint vitriolated, Conserve of the Pulp of Citrons, of each an ounce and a half; preserv'd Citron-peel, and Diascordium, of each six drams; Confection Alkermes, two drams; Salt of Wormwood, a dram; with the Juice of Quinces. Make an Electuary. In the mean while, foment the Stomac with a mixture of the Spirit of Wine, Apoplectic-water, Venice Treacle, and Camphyr; or anoint it with express'd Oil of Nutmegs, and the distill'd Oyls of Wormwood and Mace, and apply afterwards the Plaister of Caranna, or that of Tacamahac, mix'd with Venice Treacle, and Balsam of Peru.
A Looseness or griping of the Guts attending a Plague, are accounted for, by exhibiting Diascordium, Opium, absorbent Powders, Extract of Treacle, or that of Tormentil, Camphyr, Vinegar, and dulcifi'd Spirit of Salt. A suppression of Urine happening about the Crisis, is a token of critical sweats. If it assault the Patient at any other time, let the Pubes be anointed with Oyl of Scorpions, and Ointment of Marshmallows, and all blistering Plaisters omitted. Swooning, palpitation of the Heart, and anxiety proceeding from the Stomac, are alleviated by absorbent Powders. If they proceed from clotted Blood, or the convulsive motion of the Spirits, let the Confection Alkermes, Castor, Spirit of Hartshorn, and that of Sal-Armoniac, be exhibited: externally sprinkle the Face and Temples with cephalic mixtures, join'd to Castor and Vinegar of Roses.
A Prunella, or Quinsey is mitigated by applying outwardly to the Neck, a Bag quilted with Elderflowers, and Safron sprinkl'd with Spirit of Sal-Armoniac; or gargling the Mouth with the Decoction of Germander, Self-heal, and red Roses in Barley-water, mix'd with Nitre and Sal-Armoniac.
As for the Spots resembling Fleabitings, which frequently appear in the Back, Arms, and Legs, the above mention'd Sudorifics, especially Myrrh, Castor, Camphyr, and the volatil Salts, are most proper. All manner of Cold must be carefully avoided, and the Body rub'd all over every Day, with a Bag of hot Salt, or salt Petre, and cuppingglasses frequently applyed to the Back, Arms and Legs, and frequently taken off.