A collection of chronical diseases viz. the colick, the bilious colick, hysterick diseases, the gout, and the bloody urine from the stone in the kidnies / by J. Pechey ... Pechey, John, 1655-1716. 1692 Approx. 255 KB of XML-encoded text transcribed from 82 1-bit group-IV TIFF page images. Text Creation Partnership, Ann Arbor, MI ; Oxford (UK) : 2007-01 (EEBO-TCP Phase 1). A53910 Wing P1018 ESTC R13463 12254923 ocm 12254923 57356 This keyboarded and encoded edition of the work described above is co-owned by the institutions providing financial support to the Early English Books Online Text Creation Partnership. This Phase I text is available for reuse, according to the terms of Creative Commons 0 1.0 Universal . The text can be copied, modified, distributed and performed, even for commercial purposes, all without asking permission. Early English books online. (EEBO-TCP ; phase 1, no. A53910) Transcribed from: (Early English Books Online ; image set 57356) Images scanned from microfilm: (Early English books, 1641-1700 ; 157:5) A collection of chronical diseases viz. the colick, the bilious colick, hysterick diseases, the gout, and the bloody urine from the stone in the kidnies / by J. Pechey ... Pechey, John, 1655-1716. Rivière, Lazare, 1589-1655. Sydenham, Thomas, 1624-1689. [8], 152 p. Printed by J.R., and are to be sold by Henry Bonwicke ..., London : 1692. "The first chapter is taken from Riverius, the other from the worthy Dr. Sydenham's works" Cf. Advertisement. Advertisement: p. 152. Reproduction of original in British Library. Created by converting TCP files to TEI P5 using tcp2tei.xsl, TEI @ Oxford. Re-processed by University of Nebraska-Lincoln and Northwestern, with changes to facilitate morpho-syntactic tagging. 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Users should bear in mind that in all likelihood such instances will never have been looked at by a TCP editor. The texts were encoded and linked to page images in accordance with level 4 of the TEI in Libraries guidelines. Copies of the texts have been issued variously as SGML (TCP schema; ASCII text with mnemonic sdata character entities); displayable XML (TCP schema; characters represented either as UTF-8 Unicode or text strings within braces); or lossless XML (TEI P5, characters represented either as UTF-8 Unicode or TEI g elements). Keying and markup guidelines are available at the Text Creation Partnership web site . eng Diseases -- Early works to 1800. 2006-03 TCP Assigned for keying and markup 2006-03 Apex CoVantage Keyed and coded from ProQuest page images 2006-04 Judith Siefring Sampled and proofread 2006-04 Judith Siefring Text and markup reviewed and edited 2006-09 pfs Batch review (QC) and XML conversion A COLLECTION OF Chronical Diseases , VIZ. The Colick : The Bilious Colick : Hysterick Diseases : The Gout : And the Bloody Urine from the Stone in the Kidnies . By J. Pechey , M. A. Of the College of Physicians in London . LONDON : Printed by J. R. and are to be Sold by Henry Bonwicke , at the Red Lion in St. Paul's Church Yard , 1692. ADVERTISEMENT . MY Collections of Acute Diseases , being well approved of , I was encouraged to publish these of Chronical Diseases ; the first Chapter is taken from Riverius , the other from the worthy Dr. Sydenham's Works ; and 't is probable I may go through the whole History of Chronical Diseases , if God grant Life and opportunity . THE TABLE . CHap. I. Of the Colick . The Colick takes its name from the part affected , viz. the Colon , Pag. 1. The Causes of it , p. 1 , 2 , 3 , 4. External Causes of it , p. 5. The Signs of the Causes , p. 6 , 7 , 8. The difference betwixt Nephritick Pains , and the Colick , p. 8 , 9. An obstinate Colick from Acrid Matter often degenerates into other Diseases , p. 10. The Cure , ibid. The Cure of the Colick when it degenerates into a Palsie , p. 15. Chap. II. Of the Bilious Colick of the Years 1670 , 71 , 72. A Description of the Disease , p. 17 , 18. The Cure , p. 19. The Pain is apt to return , p. 23. Riding good in this Disease , p. 24. A thin Diet must be observ'd , p. 25. The Hysterick Colick , p. 26. The Cure of it , p. 28. The Cure of the Jaundice , coming upon this Disease , p. 30 , 31. Chap. III. Of Hysterick Diseases . This Disease is the most frequent of all Chronical Diseases . p. 32. The great variety of this Disease , p. 33 , 34 , 35 , 36 , 37 , 38 , 39. The procatartick , or external Causes of this Disease , p. 40. The origine and antecedent cause of the Ataxy , p. 41. Mother Fits , p. 43. Clavus Histericus , p. 44. Hypochondriack Colick , p. 45. Spitting common in Hysterical Women , p. 46. Of the Cold in Hysterical Diseases , ibid ▪ Fits of Weeping , p. 47. The disturbance and varying intemperies of the Body and Mind , is occasion'd by the inordination of the Spirits , p. 48. This Disease is not occasioned by Seed and Menstruous Blood , p. 49. The chief indications in this Disease , p. 51. Bleeding in the Arm is order'd , p. 52. Chalybeat Remedies are order'd , ibid. Steel is best given in Substance , p. 53. Purging is not to be us'd in a Chalybeat Course , p. 54. A Prescription for Swelling of the Belly , p. 56. The Rickets , p. 56. Filings of Steel , p. 57. Hysterick Medicines are to be us'd in a Steel course , ibid. Medicines to answer all the Indications , p. 58 , 59 , 60. Chalybeats sometimes cause great Disorders in Women , p. 60. What is to be done when the Disease is but small , ibid. Some Women abhor Hysterical Medicines , by a certain Ideosyncracy , ibid. Of Drinking Tunbridge-Waters in this case , p. 61. What is to be observ'd in Drinking them , p. 62. Of hot Sulphureous Waters to be us'd in this case , p. 63. Venice Treacle is a great Remedy in this Disease , ibid. Spanish Wine Medicated with Gentian is good , p. 63 , 64. A Milk Diet is to be us'd , p. 65. Riding on Horse-back best , p. 66. Riding on Horse-back not proper for delicate Women , p. 67. Riding is good for People in Consumptions , p. 68. In the Fits we must use Hysterical Medicines , p. 69. Laudanum must not be us'd to quiet the pains occasion'd by Vomiting , 'till Evacuations have been us'd , p. 70. The likeness betwixt this Disease and Nephritick Pains , p. 73. The errors which hurt Child-bed Women , p. 76. Medicines to cause the Locha to flow , p. 78. The immoderate Flux of the Courses , p. 81 , 82 , 83. A Cooling and thickening Diet must be order'd , p. 83. Falling of the Womb , p. 84. Chap. IV. Of the Gout . The Gout chiefly seizes Old Men , and People of a gross Habit of Body , p. 86. Sometimes it seizes thin People , and those that are in the Flower of their Age , p. 87. The regular Gout , p. 88. Rich Men and Wise Men are more troubled with the Gout than Poor Men and Fools , p. 97. Women are seldom troubled with the Gout , ibid. Boys and Youth have not the genuine Gout , ibid ▪ The Disease rises from the weaken'd Concoctions , p. 98. Of the Cure , p. 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111. Digestive Remedies must be us'd constantly , p. 117. A Mediocrity is to be observ'd in Meat and Drink , p. 119. A Milk Diet , p. 120. Liquors , p. 122. Dietetick Drink , p. 125. Those that have been us'd to Wine must not leave it off suddenly , p. 126. The Sick must go to Bed early , p. 127. Tranquillity of Mind must by all means be obtain'd , p. 128. Exercise of the Body most profitable , p. 129. Riding on Horse-back is the best Exercise , p. 131. Exercise must be us'd in a good Air , p. 132. Venery , ibid. Of keeping in Bed the First Days , p. 137. We must apply our selves to those Symptoms whereby the Life of the Patient is indanger'd , p. 138. The translation of the Morbisick Matter upon the Lungs , p. 140. The Stone in the Kidnies , ibid. External Remedies for the Gout , p. 141. The Pultis for the Gout , p. 142. The Moxa , ibid. Chap. V. Of the Bloody Vrine from the Stone in the Kidnies . Manna good in this case , p. 146. A Paregorick was given every Night at Bed-time after Purging , p. 147. The Regimen and manner of Diet , p. 148. If the Stone is large , Manna must not be taken in Purging Mineral Waters , p. 150. Chalybeat Waters must not be us'd when the Stone is too large to pass through the Vreters , p. 152. A TREATISE OF Chronical Diseases . CHAP. I. Of the Colick . THE Colick takes its Name from the part affected , which is the Colon , a long and winding Gut , appointed to receive the Excrements of almost the whole Body ; and if those Excrements are retained too long , they are wont to occasion Pains of this kind , the Excrementitious Matter occasioning a Dissolution of the continuity either by distending , or pricking , or corroding ; and this Matter is either Wind or Humour . Wind proceeding from Crudities , or from a cold intemperies of the Stomach or Guts , if it be stop'd by reason the Excrements are grown hard , or because something else obstructs the Intestines ( a great quantity of it remaining in the great Guts , especially in the Colon ) occasions violent Pain . Gross cold and phlegmatick Humours driven into the Tunicles of the Intestines , may occasion such Pain , either by gnawing , if they are Acrimonious or Briney , or by chilling the part which is consequently bound up thereby , and much disordered , ( as Galen says , when he was grievously afflicted with the Colick , he evacuated a Glassy sort of Phlegm actually cold , ) or by emitting Wind , which is easily elevated by a small Heat from the gross viscid and clammy Humour . Lastly , Cholerick and Acrid Humours , and also Melancholy and Acid by pricking and twiching the Intestines , cause such Pains . But it may be ask'd how it comes to pass , that in the action of these causes , the Colick should have its exacerbations and remissions , the same Matter remaining in the Intestines , which as 't is present , should continually gnaw and distend . To which I answer , that sometimes that Matter remains quiet , and so at that time occasions little or no pain ; but that at other times 't is moved and excited by various Fermentations , which happen in the Humours , as is usual in an Epilepsie , Hysterick Fits , and the accession of Fevers . But we must take notice that the Wind or Humours don't only reside in the Cavity of the Intestines , for then they would be easily excluded , by evacuating deterging and carminative Medicines ; but for the most part insinuate themselves into the Coats of the Intestines , and for that reason they are difficultly removed ; and so the Disease lasts longer , and can't be easily eradicated by the foresaid Remedies . The gross and phlegmatick and melancholy Humours flow by little and little through the Veins of the Intestines , into their substance , and so don 't presently cause Pain , 'till there is a quantity sufficient to irritate Nature for their expulsion ; and then being mov'd and exagitated , cause Pain . Or Wind , occasion'd by them , and included in the Coats of the Intestines , distends and twitches them , and not easily getting out , occasions a lasting Pain . Also Choler after the same manner pour'd through the Veins of the Intestines upon their Coats , and imbib'd by them , causes violent Pains , which are wont to be long and obstinate , because 't is difficultly removed from their Substance . There is another Species of a Bilious Colick which degenerates into a Palsie , scarce known to the Ancients , which proceeds from a bilious Humour , not pour'd as the former upon the Colon , but of a sudden upon the Membranes of the Abdomen , which is transferr'd thither , either from the Gaul-Bladder , or from the Mesentery in the Crisis of long Fevers , or by reason of violent Anger , or some other external cause , when because of Obstructions , it can't be carried to the common passages , but by a preposterous motion is put off suddenly upon the foresaid Membranes of the Abdomen . And hence great pain arises like the Colick , which yields neither to Clysters nor to any other Remedy , but continues for many Months , by which the Body Wasts , and the Sick is vex'd with a sort of intermittent Fever , and often with a slow continual Fever ; at length the pain remitting , a Palsie succeeds , that Humour leasurely creeping through the Membranes of the Abdomen , to the Spine of the Back . But this Palsie chiefly possesses the upper parts ; yet there is most commonly a Pain in the Thighs and Legs , and in some few the use of them is wholly taken away ; the Choler by reason of its Levity moving chiefly upwards ; and sometimes it breaks in upon the Brain , and causes Epileptick Fits , from whence Death generally follows . There are other causes of the Colick , but less frequent , viz. Stones growing in the Guts , Worms wound up in a bottom , and Obstructing the Intestines , a compression of the Guts , by a tumour of the Neighbouring Parts , and the narrowness of them by reason of an Inflamation , and other tumours of the Guts , or a twisting of them , occasion'd by Wind , which is next to an Iliac Passion ; and sometimes the Matter which causes a Colick is venomous and malignant , and so 't is a Pestilential Colick . As Paulus Aegineta relates , that a Pestilential Colick arising in Italy , was very troublesom to many of the Roman Provinces . Lastly , all hard Bodies by obstructing the Guts , or distending them , may occasion a Colick , as Stones generated in the Guts , a great quantity of Cherry Stones , hard Cheese , and the like . As Platerus relates of a certain Governour a long while troubl'd with the Colick and Convulsions , who after the use of Clysters , evacuated a great quantity of hard Cheese by Stool , which had remain'd a long time in his Guts ; for before he was Sick , he eat of it immoderately . The external causes , are a cold constitution of the Air pressing and hardening the Belly , or a hot Constitution which does likewise harden the Excrements , for all their Moisture is dry'd up by heat : The use of Meat and Drink unfit for the Mans Constitution , of crude and harsh Fruits , and of gross Meats of hard Digestion , too much Rest , immoderate Sleep , unseasonable Exercise , immoderate Venery , and other external Causes which may injure the Concoction of the Stomach . The Diagnosticks in this Disease are plain , for first the Pain is violent ; for if it be small , it ought not to be called the Colick ; and then the pain is wandering , sometimes it grievously afficts this part , sometimes that , so that sometimes it possesseth the Region of the Spleen , sometimes of the Stomach or Liver , or of the Reins , sometimes 't is above , sometimes below the Navel , and oftentimes 't is most violent in the left side , because in that part there is a narrowness first observ'd by Bauhinus . For when the Excrements in the upper and capacious part of the Colon being hardened into great Clods , agreeable to the capacity of it , are violently driven by the Wind towards that narrow part , they can't pass through without great pain ; by reason of which Symptom the Colick is often taken for Splenetick or Nephritick Pains ; neither are they easily distinguish'd when the Signs of each are compared one with another . But sometimes the pain is more fixed and setled in one place , and like the boring of an Auger . The Patient often Vomits , the Stomach being affected by consent of Parts , and Phlegm is sometimes cast up , and sometimes Choler , green as a Leek , and like Verdegrease : The pain is increas'd after Eating , because the Stomach being full , presses the Guts . The Belly is most commonly so bound , that the Sick can evacuate nothing that way , not so much as Wind ; but if any thing be evacuated naturally or by art , 't is chiefly windy , and like Cow-Dung , and Swims upon the Water , being for the most part Phlegmatick ; for Phlegm voided by Stool , is wont to swim upon Water and serous Excrements : But sometimes the Belly is so much bound when the pain is violent , that strong Purging Medicines will not work at all . The Signs of the Causes are distinguish'd after this manner . If the pain proceed from Phlegm , 't is not so violent , unless it be accompained with Wind , which can't break out of the Places 't is contain'd in , for then the pain is violent , and sometimes remains in one part , and seems to bore as with an Auger , and sometimes 't is in many Parts , when the Wind wanders about . The Sick is eased by hot things , but is injur'd by cold things . A course of Diet went before , apt to increase Phlegm . The Urine is crude and sometimes whitish , but not always which is wont to impose upon young and unskilful Physicians , for sometimes in a Phlegmatic and Windy Colick , the Urine is yellow and red dish , by reason of the Pain which inslames the Humours contain'd in the Veins and Arteries . Which Avicen has wisely observ'd , He says , no one should deceive himself , by judging the Disease is hot , from drouth , inflamation , and redness of the Water , for ' that 's common to all . If the Colick is occasion'd by Wind , there is a stretching Pain , and certain inflation of the Belly : The Sick perceive a great deal of Wind , and a rumbling of the Belly , they are much eased by breaking Wind. A course of Diet fit to breed Wind went before , as unseasonable Drinking of cold Water , the frequent use of Pulse , Turneps , Chesnuts , Herbs and Fruits , and the like . And if the Wind be contain'd in the cavity of the Intestines , the Pain is wandering , and not fix'd to one Place , and is renew'd by Intervals ; but if it be kept in within the coats of the Guts , the Pain is fix'd , because the Wind can't change its place , and is continual and obstinate , because it can't find vent . If the Colick proceeds from an Acrid and Cholerick Humour , 't is most sharp ; there 's a twiching and pricking Heat , Drouth , and for the most part a Fever , and the Urine is very Cholerick , and the Disease is increas'd by hot Medicines and Diet , and is mitigated by cold , and likewise by the excretion of Cholerick Matter , and a course of Diet fit to breed Choler went before . The pains of the other parts contain'd in the lower Belly , are easily distinguish'd from the Colick by their proper signs , except the Nephritick pain , whose signs are so like those of the Colick , that oftentimes the most skilful Physician can't distinguish them , as Galen confesses of himself , being afflicted with the Colick Pain , he thought 't was Nephritick , by reason of a Stone driven into one of the Ureters , 'till the Humour being evacuated by Stool , and so the pain ceasing , he found 't was the Colick . But by the following Signs , these two Diseases may be plainly distinguish'd , if they are accurately examin'd . First , The Nephritick pain is fix'd in the Kidny , and stretches it self from that to the Testis , according to the length of the Ureter ; but the Colick is wandering , and painfuly girds the lower Belly . Secondly , The Colick increases after Eating , by reason of the pressure upon the Gut by a full Stomach ; but the Nephritick pain is not at all increas'd after Eating , but rather lessen'd , because some of the nutricious Juice is carried to the Reins , which somewhat asswages the Pain . Thirdly , In the Colick , Vomiting is more severe , and the Belly is more bound , because the Colon lies near the bottom of the Stomach , and the Intestines being full or violently provok'd , contract themselves , that they may expel the Enemy ; but either of the Symptoms is common to either of the Diseases : So that the intension or remission of them , has a difficult diagnostick ; for the Nephritick pain being intense , may occasion greater Vomiting , and bind the Belly more than a remiss Colick . Fourthly , In the Colick , the Patient is more eas'd by Vomiting and going to Stool , than in Nephritick Pains . Fifthly , In the Nephritick pain , the Urine is first clear and thin , afterwards something settles to the bottom , and at length Sand or Gravel is evacuated : But in the Colick the Urine is thicker , from the beginning . As to the Prognosticks , the Colick most commonly , if it be gentle and remiss , and not very lasting , and not fix'd in one part , and intermits , and does not wholly stop the Belly , is curable and without danger . But if the pain be violent and fix'd to one part , and does not intermit , and if nothing be evacuated by Stool , and if the Patient can't Sleep ; and lastly , if Vomiting , Hickocks , Delirium , Coldness of the Extream Parts , and cold Sweats follow , the Disease is Deadly . An obstinate Colick from Acrid Matter , especially occasion'd by Choleric Matter , often degenerates into other most dreadful Diseases , as to the Gout or Epilepsie , but oftner to the Palsie . A contagious Pestilential and Epidemick Colick is most commonly deadly . The Cure of this Disease must be varied according to the variety of the Causes . And First , There is the same way of Cure for a windy and Phlegmatick Colick : You must begin with an emollient Clyster , and afterwards you must give a carminative and discutient Clyster , which must be repeated twice , thrice , or four times in a Day , till the Pain be gone . But if after the use of one or two Clysters , the Sick does not go to Stool , as sometimes it happens , the Belly must be irritated by a sharp Suppository ; but 't is convenient to add to one of the Clysters ℥ iiij of the Aq. Benedicta , or ʒij , or ʒiij of Coloquintida may be boil'd in an emollient and carminative Clyster . If Clysters don't give ease , you must not obstinately persist in the use of them ; but 't is better to use some gentle Medicine . It has been observ'd , that when a Sick Person has taken without any success Thirty Clysters , another Physician having given only ℥ iss of Manna , with ℥ ij of Oyl of Almonds in Fat Hen Broth , has cur'd the Patient : But in that pain which proceeds from thick Flegm , stronger Medicines must be given . Afterwards Fomentations , Ointments , Baths , Plasters , and other Remedies , are useful ; to which must be added some Specificks very proper in this Disease . Wash the Guts of a Wolf in White-wine , and afterwards dry them in a Furnace , in an Earthen Vessel , till they may be powder'd , let the Sick take ʒi of this Powder in White-wine , it presently eases pain . Boil Simple Water , and when 't is Boiling Hot , add a Fourth part of common Oyl , and some Grains of Pepper grosly beaten ; let the Sick take Three or Four Spoonfuls as hot as he can bear it , the pain will be gone as 't were in a moment . Take of the best Aloes ʒi , of Laudanum Opiatum , gr . iv , of Diagridium , gr . vi , Mingle them , make Six Pills , guild them . Let the Sick take them at a convenient time , they give ease in an Hours time , and afterwards purge off the noxious Humours . Instead of the Pills , a Potion may be taken , made of ℥ ss of Diaph●enicon , and ℈ ij of Philonium Romanum , in the Water or Decoction of Chamomil . Hypocrates proposes a Purge made of Wild Purslain and Meconium . Six ℥ of Fresh Oyl of sweet or bitter Almonds taken , asswage the Pain , and carry the marter sticking to the Guts downwards , and mixt with the following things , it does a great deal of good . Take of the Oyl of Almonds , or of some other Oyl for Poor People ℥ iiij , of Generous Wine ℥ i , of Syrup of Poppies ℥ i , mingle them , make a Potion . Oyl of Sweet Almonds also taken with Manna in fat Broth , asswages the pain , and evacuates the Peccant Matter . The Seed of Ammi powder'd , and ʒi of it given in Wine , soon takes off the pain , and being given a Second time , it most commonly cures the Disease ; a Cataplasm of ℥ iij of Turpentine being apply'd with Stupes at the same time , to which must be added of the Sinapisatum Piperis , and of Dragons Blood , each ʒi . Paracelsus's Galbanetum is proper to discuss the Humour , if the whole Belly be anointed with it : This Description of it is propos'd by Crato . Take of Gum Eleme , of Ivy , of Galbanum , of Oyl of Lawrel , each equal parts , distil them in a Retort in Sand ; keep what comes over apart , first the Water , then the clear Oyl , afterwards the thick Oyl like Hony , which must be used first . Take of Calamus Aromaticus ℥ i , of Galangal ʒiij , of the Yellow of the outward Peel of Oranges ℥ iiij , of choice Cinamon , of Anise and Fennel Seeds each ʒiij , of Cummin Seed ʒvi , of fresh Juniper Berries ℥ ss , of Lawrel Berries ʒiij , let them be finely Powder'd and infus'd in vi th of Malago Sack , let them stand in a warm place for vi days , afterwards distill them in B. M. the Dose is ℥ i evacuations going before . Gum Caragna and Tacamahaca may be conveniently apply'd to the Belly , and before they are put on , a Cupping-Glass may be apply'd t●●he Navel . And tho the foresaid Plaisters are not apply'd , yet the Cupping-Glass ought to be apply'd to the Navel , which Galen says , does like a Charm , remove the pain occasion'd by Wind. If the Disease is lasting , it may be successfully treated with the Decoction of Guaiacum continued for many days , purging now and then , and injecting Clysters frequently ; but if the Colick proceed from glassy Phlegm , boil the Guaiacum with Wine , as Amatus Lucitanus us'd it with good success . The pain being quieted , an Apozem evacuating Phlegm is to be prescrib'd , by which the Reliques of the Disease may be carried off , or instead of that , a decoction of an old Cock , compounded of such things as purge and attenuate . A bilious Colick is cur'd by emollient Clysters , and with such things as attemperate the Acrimony of the humours . Let the Belly be fomented with an emollient and anodyne Decoction , or which is better , let a Semicupium be prepar'd of the same Decoction . A Cataplasm will also be convenient , prepar'd with Barly-meal , and Flax-seed boil'd in Oyl of Camomel , and apply'd to the bottom of the Belly . Also a cooling Epithem compounded after this manner , to be apply'd to the region of the Liver , will be proper : Take of the Juice of Endive , of Cichory , each thss . of the Juice of Lettice and Rose-Vinegar each ℥ ij , mingle them , make an Epithem . Give Juleps of the water of erratic Poppy , of Lettice and Sorrel , with the Syrups of Violets , of Apples , and of Lemons . If the pain is very violent we must use Narcoticks . The pain being somewhat mitigated , an infusion of Rubarb in Cichory-water is to be given , with Syrup of Roses , and to be repeated often , till the stock of matter is evacuated . If gentle purging be not sufficient to eradicate the Disease , we must use Mercurius dulcis , which being given sometimes with Purging Medicines , that have Diagridium in them , perfects the Cure. They that dislike Diagridium may give Mercurius dulcis alone , made into Pills with Conserve of Roses , drinking upon them an infusion of Rubarb and Senna , with Manna and Syrup of Roses added to it . Afterwards 't will be convenient to use Tunbridge , or such like Water . When the pain is violent , we must fly to Baths and Laudanum , with which Catharticks may be sometimes given , but in a large Dose , because the quality is much blunted by Laudanun . Paracelsus's Galbanetum , tho 't is hot , is proper to discuss the humour , if the whole Belly is anointed with it ; the description of it is above . Bleeding is sometimes proper in this sort of Colick , when there is danger , lest the violence of the heat should occasion a Fever ; but if there be a Fever already , 't is presently to be us'd . When there 's a great drouth , Cold water must be given , according to Galen's instruction ; and Amalus Lusitanus says , he wonderfully Cur'd of a sudden , such a pain by the use of it ; and Septalius declares in two Observations , that he us'd it inwardly and outwardly with great success . For the Cure of a Colick that degenerates into a Palsie , put the Patient into a warm Bath , made of a Decoction of emollient things , the Belly being loosen'd with various Clysters , and the first passages open'd by Catharticks . The Patient must be bath'd twice , thrice , or four or five times in a day , that the Acrimony of the Humours may be attemperated , and that the Pores of the Membranes may be open'd . The next day let the Humour be purg'd with some proper Cathartick , and then the Bath must be repeated ; and so you must do every other day , if the Patient be able to bear it , till the humours being purg'd off , and the pain quieted , he is recover'd . In the mean while , you must continue the use of Clysters ; but those made of Milk are best to asswage the pain ; to which you may add Cassia , Oyl of Violets , and Oyl of Lillies . Let the Belly be frequently anointed with Oyl of Chamomel , of Dill , sweet Almonds , Lillies , and with Butter . Lastly , Use Whey and Tunbridge-waters , or the like : And if the Disease continue a long while , those things may be used which are proper to Cure Hypocondrical Melancholy . And Bleeding is to be us'd at the beginning of the Disease , and before Purging , and to be often repeated , if the Bloud seem to be bad , or if something of a Rheumatism seem to be join'd with it . Lastly , All those Remedies which are propos'd for the Cure of the Bilious Colick , may be used in this case ; and if these things do no good , some Physicians prescribe the following Potion , which though it be loathsom , and won't go down with the delicate , yet they say it presently mitigates the pain . Take of Horse-Dung ℥ i , crumble it into small pieces , and infuse it in lb i of Erratic Poppy water , to which add viij or x Drops of Spirit of Wine ; stram it gently , and divide it into Three Doses , to be taken at the times in which the Pain is most violent . But if the Disease degenerate into a Palsie , you must use to the Spine of the Back , and the Paralitick Parts , some resolvent Balsom , and such a one as strengthens the Nerves if there be a Fever . But if there be no Fever , you may apply Wool dipt in Oyl or Ointment to the Paralitick parts , taking great care that the Patient does not catch cold , for by that means the Humour will be more fix'd upon the part , and the perspiration of it will be hinder'd . Paracelsus's Galbanetum is very useful in this case , if it be apply'd to the foresaid parts , and also to the Navel . CHAP. II. Of the Bilious Colick of the Years 1670 , 71 , 72. IN all these Years the Blood was much inclin'd to put off upon the Bowels Hot and Cholerick Humours , upon which account this Colick was more frequent than is usual : The same Febrile Symptoms preceeded this Disease as us'd to go before the Dysentery that reign'd in those times ; and sometimes this Disease follow'd the Dysentery , when it had a long while afflicted the Patient , and was just about to leave him . But when it did not follow a long Dysentery , it generally took its rise from a Fever , which after some Hours was wont to end in this Disease . It chiefly siez'd young People of a Hot and Cholerick Constitution , especially in the Summer . The pain of the Bowels was extreamly violent , and more intollerable than any other that afflicts poor Mortals . It sometimes binds as it were the Guts , and sometimes being contracted to a point , it bores like an Auger . The pain now and then remits , and presently the Fit approaches again , which as soon as the Patient perceives , he looks sadly , and bemoans himself as if 't were actually upon him . At the beginning of this Disease , the pain is not so certainly determin'd to one point , as in the progress of it ; neither is the Vomiting so frequent , neither does the Belly so obstinately resist Catharticks ; but the more the pain is increas'd , the more pertinaciously is it fix'd in a point , the Vomiting is more frequent , and the Belly more bound , till at length by the dreadful force of these Symptoms , a total inversion of the Peristaltick motion of the Guts , ( if the Patient be not soon relieved , ) and by consequence an Iliac Passion is procur'd ; in which Disease all Purging Medicines become presently Emetick , and Clysters that are injected , are vomited up with the Excrements . The Matter that is cast up after this Manner , if it be sincere and without mixture , is sometimes green , and sometimes yellow , and sometimes of an unusual colour . Now seeing every Phaenômenon of this Disease shews plainly that it proceeds from some Acrid Humour , or Vapour put off by the Blood upon the Intestines ; this in my Opinion is the chief curative Indication , namely , that the said Humour should be evacuated , as well that which is antecedently in the Veins , as that which is contain'd in the Guts ; and the next to this is , that the force of the Humours tending thither ▪ should be restrained by the use of Anodines ▪ and that the violent pain should be mitigated by them . Therefore I order that Blood should be freely taken from the Arm , if no Blood has been taken away before ; and after Two or Three Hours , I give an Anodine . The next day I prescribe some gentle Purge , and to be repeated the next day save one , and sometimes thrice , according as the Relicks of the Humour are more or less . But we must take notice , that if this Disease proceed from Eating too much Fruit , or from any Meat of hard Digestion , upon which account ill and corrupted Juices are first transmitted to the Blood , and afterwards to the Bowels , I say in this case the Stomach must be wash'd with large Draughts of Posset-Drink , which must be Vomited up again ; which being done , an Anodine is to be given , and the next day a Vein must be open'd ; and as to other things , you must proceed according to the Directions above-mention'd . But when the violence of the Pain , and the Vomiting ( by reason of which the Guts are as it were inverted ) do resist the operation of the Catharticks , they must be made stronger ; for 't is in vain to give a gentle Cathartick , unless the Patient is easily Purg'd , which must be carefully enquir'd into ; for such a Medicine being not strong enough to make its way through the Intestines , the Patient is more injur'd thereby ; for by its ineffectual agitation , the Vomiting and the Pain is increased . A Lenitive Cathartick Potion , of the infusion of Tamarinds , of the Leaves of Senna and Rubarb , in which may be dissolved Manna , and Syrup of Roses , is to be preferr'd before other Catharticks , for it least exagitates and moves the Humours . But if the Sick can't retain a Liquid Medicine , by reason of an aversion , or because of the Vomiting , you must necessarily use Pills , among which the Pill Cochia pleases me best , for they pass best through the Body in this and in most other cases . But when the weakness of the Stomach , or the Vomiting is so great , that the Pills can't be retain'd , then I first order an Anodine , and a few Hours after a Purge ; but there must be so much space betwixt them , that the Cathartick be not quell'd by the Narcotick , and so render'd ineffectual ; but that it may continue so long in the Stomach , as is necessary for its imparting its Purgative ▪ quality to it , that it may operate when the virtue of the Narcotick is spent ; though the Purge if it could be conveniently done , is best given a long while after the Anodine ; for Twelve Hours after taking it , the Patient is difficultly Purg'd . But because in this as well as in most other Diseases , in which Narcoticks are indicated , a Purge always increases the Pain ( at least when it has done working , for while 't is in operation , the Patient is not so ill , ) therefore I usually give an Anodine as soon as the Purge has done working , which I order to be taken Morning and Evening Daily , viz. In the middle spaces betwixt the Purges , that I may the more certainly appease the Pain till the Patient has been sufficiently Purg'd . The Purging of the Humours being over , I endeavour to bridle the fury of the Disease , ( which now only remains to be done , ) by giving an Anodine constantly Morning and Evening , which must be sometimes repeated oftner ; nor cou'd I ever take off violent pains , without a larger Dose than is usual , and that repeated too ; for that which is sufficient to vanquish another Disease , will be altogether insufficient in this case , the violence of the Disease subduing the force of the Medicine : And 't is indeed safe to repeat Narcoticks , while such a pain as this continues violent , but not when 't is gone off . Wherefore I repeat the Anodine according to the degree of the pain , till it ceases , or till it be very much lessen'd ; yet there must be such a space of time between them , that I may find what may be hop'd for from the former Dose , before I give another : But for the most part , unless the pain be very violent , a Paregorick given Morning and Evening may be sufficient . Liquid Laudanum is the Anodine I chiefly use , of which I give Sixteen Drops in some Cordial Water , or the Dose may be increas'd according to the violence of the Pain . This plain Method by which first the Peccant Matter is evacuated by Bleeding and Purging , and then ease procur'd by the help of Narcoticks , succeeded better in my practice , than any other I ever knew ; whereas Carminative Clysters , injected in order to Exterminate the Acrid Humours , do only stir the Coals , and render the Disease more lasting , by the tumult they raise in the Humours . But here I must admonish you , that though I have said Bleeding and Purging must necessarily precede this quieting Method , yet sometimes upon occasion both being omitted , you must begin with Anodines . For instance , when by reason of some preceding Sickness , large Evacuations have been us'd not long before the coming of the Colick , ( for many times they who have recover'd of another Disease , have fell suddenly into this , by reason of a weakness of the Bowels , especially if there be a great degree of Heat , occasion'd by drinking of Wine , or some other Spirituous Liquor immoderately , ) I say in this case , 't is not only unnecessary , but I think 't is injurious to give Catharticks again , for by them new Tumults will be rais'd . Moreover the Guts are most commonly sufficiently cleans'd by Clysters , frequently us'd before the Physician is advis'd with ; so that partly for this cause , and partly by reason of the long continuance of the Disease , Narcoticks seem in a manner to be only useful . In August , 1671 , the Noble Baron Annesly being afflicted with the Bilious Colick , with intolerable Pain , and frequent Vomiting for some Days , sent for me to the Castle of Belvoir ; he had try'd all sorts of Clysters and other Remedies , by the prescription of Learn'd and Experienc'd Physicians living thereabout . I advis'd without any more adoe , the repeated use of Narcoticks , according to the Method just deliver'd , by which he recover'd in a few Days , and came to Town well with me . But because this pain of its own nature is wont to return more than any other , all occasions of its Relapse must be prevented , by giving an Anodine twice a Day for some Days : But if as often as the Narcotick is intermitted , the pain now and then returns , as it sometimes happens , I don't know any thing that will so certainly perfect the Cure , as Riding on Horse-back , or in a Coach , with which the Patient must take long Journies ▪ and in the mean while an Anodine must be given constantly Morning and Evening ; for by this kind of Exercises , the Matter causing the Disease , is remov'd to the habit of the Body , and the Blood being broke into small parts by perpetual agitation , is as it were depurated again , and at length the Intestines are much strengthen'd and refresh'd by this way of stirring up the natural Heat . Nor am I asham'd to confess , that by the help of this Exercise , I have more than once perfectly cur'd this Disease , when I was not able to cure it any other way ; but this must not be us'd before the Patient has been well Purg'd , and then he must continue the use of it for many Days . One of my poor Neighbours who is now Living , was afflicted in these Years with a most violent Bilious Colick , who a long time endeavour'd , but in vain , to conquer the Disease by Catharticks , Clysters , and Leaden Bullets swallow'd down ; I order'd him to use Narcoticks frequently , which he did with good success , for as often as he us'd them , he found himself very easie ; but seeing the Disease was only palliated with these things and not extirpated ( for it return'd assoon as the vertue of the Narcotick was spent , ) I took pity upon the Man , being grievously afflicted with this Disease , and also with Poverty , and lent him one of my Horses , that he might go a Journy as above directed , and having travelled a few Days , the Bowels grew so strong , as to be able to shake off the Relicks of the Disease , and so he perfectly recover'd , without the help of Anodines . And to speak the truth , I have known this kind of Exercise has been always us'd with admirable success in most other Chronical Diseases , if the Patient continued it resolutely . For if we consider with our selves , that the lower Belly in which are plac'd the Organs of Secretion , are much shaken by this Exercise , perhaps some Thousands of times in a Day , we shall easily believe that they are able by the help of the foresaid Exercise , to shake off any Excrementitious Juice that is impacted there ; and ( which is of greater Moment yet , ) that they are so corroborated by that powerful excitation of the native Heat , that they may duly perform that office of purifying the Blood which Nature has appointed them . If the Patient be Young , and of a Hot Constitution , I order a cooling and thickening Diet , suppose Pulp of Barly , Panada , and the like , and every third day if the Stomach is craving , a Chick , or a Whiting boyl'd . I allow no other Drink than Small-beer , or Milk-water : And this is all I order , unless Riding necessary to recover the Health , requires more nourishing Food , and more generous Liquor , by which the Spirits exhausted by Exercise may be repair'd . But when the Disease being unskilfully treated has a long while afflicted the Patient , so that the Bowels become weak and infirm , and he is in a manner quite wasted , I say in this case we find by experience , that the free use of Epidemick Water , or of Aq. Mirabilis , or of any other the Patient likes best , relieves him at this time beyond expectation ; for by this means the small Relicks of the Native Heat and the Spirits will be excited , and the preternatural ferment sticking to the Bowels , and now and then occasioning new Fits , will be extinguish'd by Spirituous Liquors . Moreover as in the cure of the Disease , so when 't is over , the thin Diet we have mention'd must be observ'd for some time ; for this Disease being more apt to return than any other , and seating it self upon the principle parts for Concoction ( I mean the Bowels already weaken'd by it ) the least error of this kind will presently occasion much pain . Wherefore in this and all other Diseases of the Bowels , Meats of hard Digestion are carefully to be avoided , and things of easie Digestion must be taken only in such a quantity as will suffice to sustain Life . A certain kind of Hysterical Disease afflicts some Women , very like the Bilious Colick , both as to the sharpness and situation of the Pain , and also upon the account of the Humours ejected by Vomit , of a Yellow and Green Colour : I will treat of it by the by , lest any one should take it for the bilious Colick just now mention'd . Those Women that are of a laxe and crude habit of Body , are chiefly afflicted with this Disease , and they that have lately labour'd under some other Hysterick indisposition , ( or which is very often ) those that have scarce evaded a difficult and hard Labour , in bringing forth a large Child , whereby the Mothers Nature and Strength has been almost spent . A pain as violent almost as that of the Colick or Iliack Passion , seizes the region of the Stomach ; and sometimes it comes a little lower , and then violent Vomitings follow , and the Matter which is cast up , is sometimes Yellow , and sometimes Green ; and moreover ( which I have often observ'd , ) there 's a greater dejection of Spirit and desperation than in any other Disease whatever . After a Day or Two the pain goes off , and returns again a few Weeks after as violent as 't was before . Sometimes 't is accompanied with the Jaundice , which is very visible , and which goes off of its own accord in a few Days . When all the Symptoms are gone off , and when the Patient seems very well , the smallest disorder of the Mind , whether it be occasion'd by Anger or Sorrow ( to both which in this case Women are very prone , ) almost recalls the pain , which may be said of Walking or any other Exercise us'd too soon ; for by these means Vapours are elevated in a laxe and weak habit of Body . When according to the vulgar Opinion , I say , Vapours , whether they be so or no , or whether they are convulsions of particular parts , the Phaenomena may be solved either way . These Vapours or Convulsions when they invade this or that region of the Body , produce Symptoms agreeable to the part they invade ; and though they are one and the same Disease every where , yet they cunningly resemble most of the Diseases Mankind is expos'd to , which is manifest from this Symptom , which when it seizes upon the parts near the Colon , imitates exactly the Bilious Colick , which is also as apparent in many other parts of the Body afflicted with this Disease . For instance , Sometimes it seizes one of the Kidneys with a violent pain , from whence arises violent Vomiting , and being oftentimes convey'd by the passage of the Ureter , it resembles the Stone ; and being exasperated by Clysters and other Lithontriptick Medicines design'd to force away the Stone , it afflicts the Patient in the same manner a long while , and sometimes ( contrary to its nature , for left to it self , 't is no way dangerous ) kills the Patient . I have seen moreover Symptoms occasion'd by it , exactly resembling the Stone in the Bladder . Not long agoe I was call'd up in the Night to visit a Countess , my Neighbour , seiz'd suddenly with a violent pain in the region of the Bladder , and with a suppression of Urine ; and having known that she was subject to various Hysterick Indispositions , I suppos'd the Disease was not that they imagin'd , and therefore I would not suffer a Clyster that her Maid had prepared to be injected , lest the Disease should be increas'd thereby ; and instead of this and Emollients , namely Syrup of Marsh Mallows and the like , which the Apothecary had brought , I order'd a Narcotick , which soon took off that Symptom . And indeed there is not one part of the Body wholly secur'd from the assaults of this Disease , whether they are internal or external , as the Jaws , Hips and Legs ; in all which it excites violent pain , and when it goes off , leaves a tenderness behind , which will not bear touching , just as if the Flesh was bruis'd with violent Strokes . But now seeing I have deliver'd some things by the by , appertaining to the History of the Hysterick Colick , lest it should be mistaken for the Bilious Colick , I will transiently ▪ touch upon some things relating to the cure of the Symptom of pain which accompanies it . For the perfect Cure which takes off the Disease , by removing the cause , comes under another Speculation , and belongs to another place . Bleeding and Purging repeated , which are plainly indicated at the beginning of a Bilious Colick , are not to be used here , unless in the case to be mention'd by and by ; for experience teaches , that the pain is exasperated , and that all the Symptoms increase by reason of the tumult which those things occasion ; and I have more than once observ'd , that the repetition of the gentlest Clysters have brought on a long series of Symptoms . And reason as well as experience dictates , that this Disease is rather produced by an inordinate motion of the Spirits , than by vicious Humours , if we consider what things most commonly occasion it ; and they are such as these , large and unnecessary profusions of Blood , violent motions of the Mind and Body , and such like : All which forbid those Remedies by which a greater disturbance of the Spirits may be occasion'd ; and instead of them Anodines are to be us'd , though the green and ill colour of the Matter vomited up may seem to indicate the contrary ; for the speculation of colours is too nice to authorize those Evacuations , which we find ipso facto injurious . And I don 't at all doubt that this Disease ( which though it occasion violent pain , is no way Mortal , ) has prov'd deadly by reason of Errors committed upon the belief of such Speculations . Moreover if any one should give the strongest Vomit to Day , to eject that which he supposes to be the occasion of the Disease , yet the next Day the Patient would vomit up Matter quite as green or of some other ill colour , as was the former . But we must take notice , that there is sometimes so great a quantity of Blood and Humours which so resists the operation of the Narcotick , that though it be often repeated , it can't quell the tumult , till the Patient is Blooded and Purg'd , which I have observ'd in Women of a very Sanguine Constitution , and in Virago's . If the case is so , Bleeding or Purging , or perchance both , must make way for the Anodine ; for either of these being us'd , a moderate Dose of the Narcotick will perform the business , which otherwise would signifie nothing , though the largest Dose was given : But this seldom happens , and then these Remedies must not be repeated ; and when they are us'd when there is need of them , you must proceed in giving Anodines in that Method which I have propos'd in the Bilious Colick , and they must be taken often or seldom , according to the degrees of pain . Which Method indeed respects only the Symptom of violent pain ; for I don 't now undertake to treat of that Method which takes off the cause . But for as much as this Disease in Hypocondriacal as well as Hysterical People , ( for the reason is the same in both , as is said in another place , ) often ends in the Jaundice , and as this comes on , so that goes off ; we must take notice , that in curing this kind of Jaundice , all Catharticks are either wholly to be omitted , or if they are given , you must use only ▪ Rubarb or some other gentle Purge ▪ for there 's danger lest by Purging , new Tumults should arise , and so all the Symptoms return . And therefore in this case , nothing must be done presently , seeing the Jaundice taking its rise on this account , generally lessens of its own accord , and wholly vanishes in a short time ; but if it continues a long while , and seems to go off difficulty , Remedies must be taken for it : I use the following . Take of the Roots of Madder , of Curcuma , each ℥ i , of all the greater Celandine , and of the tops of the lesser Centauris , each M i ; boil them in equal parts of Rhenish Wine , and of Fountain Water , to lb ij , in the straining Dissolve ℥ ij of the Syrup de quinq . Radicibus , mingle them , make an Apozem ; let the Patient take lb ss Morning and Evening , till he 's well . But if the Jaundice comes of it self , the Colick not going before , 't is necessary besides the alteratives just mentioned , to give Cholagoges , that is , such things as purge Choler by Stool , namely once or twice before the Patient enters upon the Apozem prescrib'd , and afterwards once a Week as long as he takes it . As take of the Electuary of the Juice of Roses ʒij , of Rubarb finely Powder'd ʒss , of Cream of Tartar ℈ i , make a Bolus with a sufficient quantity of Syrup of Rubarb , with Cichory ; give it early in the Morning , and let the Patient drink upon it a small Draught of Rhenish Wine . But if notwithstanding the constant taking of these things a long while , the Disease continues obstinate , the Patient must drink Tunbridge Water or such like , from the Fountain every Morning 'till he recovers . CHAP. III. Of the Hysterick Disease . THIS Disease if I calculate right , is the most frequent of all Chronical Diseases , and as Fevers with those Diseases that appertain to them , if they are compar'd with Chronical taken all together make two Thirds , so Hysterical Diseases ( at least those that go under that Name , ) are half the remaining Third ; that is , Chronical Diseases are half Hysterick , for very few Women ( which Sex contains the half of grown People ) are wholly free from all kinds of Hysterick Diseases , if you except those who being accustomed to labour , live hardly . Yea , many of those Men that live sedentary Lives , and are wont to Study hard , are afflicted with the same Disease . And though heretofore Hysterical Symptoms were always reckon'd to proceed from a vitious Womb , yet if we compare Hypocondriacal Symptoms which we are supposed to proceed from obstructions of the Spleen or Bowels , or from some other I know not what Obstructions , with Womens Hysterick Symptoms , an Egg is scarce more like an Egg , than these Symptoms are one another in all respects . But it must be confess'd that Women , are much more subject to this kind of Disease than Men , not for that the Womb is more faulty than any other region of the Body , but for causes to be shewn by and by . Nor is this Disease only frequent , but so wonderfully various , that it resembles almost all the Diseases poor Mortals are subject to , for whatever part it seats it self in , it presently produces such Symptoms as appertain to it ; and unless the Physician is very sagacious and very skilful , he will be mistaken , and suppose that those Symptoms proceed from some essential Disease of this or that part , and not from an Hysterical Distemper . Sometimes for instance , it possesses the Head , and occasions an Apoplexy , which also ends in an Hemiplegy , and is exactly like that Apoplexy by which Corpulent and Antient People are destroy'd , and which happens by reason the passages of the Animal Spirits are stopt , the Cortex of the Brain being stuffed by a great deal of Phlegm , from which cause the Apoplexy that happens to Hysterical Women , does no way seem to arise , for it seizes such very often presently after delivery , a great quantity of Blood being at the same time evacuated , or it 's occasion'd by hard Labour , or some violent commotion of the Mind . Sometimes it produces violent Convulsions , very like an Epilepsie , the Belly and Bowels swelling towards the Throat , the Patient strugling so violently , that though at other times her strength is but ordinary , she now can scarce be held by all the strength of the by Standers , uttering some odd and inarticulate sounds , and striking her Breast . Women who are accustom'd to this Disease , commonly call'd Mother Fits , are generally extraordinary Sanguine , and have an habit of Body almost like that of a Virago . Sometimes it possesses the outward part of the Head betwixt the Pericranium and Skull , causing violent pain continually fix'd in one part , which may be cover'd with the top of your Thumb ; and violent Vomiting accompanies this pain . I call this Species , Clavus Hystericus , chiefly afflicting those that have a Chlorosis . Sometimes falling upon the Vital parts , it occasions so great a palpitation of the Heart , that the Women who are afflicted with it may verily believe that the by Standers may hear the sound of the heart thumping upon the Ribs ; this kind chiefly afflicts those that are of a thin habit of Body , and of a weak Constitution , and who look almost tabid ; and also Young Maids that have the Green Sickness . Sometimes it seizes the Lungs , and the Patient coughs almost without intermission , but expectorates nothing ; and though this sort of Cough don't shake the Breast so violently as that which is Convulsive , yet the Explosions are much more frequent : But this kind of Hysterick Cough is very rare , and chiefly invades Women that abound with Phlegm . Sometimes rushing violently upon the Colon , and the region under the Scrobiculum Cordis , it occasions violent Pain , much like the Iliac Passion , and the Woman Vomits exceedingly , ejecting a certain green Matter , somewhat like that they call Porraceous Bile , and sometimes of an unusual colour . And often after the Sick has been almost destroy'd by the said Pain , ( which would tire a Stoical Apathy , ) and reachings to Vomit for many Days , at length the Fit is carried off by the Jaundice , tincturing the Superficies of the Body like Saffron . Moreover the Sick is oppressed by an anguish of Mind , and wholly despairs of Recovery , with dejection of Mind , and as it were a certain Desparation which as certainly accompanies ( as I have observ'd ) this kind of Hysterick Diseases , as the Pain and Vomiting above mention'd . This kind chiefly invades those that are of a Laxe and Crude habit of Body , and those that have suffer'd much in bringing forth great Children . When this Disease falls upon one of the Kidneys , it plainly represents by the pain it causes there , a Nephritick Paroxism , and not only by that sort of Pain , and by the place it rages in , but also by violent Vomitings , which accompany it , and also for that sometimes the pain extends it self through the passage of the Ureter ; so that 't is very difficult to know whether these Symptoms proceed from the Stone , or from some Hysterick Disease , unless perchance some unlucky accident disturbing the Womans Mind a little before she was taken ill , or the Vomiting of green Matter , shews that the Symptoms rather proceed from an Hysterick Disease , than from the Stone . Neither is the Bladder free from this false Symptom , for it does not only cause Pain there , but it also stops the Urine , just as if there were a Stone , whereas there is none . But this last kind seizing the Bladder , happens very seldom ; but that which resembles the Stone in the Kidnies is not so rare : Both us'd to invade those Women who are much weaken'd by Hysterick Fits coming frequently ▪ and whose health of Body is much impair'd . Sometimes falling upon the Stomach , it causes continual Vomiting , and sometimes a Diarrhaea , when 't is setled upon the Guts ; but no pain accompanies either of those Symptoms , tho oftentimes in both , that green Humour appears : Both these kinds are familiar with those that are much weaken'd by Hysterick Fits coming frequently . And as this Disease afflicts almost all the inwards parts , so sometimes it also seizes the outward parts , and the Musculous Flesh , occasioning pain , and sometimes a tumour in the Jaws , Shoulders , Hands , Thighs and Legs , in which kind that tumour which swells the Legs is more conspicuous than the rest ; but whereas in Hydropical Tumours these Two things may be always taken notice of , namely , that the Swelling is most in the Evening , and that the Finger press'd upon it , leaves a Pit. In this tumour the Swelling is most in the Morning , neither does it yield to the Finger , or leave any Mark behind it ; and for the most part it only swells one of the Legs . As to other things , if you mind the largeness of it , or its superficies , 't is so very like Hydropical Swellings , that the Patient can scarce be brought to believe 't is any other Disease . Neither can the Teeth free themselves from the assaults of this Disease , though they are not hollow , and though there 's no apparent defluxion that may occasion the pain , yet is it no whit gentler , nor shorter , nor easier cured . But those pains and tumours which afflict the outward parts , chiefly seize those Women that are in a manner quite destroy'd by a long series of Hysterick Paroxisms , and by the force of them . But among all the torments of this Disease , there 's none so common as a pain in the Back , which most certainly all feel , how little soever they are afflicted with this Disease . Moreover this is common to the foresaid Pains , that the place on which they were , will not bear touching after they are gone , but is tender , and akes , just as if 't were soundly beaten ; but this tenderness goes off by degrees . And this is worth observing , that often a notable cold of the External parts , makes way for these Symptoms , which for the most part does not go off till the Fit ends ; which Cold I have observ'd is almost like that by which a Carkas grows stiff , yet the Pulse are good . And moreover , almost all Hysterick Women which I have hitherto taken care of , complain of a dejection and sinking of the Spirits ; and when they wou'd shew the place where this contraction or sinking of the Spirits is , they point to the region of the Lungs . Lastly , Every one knows that Hysterick Women sometimes Laugh excessively , and sometimes Cry as much , without any real cause for either . But among all the Symptoms that accompany this Disease , this is the most proper , and almost inseparable , namely a Urine as clear as Rock Water ; and this Hysterick Women evacuate plentifully , which I find by diligent inquiry , is in almost all the Pathognomonic sign of this Disease which we call Hysterick in Women , and Hypocondriack in Men ; and I have sometimes observ'd in Men , that presently after making Water of a Citron colour , ( yea almost the next moment ) being suddenly seized with some violent commotion of the Mind , they presently make Water as clear as Crystal , and in a great quantity , with a continued violent Stream , and continue ill 'till the Urine comes to its wonted Colour , and then the Fit goes off . And it happens to all Hysterical and Hypocondriacal People , that sometimes they belch up ill Fumes as often as they eat , though they eat only moderately , and according as they have an Appetite ; and sometimes the Wind that comes from the Stomach is sour , just like Vinegar when it comes into the Mouth , the Concoction being much impair'd , and the Juices quite differing from their natural state . Neither are they unhappy upon this account only , viz. that their Bodies are so ill affected , and as it were tottering like ruinated Houses just about to fall ; for their Minds are more diseased than their Bodies , for an incurable Desparation is mix'd with the very nature of the Disease ; they are in a great rage when any one speaks never so little of the hopes he has conceived of their Recovery , easily believing that they suffer all the miseries that can befal a Man , foreboding the most dreadful things to themselves , entertaining in their restless and anxious Breasts upon a slight occasion , or perhaps for none at all , Fear , Anger , Jealousie , Suspicions , and worse Passions of the Mind if any can be worse , abhoring all Joy , Hope and Mirth , and if any one of these do chance to occur , 't is rara Avis , and soon flies away , and does no less exagitate the Mind , than the sorrowful Passions ; so that they never observe a mean , constant only to inconstancy : Sometimes they love beyond measure , and presently hate the same without any cause ; sometimes they design to do this or that , then presently alter their Intentions , and begin the quite contrary , and yet they don't perform that neither ; so wavering are they , that their Minds can't be at all at rest ; and that which the Roman Orator said of the Superstitious , exactly agrees with these Melancholy ▪ People ▪ Sleep ( says he ) seems to be a refuge for the Laborious and careful , but from thence cares and fears arise . Whilst only Funerals and Apparitions of their Deceas'd Friends are represented in Dreams , and they are so tormented in Body and Mind , that one would think their Lives were a Purgatory , in which they were to purifie themselves , and to expiate Crimes committed in some other state . Nor does this happen only to Mad People , but also to those who if you except these impetuosities of Mind , are very Prudent and Judicious ▪ and who much excel for deep Thought and wisdom in Speech , others whose Minds were never excited by these Provokements to thinking , so that Aristotle was much in the right , when he said Melancholy People are most ingenious . But this dreadful condition of the Mind which we have above describ'd , seizes on those only that have much and a long while conflicted with this Disease , and have been at length wholly vanquish'd by it , especially if Adversity , Care or Trouble of Mind , or hard Study or the like , joyn'd with an ill habit of Body , have added Oyl to the Flame . A day would scarce be sufficient to reckon up all the Symptoms belonging to Hysterick Diseases , so various are they , and so contrary one to the other , that Proteus had not more shapes , nor the Chamelion greater variety of colours : And I think Democritus reckon'd pretty right ( though he mistook the cause of the Disease , ) when he said in an Epistle to Hippocrates , that the Womb was the cause of Six Hundred Miseries , and of innumerable Calamities . Nor are they only very various , but also so irregular , that they can't be contain'd under any uniform type , which is usual in other Diseases , for they are as it were a disorderly heap of Phaenomena , so that 't is very difficult to write the History of this Disease . The procatartick or external causes of this Disease , are either violent motions of the Body , or which is much oftner , vehement commotions of the Mind from some sudden assault , either of Anger or Grief or the like Passions ; therefore as often as Women advise with me about this or that disorder of Body , the reason of which can't be deduc'd from the common Axioms , for finding out Diseases , I always diligently inquire of them whether they are not chiefly afflicted with that indisposition which they complain of when they have been disturb'd in their Minds and afflicted with Grief , which if they confess , I am sufficiently satisfied that the Disease must come under this Tribe we are now speaking of , especially if Urine as clear as Chrystal evacuated copiously at some certain times , makes the diagnostick more manifest . But to these disorders of the mind which are usually the occasions of this Disease , is to be added emptiness of the Stomach by reason of long fasting , immoderate bleeding , and a Vomit or a Purge that work'd too much . Now having drawn the Picture of this Disease according to its most vulgar Phaenomena , in the next place its internal efficient causes are to be consider'd , as well as we can gather them from all the circumstances join'd together , which we have describ'd : And in my opinion those Diseases which we call hysterical in Women , and hypochondriacal in Men ▪ proceed from a confusion of the Spirits , upon which account , too many of them in a croud contrary to proportion , are hurry'd violently upon this or that part , occasioning Convulsions and pain , when they rush upon parts endued with exquisite Sense , perverting the Functions of the Organs , both of that , into which they thrust themselves , and also of that from whence they departed ; both being much injur'd by this unequal distribution , which is quite contrary to the oeconomy of Nature . The origine and antecedent cause of this Ataxy , is a weak constitution of the said Spirits , whether it 's natural or adventitious ; for which reason , they are easily dissipated upon any occasion , and their System soon broke . For as the outward man is fram'd with parts obvious to Sense , so without doubt the inward man consists of a due Series , and as it were a Fabric of the Spirits , to be view'd only by the eye of Reason ; and as this is nearly join'd , and as it were , united with the constitution of the Body , so much the more easily or more difficultly is its frame disordered , by how much the constitutive Principles that are allotted us by nature , are more or less firm : Wherefore this Disease seizes many more Women than Men , because kind Nature has given them a more delicate and fine habit of Body ▪ having design'd them only for an easie life , and to perform the tender Offices of Love : But she gave Men robust Bodies that they might be able to delve and manure the Earth , to kill Wild Beasts for Food , and the like . But that the said confusion of the Spirits is the cause of this Disease , the Phaenomena now describ'd , will sufficiently prove ; the chief of which I will only mention . And I begin with Mother-Fits , here the Spirits are crouded in the lower Belly , and rushing together violently towards the Jaws , occasion Convulsions in every Region through which they pass , blowing up the Belly like a great Ball ; which yet is nothing but the rowling together , or conglobation of the parts seiz'd with the Convulsion , which can't be suppress'd without great violence . The external parts in the mean while , and the Flesh being in a manner destitute of Spirits , by reason they are carried another way , are often so very cold , not only in this kind , but in all other kinds of hysteric Diseases ( as was noted above ) that dead Bodies are not colder . But the Pulse are as good as those of People that are well ; nor is the Womans life in danger by this Cold , unless 't is occasion'd by some very large evacuation going before . The same may be said of that violent hysteric Disease , which to outward appearance is like the bilious Colick or the iliack Passion , in which the Woman is seized with a violent pain in the Region , about the Scrobiculum cordis , together with violent Vomiting , by which a matter is cast up , in colour like Herbs , which Symptom I suppose , proceeds only from a vehement impulse of the Spirits crouded together in the said parts , which occasions the Convulsion and pain , and the total subversion of all the Faculties . Nor is it to be presently concluded that this Disease resides in the Humours , because those things that are evacuated upward or downward , are sometimes of a green colour , or that the violent pain is occasion'd by the acrimony of some Humour tearing the part it adheres to , which for that cause , we account the occasion of the Disease , and therefore suppose it ought to be eradicated by Vomits and Purges ; for 't is manifest that the Sickness which seizes People that go to Sea , ( arising from the agitation of the animal Spirits in the boisterous Sea ) occasions the vomiting up of matter as green as an Herb , from the Stomacks of those that are in perfect health ▪ when they first go to Sea , and are a good way from Land ; in whom , half an hour before , there was none of that Choler which is call'd porraceous . And don't Infants in convulsive Fits in which the animal Spirits are chiefly concern'd , evacuate upward or downward , matter of the same colour , to which must be added that which almost daily experience teaches , viz. that tho' such Women and Children shou'd be quite exhausted by repeated Purges , yet the said colour wou'd still appear in that which they evacuate by Vomit or Stool ; yea , the green matter increases by the frequent use of cathartick and emetick Medicines , because by both , the confusion of the Spirits is heightned , which I know not how either destroys or Perverts the ferment of those parts , or throws into the Stomach or Guts , by the force of the Convulsions , some juice of a strange nature , which is dispos'd to give the Humours such a Tincture . And tho' Chymists are not so happy as to prepare better Medicines in their fruitful Glass , than are made in a Mortar or a Pipkin , yet they know how to please the vain Humour of the Curious , by shewing two Liquors equally limpid and clear , which being mixt together , presently change into some deep colour , as if there was conjuring in the case . And truly the speculation of colours is so uncertain and vain , that we can learn nothing certainly from them , concerning the nature of the Bodies they appear in ; nor does it more necessarily follow , that those things which are of a green colour shou'd be acrid , than that all acrid things shou'd be green . The thing therefore being throughly consider'd , it will plainly appear , that the violent pain which almost destroys those that are afflicted with the hysterick Colick , and the evacuation of green matter , are wholly occasion'd by the Spirits rushing impetuously upon the parts about the Scrobiculum cordis , and contracting the same by Convulsions . That Symptom which I term'd above clavus hystericus , is to be attributed to this enormity of the Spirits , in which the Spirits in all the compass of the Body , are as it were concentrated in a cercain point of the Pericranium , occasioning a pain , boring as it were through ; just as if a Nail was driven in to the Head , together with violent vomiting and casting up of green matter , which Contraction indeed , of all the Spirits of the Body as i were to a Point , is somewhat like that Collection of the Raies of the Sun , which is made by a burning Glass : And as the force of these united , burns , so they for the same reason occasion pain , by tearing the membranes with their forces joind . And then from that inordinate agitation of the Spirits disturbing the Blood , arises that Symptom , which as we have mention'd above , is frequent in hysterical and hypochondriacal People , viz. clear , limpid and copious Urine : For when the oeconomy of the Blood is interrupted , the Sick can't long enough contain the Serum that is imported , but lets it go before it 's impregnated with saline particles , by which the citron colour is to be imparted to it ; whereof we have a daily experiment in those that drink much , especially of thin and attenuating Liquors , for then their Urine is very clear , in which case the blood being overpower'd by that quantity of Serum , and being wholly unable to retain it , puts it off quite clear , not yet dy'd by the juices of the Body , by reason of its too short stay . Three years ago a Nobleman sent for me , he seem'd to labour under an hypochondriack Colick , that was almost come to an iliack Passion , with pain and violent vomiting , with which he was much and a long while afflicted and almost worn out : I observ'd through the whole course of the Disease , that when he was worst his Urine was always clear , but when he was a little better it was somewhat of a citron colour . Visiting him one day , I view'd his Urine made at three times , kept apart in three Chamber-pots , of a citron colour ; he was then merry and chearful , and thinking of eating some meat of easie Digestion , and he said he had a craving Appetite ; but one coming in at that very moment , who vext him so much , that suddenly growing ill , he call'd for a Chamber-pot , which he almost fill'd with Urine as clear as Chrystal . And perhaps that spitting which is common in hysterical Women , proceeds from the Spirits so disturbing the blood ; they spit thin for many Weeks , just as if they were salivated by unction ; for during this disturb'd condition of the blood , in which 't is unable to perform evacuations according to Natures method , the Serum by chance taking this contrary course , is not evacuated according to the rules of Nature by the Reins , but is put off by the extremities of the Arteries upon the Glands , and so comes forth by the salivary passages in the form of Spittle . The same may be said of those violent nocturnal Sweats which afflict hysterical Women , which proceed from no other cause than the ill disposition of the Serum of the blood , by which 't is inclin'd to be put off upon the habit of the Body . As to the cold by which the external parts are so often chill'd in hysterical Diseases , 't is very manifest that that happens because the Spirits forsaking their Stations , too officiously intrude themselves into this or that part ; nor is it to be doubted that weeping and laughing Fits , which often seize hysterical Women withou any occasion , are procured by the animal Spirits forcing themselves violently upon the Organs , that perform these animal Functions . And by the by , Men are also subject ( tho' rarely ) to Fits of weeping . I was sent for sometime ago to an ingenious Gentleman , who but a few days before , recover'd of a Fever ; he made use of another Physician , who blooded him and purg'd him thrice , and forbid him to eat Flesh : When I came and saw him with his cloaths on , and heard him discourse judiciously , I ask'd to what purpose I was sent for ? One of his friends answer'd , if I wou'd have a little patience I should see ; sitting down therefore , and discoursing with him , I presently observ'd that his lower Lip was thrust out , and mov'd frequently ( as froward Children us'd to do to prepare for crying ) and then wept so violently , that I scarce ever saw the like ; with such deep sighs as were almost convulsive : Which suddain Torrent in a little time quite asswag'd . I supposed that this disorder proceeded from a confusion of the Spirits , which was occasion'd partly by the long continuance of the Disease , and partly by evacuations which the method of cure necessarily requir'd ; and partly also from emptiness and abstinence from Flesh ; which the Physician order'd for some days after he was well , to secure him from a Relaps . But I affirm'd he was clear from all danger of a Fever , and that the foresaid Symptom was wholly occasion'd by emptiness , and therefore I advis'd , that a roasted Chick shou'd be provided for his Dinner , and that he shou'd drink Wine moderately ▪ which being done , and he returning again to the eating of Flesh moderately , was never afterwards troubl'd with this convulsive weeping . And now at length to come to a conclusion , ( for I omit other Phaenomena which belong to this Disease ) that disturbance and varying Intemperies both of Body and Mind , which prevails over hysterical and hypochondriacal People , is occasion'd by this inordination of the Spirits ; for in both , that firmness of Spirits being wanting , which is always found in the robust , and in those who are continually invigorated by the assistance of brisk Spirits , they can't bear the impressions of cross accidents , but are soon mov'd by anger or pain , and are as apt to be angry , as those to whom either Nature has given a soft and weak Government of Mind , or when it has been render'd so by a long series or continuance of Diseases . For the strength and constancy of mind as long as 't is confin'd in the Body , much depends on the firmness of the Spirits that are subservient to it ; which indeed , are made of the finest matter , and are plac'd in the confines of immaterial entities ; and as the frame of the mind , if it 's lawful to call it so , is much more curious and delicate , than the structure of the Body , for it consists in the harmony of the most excellent and almost divine Faculties ; so if its constitution is any way spoil'd , by so much the greater is the ruin , by how much 't was more excellent and more exquisitely compos'd when 't was whole . And this indeed is the condition of these miserable and dejected People we have describ'd , for which Disease , some obstinate Decree of the most insolent Stoick wou'd give no greater ease , than he that wou'd prevent the Tooth-ach , by firmly resolving that he wou'd not by any means suffer his Teeth to ake . And now I suppose that 't is manifest that this whole Disease is occasion'd by the animal Spirits being not rightly dispos'd , and not by Seed and menstruous Blood corrupted , ( as some Authors assert ) and sending up malignant Vapours to the parts affected ; nor from I know not what depravation of the Juices or Congestion of acrid Humours as others think , but from those causes we have assign'd . For that the Fomes of the Disease don't lurk in matter , will plainly appear by this one Instance , viz. a Woman that us'd to enjoy perfect Health being delicate , and of a thin habit of Body , if she chance to be weaken'd and exhausted by some Error , or by a strong Vomit or Purge , will certainly be afflicted with some one of those Symptoms that accompany this Disease ; which wou'd rather be remov'd than occasion'd by such vomiting or purging , if the Fomes of the Diseases was contain'd in a Humour . The same may be said of a great loss of Blood , whether it 's taken away by opening a Vein , or flows immoderately in Labour , or of Emptiness , or too long Abstinence from Flesh ; all which would rather prevent Hysteric Diseases than occasion them , if the Fomes of them was involv'd in some matter : Whereas on the contrary , nothing does so constantly occasion this Disease as these Evacuations . But tho' 't is apparent enough that the original Fomes of this Disease , is not lodg'd in the Humours , yet it must be confess'd that the confusion of the Spirits produces putrid Humours in the Body , by reason the Function as well of these parts which are distended by the violent impulse of the Spirits , as of those which are depriv'd of them , are wholly perverted . And most of these being as it were separatory Organs designed for the reception of the impurities of the Blood , if their Functions are any way hurt , it can't be but a great many feculencies will be heap'd up , which had been eliminated , and so the Mass of Blood purified , if the Organs had perform'd their Office ; which they had certainly done , if a due oeconomy of the Spirits had invigorated them all . To this cause I attribute great Cachexies , loss of Appetite , a Clorosis , and the White Fever in young Women , ( which I don 't at all doubt , is a Species of hysteric Diseases ) and the source of all the miseries that overwhelm poor Women , that have Languish'd a long while under this Disease ; all which proceed from putrifying Juices heapt up in the Blood , and flowing from thence upon the various Organs . Of this kind is a Dropsie of the Womb in Women , which have been long afflicted with this Disease , occasion'd by deprav'd Juices cast from the Blood upon the Organs , by which , their Faculties being perverted , they first become Barren , the oeconomy of the parts being wholly destroy'd , and then Serum and Sanies are generated , which don 't only stuff the Eggs of the Testes , but also insinuating themselves into the Interstices of the Coats , cause them to grow very big , which is perceiv'd by the dissection of those that dye of this Disease : And the hysterical disposition , is the prime cause of these and other Humours , though they are not of the same kind with it . As in a quartan Ague , with which any one that 's perfectly well may be seized , if he continues two or three days in Moorish and Fenny Places ; first some Spirituous Venom of the Disease being imprinted upon the Blood , which continuing a long while , and at length the oeconomy of nature being hurt , it infects all the Juices of the Body , and quite changes their Dispositions ; so that the Sick ( especially if he begins to grow old , ) is render'd obnoxious to Cachexies and other Distempers which come upon long Agues ; yet these Agues are not to be cured by those Remedies that are proper to Purge off such Humours , but by such things as cure Agues by a Specifick quality . From all that has been treated of , it 's very manifest to me , that that 's the chief indication in this Disease , which directs the corroboration of the Blood that is the Fountain and Origine of the Spirits ; which being done , the invigorated Spirits can preserve that tenor that 's agreeable to the oeconomy of the whole Body , and the particular parts . And therefore when the Ataxy of the Spirits ( which we have allow'd above may be ) has vitiated the Humours by long continuance , 't will be proper first to lessen those Humours so corrupted , by Bleeding and Purging , if the Patient has sufficient strength , before we endeavour to corroborate the Blood , and which indeed we can scarce do , whilst a feculent heap of Humours lies in the way . But forasmuch as Pains , Vomiting and Looseness are sometimes so very severe that they will not bear a truce so long until we have satisfied the first intention of fortifying the Blood , therefore sometimes we must begin the cure , by quieting the effects , ( the cause being let alone a little while , ) with some Anodine Medicine , and then we must endeavour to rectifie the Spirits , whose infirm Constitution is the cause of this Disease , by which we may again endeavour to cure such kind of Symptoms ; and because experience teaches , that there are many stinking things that will repel the inordination of the Spirits , and contain them in their Places , ( which are therefore call'd Hystericks , ) we must make use of them when we would answer such intentions . According to what has been said , I order the Patient to be Blooded in the Arm , and that after she be Purg'd Three or Four Mornings following , the Patient thinks her self worse of those Days she is Blooded and Purg'd , for these Evacuations promote the Ataxy , which I take care to forewarn her of , that she may not despond , the Disease of it self being apt to incline her to do so ; but however those vicious Humours we suppose are heap'd up by the long continuance of the Disease , are in some sort to be evacuated before we can conveniently answer the prime intention . After these Evacuations , I prescribe some Chalybeat Remedy to be taken Thirty Days to comfort the Blood , and so by consequence the Spirits that proceed from it ; and nothing will more certainly answer your intention in this case , for it raises a volatile Ferment in the vapid and languid Blood , by which the weak Spirits are rous'd that before were press'd down by their own weight : And this is very manifest , for as often as Steel is given in a Chlorosis , the Pulse are presently greater and quicker , and the outward parts grow warm , and the pale and dead Countenance is chang'd , and becomes fresh and lively . But here we must take notice , that Bleeding and Purging must not always be us'd before Chalybeats ; for when the Patient is weak , and almost worn out by the long continuance of the Disease , they may and ought to be omitted ; and you must begin with Steel , which must be well minded . But in my opinion 't is most conveniently given in substance , and as I have never observ'd nor heard , that so taken , it ever injur'd any Body , so I have been fully satisfied by frequent experience , that the bare substance performs the Cure sooner and better than any of the common Preparations of it , for busie Chymists make this as well as other excellent Medicines , worse rather than better by their perverse and over officious Diligence . I have also heard , ( and if it be true , it much strengthens our Assertion , ) that the crude Mine as 't is digged out of the Earth , is more effectual in curing Diseases , than Iron that has pass'd the Fire , and been purified by Fusion , so the Author affirms , but I have not yet try'd whether it is so or not . This I certainly known , that no excellent and powerful Remedy has been any where made , which has not received its chief Virtues from Nature ; upon which account grateful Antiquity call'd excellent Medicines , God's Handicraft , not Mans. And that some excellent thing does produce wonderful effects by its native goodness and efficacy , may be prov'd by Opium , or the Peruvian Bark . Nor is a Physicians skill so much perceiv'd by preparing Medicines , as by choosing such as are fit , which Nature has prepar'd with her own Fire , and freely bestow'd upon us ; so that all that we have to do , is to reduce Medicines into that form , whereby either their substance , or their vertue and efficacy may be better imparted to our Bodies , for the performance whereof we are sufficiently instructed . Next to the substance of the Steel , I choose the Syrup of it , prepar'd with the Filings of Steel or Iron infus'd in the cold , in Rhenish Wine , 'till the Wine is sufficiently impregnated , and afterwards strain'd , and boyl'd up to the consistence of a Syrup , with a sufficient quantity of Sugar . Nor do I use any Cathartick Medicine at set times during the whole Chalybeat course ; for I am of the opinion , that the vertue of Steel is destroy'd by a Purge , both in Hysterical and Hypocondriacal Diseases ; and when my chief dedesign is to reduce the Spirits to order , and to renew and confirm their System , if I should use the gentlest Purge but once , I should undo all that I had done in a Week before , and by pulling down what I have built , and by building what I have pull'd down , I should trifle with my self and Patient too ; and I believe Mineral Waters which participate of an Iron Mine , are render'd less effectual by this means ; though I know that some have been cur'd when Purges have not been given only now and then ; but daily with the Steel ; which does not so much prove to me the Prudence of the Physician , as the extraordinary virtue of the Steel ; for if they had been omitted , the cure would have been performed in a less time . Nor indeed do I see what advantage , or rather not what disadvantage Purges often repeated may produce in many other Diseases besides that just mention'd ▪ for though it can't be denied that they clear the Intestines of Impurities , and likewise that they somewhat discharge ill Humours that are lodg'd in the Mass of Blood , yet on the contrary , 't is no less certain , that when they are frequently repeated in weak Bodies , especially in the tender age , they do much hurt , because upon this account a great many Humours are drawn to the Intestines , and being put off upon these parts , occasion praeternatural Ferments , whereby tumours arise in the Belly , increasing daily so much the more , by how much the oftener the Sick is Purg'd ; and at length it happens that those parts by reason of weakness ( being as it were overwhelm'd with a burden of Humours , ) and by a defect of natural Heat soon become tabid and putrifie . And sometimes also the oeconomy of the Bowels being quite destroy'd by reason of the Causes mentioned , preternatural Kernels , a-kin to the Kings-Evil , and the like , grow to the Mesentery , and make way for Death . For these Reasons I judge 't is safest in Children after general Evacuations , and those but very few , to direct the Curative Indication , so as to comfort the Blood and Bowels , which may be done with Spanish Wine alone , or with Corroborating Herbs in it , if Morning and Evening some Spoonfuls of it , ( according to the Age of the Sick ) be given long enough . And because things outwardly apply'd can easily penetrate the tender Bodies of Infants , and so can throughly affect the Blood with their Virtue whatever it is , 't will be convenient in Swellings of their Bellies , whether occasion'd by the King's-Evil , or by the true Rickets , to use Liniments that are proper to corroborate the Blood and Bowels , and likewise to cure any Morbifick indisposition of them . Take of the Leaves of Common-Wormwood , of the Lesser Centaury , of white Whorehound , of Germander , of Ground-pine , of Meadow Saxifrage St. John's-wort , Golden Rod , Wild Thime , Mint , Sage , Rue , Carduus Benedict . Penny-royal , Sothernwood , Chamomel , Tansie , Lilly of the Vallies , ( of all fresh gather'd and cut ) each Mi , of Lard lb iiij , of Sheep-Suet , and Claret-Wine , each lb ij ; let them be steep'd in an Earthen Pot upon Hot Embers twelve Hours , and then let them boil till all the Moisture is consumed ; afterwards strain them , and so make an Ointment , with which let the Belly be anointed Morning and Evening for Thirty or Forty Days following , and also both the Arm-pits . But as to the Rickets , this must be noted , that in those tumours that afflicted the Bellies of Infants heretofore after long Agues , not much unlike the true Rickets , Purges repeated seem'd to be indicated ; for before the use of the Peruvian Bark , Agues continued a long while , and put off a Sediment , which was the cause of tumours of this kind , which could be carried off only by Purges repeated . But in the true Rickets , Catharticks are not to be us'd above once or twice at the most , before the Patient enters upon the use of Alteratives ; and all the time the parts are anointed , let him take inwardly of the Wine above mention'd ; or if it may be , let him use for his ordinary Drink Beer , with the foresaid Herbs , or at least many of them put up with it in the Vessel . Lastly , this I have hinted ought to be carefully minded , for I am fully satisfied , that many Infants and Children have been destroy'd by Purges often repeated , which perhaps were given to asswage the Belly : But this by the by . If any one object that the Filings of Steel may hurt those that take them by sticking in their Bowels , unless they are Purg'd now and then , I answer first , that I never found any such thing in any one , and then 't is much more probable that being involv'd in the Slime , and with the Excrementitious Humours of the parts , they should all at length pass away with them , than when they are exagitated by Purging Medicines , which occasion unusual compressions , twisting and contraction of the Guts , whereby the Particles of Steel thrust upon the Coats of the Bowels may penetrate deeper into them . When the Patient is in a Steel course , Remedies commonly call'd Hystericks are to be us'd as 't were by the by , ( to comfort the Blood and Animal Spirits , ) in that manner and form which is most agreeable to the Patient ; but if she can take them in a solid form , they will more powerfully retain the Spirits in their office and place , than things that are Liquid , that is , either Decoctions or Infusions , for the very substance affects the Stomach longer with its savour , and works more forceably upon the Body . Upon the whole , being about to answer all the Indications which I have touch'd upon above , I us'd to prescribe these few and common things , which though they are not at all pompous , yet they most commonly do what I desire . Let. ℥ viij of Blood be taken from the Right Arm. Take of Galbanum dissolv'd in tincture of Castor , and strain'd ʒiij , Tacamahac ʒ ij , make an Emplaister to be apply'd to the Navel . The next Morning let her enter upon the use of the following Pills . Take of Pill Cocb . Maj. ℈ ij , of Castor powder'd , gr . ij , of Peruvian Balsam gutt . iv , make Four Pills , let her take them at Five in the Morning , and Sleep after them ; repeat them twice or thrice every Morning , or every other Morning , according to their operation , and the strength of the Patient . Take of Black-Cherry-Water , of Rue Water , and compound Briony Water , each ℥ iij , of Castor tied up in a Rag , and hang'd in the Glass ʒss , of fine Sugar , a sufficient quantity , make a Julap , of which let her take Four or Five Spoonfuls when she is faint , dropping into the first Dose if the Fit is violent gutt . xx of Spirit of Harts-horn . After the Purging Pills just describ'd are taken , let her use the following . Take of the Filings of Steel , gr . viij , with a sufficient quantity of extract of Wormwood , make Two Pills , let her take them early in the Morning , and at Five in the Afternoon for Thirty Days , drinking upon them a draught of Wormwood Wine . Or for daily use , Take of the Filings of Steel , and of extract of Wormwood , each ℥ iiij , mingle them , and keep them for use , let her take gr . xv , or ℈ i , made into Three Pills . Or if she likes a Bolus better , Take of Conserve of Roman Wormwood , and of the Conserve of the Yellow Rind of Oranges each ℥ i , of Candied Angelica , and Nutmegs Candied , and Venice Treacle , each ℥ ss , of Candied Ginger ʒij , make an Electuary with a sufficient quantity of Syrup of Oranges . Take of this Electuary ʒiss , of the Filings of Steel well rubb'd , gr . viij , make a Bolus , with a sufficient quantity of Syrup of Oranges , to be taken in the Morning , and at Five in the Evening , Drinking upon it a Draught of Wormwood Wine . Take of choice Mirrh , and Galbanum each ʒiss , of Castor , gr ▪ xv , with a sufficient quantity of Balsam of Peru ; make Twelve Pills of every Dram , let her take Three every Night , and Drink upon them Three or Four Spoonfuls of Compound Briony Water , through the whole course of this process . But if the Pills last prescrib'd move the Belly , which sometimes happens in Bodies that are very easily Purg'd , by reason of the Gum that 's in them , the following are to be substituted . Ta kt of Castor ʒi , of Volatile Salt of Amber ʒss with a sufficient quantity of extract of Rue , make xxiv small Pills , let her take Three every Night . But here we must take notice , that Chaly beats in whatsoever form or Dose they are taken , occasion sometimes in Women great Disorders both of Body and Mind , and that not only on the first Days ( which is usual almost in every Body , ) but also all the time they are taken . In this case the use of Steel must not be interrupted at those times , but Laudanum must be given every Night for some time in some Hysterick Water , that they may better bear it . But when the Symptoms are mild , and it seems that the business may be done without taking Steel , ( namely when the Disease is small , ) I think it sufficient to Bleed , and to Purge Three or Four times , and then to give the altering Hysterick Pills above mention'd Morning and Evening for Ten Days , which Method seldom fails when the Disease is not violent ; yea , the Pills alone , Bleeding and Purging being omitted , oftentimes do a great deal of good . Yet we must take great notice , that some Women by a certain ideosyncrasy do so abhor Hysterical Medicines , ( which give ease in most of the Symptoms of this Disease , ) that they don't only not receive Benefit , but are much injured thereby ; therefore they must not be given to such , for Hipocrates says , 't is in vain to do any thing contrary to Natures inclination . Which ideosyncrasy indeed is so great and so frequent , that if we have not regard to it , the Lives of the Sick may be hazarded , and not only by Hysterical Medicines , but by many other , whereof I will at present mention but one thing , viz. That some Women that have the Small-pox can't bear the use of Diacodium , for thereby Giddiness , Vomiting , and such Symptoms belonging to Hysterical Diseases are occasioned , and yet Liquid Laudanum agrees with them very well . Which I observ'd whilst I was writing this , in a Young Woman a Person of Quality , to whom I had given the said Syrup on the Sixth and Seventh Night ; the Symptoms above mention'd invaded both Nights ; nor did the Inflamation of the Pustules duly proceed , but when afterwards she us'd Laudanum , she was quite freed from the said Symptoms ▪ the Swelling of the Face and Pustules daily increasing , the anxiety and restlessness of Body and Mind ( which us'd to be as it were a Fit of the Small-pox , ) was wholly removed as often as this Paregorick was given , the Patient being strengthen'd and reviv'd by it : But this by the by . And so Hysterical Diseases are most commonly cur'd , and most Obstructions of Women , but especially a Clorosis , or Virgins pale Colour , and also all Suppressions of the Courses . But if the Blood is so very feeble , and the confusion of the Spirits so great , that Steel order'd to be us'd according to the Method prescrib'd is not sufficient to cure the Disease , the Patient must Drink some Mineral Waters , impregnated with the Iron Mine , such as are Tunbridge , and some others lately found out , for the Chalybeat virtue of these is better mingled with the Blood , by reason of the great quantity that 's taken of them , and also because they are more agreeable to Nature , and they cure Diseases more effectually than Iron , how much soever exalted by art , as imprudent Chymists talk . But this is more especially to be observ'd in Drinking of them , that if any Sickness happens that is to be referr'd to Hysterical Symptoms , in this case the Patient must forbear drinking them a day or two , 'till that Symptom that hinder'd their passage is quite gone . For though these Waters are less apt to stir the Humours , and so to cause a Confusion of the Spirits , than the gentlest Catharticks of the Shops , yet they do somewhat exagitate them as they are diuretick , though they often also purge by Stool too . But if the Waters themselves hinder their own Passage by disturbing the Humours and Spirits , let those consider how impertinently they act , who order Purging Medicines to be given once or twice a Week , whilst the Patient is Drinking these Waters ; or which is yet more foolish , to be mix'd with the Waters , by which means these and other Mineral Waters pass more difficulty . And here I must acquaint you , that though some think the Iron is in these Waters in principiis solutis , ( which is plainly the same as if we should suppose Liquid Iron , ) yet I don 't at all doubt but that they are Simple Waters , impregnated with the Mine through which they pass , which will be manifest to any one , if he pour some Gallons of Water upon a sufficient quantity of Rusty Nails , for then he will perceive that this Water , when the Powder of Gauls , or the Leaves of Tea , or the like are put into it , will plainly appear of the same colour with the Waters of a Mineral Fountain , when such things are put into them . Nor truly have these artificial or inartificial Waters ( which you please to call them , ) when they are taken , different effects , if they are us'd in Summer-time , and in a good Air. But however it is , if the Disease by reason of its obstinacy does not yield to Steel Waters , the Patient must go to some hot Sulphureous Waters , such as is our Bath , and when he has us'd them inwardly Three Mornings following , the next Day let him go into the Bath , and the Day following let him Drink them again , and so let him do by turns for Two whole Months . For in these and in others of what kind soever they are , this must be carefully noted , that the Patient must persist in the use of them , not only till he receives some benefit , but till he is quite well , that the Symptoms may not return again in a short time . Venice Treacle alone , if it is used often , and a long while , is a great Remedy in this Disease , and not only in this , but in very many other Diseases that proceed from want of Heat and Concoction or Digestion ; 't is perhaps the most powerful that has been hitherto known , how contemptible soever it may seem to most People , because 't is common , and has been known a long while . Spanish Wine Medicated with Gentian , Angelica , Wormwood , Centaury , the Yellow Rind of Oranges , and other Corroboratives infus'd in it , does a great deal of good , some Spoonfuls of it being taken Thrice a Day , if the Woman be not of a thin and Cholerick habit of Body . And truly a large Draught of Spanish Wine by it self taken at Bed-time for some Nights , by my advice has been very beneficial to some Hysterical Women , for by it the habit of the whole Body was render'd stronger , and they who before were Cachectical , became fresh colour'd and brisk . Moreover sometimes we find that the Peruvian Bark wonderfully comforts and invigorates the Blood and Spirits , whereof a Scruple taken Morning and Evening for some Weeks , has as I have observ'd restored ( both to Hypocondriacal Men , and Hysterical Women that have been very Sick a long while , and when the oeconomy of their Bodies has been much weaken'd , ) a firm and Healthy Constitution . But it succeeds best in that kind of Hysterick Diseases , in which Women are affected with Convulsions , wherein they struggle violently and beyond the strength of Women , and at the same time beat their Breasts . Yet it must be confess'd that this Medicine does not so certainly , and so often cure this Disease as Agues . But though ( to mention this by the by , ) the Peruvian Bark does wonders in the cure of Agues , and though we use it freely our selves , and give it to our Wives and Children , as often as there 's occasion , yet there are some now as much displeas'd with it , because it cures so certainly and suddenly as they were heretofore , because it was but lately known among us ; to which fate the best Men , and most excellent Remedies have been almost always expos'd . But by this we may try as by a Touch-stone our Dispositions , and from thence judge whether we are good or ill Men , namely , according to the degree of our joy or grief , as often as the welfare of Mankind is promoted by some common benefit , or the Blessing of God. But if any of the Remedies above mention'd don 't well agree , which often happens in Cholerick and thin Constitutions , then a Milk Diet may be us'd ; for some Women ( which one would wonder at at first ) that have conflicted a long while with Hysterick Diseases , and even such as have frustrated all the endeavours of Physicians , yet have recover'd by Dieting themselves for some time only with Milk , and especially those that labour with that Disease I call an Hysterick Colick , which can't be appeas'd by any thing but Narcoticks , to which repeated by intervals , these Women are much accustom'd , the Pain returning as soon as the Vertue of the Anodine fades ; but this is chiefly to be admir'd in this Method of cure , that Milk which yields only a cold and crude nourishment , should notwithstanding by use strengthen and invigorate the Spirits ; and yet this will not seem disagreeable to reason , if you consider that Milk affording only a simple nourishment , does not busie nature much in concocting it , otherwise than Meats and Liquors more compounded use to do , and that an equal temper of the Blood and Spirits necessarily follows that perfect Concoction . For this must be also consider'd , that a bare debility of the Spirits consider'd by it self , is not the cause of those Confusions they are under , but the weakness of them compair'd with the state of the Blood. For it may be an Infant has Spirits strong and firm enough with respect to it's Blood , but yet not proportionable to the Blood of a grown Person . Now when by the continual use of a Milk Diet , ( tho' 't is crude and weak ) the Blood is render'd more soft and tender , if the Spirits that are made by it , are only equal to it , all 's well . Yet all can't undergo those Inconveniencies which most commonly accompany it the first days , namely , because it curdles in the Stomach , and is insufficient to maintain the usual strength of the Body ; but if they cou'd , they might receive benefit by it . But nothing of all I have hitherto known , does so much comfort and strengthen the Blood and Spirits , as riding much a Horse Back every day for a long while ; for seeing by this kind of Exercise the lower Belly is most forceably mov'd , in which the Vessels for excretion ( as many as are appointed by Nature to drain the Impurities of the Blood ) are plac'd : What disorder of the Functions or other natural Impotence of the Organs , can be imagin'd so great as not to be helpt by the frequent jolting of the Horse , and that too in the open Air ? Whose innate heat is so extinguish'd that it can't be stir'd up by this motion and ferment afresh ? Or what preter-natural Substance or deprav'd Juice can there be in any Creek of these parts , which can't by this Exercise of the Body , be either reduced to such a condition as is agreeable to Nature , or scatter'd every way and ejected ? Moreover , the Blood being perpetually exagitated by this motion , and throughly mix'd , is as it were renew'd , and grows vigorous again . And indeed , this method , tho 't is inconvenient for Women that are accustom'd to a slothful and delicate way of living , for they may be injured by motion , especially at the beginning ; yet is it very proper for Men , and soonest recovers their Health . One of our Reverend Bishops , famous for Prudence and Learning , having studyed too hard a long while , fell at length into an hypochondriacal Disease , which afflicting him a long time , vitiated all the ferments of the Body , and wholly subverted the Concoctions . He had pass'd through long courses of Steel more than once , and had try'd almost all mineral Waters , with purging often repeated , and Antiscorbuticks of all kinds , and very many testaceous Powders , which are reckon'd proper to sweeten the Blood : And so being in a manner worn out , partly by the Disease , and partly by Physick us'd continually for so many years , he was at length seiz'd with a colliquative Loosness , which is wont to be the forerunner of Death , in Consumptions and other Cronical Diseases ▪ when the Digestions are wholly destroy'd . At length he consulted me . I presently consider'd that there was no more room for Medicine , he having taken so many already , without any relief ; for which reason I perswaded him to ride a Horse-Back , and that first he shou'd take such a small Journy as was agreeable to his weak condition : Had he not been a very judicious man , and one that weighed things well , he wou'd not have been perswaded so much as to try such a kind of Exercise . I intreated him to persist in it daily , till in his own opinion he was well , going daily further and further , till at length he went so many Miles , as prudent and moderate Travellers , that go a large Journy upon business , use to do , without any regard to Meat or Drink , or the Weather ; but that he shou'd take every thing like a Traveller as it happens . To be short , he continued this method , increasing his Journies by degrees , till at length he rode Twenty or Thirty Miles daily ; and when he found himself much better in a few days , being incourag'd by such wonderful Success , he continued this course a pretty many Months , in which time , as he told me , he rode many Thousand Miles , till at length , he did not only recover , but also gain'd a strong and brisk habit of Body . Nor is this kind of Exercise more beneficial to hypochondriacal People , than 't is to those that are in a Consumption ; whereof some of my Relations have been cur'd by riding long Journies by my advice ; for I knew I cou'd not cure them better by Medicines of what value soever , or by any other method . Nor is this Remedy proper only in small Indispositions , accompanied with a frequent Cough and Leanness , but in Consumptions that are almost deplorable ; when the Diarrhaea above mention'd , accompanies the Night Sweats , which is wont to be the forerunner of Death , in those that dye of a Consumption . In a word , how deadly soever a Consumption is , and is said to be , two Thirds dying of it , which are spoil'd by Chronical Diseases : Yet I sincerely affirm , That Mercury in the French Pox , and the Peruvian Bark in Agues , are not more effectual than the Exercise above mention'd , in curing a Consumption , if the Sick takes care that his Sheets are well air'd , and that his Journies are long enough . But this must be noted , that those that have pass'd the Flower of their Age , must use this Exercise much longer than those that have not yet arriv'd to it . And this I have learn'd by much Experience , which scarce ever fails me . And tho' riding on Horse-Back is chiefly beneficial to consumptive People , yet riding Journies in a Coach , does sometimes a great deal of good . But to return to the business in hand , this is the general way of cure in this Disease , which is apply'd to the original cause , viz. the weak crasis of the Blood , and so is to be us'd only when the Fit is off ; therefore as often as the Fit invades , join'd with any one of the foresaid Symptoms , if the Disease be such , or so great a one , that 't will not bear a truce , 'till it may be cured by Medicines that corroborate the Blood and Spirits , we must presently make use of hysterick Remedies , which by their strong and offensive Smell , recall the exorbitant and deserting Spirits to their proper Stations , whether they are taken inwardly , or smelt to , or outwardly apply'd ; such are Assafaetida , Galbanum , Castor , Spirit of Sal Armonicack : And lastly , whatever has a very ungrateful and offensive Smell . And in truth , whatever stinks is proper for this intention , whether 't is naturally ill sented , or made so by Art ; and unless I am deceiv'd , Spirits of Harts-horn ▪ of human Blood , of Urine , and of Bones , and the like ; take their chief Vertues from the force of the Fire , in their preparation contracting an ill sented empyreuma , which is intimately join'd with their Essence , which is likewise in the Fumes arising from Feathers , and such kind of parts of Animals , when they are burnt . For this is common to the Substances of all Animals , viz. to emit a stinking Fume while they are burning ; and if 't is forc'd by Fire , and receiv'd in Glasses , when 't is condens'd , it becomes those Liquors call'd Volatile Spirits , which assume Faculties that were not primitively in their Subjects ; and are indeed , only Creatures of Fire , and their Vertues are really all the same , from whatsoever Substance ( so it is animal ) they are extracted . In the next place we must take notice , That if some intolerable pain accompanies the Paroxysm , in whatever part it is , or violent Vomiting , or a Diarrhaea ; then besides the hystericks above mention'd , Laudanum must be us'd , which only is able to restrain these Symptoms . But in quieting these pains which vomiting occasions , we must take great care that they are not mitigated either by Laudanum or any other Paregorick , before due Evacuations have been made , unless they almost exceed all human Patience . First , because sometimes there is so great a quantity of Blood and Humours heapt up , ( especially in sanguine Women and Men of a proper habit ) that 't is able to withstand the Operation of the most effectual Narcotic , tho' it be often repeated : And therefore in such , Blood must necessarily be evacuated from the Veins of the Arm , and a Purge must be given before we come to use Laudanum . For when these things are duly perform'd , that which before given in a large Dose wou'd do no good , will now perform the business in a moderate Dose . And then because I have found by frequent Experience , that when the Sick has been accustom'd by little and little to Laudanum , and has not been duly evacuated before , she was forc'd by reason of the return of the pain , presently after the Vertue of the Medicine vanish'd , to take a Paregorick again ; and so daily for some years , the Dose being sometimes by degrees increas'd , so that at last they can by no means abstain from Laudanum , tho' thereby all the Digestions are vitiated , and the natural Functions weakned . Tho' I don't think that the use of Laudanum does immediately hurt the Brain or Nerves , or the animal Faculties . Therefore I judge , and I speak what I have found , that Evacuation ought to go before Anodynes , viz. in Virago's , and in Women that abound with Blood , a Vein must be open'd , and the Body purg'd ; especially if they have been lately seized with the Fit. But if the weak Women and those of a quite contrary Constitution , labour with such a Fit and Pain , and have been not long ago afflicted with it , 't will be sufficient to cleanse their Stomachs with a Gallon of Posset-drink , more or less , taken in and ejected by Vomit ; and then to give a large Dose of Venice Treacle , or of the Orvietan Electuary , and a few Spoonfuls of some Spirituous Liquor , that is pleasing to the Taste ; with a few Drops of Liquid Laudanum ▪ to be taken presently after it . But if the Sick has vomited a great while before the Physician was call'd , and there is danger , lest by a further Provocation by Emeticks , the Spirits shou'd be put in a rage , and the Sick too much weaken'd ; In this case you must give Laudanum without delay , and such a Dose as is not only equal to the violence and duration of the Symptom , but such a one as is sufficient to vanquish it . But here two things are to be chiefly noted . First , that when you have once begun to use Laudanum after due and necessary Evacuations , it must be taken in that Dose , and often repeated , till the Symptom is quite conquer'd ; only such a space must be betwixt each Dose , that we may know what the former has done , before we give another . And then when we treat the Disease with Laudanum , we must do nothing else , and nothing must be evacuated ; for the gentlest Glyster of Milk and Sugar , is sufficient to spoyl whatever has been repair'd by the Paregoric , and to occasion the return of the vomiting and pain . But tho' the pains above mention'd , as we have said , are apt to overcome the Vertue of the Anodyne , yet violent Vomiting indicates the largest Dose of it , and that it shou'd be very often repeated ; for by the inverted peristaltick motion of the Stomach , ( by which that which is contain'd in it , ought to be carried downwards ) the Paregorick is ejected through the oesophagus , before it can do any good , unless after every time the Sick vomits , the Narcotick be given afresh , and chiefly in a solid form ; or if it be given in a Liquor , the Vehicle must be so small , as that it may but just wet the Stomach , so that by reason of the small quantity of the matter , it can't be cast up ; for instance , some drops in one Spoonful of strong Cinamon Water , or the like ; and the Sick must be admonish'd to keep her self quiet , presently after taking the Laudanum ; and that she keep her Head as much as is possible immoveable , for the smallest motion of the Head , provokes vomiting more than any thing else , and then the Medicine just taken , is ejected . Yet when the vomiting ceases , and is as 't were tam'd , 't is expedient to give an Anodyne Morning and Evening for a few days , to prevent a Relaps ; which also ought to be observ'd after a Diarrhaea , or an hysterick pain taken off by a Narcotick . And so at length by this method , we may readily cure the symptomatick pain and vomiting , whereby , because they are very often , like other Diseases , Physicians are easier impos'd upon , than by any other Symptoms whatever , that require their help ; concerning which , I will add a few things , for instance : In that kind of hysterick Disease now describ'd , which resembles a nephritick pain , is not the great Parity and Similitude of both Diseases , apparent to any one , both because the pain in both is in the same part , and also for that the Woman vomits in both Diseases ? And yet they proceed from causes differing from one another ; and the methods for the cure of them so unlike , that that which does good in this , is injurious in the other , and so on the contrary . For whether a Stone or Gravel , fretting upon the Substance of the Reins , occasions Pain , and by consent of Parts , vomiting , nothing is so beneficial , as very large and frequent revulsion of the antecedent cause by Phlebotomy , and Dilatation and Laxation of the Passages , by which the Stone is to be excluded , by emollient Clysters very often repeated , and inward Remedies of the same kind , to which are to be added Linthontriptick and Diuretic Medicines . Now if the said Symptoms do no way arise from the Stone , but from the animal Spirits rushing impetuously in a great quantity upon the Reins , ( in which case , Paregoricks are only indicated ; nor is the gentlest Clyster injected after the first Evacuations , without danger ) in what great danger the unhappy Woman is put into , whose Life is so triffl'd with , I need not say . The same may be affirm'd of that hysteric Disease , which resembles the Bilious Colick , or the Iliack Passion , when 't is taken for granted , that that Disease , ( tho' of a quite different , yea contrary nature ) is the Bilious Colick , and proceeds from a sharp Humour cast upon the Bowels , through the Mouths of the mesenterick Arteries ; ( into which Error the intollerable Pain and the green colour of the Matter expell'd by Vomit and Stool , easily seduces the unwary and unthinking Physician ) what method is so proper , as that whereby we endeavour to attemperate the Acrimony of the Humours , by the help of cooling and incrassating Medicines ? And what is fitter than Catharticks frequently given , besides Clysters daily injected to exterminate the Humous from the Guts , especially Mercurius dulcis mixt with diagrydiate Medicines , to eradicate perfectly the morbific Matter ? But 't is plain to every one , how ill the Patient wou'd be treated , and in what great Danger he wou'd be , whilst we shou'd insist upon this method , if the Disease which is supps'd to be a bilious Colick , shou'd really prove an hysterick or hypocondriacal Symptom , when Experience openly proclaims , that after the first general Evacuations ( which are appointed to remove the Rubbish of the putrifying Humours , which the Ataxy has occasion'd , whereby the Vertue of the Anodyne may be obstructed ) nothing remains to be done , besides the quieting the tumultuous Spirits , till the Symptom goes off , and afterwards 't will be seasonable to give Chalybeats , or any other Remedy , if there be any that by kindling and invigorating the Blood , may eradicate the Disease . 'T is not my business to reckon up those great Calamities which I have known befal Women , when this hysterick Colick has been suppos'd to proceed from Choler , notwithstanding I affirm , that Evacuations often repeated , which are indeed indicated in the Bilious Colick , have been so far from lessening the Pain and Vomiting , that they have irritated them more , by promoting the Disturbance of the Spirits , which is the true cause of these Symptoms . And at length the Disease being prolong'd for some Months , ends in Convulsions , there being a suddain Translation to the Brain , whereby the Sick is soon destroy'd ; and especially when after other Evacuations repeated a long time , by reason of the green colour of those things that are vomited up , a Vomit is given . In a word , if I have learnt any thing by Observation , I judge we must chiefly take care , that those Symptoms familiar to hysterick Women , be not suppos'd by a Mistake in the Diagnostick , to proceed from other Diseases , which they often resemble . And here I must acquaint you , that besides the Errors before mention'd , whereby Women obnoxious to hysterick Diseases , are put in danger of their Lives ; very many moreover , suffer by these Diseases , by an Error no less fatal , at a time wherein , tho' this Disease is not of its own nature deadly , yet by reason of the Disasters that come upon it ▪ and follow'd it , 't is Destructive to many : For instance , a Woman of a tender and infirm habit of Body , brings forth a Child , and all succeeds well , and according to Nature . The Midwife , whether Rude and Unskilful , or Vain-glorious , to shew how well she has perform'd her business , advises that her Woman shou'd rise a few days after she has been brought to Bed , and that she shou'd keep up a while ; the Woman does so , and is presently seiz'd upon the first motion of her Body , with an hysterick Indisposition , and according as the Disease increases , the Lochia are first lessen'd , then they quite stop , whose Suppression , a long Series of untimely Symptoms follow ; which soon destroys the Sick , unless great Diligence and Skilfulness interceed . And sometimes they are seiz'd with a Phrensie on this account , which growing daily worse and worse , occasions Convulsions first , and then Death . But if they escape Death , they are maddish , and sometimes continue so as long as they live . Sometimes after the Suppression of the Lochia , they fall into a Fever , which either turns to that which is then epidemical , or depends only on that beginning . Moreover , the same hysterick Symptoms which were first occasion'd by the Suppression of the Lochia , rage more now , as if afterwards they proceeded from it . I thought long ago , that of those Women that dye in Child-bed , scarce one in ten , to speak within bounds , dies , because she has not strength necessary for Delivery , or from the pains that accompany difficult Labour , but chiefly by reason they rise too soon , Hysterical Fits being occasioned by that motion , whereby when the Lochia are stopt , a numerous train of dreadful Symptoms follows ▪ Wherefore they that are advised by me , keep in Bed at least till the Tenth Day , if they are of a ▪ weakly Constitution , especially if they have been long since troubled with Vapours . For besides that , the Rest which they have in Bed , frees them from those Dangers we have so often mentioned ; the warmth of the Bed not interrupted , likewise refreshes the Spirits weakned and exhausted by the pains in Labour , and by the Evacuations usual in this case , and recruits Nature , and digests and removes all those Crudities which are heapt up during the time of Child-bearing . But if by reason of this error committed , any one of the said Symptoms supervenes , the curative Indications are to be directed so , that the Spirits disquieted by this motion should be appeas'd , and that the Lochia should flow again , for as much as the suppression of them is the next and immediate cause of these Symptoms . But we must not obstinately insist upon this method , but having given a while those Remedies that are wont to be used with success in this case , if they don't answer according to our desires , we must leave them off ; for as strong things must not be us'd , so neither ought we to persevere in the use of gentler , by reason Women in Child-bed so affected , are much weaken'd , and their strength almost worn out . For instance , when it first appears that the Lochia are stopt , 't is convenient to put the Woman presently to Bed , and then to apply an Hysterick Plaister to the Navel , and to order this Electuary following to be taken forthwith . Take of the Conserve of Roman Wormwood , and of Rue each ℥ i , of the Trochisc . of Mirrh ʒij , of Castor , English Saffron , of Volatile Salt of Sal Armoniac , and of Assa Faetida , each ʒss , make an Electuary with a sufficient quantity of the Syrup of the five opening Roots ; let her take the quantity of a large Nutmeg every third Hour , drinking upon it Four or Five Spoonfuls of the following Julap . Take of Rue Water , compound Briony Water , each ℥ iij , of Sugar Candy , s . q. mingle them , make a Julap . And if these things are given as soon as the suppression begins , the Disease is most commonly conquer'd , but if having continued the use of the said Remedies , till the whole quantity is taken , in this case we must try Laudanum once . Here Laudanum though of its own nature 't is astringent , yet by quieting the disturbance of the Spirits whereby the usual Evacuation of the Lochia is interrupted , does sometimes much good , and when Emmenagogs do no good , it may recall the Flux of the Lochia ; but Narcoticks are most conveniently given with Hystericks and Emmenagogs . For instance , Fourteen Drops of Liquid Laudanum in Compound Briony Water , or one Grain and a half of Solid Laudanum made into Two Pills , with half ae Scruple of Assa Faetida ▪ But we must be sure to take notice , that if we don't hit the Mark at once , if the Lochia don't follow , we must by no means repeat the Opium , as is usual in other cases , and ought to be : For if here the Paregorick is repeated , 't will so powerfully stop the Lochia , that afterwards they can by no means be provok'd ; for truly if this dont succeed ( some time being pass'd that we may know what it has perform'd , ) we must return to the use of Emmenagogs , mixt with Hystericks , and then inject a Clyster of Milk and Sugar ; and what was said above of Opium ▪ holds good likewise here of Clysters , for unless the first injected bring the Lochia , nothing is to be expected from more , one being sufficient , by turning the Humour gently , to cause the Lochia to flow , but more may divert them another way . These things being perform'd ( which are to be touch'd upon lightly , ) 't is most safe and the duty of a prudent Physician , to wait and see what time will do , for every Day the business of the Cure is more and more removed from Danger , and if the Sick live beyond the Twentieth Day , she 's in a manner out of danger . For when the Woman has been recruited a little , and gain'd some Strength , in a long Disease whatever 't is , she will be able to bear that Remedy which is fittest for the cure of that Disease , which was occasion'd by a suppression of the Lochia ; whereas Medicines cram'd in obstinately , the first doing no good , may increase the Disease , and also the disturbance of the Spirits from whence the Disease arises , which must be carefully noted . Lately a Vertuous Matron of good Parentage sent for me , she upon the foremention'd occasion , presently after she was brought to Bed , was seiz'd with Hysterick Fits , and the Lochia stop'd . I endeavour'd by the Medicines aforesaid to provoke them , but in vain , the violence of the Hysterick Disease being too powerful for the Medicines ; and at length when I perceiv'd she would be well if I did nothing , I committed all to time , by much the best and most successful Physician ; and according to my Opinion things went well with her to the Fourteenth Day : Visiting her daily , I found she was no day worse than she was the Day before . After this the Women that had attended upon her , whom I had hitherto kept from doing mischief by their over-officiousness , enforc'd the Husband to have a Vein opened instantly in his Wives Foot , which being done , the Hysterick Fits so far prevailed , that within a few Hours she was seiz'd with Convulsions , and soon after by Death , that ends all our Miseries . And if it be lawful to speak what I think , I have been a long time of the Opinion , that I have well perform'd the Duty of an Honest Man and good Physician , ( not only in the said Diseases of Women in Child-bed , but also in all other Acute Diseases , when I can't certainly promise that a Cure will follow this or that method I please to use ) , as often as I do nothing , when visiting the Patient , I find he is not worse this day , than he was the Day before , and when I can conjecture he will not be worse to Morrow than he is to day ; whereas if I proceed in curing the Sick with a method , the efficacy whereof I don 't yet know , he will be in danger both upon the account of the Experiment I am about to make upon him , and also by the Disease , nor will he as easily evade two Dangers as one . For though at present there is no manifest sign of his beginning to be well , yet 't is most certain that according to the nature of Acute Diseases , no one can always labour with them . And besides every Day will more and more secure the Patient , or yield an occasion to the Physician , whereby he may more opportunely and certainly vanquish the Disease , than he could before . Which as it may be truly affirm'd of most Disease , so especially of the Diseases of Child-bed Women , wherein the least error may prove fatal , and in which we are so little able to govern that natural Evacuation , the suppression whereof occasions the Diseases we have been treating of . But forasmuch as Hysterical Diseases dont always owe their Original to the prime cause , namely the native debility of the Spirits , but sometimes to an adventitious weakness ; therefore I design before I make an end , to discourse of this sort of cause , which most commonly is the occasion of Vapours as they are call'd ; and 't is an immoderate Flux of the Courses either in Child-Bed , or at other times as to the first kind , that comes and is very troublesom the first Days after hard Labour , accompanied with a numerous train of Hysterical Symptoms ; and as it only comes , and is troublesom on these first Days , so it soon goes away , for a Diet that is somewhat thickening , easily drives it away , for which also the following Drink may be used . Take of Plantain Water and Red Wine , each thi , boil them together , till a third part is Consumed ; then sweeten it with a s . q. of White Sugar , whereof when 't is cold , give half a Pint twice or thrice a day ; in the mean while some very gentle Hysterick Julap may be taken now and then , and the following Nodulus may be held to the Nose . Take of Galbanum , and Assa faetida , each ʒij , Castor ʒiss , of Volatile Salt of Amber ʒss , mingle them and make a Nodulus . Or , take ʒij of Spirit of Sal Armoniac , to which let her smell often . But as to the Flux , when Women are not in Child-bed , though that is wont to happen at any time , yet most commonly it comes a little before the time the Courses are about to leave them , namely about the Age of Forty Five if they flow early , but about Fifty , if they come somewhat later ; from these as is said a little before they quite go away , ( like a Candle burnt to the Socket , which gives the greatest Light just as 't is about to go out , ) they flow impetuously , and cast the poor Women into almost continual Hysterick Fits , by reason of the great quantity of Blood which is continually evacuated . Now though in this case , Hystericks both inward and outward must be us'd by the by ( avoiding those that are strong , lest they should promote the Flux ) yet the chief intention must be to stop the Courses , which may be soon done after this manner . Let ℥ viij of Blood be drawn from the Arm , the next Morning give the common Purgative Potion , which must be repeated every Third Day for Twice , and every Night at Bed time through the whole Course , let her take a Paregorick made with one Ounce of Diacodium . Take of Conserve of Dry'd Roses ℥ ij , of Trochisc , of Terra Lemnia ʒiss , of Pomegranate Peel , and Red Coral , each ℈ ij , of Lapis Haematitis and Dragons Blood , and Bole Armenic , each ℈ i , make an Electuary with a sufficient quantity of Simple Syrup of Coral , whereof let her take the quantity of a large Nutmeg in the Morning , and at Five in the Afternoon , Drinking upon it Six Spoonfuls of the following Julap . Take of the Water of Oak Buds and Plantain , each ℥ iij , of Cinamon Water hor deated , and of Syrup of dry'd Roses , each ℥ i , of Spirit of Vitriol a sufficient quantity to make a pleasant Acid . Take of the Leaves of Plantain , and Nettles , each a sufficient quantity , beat them together in a Marble Mortar , and press out the Juice ; then clarifie it ; let her take Six Spoonfuls cold three or Four times a day . After the first Purge , apply the following Plaister to the region of the Loins . Take of Diapalma , and of the Plaister ad herniam , each equal parts , mingle them , and spread upon Leather . A cooling and thickening Diet must be order'd , only 't will be proper to indulge the Sick a small draught of Claret Wine , once or twice a day , whch though 't is somewhat inconvenient , because its apt to raise the Ebullition , yet it may be allow'd to repair the Strength . And as indeed this Method is very beneficial to Women thus affected , so is it also as useful for those that are in danger of Abortion , only the Purges and Juices must be omitted . There is another cause , though 't is not so frequent of Hysterical Diseases , viz. a falling of the Womb by reason of a hard labour , it s accompanied with a large train of this kind of Diseases , yet is it soon and easily cur'd this way . Take of Oak Bark ℥ ii , boyl it in lb iiij of Fountain Water to lb ij , add at latter end ℥ i of Pomegranate Peel bruis'd , Red Roses , Granate Flowers , each Mij ; and then add lb ss of Red Wine , strain it , bath the parts affected with Flannel Cloaths dipt in it , in the Morning Two Hours before the Woman rises ▪ and at Night when she 's in Bed ; continue the use of it till the Symptom is quite gone . But enough of these things . And now worthy Sir , I have mention'd the chief of what has been hitherto observ'd in the History and Cure of this Disease , and have nothing else to do but to beg your Pardon , if I have err'd in describing these things not so accurately as I ought to have done , and also to desire you to accept favourably of this small Treatise , which was designedly written to return you thanks for your approbation of my other Works : And indeed I have so seldom receiv'd any thing of this nature , that either ▪ I have deserv'd no such thing , or else those candid and ingenious Men which Nature has fram'd with such excellency of Mind , as to know how to be grateful , are very few , scarce so many as the Gates of Thebes , or Entries of Wealthy Nile . Yet notwithstanding I endeavour all I can , and will do so , to learn and promote the method of curing Diseases , and to instruct those that are less conversant in practice than my self , let other People have what Opinion of me they please . For having nicely weigh'd whether 't is better to be beneficial to Men , or to be praised by them , I find the first preponderates , and much conduces to the tranquillity of Mind . But as for fame and popular applause , they are lighter than a Feather or a Bubble , and more vain than the shadow of a Dream . But if any one thinks that Riches got by such a Reputation have something more of weight in them , let them injoy what they have scrap'd together with all my Heart , but let them remember that some Mechanicks of the most fordid Trades , get and leave more to their Children , yet do they not exceed the Beasts in this , who take as much care as they can of themselves and theirs ▪ and if we except things honest , proceeding from the judgment of the Mind and Vertue ( whereof the Nature of Beasts is not capable , ) the ▪ Beasts are plainly as good as these and all others who don 't endeavour to do all the good they can in their Generation . CHAP. IV. Of the Gout . WIthout doubt Men will think , that either the nature of the Disease we now treat of is almost incomprehensible , or that I who have been vex'd with it Thirty Four Years , am a very dull Fellow , seeing my Observations about the Disease , and the cure of it ▪ do little answer their Expectation . But however it be , I will faithfully deliver those things I have hitherto learnt , the difficulties and intricacy , respecting either the account of the Disease , or the Method of Cure , leaving them to be clear'd and made plain by time the guide of truth . The Gout chiefly seizes those Old Men , who after they have lived the best part of their Lives tenderly and delicately , indulging themselves freely with splendid Banquets , Wine , and other Spirituous Liquors ; and at length having by reason of the Sloath that always accompanies Old Age , wholly omitted those Exercises of Body which Young Men are accustom'd to . Moreover they who are obnoxious to this Disease , have large Skulls , and are most commonly of a Gross habit of Body , Moist and Laxe , and of a Lusty and Luxuriant Constitution , the best and richest Foundation for Life . Not that the Gout only seizes those that are Corpulent , for sometimes also though seldomer , it invades thin People ; nor does it wait always till they are old , for sometimes it seizes those that are in the flower of their Age , when they have receiv'd the unhappy Seeds of the Disease from their Parents , as it were ex traduce ; or if this be not the cause , they have too early us'd Venery , or have quite forsook violent Exercises that they us'd formerly ; moreover they have great Stomachs , and have drank Spirituous Liquors immoderately , and afterwards they have suddenly betook themselves to thin and cooling Liquors . When it first seizes any one when he is very old , it never afterwards has such exact Periods , nor rages so violently , as when it falls upon a younger Man , both because he dies most commonly before the Disease accompanied with its natural Symptoms can come to its heighth , and also because the native heat and vigour of the Body being lessen'd , it can't be so constantly and violently shot off upon the Joints . But if it seizes any one earlier , though it does not yet fix upon one part , nor handle him so roughly , but comes with uncertain periods upon occasion given , paining him lightly for a few Days , coming and going without any Method , yet by degrees it formally besieges the Man , and proceeds regularly , both as to the time 't will come at , and as to the continuance of the Fit , and moreover assaults him more violently than at first . I will first Discourse of this Disease as it proceeds regularly , and afterwards of its anomalous and uncertain Phaenomena , when being put out of its course , either by a praeposterous use of ▪ improper Medicines , or by the weakness of the Subject , it can't attain to its proper and genuine Symptoms . Therefore when the Gout is regular , it seizes the Patient most commonly after this manner , about the latter end of January , or the beginning of February , it comes suddenly , and for the most part without giving any notice , except that the Patient has been troubled with indigestion and crudities of the Stomach some Weeks before ; moreover the Body is oppress'd and puff'd up with Wind , which daily increases till the Fit thunders upon him ; but a few Days before it comes , the Thighs are benumm'd , and there is as it were a discent of Wind through the Flesh of them , with Convulsive Motions , and the day before the Fit the Appetite is sharp , but not natural . He goes to Bed and to Sleep well , but about Two a Clock in the Morning is wak'd by the pain , seizing either his great Toe , the Heel , the Calf of the Leg , or the Ancle ; this Pain is like that of dislocated Bones , with the sense as it were of Water almost cold , pour'd upon the Membranes of the Parts affected , presently shivering or shaking follow , with a Feverish Disposition ; the Pain is first gentle , but increases by degrees , ( and in like manner the shivering and shaking go off , ) and that hourly till towards Night it comes to its heighth , accomodating it self neatly according to the variety of the Bones of the Tarsus and Metatarsus , whose Ligaments it seizes , sometimes resembling a violent stretching or tearing of those Ligaments , sometimes the gnawing of a Dog , and sometimes a pressure ; moreover the part affected has such a quick and exquisite pain , that 't is not able to bear the weight of Cloaths upon it , nor hard Walking in the Chamber ; and the Night is not pass'd over in pain upon this account only , but also by reason of the restless turning of the part hither and thither ▪ and the continual change of its place . Nor is the tossing of the whole Body , which always accompanies the Fit , but especially at its coming , less than the continual agitation and pain of the tormented Member . There are a Thousand fruitless endeavours us'd to ease the pain by a continual change of the place whereon the Body and the affected Members lye , yet there is no ease to be had , 'till Two or Three a Clock in the Morning ( viz. a Night and a Day being spent from the first approach of the Fit , ) at which time the Sick has suddenly ease , by reason there 's a little Digestion of the peccant Matter , and some discussion of it , though he undeservedly attributes it to that position of the affected part he us'd last . And now being in a breathing Sweat , he falls asleep ; when he wakes , he finds the pain much abated , and the part affected swell'd afresh ; for before there was only ( which is usual in the Fits of those that have the Gout , ) visible , a Swelling of the Veins intermix'd with the affected Member . The next day , and perhaps Two or Three days after , if the matter apt to genetrate , the Gout is copious , the part affected will be in pain , which will be violent too towards Evening , but 't will be eased about the time of the Cock's Crowing ; within a few Days the other Foot will be in pain , as the former was , and if the former has left off aking , the weakness which render'd it infirm will presently vanish , strength and perfect Health being so presently restor'd , as if it had never been out of order , if the pain is violent in the Foot lately seiz'd . And yet it acts the same Tragedy in the other Foot as it did in the former , both as to the violence of the Pain , and the duration of it ▪ and sometimes on the first Days of the Disease , when the Peccant Matter is so exuberant , that one Foot is unable to contain it , it afflicts both at the same time with the like violence ; but most commonly it seizes them successively as we said : After it has vex'd the Feet , the Fits that follow are irregular , both as to the time of Invasion and Duration , yet the pain always returns in the Evening , and is less in the Morning , and of a Series of these small Fits , consists that which is call'd a Fit of the Gout , longer or shorter , according to the Age of the Sick ; for 't is not to be supposed , that when any one is afflicted with this Disease two or three Months , that that 's one Fit , but rather a Series and Chain of small Fits , whereof every latter is gentler and shorter than the former , till at length the peccant Matter being wholly consum'd , the Patient recovers his former Health , which in those that are brisk , and in others whom the Gout has rarely visited , comes to pass often in Fourteen Days , and in those it has often afflicted in Two Months ; but in those who are more debilitated , either by the long continuance of the Disease , or by age ; it does not go off till Summer coming pretty well on , drives it away . The first Fourteen Days the Urine is high Colour'd , which after Separatión puts off a red Sediment , and as it were full of small Sand ; nor does the Patient render by Urine more than the third part of what he Drinks , and the Belly is most commonly bound the said first Days , want of Appetite , shaking of the whole Body about Evening , heaviness and a troublesom uneasiness of the parts that are not affected , accompanies the whole Fit , a violent itching of the Foot affected , follows the departing Fit , especially betwixt the Toes , and the Feet scale as if the Sick had been Poison'd . The Disease being discuss'd , a good habit of Body and Appetite return , according to the degree of Pain with which the Fit last past rag'd ; and so proportionably the following Fit will be hasten'd or deferr'd , for if the last Fit was very severe , the following Fit will not come , till the same time of the Year return again . And in this manner , the regular Gout shews it self with its genuine and proper Phaenomena , but when 't is disturb'd by improper methods of Cure , or by the obstinate continuance of the Disease , the very substance of the Body being as it were , perverted to the Nourishment of the Disease ; and Nature unable to eliminate the same by its wonted method , then the Phaenomena are much different from those describ'd . For whereas the Pain was hitherto only troublesome to the Feet , ( which are the genuine seat of the peccant matter , and if it possesses any other Parts , 't is most certain , that either the method of the Disease has been alter'd , or that the vigor of the Body , is by little and little diminish'd ) now it possesses the Hands , Wrists , the Arms , the Knees , and other regions , tormenting these , as much as it us'd to do the Feet : For sometimes distorting one or more of the Fingers , it makes them like a bunch of Parsnips , taking away the motion by degrees , and at length it generates Stony Concretions about the ligaments of the Joints , which destroying the Cuticle , and the very Skin of the Joints , renders visible , naked Stones , like Chalk or Crabs eyes ▪ which may be pick'd out with a Needle . Sometimes the matter occasioning the Disease thrust upon the Arms , causes a whitish Swelling , almost as big as an Egg ; which is by degrees inflam'd with Redness , sometimes falling upon the Thigh , it feels as if there were a great Weight hanging upon it ; yet without any considerable Pain , but passing to the Knee , it handles that more severely , so hindering all motions , that 't is as 't were , nail'd to the Bed : So that it can't move a Hairs-bredth from the place wherein it is . And when by reason of the restlessness of the Body , or to ease Nature , the Patient must be mov'd by the help of others , there 's need of great care , lest by chance , the least contrariety of motion ▪ shou'd occasion Pain , which for this reason only , is tollerable , viz. because it presently vanishes : And indeed , this carrying of the Body , that must be perform'd so carefully and tenderly , is not a small part of the Troubles , wherewith the Gout is burden'd ; for the pain is not violent through all the Fit , if the part affected , be kept quiet . Whereas the Gout before , did not use to invade before the latter end of Winter , and was wont to go off , after two or three Months , now it continues upon the Sick a whole year , excepting only two or three of the hot Summer Months : And what is moreover to be observ'd , as the great and general Fit is longer than heretofore it was , so those particular Fits , whereof the general is compounded , rage longer ; for whereas before those particular Fits did not torment the Patient above a day or two , now wherever it fixes , especially if it possesses the Feet or Knees , it does not cease , till the Tenth or Fourteenth day , moreover the First or Second day after its coming , the Patient feels some Sickness , besides the Pain , together with a total prostration of the Appetite . Lastly , before the Disease was grown to such a heigth , the Sick did not only enjoy longer Intervals of the Fits , but also during that Intermission , he was well in his Limbs , and in the other parts of Body , all the natural Faculties performing their Offices duly ; but now his Limbs are contracted and cumbred , so that tho' he can stand , and perhaps go a little , yet he creeps along so very lamely and troublesomely , that when he walks , he seems to stand still ; and if he endeavours to walk beyond his strength , that he may the better recover his Feet , the more he confirms them by walking , and renders them less apt to receive the pain , so much the more the Fomes of the Disease not perfectly dissipated by all this interval , hovers more dangerously about the Bowels , when it can't be so freely discharg'd upon the Feet , which at this time of the Disease , are scarce ever free from pain , but are always uneasie more or less . The Sick is also afflicted with many other Symptoms , as with a Pain of the Haemorrhoidal Veins , with unsavoury Belchings , resembling the taste of the Meat last eat , putrifying in the Stomach , when something of hard Digestion is eaten , or only so much as is requisite for People in Health , the Appetite Languishes , and also the whole Body , by reason of a penury of Spirits . Lastly ▪ He lives only to be wretched and miserable , and not at all to taste of the Happiness of Life . The Urine that us'd to be formerly high colour'd , especially in the Fits , and render'd in a small quantity , now is like that , both for colour and quantity which is evacuated in a Diabetes : The Back and other Parts , itch troublesomely about Bed-time . And this Incovenience also happens in this Disease , when 't is confirm'd , viz. that upon yawning , especially in the morning , the ligaments of the Bones of the Metatarsus , are violently pull'd , and seem to be hardly press'd with a strong Hand ; and sometimes when yawning does not go before , the Sick just dropping asleep , suddenly feels a Blow as it were of a Club , breaking in pieces the Metatarsus ; so that he wakes crying out : The Tendons of the Muscles that sustain the Legs , are sometimes taken with such a sharp and violent Convulsion , that the pain which it occasions , if it should last but a little while , would overcome all Humane Patience . After many and dreadful Torments , and long execution , the following Fits as to Pain are more gentle , as a pledge of the discharge which approaching Death is about to give , ( Nature being partly oppress'd by the burden of the Peccant Matter , and partly by Old Age , is no more able to expel it constantly and forceably to the extremities of the Body , ) but instead of the accustom'd Pain , a certain Sickness with a pain of the Belly , Spontaneous weariness , and sometime a propension to a Diarrhaea supervene . These Symptoms ease the pain of the Limbs when they are violent , and likewise vanish when the Pain is in the Joints ; and sometimes the Pain ▪ and sometimes the Sickness afflicting alternatively , prolong the Fits much . For 't is to be noted , that when any one has had the Gout many Years , the Pain is by degrees lessen'd every Fit ▪ and at length he dies more of the Sickness than the Pain : For the Pain which is in these Fits ▪ though 't is longer , yet is it not the Tenth of that which he us'd to suffer when his Strength was more intire . But this Severity of the Disease is compensated most commonly by the longer space betwixt the Fits , and by the good Health he in the mean while enjoys . For in this Disease , pain is Nature's most bitter Medicine ; and the more violent it is , the sooner will the Fit pass over , and the longer will be the intermission and more perfect , and so on the contrary . Nor does the Pain , the lameness , and the obstructed motion of the affected parts , the Sickness and other Symptoms describ'd , compleat the Tragedy of this Disease : For it breeds the Stone of the Kidnies in very many , either because the Sick lies long upon his Back , or because the Organs of Secretion have ceas'd to perform their due Functions , or for that the Stone is made of a part of the same kind of Matter , but which is the cause I shall not determine ; whatever is the origine of this Disease , the Sick has sometimes many sad Contemplations , to know whether the Stone or the Gout is most severe ; and sometimes the Stone hindering the passage of the Water into the Bladder through the Urinary Passages kills him , not waiting any longer upon the Slow Gouty Execution . Nor is it enough that the Sick is tormented in such a Miserable manner , as that he can't help himself , but wants the help of others , but this is also added to the heap of his Sorrows ▪ viz. that during the Fit , his Mind is as it were affected with the Contagion , and so far suffers with the Body , that 't is difficult to say which of them is most afflicted , for every Fit may as properly be call'd a Fit of Anger , as of the Gout , for the Mind and Reason are so extreamly enervated by the infirm Body , that they are disorder'd by the least motion of the Affections , so that he 's as troublesom to others , as to himself : Moreover he is as obnoxious to the rest of the Passions , viz. to fear , care , and others of the same kind , by which he 's also vex'd , till the Disease going off , the Mind also has recover'd its former tranquillity . At length the Sick ( that I may dispatch the Catastrophe of this dreadful Disease , ) his Bowels being so hurt by hatching and embracing the Peccant Matter , that the Organs of Secretion can no longer perform their Office , upon which account the Blood stuff'd with Faeculencies stagnates , and the peccant Matter is not as heretofore cast upon the extream parts of the Body ; at length I say the thrice Miserable Wretch is so happy as to Dye . But ( which may be a comfort to me and others that are afflicted with this Disease , though we are but moderately furnish'd with Mony and the Graces of the Mind , ) so liv'd and so died great Kings and Potentates , Generals of Armies , and Admirals of Fleets , Philosophers , and many such as these . In a word , this Disease of the Joints ( which can scarce be said of any other , ) kills more Rich than Poor , more Wise Men than Fools , Nature shewing as it were with the Finger how just the Parent and Disposer of all things is , and how little he sides with Parties ; for those that want something , are wont to be abundantly replenish'd with an other kind of good , and he allayes profuse munificence , by mixing an equal share of Miseries with it ; so that 't is every where inviolably decreed , that no Man shall be perfectly happy , or compleatly miserable , but that all shall partake of both Lots , which mixture of good and ill , so proper to our frailty and mortality , is perhaps very fit for us . Women are very seldom troubl'd with the Gout , and if they are , not till they are Old or of a Masculine habit of Body : Thin Women who in their Youth or Middle Age are troubled with Symptoms resembling the Gout , receive them from Hysterical Diseases , or a Rheumatism which they were afflicted with heretofore , the Fomes whereof was not well carried off . Nor have I hitherto observ'd that Boys or Youths are vext with the true and genuine Gout , yet some that I have known , have perceived some small touches of it , before they have arriv'd to that Age , viz. when their Fathers had this Disease when they begat them . And here ends the History of the Disease . Having very much contemplated the various phaenomena of this Disease , I suppose it arises from the Concoction weaken'd , both in the parts , and in all the Juices of the Body ; for in those who are subject to this Disease , they being either worn out by Age , or having by Intemperance hastened Old Age , the Animal Spirits are decay'd throughout the whole Body , being consum'd by the immoderate exercise of the brisk Functions in the heat of Youth , for instance , by too early , or too much use of Venery , by Mad and Extravagant Labours , whereby they unweariedly serve their pleasures ; to which is to be added a sudden intermission or cessation from the Exercises of the Body , to which they have been heretofore accustomed , either by reason of Years or Laziness , ( by the use whereof the Blood was wont to be render'd more vigorous , and the tone of the parts more firm , ) upon which account the Body becomes now wither'd , and the concoctions are no more rightly perform'd ; but on the contrary the dross of the Juices of the Body which were discharg'd before by the help of such Exercises , are from henceforth laid up in the Vessels , as a Stock for the Disease . And sometimes hard Study or Meditation concerning some serious and lasting Matter , has increas'd the Disease , whereby the Fine and Volatile Spirits are too much diverted from their business of Concoction , which they ought to perform . Moreover they that are subject to this Disease , are not only most commonly greedy of Meats in general , but chiefly of those that are hardest to digest , whereof when they eat as much as they were wont to do when they exercised themselves , they are unable to digest them . Nor does the said voracity or full feeding , so frequently ( though it does often ) occasion the Gout , as the immoderate and mad drinking of Wine , whereby the ferments appointed for various Concoctions are wholly destroy'd , and the Concoctions themselves , and the natural Spirits are vanquish'd and dispers'd by the great quantity of adventitious Vapours . But when at one and the same time , the vigour of the Spirits that are the Instruments of Concoction are lessen'd , and moreover a great haep of Humours oppresses the Blood , 't is impossible that all the Concoctions should be duly perform'd , when all the Viscera are so overwhelm'd , upon which account the Spirits long ago weaken'd , are now suffocated . For if this were occasion'd only by a weakness of the Spirits , Women and Children , and those which long Sickness has wasted , would likewise be invaded by it ; whereas for the most part it seizes the Strongest , and those that have the most robust Principles of Nature : Yet it does not seize them , 'till Humours are heapt up , by reason of the defect and declination of the Natural Spirits , by which join'd together the vitiated Concoctions are perverted . Moreover as every one of the causes we have mention'd , promote indigestion , so most of them occasion a Looseness of the habit and muscules of the Body , by which means a passage is open'd for the receiving crude and indigested Humours , as often as they are protruded to the outward parts , and when lying long in the Blood , they increase in bulk and contract an ill Disposition , and at length acquire a putrifying heat , and can no longer be govern'd by Nature , they break forth into a Species , and fall upon the Joints , and by heat and sharpness occasion most exquisite pains in the Ligaments and Membranes covering the Bones , which being either weaken'd and loosen'd by Age , or by Luxury , or Intemperance , make room for them , when they make an attempt ; but this falling of the Humours that generate the Gout , which constitutes the Fit , happens sooner or later , as occasion is offer'd for putting these Humours into motion . As to the cure , ( I will first mention those things that are to be omitted , ) though if we respect the Humours and the Indigestion whereby they are occasion'd , it may seem at first , that the curative indications are chiefly to be directed for the Evacution of the Humours already made , and for corroborating the Concoctions ; so that the heaping up of other Humours may be prevented ▪ forasmuch as these are the more general Indications , whereby we should do the business in most other humoral Diseases ; but in the Gout there 's a kind of prerogative in Nature , for exterminating the Peccant Matter after its own way , by putting it off upon the Joints , and by discussing it by insensible transpiration . About Three ways are propos'd , whereby we may eject the containing cause of the Gout , viz ▪ Bleeding , Purging and Sweating , and yet neither of these Methods will ever perform the business . First , Though Bleeding may seem both to Evacuate those Humours that are just ready for a descent , and also those that have already besieged the Joints , yet it plainly opposes that indication , which the antecedent cause , that is , indigestion , arising from a depravation and defect of the Spirits , ( which Bleeding lessens and oppresses more ) requires , and therefore Bleeding is not to be us'd , either to prevent the Fit which is fear'd , or to mitigate that which is now present , namely , in ▪ those that are old ; for though that Blood that is drawn out , is most commonly like that of Pleuriticks , and of those that have a Rheumatism , yet Bleeding does as much hurt to the Sick in this Disease , as it does good in the Two just mention'd ▪ for if Blood is extracted in the intermission , though a good while after the Fit , there 's danger lest by the agitation of the Blood and Humours , a new Fit should be occasion'd more lasting than the former , and accompanied with more violent Symptoms , the strength and vigour of the Blood being blunted thereby , by the help of which the nourishment of the Disease should have been diligently and constantly expell'd . And this inconvenience happens as often as Bleeding is us'd at the beginning of the Fit , and if it be us'd presently after the Fit , there 's great danger , lest Nature , the Blood having not yet recover'd its former strength , weaken'd by the Disease , should be so much dejected by this unseasonably us'd , that a Dropsie should be occasion'd thereby . But if the Sick is yet Young , and has been over-heated by hard Drinking , Blood may be drawn at the beginning of the Fit ; but if in the following Fits it is continually us'd , the Gout is soon confirm'd even in Youth , and will more propagate its Tyranny in a few Years , than otherwise in a great many . And then as to Purging , whether upward or downward , this must be noted , that whereas by the inviolable Law of Nature annex'd to the very essence of this Disease , the Fomes of it ought to be expell'd always to the Joints ; Emetick or Cathartick Remedies will do nothing else , but recal into the Blood the Peccant Matter , which was put off by Nature upon the Extremities of the Body ; upon which account that which ought to be cast upon the Joints , rushes perhaps upon some of the Viscera , and so the Patient's Life is in danger , when before 't was not in danger at all . Which is often observ'd to be fatal to those who have been accustom'd to Purging Medicines , that they might prevent the Gout , ( or which is worse , ) to lessen the Fit : For when Nature is put by her usual method , whereby as being best and more secure , she drives the Morbifick Matter upon the Joints , the Humours are turn'd inward upon the Intestines , and instead of Pain in the Joints , where there is none at all , or certainly but very little , the poor Wretches are almost destroy'd by Stomach Sickness , Gripes and Faintings , with a great troop of irregular Symptoms . Therefore I am fully perswaded , having learnt by continual and repeated experience , that all Purging whether by gentle or strong Medicines , such as are usually design'd to purge the Joints , do much hurt , whether it 's us'd in the Fit to lessen the Peccant Matter , or at the end to dissipate the Relicks of the Disease , or in a perfect intermission or good health , to hinder the approaching Fit. For I have found at my own peril , as well as of others , that Catharticks administred at any of these times , have been so far from doing good , that they have hasten'd the Mischief they should have prevented . First therefore Purging when the Fit rages , disturbing Nature when she is busied in separating the Morbifick Matter , and in putting it off upon the Joints , sometimes occasions a great confusion of the Spirits , so that the Fit is not only increas'd thereby , but the Patient's Life also is not a little hazarded ; and then Catharticks us'd at the end of the Fit , instead of removing the Relicks of the Disease , bring on another Fit afresh , as bad as the former , and thus the Sick being vainly deceiv'd , contrives Misery for himself , which he had not felt , if the Humours had not been inrag'd again : Which inconvenience I have found often , having preposterously crav'd for Medical help , to expel as I thought the relicks of the Disease . Lastly , As to Purging to be repeated at certain intervals , and in perfect Health , to prevent the Fit , though which must be confess'd , there is not so much danger of a new Fit , as in the case just mention'd , when the Patient was not wholly freed , yet at this time it produces a Fit ; and if by chance the Patient is not presently seiz'd , yet it does not at all free him from the Disease , though he take this or that Purge constantly at due distances , for I have known some obnoxious to this Disease , who have not Purg'd only at Spring and Autumn , but also Monthly and Weekly , that they might recover their Health , and yet none of these have escaped the Gout , for most commonly it handl'd them more cruelly afterwards , and with worse Symptoms than if they had taken no Physick at all . For though the said Purging might take away some part of the containing cause , yet no way conducing to the corroboration of Concoction ( so far from that is it , that it debilitates the same , and wounds Nature afresh , ) it opposes only one cause , and so is wholly unable to cure the Disease . But this must be noted moreover , that from the same defect of the Spirits , whereby the Concoctions are vitiated , in those who are wont to have the Gout , the frame of the same Animal Spirits is render'd less firm and vigorous , so that 't is presently disturb'd by any cause , whereby the Mind or Body is somewhat violently mov'd , and so very fleeting and shatter'd is it , as it happens to those that are subject to Hysterick and Hypochondriacal Diseases . From which inclination of the Spirits to be disturb'd , it comes to pass that the Gout most commonly follows the least evacuation . The tone of the Body being dissolv'd , which the firmness of the Spirits whilst they continue vigorous , keeps compact and brisk , the Peccant Matter moves without resistance ; and by this injury to the Body a Fit is presently occasion'd . But how pernicious soever this Method is , yet some Empericks are much esteem'd for it , by cunningly concealing the Purging Medicine they use ; for it must be observ'd , that during the Purging , the Patient has little or no Pain at all ; and if Purging could be continu'd many Days , and no new Fit supervene , the Sick would presently recover of that he has now upon him ; but truly he will be dreadfully punish'd afterwards by the confusion into which the said agitation of the Humours has precipitated Nature . Lastly , The Evacuation of the Peccant Matter by Sweat , though it does less hurt than the foresaid Evacuations , yet it plainly appears to be injurious , for though it don't draw back the Fomes of the Disease into the Bowels , but on the contrary , drives it to the habit of the Body ; yet for these Reasons it does hurt . First indeed because when the Fit is off , it forces the Humours as yet crude and not prepar'd for Separation , upon the Limbs , by which means it brings the Fit before its time , and contrary to Nature's consent ; and then because the forcing of Sweat in the Fit , does cast the Morbifick Matter too violently upon the affected Member , and occasions at the same time an intollerable pain ; and if the quantity of the Peccant Matter is greater than can be contained in the affected part , it forces it presently upon other Members , and upon which account there is a great Ebullition and Fury of the Blood and other Humours ; and if the Body abounds very much with serous Matter , fit to generate the Gout , there 's danger lest an Apoplexy should be occasion'd . Wherefore in this Disease as well as in all other , wherein Sweat is provok'd by Art , to cast forth the Morbifick Matter , and does not come naturally , 't is very dangerous to force them out too violently , and beyond that degree of Concoction whereunto the Humours to be evacuated have come of their own accord . And that excellent Aphorism of Hippocrates , that things concocted , not crude , are to be medicated , is of as much use in provoking Sweat , as in Purging the Belly , which is very apparent in that Sweat that uses to come at the latter end of Agues , which if it is moderate and agreeable to the concocted quantity of Febrile Matter of the preceding Fit , much relieves the Sick ; but if it 's forc'd beyond Nature's bounds , by keeping the Sick continually a-bed , a continual Fever is occasion'd , and instead of extinguishing the former Fire , a new one is kindled . In like manner in the Gout , that gentle Breathing Sweat which most commonly comes in the Morning of its own accord after each of the small Fits , whereof as I have said the great Fit consists , mitigates both the pain and restlessness , wherewith the Sick has conflicted all the Night . But on the contrary , when at any time this gentle breathing Sweat that naturally soon goes off , is provoked longer and more violently than the proportion of Peccant Matter requires , the Disease is encreas'd thereby . Therefore in this Disease and in all other I have ever seen , except the Plague only , 't is not so much the Physicians , as Nature's business to force Sweat , because we can't know by any means what part of Matter is already prepar'd for such a Separation , and by consequence what Measures we are to take in provoking it . Now seeing it plainly appears from what has been said , that 't is not only in vain to endeavour the cure of the Gout by Evacuating Medicines , but that they are also injurious to Gouty People , it remains , that we inquire to what other end the curative Indications are to be directed . I indeed having accurately weigh'd , and diligently examin'd the foresaid Phaenomena , gather from thence that we must have respect to two causes chiefly in the cure of this Disease ; the first is the Antecedent cause , or the indigestion of the Humours arising from a defect of heat and natural Spirits ; the other is the containing cause , or the heat and boiling of the Humours , when they are putrified and grown sharp by remaining too long in the Body , which their delay is occasion'd by the indigestion above mention'd : These Causes are so absolutely contrary one to the other , that those Remedies that do good for this , are injurious for the other ; upon which account this Disease is so very difficultly Cur'd . For when we endeavour to remove Indigestion by hot Medicines , there 's danger lest on the other hand we increase the heat of the Humours ; and when on the contrary we would mitigate the hot and acrid Humours , either by cooling Remedies or Diet , we occasion Indigestion , the natural Heat being weaken'd . But here by the containing cause , I don't only mean that which actually besieging the Joints , forms the Fit , but that moreover which lurking in the Blood , is yet unfit for Separation ; for all the Morbifick Matter is very seldom so clearly ejected , how long and severe soever the Fit has been , as that there are no relicks of it in the Body , after the Paroxism is gone off , and therefore regard must be had to this cause , as well when the Fit is off , as when it rages . But forasmuch as the ejection of the containing Matter is wholly Nature's Business , it must be done by her Method alone , for nothing can be in the mean time attempted to asswage the hot and acrid Humours , without injury to the Digestions , only the Sick must forbear hot Medicines and Diet whereby the Humours are inflam'd ; so that certainly the greatest and chiefest intention of Curing , consists in helping Concoction , by removing Indigestions , of which I will now treat , yet so as that in the series of my Discourse , I may touch upon those Remedies occasionally , which conduce to the asswaging of the Heat , and sharpness of the Humours . Therefore whatever helps Nature in duly performing her offices , either by strengthening the Stomach , that it may concoct the nourishment well , or the Blood , that it may duly assimilate the Chyle brought into it , or by strengthening the Solid Parts that they may the better convert the Juices design'd for their nourishment and increase , into their proper substance . Lastly , Whatever preserves the Organs of Excretion , and the emunctories of the Body , in that state whereby the Faeculencies of each part may in due time and order be carried off , these and all things of this kind conduce to the fulfilling this intention , and are properly call'd Digestives , whether they are Medicines , or a Rule for Diet or Exercise , or any other of those things which are call'd the Six Non-naturals . These kind of Medicines in general , are those which moderately heat , and are either bitter , or gently bite the Tongue , for they are very agreeble to the Stomach , they purifie the Blood , and comfort the other Parts . For instance , they are such as these Roots of Angelica , Elecampane , the Leaves of Wormwood , the lesser Centaury , Germander , Groundpine , &c. also those that are vulgarly call'd Anti-scorbuticks may be added , as the Roots of Horse-Radish , the Leaves of Garden Scurvy-Grass , Water-Cresses , and the like . But yet these acrid and pungent Herbs , how pleasing soever they are to the Stomach , and how much soever they help Concoction , are to be us'd more sparingly than others that corroborate the Stomach by their gentle heat and bitterness , and render the Mass of Blood more brisk and lively , for they stir up the Fomes of the Disease that has been long form'd , and increase the Heat . Some Species of them neatly mix'd , are better in my Opinion to concoct the Humours , than any one Simple of their Tribe . For though when we have need of the Specifick Vertue of any Medicine , that Rule holds good , the simpler 't is , the better 't is ; but when we design to cure the Sick by satisfying this or that Indication , every Ingredient contributes somewhat for the cure of the Disease ; and in this case the greater the number of Simples is , the more powerfully does the Medicine work ; therefore various forms of Medicines tending to this end , may be neatly fram'd of the foresaid , and of the rest of the Materia Medica of this sort . I prefer an Electuary before the rest made like Venice-Treacle , as the most excellent , for that a mutual Fermentation of the Simples , increases the vertue of them all , as if it produc'd some third thing , which in the things so join'd , has greater vertue than any one of them in the same quantity . But I willingly leave the choice of such Ingredients , and the forms wherein they are to be given , to the prudent Physician ; for I never thought it my business to write Receipts as they call them , but rather to note the Indications , according to which the Methods of Cure are to be directed ; and this being not well minded , is the cause why Empericks boast that they are the chief of the Medical art . But for the benefit of Beginners , I will set down the remedy I am wont to use , which is compounded after this manner . Take of the Roots of Angelica , of the sweet Smelling Flag , of Masterwort , Elecampane , of the Leaves of Common Wormwood , of the lesser Centaury , of white Whore-hound , of Germander , of Ground-pine , of Scordium , of common Calaminth , of Feverfew , of Field Saxifrage , St. John's-wort , Golden-Rod , Thime , Mint , Sage , Rue , Carduus B. Penny-Royal , Sothernwood , of the Flower of Chamomel , Tansie , Lilly of the Vallies , English Saffron , of the Seeds of Treacle Mustard , Garden Scurvy-Grass , Carraway , Juniper-Berries , each a sufficient quantity ; let the Herbs and Flowers and Roots be gather'd when they have most vertue in them ; let them be dry'd , and kept in Paper Bags till they may be finely powder'd ; to six Ounces of each well mixt , add a sufficient quantity of purified Hony and Canary Wine , to make an Electuary ; take ʒij Morning and Evening . Or for want of this , use the following . Take of the Conserve of Garden Scurvy-grass ℥ iss , of Roman Wormwood , and of the Yellow Rind of Oranges , each ℥ i , of Candied Angelica , of Nutmegs Candied , each ℥ ss , of Venice Treacle , ʒiij , of Compound Powder of Wake Robin ʒij , make an Electuary , with a sufficient quantity of Syrup of Oranges ; let him take ʒij twice a day , drinking upon it Five or Six Spoonfuls of the following Water . Take of the Roots of Horse-Radish slic'd ℥ iij , of Garden Scurvy-grass , M. xij , of Water Cresses and Brook-lime , of Sage and Mint , each M. iiij , the Peel of Six Oranges , two Nutmegs bruis'd , of Brunswick Mum lb xij , distil them in a common Still , and draw only Six Pints of Water for use . Among the Medicines commonly known , Venice Treacle is the best to corroborate the Concoctions ; but because it contains a great many Species that heat too much , and besides , a great deal of Opium , the Electuary above-mention'd may be more commodiously prepar'd of the chief heating Vegetables ; but we must take care to choose such Simples as are pleasant to the Taste , for the Sick must take it a long while , viz. almost as long as he lives , and therefore 't is very requisite that they should be palatable ; among the Simples ; the Peruvian Bark is the best , for it strengthens the Blood , and renders it vigorous , if some Grains of it are taken Morning and Evening . And truly as in this Disease we now treat of , so in most other Chronical Diseases , these and such like Remedies that strengthen the Blood , and render it Brisk ( if their heat don't consist of Vinous Spirits , for reasons to be shewn hereafter , ) do most good , forasmuch as every Disease of this kind , if I conjecture right , ought to be referr'd to one and the same cause , viz. the indigestion of the Humours . But it can no way be made more apparent and better prov'd , than by setting in view the difference that is betwixt Acute and Chronical Diseases ; wherefore I hope the Reader will not take it amiss , if I do a little digress from the business in hand . As therefore those for the most part are accounted Acute Diseases , which either soon kill , or are brought to Concoction , so those are Chronical Diseases which either are not Concocted at all , or require a long time for their Concoction ; and indeed the very nature of the thing , as well as the words by which 't is express'd , plainly signifie as much ; but the cause of this difference which is perceiv'd betwixt these two kinds of Diseases , is more obscure , and not easily to be clear'd . I suppose 't will be worth our labour , to spend a little time in the search after it , for the clear and distinct knowledge of these things , contributes much towards the finding out true and agreeable Indications for the cure of these Diseases . Whether the innermost Bowels of the Earth , if it 's proper to say so , undergo various changes , upon which account the Air is infected by Vapours exhaling from thence , which seems very probable to me , or whether the whole Atmosphaere is infected by an alteration occasion'd by a certain Conjunction of Heavenly Bodies : 'T is most certain , that for this space of time , the Air is stuff'd with Particles which are injurious to the oeconomy of the Human Body ; and that at another time 't is impregnated with such Particles , as are Enemies to the Bodies of some species of Beasts . When at these times we breath into the naked Blood , the noxious Venom that 's an Enemy to Nature , and fall into those Epidemical Diseases which that is apt to produce , Nature produces a Fever , its usual engine to free the Blood from any disagreeable Matter that lodges within ; and such Diseases are commonly reckon'd Epidemical , and are therefore acute and short , because they have so quick and violent a motion . But besides these Diseases occasion'd by an External cause , there are others as acute , proceeding from this or that peculiar Inflammation of the Blood , which don't depend on any general cause from the Air , but on a particular irregularity or intemperies of particular Bodies , which kind of Fevers I call Intercurrent and Sporadick , which happen almost in all Years . But Chronical Diseases have quite another genius , for though an unhealthy Air of this or that kind may conduce much to the generating these Diseases , yet they don 't so immediately take their rise from the Air , but most commonly to the indigestion of the Humours , the common Parent of them all . For when any one has the Principles of his Nature weaken'd and worn out , either by Old Age , or by great and continual errors in the Six non-naturals , especially in Meat and Drink ; or if the Secretory Organs have been so debilitated , that they are wholly unable to purifie the Blood , and to carry off its Superfluities : In these cases a greater stock of Humours being heap'd up than a Man's strength is able to digest , the said Humours by long continuance undergo various Fermentations and Putrefactions , and at length break out in specie , and occasion various kinds of Diseases , according to the variety of Depravation ; and as these deprav'd Juices have a various disposition , so they variously fall upon this or that part which is fittest to receive them , and at length by degrees they shew their long train of Symptoms , which are wont to arise partly from the nature of such Juices , and partly from the Confusion brought upon those parts , which two join'd together , constitute the irregularity of Nature , which is mark'd with the name of some Disease . Now 't will plainly appear , that such an impotency of Nature for the concocting the Humours , is the chief cause of Chronical Diseases , if we consider that Old Men whose Concoctions are weaken'd , and the Spirits the Instruments of them wasted by the repeated functions of a long Life , are more subject to these Diseases than Younger People , whose flame of Life being more kindled , scatters those Feculencies heap'd up , and whose Secretory Organs are constantly assisted by the natural heat , that they may not be deficient in purifying the Mass of Blood , unless they are oppressed , and as it were suffocated by too great a quantity of Humours . Moreover that such an indigestion of the Humours , is the cause of most Chronical Diseases , is manifest from hence , viz. because Winter is much more apt to breed such Diseases than Summer ; though some of them don't actually break out till the latter end of Winter , yet the stock of Humours on which they depend , increasing all the Winter , is inlarg'd by that cold and raw Season , weakening Nature , so that she is not so able to preserve the oeconomy of the Body . Upon which account it happens , that they who are very well in Summer , seldom escape those Diseases in Winter whereunto they are most inclin'd . For instance , the Gout or Asthma , and a Cough , and the like . And from hence we may learn the reason why travelling into more Southerly Regions does so effectually vanquish those Diseases , the cure whereof is vainly attempted in colder Climates . The truth of what I have said already concerning the general cause of Chronical Diseases , will moreover manifest it self by that great and incredible relief which those that are afflicted with most Chronical Diseases , especially with a Phthisis , receive by Riding on Horse-back , which kind of Exercise invigorates and strengthens all the Digestions , the natural Heat being reviv'd by the continual shaking of the Body , and the Organs destin'd for Secretion , assisted in duly performing their Office of purifying the Blood , so that a Renovation of the ruin'd Digestions must necessarily follow , and by consequence , the best Constitution of Body . Wherefore 't is manifest enough by the reasons already alledg'd , that not only in the Gout , but also in other Chronical Diseases , where no manifest Symptom contraindicates ; such kind of hot Herbs are sometimes very beneficial , for they procure the heat of Summer , in the middle of Winter ; tho' if we accustom our selves to the use of them in Summer-time , they will the better prevent those Diseases , which the contrary Season is wont to occasion : And truly if they are deferr'd till Winter approaches , at which time a great deal of Matter is heapt up , 't is to be fear'd , we may fly too late to this Refuge . But tho' ( as I have discours'd largely above ) the Gout by a peculiar Disposition , is made worse by Catharticks ; yet in most other Chronical Diseases , Bleeding repeated as often as there is occasion , and Purging is to be order'd , before these digestive and corroborating Medicines are to be us'd ; but when the Patient has once enter'd upon the use of these , he must persevere , without Purging betwixt whiles ; for this must be constantly maintain'd , that as often as the Cure of any Disease is assay'd by corroborating Remedies , all Evacuations are wholly injurious . Lastly , I don't affirm that these digestive Medicines now mention'd , are better than all others ; but this I say , that he that can find out the best Remedy to answer this Intention , will do much more in curing Chronical Diseases , than he wou'd imagine he was able to do . But this must be first taken notice of , and chiefly observ'd above all the things I am about to mention concerning the Cure of the Gout , namely , That all digestive Remedies whatsoever , whether Courses of Physick , or Diet , or Exercise , are not to be taken up by the by , but must be us'd constantly and daily with the greatest Diligence ; for whereas in this Disease , as also in most other Chronical Diseases , the cause of it has pass'd into an Habit , and is become as it were a new Nature : No Man in his right Senses , can think that some small and short alteration , superinduc'd upon the Blood and Humours , by any sort of Remedy or Diet , can perfect the Cure ; for the whole Habit of the Body must be chang'd , and the whole Man must be as it were new fram'd ; for 't is not so here , as in some accute Disease , where he that even now was strong , and perfectly well , is suddenly seiz'd with a Fever , and precipitated from the best state of Health , into the most dangerous Disease . No , the case of the Gout is quite different , where he that for many years together , by immoderately indulging himself in Surfeiting and Drunkenness , and neglecting his wonted Exercises , is worn out by Sloth and Negligence , or by hard Study , or continual and intense Thinking , or by some other Errors of Life ; as if he had designedly perverted the various Ferments of the Body , and oppress'd the animal Spirits , ( which are the chief Instruments of Digestion ) by which means the preternatural Humours that were heapt up , break out at length , when they are arriv'd to the highest degree , and confound all , the Flesh being soften'd , and the Joynts weaken'd , so that they readily receive the Humours falling upon them . And so at length another Nature is as it were , superinduc'd by degrees , the pristine and natural oeconomy of the Body being wholly subverted , and destroy'd : And those Fits about which unwary and unthinking Men are so busied , are indeed nothing else but the Series and order of Symptoms , depending on that method which Nature is wont to use in driving out the Matter that occasions the Disease ; wherefore he labours in vain , that endeavours to drive away this Disease , by this or that Medicine or Regimen now and then us'd . For this Habit being chiefly founded , and consisting both in the weakness of all the Digestions , and in the want of the natural Strength of the particular Parts , we must provide against both these Ills , and the strength of Concoction , as well as the Soundness of the Parts , must be reduc ▪ d and restor'd by degrees to the former state and accustom'd oeconomy of the Body , tho' to do this fully and perfectly , may not seem possible , not only because any Habit is difficultly chang'd into the quite contrary , but also because Old Age which most commonly accompanies this Disease ▪ violently opposes ; yet the Cure is to be endeavour'd as much as the Strength and Years will permit : And the nearer or farther from this Mark the Patient is , he will more or less avoid the Tyranny of the Gout . And 't is moreover to be noted , That digestive Remedies , either medicinal or dietetic , are chiefly to be us'd in the Intervals of the Fits , and as long as may be before the next Fit ; for by reason of Old Age , much time is requir'd , and a constant use of Remedies , before the corroboration of all the Concoctions and the Restauration of the enfeebl'd Ferments of the Body , and such a Soundness as is requisite for the Blood and Viscera can be obtain'd . But tho these Remedies and other things of the same kind , may do good , yet this intention of corroborating , can't be answer'd by these things alone , but respect must be also had to those things which don 't properly belong to Physick . And he will be most certainly deceiv'd that thinks he can perform the Cure of this , or some other Chronical Disease , by Medicines alone . First therefore , a Mediocrity is to be observ'd in Meat and Drink , so that neither more Nourishment be taken in , than the Stomach can concoct , lest the Disease shou'd be heigthen'd by it ; nor on the contrary must the Parts , by too much Abstinence , be defrauded of that Proportion , whereby their Strength and Vigor ought to be sustain'd , for by so doing , they will be more weaken'd , for either is alike injurious , as I have often found in my self and others ▪ : Moreover , as to the quality of the Meat , tho' things of easie Digestion consider'd by themselves , are to be prefer'd before things of hard Digestion ; yet regard must be had to the Patients Palate : For we must take notice , That that which the Stomach earnestly craves for , tho' of difficult Digestion , is sooner conquer'd by Nature , than that which is accounted to be of easier Digestion , if it be offensive to the Stomach ; but those things that are reckon'd of hard Digestion , are therefore to be eaten more sparingly ; and I suppose the Patient ought to feed upon one sort of Meat at a Meal ▪ for various sorts of Flesh eaten at once , disturb the Stomach , more than one sort eaten in the same quantity . As to other things beside Flesh , let him eat at Pleasure , if they are not Sharp , nor Salted , nor Spic'd ; which tho' they don't hurt Concoction , yet are they injurious , for that they exagitate the Fomes of the Disease . As to the times of eating , a Dinner is only necessary ; for the Bed being most proper to digest the Humours , that time ought not to be wasted about concocting the Meat ; therefore they that are subject to the Gout , shou'd not eat Suppers , yet they may allow themselves a large Draught of small Beer , for such are also most commonly inclinable to breed the Stone in the Kidnies , the Concretion whereof , is much hinder'd by such a kind of Liquor , drank at this time ▪ the Reins being cool'd and cleans'd thereby . The drinking of Milk , or a Milk Diet , either crude or boyl'd , without any thing else , except perhaps a piece of Bread with it once a day , has been much us'd these Twenty years , and it has done more good to many , than any other sort of Remedy for this Disease , as long as they kept to it : But as soon as they return'd to common Diet , tho' of easie Digestion , the Gout return'd more violently than before , and held them longer ; for the Principles of Nature being weaken'd by this method , the Sick was render'd less capable to repell the Disease , upon which account 't was more dangerous and lasted longer . Therefore he that intends to betake himself to this method , ought first to consider seriously whether he can persist in the use of it all his Life long , which perhaps is not in his Power , how resolv'd so ever he may be . For I knew a Noble Man , who after he had been dieted with Milk only , a whole year with Pleasure , ( all which time , he went to Stool daily once or oftner ) was forc'd to leave it off , by reason he was suddenly bound in Body , and the Temper of his Body alter'd , and because his Stomach at length nauseated Milk , tho' the inclination of his Mind still continued . But some hypochondriacal People of a gross habit of Body , or who otherwise have accustom'd themselves much and a long while to spirituous Liquor , can by no means bear a Milk Diet. Moreover , that very short and fading Benefit that they receive by this Diet , to whom Milk is agreeable , proceeds hence , viz. not only for that this Diet is most simple , ( for I don't doubt but that Barly-Broath , if the Stomach will bear it , may do as well ) but also because it renders the Blood more mild and sweet by quelling the Acrid Particles in it ; and moreover , which I suppose is most considerable , Milk being a sort of aliment very unfit for grown People , suppresses that Turgescency of the Humours , which occasions the Gout ; and for that reason those few with whom a Milk Diet agrees , are so long free from the Gout as they feed upon it , and no longer ; for by being wholly contrary to the original cause of the Gout , viz. the weakness of the Ferments and Concoctions , 't is much more injurious than beneficial . And because this has not been sufficiently regarded , some unwary People have fell into great and fatal Errors ; for by endeavouring to oppose the containing cause , viz. the heat and sharpness of the Humours , they have destroy'd the concoctions and all the natural Functions . As to Liquors , those in my opinion are best , that are neither as strong as Wine , nor as weak as water , of which sort is our London Small-Beer , with or without Hops ; for extreames on either hand are hurtful . First as to Wine , tho' the Proverb says , Drink Wine and have the Gout , and drink no Wine and have the Gout : Yet 't is without Controvesie , and confirm'd by various Experiments of gouty People , that Wine de facto is injurious . For tho' it may be suppos'd to do good by helping the Concoctions , the Disorders whereof , I have long accounted the antecedent cause of the Gout ; yet with respect to the containing cause , it mst be reckon'd wholly injurious , for that it fires and exagitates the Humours , the Fomes of the Disease , already prepar'd to give Battel : Yet I don't grant that Wine us'd for ordinary drink , does promote Concoction , but rather spoyls it , unless in those that have been accustom'd to Wine a long while ; for tho' as it passes by it imparts some Heat , yet it certainly injures the Ferments of the Body , and destroys the natural Spirits ; and for this reason I suppose , great Drinkers dye of the Gout , Dropsie , Palsie and other cold Diseases . Moreover , a continual and immoderate swilling of Wine , renders the Body soft like Womens Bodies , whereas temperate Liquors strengthen and confirm the Tone of all the Parts ; for which reason , they that have always us'd small Liquors , seldom know what the Gout means . 'T is moreover to be noted , That those Men are most inclinable to this Disease , who tho' their natural Concoction is lessen'd , are nourish'd more than enough by reason of a certain Luxury of the Blood , and they grow bulky by some indigested Matter , instead of good Substance and well compacted . And drinking of Wine does more increase this Luxury of the Blood ; and moreover , heaps up a new Stock of Matter , and actually occasions the Disease , by firing as it were the Fomes of it , which has been laid up a long while . And besides , the Blood of gouty People , being very like that which is taken from those that have a Pleurisie , or some other inflamatory Disease ; 't would be a mad thing to inrage it more with spirituous Liquors . Nor on the contrary , are Liquors too much cooling to be us'd ; for these by quite spoyling the Concoctions , and by extinguishing the natural Heat , occasion the greater Mischief ; not Pain as Wine does , but Death it self : As Experience teaches in those who freely indulging themselves in drinking Wine , till they are Old , and betaking themselves suddenly to drink Water or small Liquors , have soon destroy'd themselves . Therefore those that are subject to the Gout , must take care that they use those Liquors , that can neither cause Drunkenness when they are taken in a large quantity , nor yet injure the Stomach by chilling it ; of this kind as I said , is our Small-Beer , and a proper Liquor may be made in other Countries , by mixing a little Water with a great deal of Wine . I count Water by it self , crude and injurious , and I have found it so to my hurt . But Water may be safely drunk by young People , wherewith at this day , the greatest part of Mankind quenches Thirst , being more happy with their Poverty , than we with Plenty and Luxury . To confirm which , I produce that great Train of Diseases , whereby our Bodies on this accout are tortur'd , viz. the Gout , Stone , Apoplexy , Palsie and the like ; and that Violence upon the Mind , whereby 't is driven contrary to its native Rectitude , while the adventitious Spirits of such Liquors , complicated with the animal Spirits , serving for the forming Thoughts , disturb the Mind , by volatilising it too much , suggesting vain and frivolous Fancies , instead of things that are solid and of some moment ; and so makes us Jesters and merry Fellows , instead of Wise Men , between which , the difference is almost the same , as betwixt a Substance and a Shadow : But enough of this . But now , tho' it may be sufficient for him that has the Gout but a little , and at some times only , to use Small-beer and diluted Wine , the degree of his Disease not requiring a more sever usage ; yet when the whole Substance of the Body is as it were , degenerated into the Gout , he will be less able to conquer the Disease , who does not wholly abstain from any sort of fermented Liquors , tho' Small and Mild ; for all these contain a pungent Spirit , and some degree of Sharpness , and what is worse , as they have a Ferment in them , ( even as Yeast put into Liquors , imparts a fermentative Vertue to the whole Mass ) so they incline the Humours to a perpetual Fermentation . Therefore a Dietetick Drink must be prescrib'd of the Ingredients commonly known and appointed for this use , for ordinary Drink , if it be not too strong , for if so , the Humours will be almost as much inrag'd as by Wine : And on the contrary , it must not be so small , as to injure the natural Functions , by over-cooling them . This sort of Drink if it be made of such Ingredients as are least displeasing to the Sick , tho' the constant taking them , may cause some loathing for a Week or too , will afterwards be as pleasing and as acceptable , as any other Liquors to which he has been most accustom'd . And by this kind of Liquor , the Appetite will be increas'd , and become more natural than it us'd to be with fermented Liquors . And moreover , there will be this advantage , that he that uses this dietetick Liquor for his ordinary Drink , may the freer indulge himself in other Diet , than when he drank Beer or Wine , for the Errors in Diet ( all which 't is almost impossible for a Man to avoid ) will by this means , be somewhat corrected and amended . But which is the chiefest of all , the Sick may prevent the Stone by this means , which is usually the constant companion of the Gout ; for all sharp and attenuating Liquors , occasion a Fit of the Stone , as well as generate it . The following Liquor being of a pleasant Taste and Colour , pleases me best . Take of Sarsaparilla ℥ vi , of Sassaphras , China , and the Shavings of Harts-horn , each ℥ ij , of Liquorish ℥ i ; boyl them in Two Gallons of Fountain Water for half an hour , afterwards let them stand cover'd upon hot Ashes 12 hours , afterterwards boyl it to the consumption of a Third part ; as soon as 't is taken from the Fire , infuse half an Ounce of Anniseeds , after 2 hours strain it , and let it stand till it 's clear ; keep the clear Liquor in Glass Bottles well stopt for use . This Liquor is most conveniently us'd at first , when the Patient recovers of the Fit , and he must persevere in the use of it all the rest of his Life as well when he has the Fits , as at other times . At the same time the foresaid Electuary must be us'd daily , as well in the Fits , as when they are off ; the Heat of this will somewhat allay the Waterishness of the dietetick Drink , affording a due degree of heat to the Blood and Bowels , without that agitation which us'd to be occasion'd by the heat of fermented Liquors . If any one shou'd object that that Life is scarce vital , wherein a total Abstinence from Wine and other fermented Liquors is observ'd : I answer , it must be consider'd whether it be not much more miserable and less tolerable , to be rack'd and dreadfully tortur'd by the Gout , grown strong by continuance , ( for when the Disease is gentle , this is not requisite ) than to be confin'd to this Liquor ; the use of which being continued , he may indulge himself in almost all sorts of Food : Not to repeat now that this Drink ( as all other things ) grows pleasant by custom . Certainly he that has felt this Disease , if he be a Man , will not long dispute which is best . Yet notwithstanding , if the Sick by reason of a long and too great use of intoxicating Liquors , or by reason of Old Age or Weakness , can't concoct his Meat without Wine or some other fermented Liquor , he can't leave it off suddenly without great danger , the doing whereof has been fatal to many . Therefore in my opinion , he shou'd not use the dietetick Apozem above describ'd ; but if he be resolv'd to use it , let him be accustom'd to it leisurely , ( drinking a Draught of Wine at Meals for some time ) more like a Remedy than a Diet , till the Decoction becomes more familiar : But Spanish Wine is to be preferr'd in this case before French or Rhe●●sh Wine , the two last being apt to inrage the Humours , and to increase the Fomes of the Disease , tho' they are very grateful to the Stomach . Moreover , they are almost as crude , and scarce more concocted than our Syder , and besides they are not so cordial and hot , as the case requires . And so much may suffice for the Meat and Drink of gouty People . There 's another thing which tho' it may seem small , yet is it of great moment , as well for digesting the Fomes of the Disease , when the Fit is violent , as for hindering the generation of the Matter , when the Fit is off ; namely , that the Sick , especially in Winter , go to Bed early ; for besides , Bleeding and Purging , nothing does so much destroy the strength of Nature , as watching a Nights , which every sickly person can affirm by Experience , if he considers how much brisker and more chearful he rises ▪ when he goes to Bed early , and how languid and faint he is when has sat up late ; and tho' it may seem as well , if he lyes a Bed so many hours , whether he goes to Bed sooner or later : For instance , whether he goes to Bed at Nine , and rises at Five , or goes to Bed at Eleven , and rises at Seven ; yet 't is not so , and I suppose chiefly for this reason , viz. in the Day-time the Spirits are dissipated , either by the Exercise of the Body or Mind , which in People that are sickly , are so infirm and weak , that they have need of Rest earlier in the Evening ; for the approach of Night occasioning as it were , a kind of Relaxation of the Economy of the Body , which was kept up in the Day-time , by the influence of the Sun ; 't is necessary that the heat of the Bed shou'd supply the want of the Sun , especially in Winter . But in the Morning , the Spirits being refresh'd and invigorated by the rest of the foregoing Night , and the warmth of the Bed , ( besides , for that the supervening day adds Firmness and Strength to the Tone of the Body ) rising early at this time , tho' an hour or two is taken from the Morning Sleep , Nature is not so much injur'd as by Evening Watchings protracted an hour or two . Wherefore I wou'd perswade those that are subject to the Gout , to go to Bed early ; especially in the Winter , and to rise early , tho' Sleep somewhat shorter , may intice them to lye longer ; for sleeping in a Morning , prevents so much Sleep the next Night , and so at length , a force being brought upon Nature , and its wise Institutions despis'd , Night is turn'd into Day , and Day into Night . Moreover , Tranquility of Mind , must by all means be obtain'd ; for all Perturbations , when they break the Bounds , mightly dissolve the frame of the Spirits , that are the Instruments of Digestions ; and so by consequence , much promote the Gout . Therefore the Sick shou'd prudently consider his own mortal Condition , and not foolishly imagine that he is freed from those Troubles , that necessarily follow it ; for whether he suffers this Affliction of Mind , either by his own Fault , or Fault of others , he can never prescribe Laws to the World , who has not been always obedient to any one , how Potent and Wise soever he has been ; nor does ever all things fall out so exactly , according to any ones Mind , as he fondly imagines , but suddenly as he is busied in Mind about the ordering of things , he becomes the Specimen of humane Frailty , having unreasonably depriv'd himself of the Enjoyment , of the fading Fruits of Life . The same Inconvenience , follows too great an Application of Mind to Study and serious things ▪ for Melancholy always accompanying this Disease more than any other , those that are subject to it , are wont to tire and overwhelm the Animal Spirits , by thinking much and long , without the artificial help of Books ; and they do so mightly overthink , that the oeconomy of the Body , can't any longer preserve it self whole : For which reason in my opinion , this Disease seizes ( except my self if you please ) very few Fools . But the Exercise of the Body is more profitable , than all other things that are us'd to hinder the Indigestion of the Humours , ( which I reckon the chief cause of the Gout ) and to corroborate the Blood , and to restore strength to the Parts : But it must be noted , which I have mention'd above , that as in this Disease , more than in any other Chronical Disease , the Habit of the whole Body ought to be chang'd , ; the Exercise of the Body , unless 't is daily , will do no good ; for this kind of Exercise intermitted by turns , as it does scarce conduce any thing ▪ to the change of the Habit of the Body grown Languid and Esseminate , by Sloth and Indulgence , so perhaps it may prove injurious , by occasioning the Fit when the Patient has disus'd it a long while . But this exercise ought not to be violent , but such as is agreeable to Old Men , which are most usually the subjects of the Gout . For too violent a motion of the Body does too much dissipate the Spirits , and by consequence hurts the Concotions , whereas constant and moderate Exercise strengthens them . Though this may seem hard to a Man , who besides Old Age and Sloth , and the unfitness of the Body for motion , which is as it were natural in this Disease , is moreover punish'd with Pain ; and yet if this be omitted , nothing which has been already found out will do any good . And as the Intervals of the Fits without constant Exercise of the Body can't be long , so such a one will be more prone to breed the Stone , which is more dangerous and more tormenting than the Gout . Moreover ( which is of great moment ) the Stony Matter is much increas'd by long rest in the Joints of the Body , especially of the Fingers , so that at length they are wholly deprived of all motion . For how confidently soever some People affirm , that the Matter ▪ of these Stones is nothing else but the Tartar of the Blood put off upon the Joints , yet 't will easily appear to any one that does a little weigh the thing more seriously , that when a great deal of unconcocted Matter causing the Gout , flows upon some of the Joints , and renders the neighbouring parts tumid a long while , at last it happens that partly by reason the assimulative vertue of these is choak'd , and partly by reason of a suffocating obstruction which this dull Humour breeds in them , the said Matter is generated , which is turn'd into this kind of Substance by the heat and pain of the Joints , and is daily increas'd , changing the Flesh and Skin into its own nature , which now lies naked , and may be pick'd out with a Needle , and is like Chalk , or Crabs Eyes , or some such thing . But now this ill may be prevented by daily exercise , by which the Humours causing the Gout , which are apt to seize on one part , are duly scatter'd through the whole Body . So that it come to pass as I have observ'd in my self , that long and daily exercise does not only hinder the generation of this Stony Matter , but also dissolves the Stones when they are hard and old , if they have not prevail'd so far , as to change the outward Skin into their own Substance . As to the kind of Exercise , riding on Horseback , when Old Age or the Stone does not hinder , is much to be preferr'd before the rest : And truly I have many times thought with my self ▪ that if any one knew a Medicine which he cou'd also conceal , as effectual in this and most other Chronical Diseases , as constant and daily riding on Horse-back , he might easily get a vast Estate . If this can't be us'd , riding in a Coach does almost as well ; and on this account at least 't is well with Gouty People , for their Riches which enticed them to Luxury ▪ whereby the Disease was bred , can provide them a Coach , which kind of Exercise they may use , when they can't the other . But 't is to be observ'd , that 't is best to use Exercise in a good Air , viz. in the Country , and not in a City , where the Air is fill'd with Vapours exhaling from the Shops of various Artificers , and thicken'd by the closeness of the Buildings , as 't is here in London , which is generally suppos'd to be the most spacious City in the whole World. But how great the difference is betwixt Exercising in the Country , and Exercise in Town , any one that has the Gout will soon find . As to Venery , he that is Old and Gouty ( being now destitute of a stock of Spirits , whereby the Concoctions ought to be promoted , and by consequence his Joints and the neighbouring parts to them are but too much weaken'd and loosen'd without this adventitious destruction , ) is equally as improvident in my opinion , if he indulge himself in these allurements , as he that having undertaken a long Journey , should consume all his Provisions before he sets out ; for besides the Mischief he brings upon himself by not restraining the impotent desires of feeble Age , he deprives himself of the great priviledge of injoying that Jubile which is reserv'd as the great and special favour of Nature for Old Men only , whereby in the last Scene of their Lives , they are at length emancipated from the impetuosities of Lust , which like a ravenous Beast worried them all the time of their Youth Night and Day : For the full satisfaction of these Appetites , can no way compensate for that long train of Miseries that either accompany or follow it . And so much for the Regimen . But though Rules of this kind respecting Diet and the other Regimen , if they are carefully observ'd by those that are subject to the Gout , may preserve them from violent Fits of it , and may restore that strength to the Blood and Solid parts ▪ whereby they may be freed from the many Miseries , on which account this Disease exceeds Humane Patience , and at length becomes Mortal ; yet after some intervals , especially at the latter end of Winter , they will be sometimes seiz'd with the Gout ▪ for though in the Summer-time , when the tone and vigour of the Blood is excited and preserv'd in its state by the heat of the Sun , and there is likewise a due Elimination of the Humours through the Pores , 't is reasonable to suppose , that the Concoctions should proceed much better than in the Winter ; yet when Winter approaches , the strength of the Blood being lessen'd , and the perspiration through the Pores hinder'd , there must needs be a great heap of indigested Matter , which by its long continuance causes a Fit , as soon as occasion is offer'd , either by the Humours put into Motion by the Patients so near approach to the Sun , or by drinking of Wine , or by violent Exercise , or any other evident cause . 'T is manifest from what has been said , that he that endeavours to cure this Disease , ought to make it his business to change the habit of his whole Body , and to restore its old Constitution , as much as Age and other Circumstances will permit , which must be endeavour'd in the Spaces betwixt the Fits ; not when the Fits are on , for when the Fomes is not only generated , but now is cast upon the Joint , 't is too late to strive to change it , or to cast it out any other way , for 't is to be ejected by no other method than Nature shews , wherein alone we must acquiesce ; which is observ'd in the Fits of Agues , and for which-reason we do nothing till the heat is over : Nor is he more absurd , that is anxiously busied about taking off the heat , drouth and restlefness , and other Symptoms of these Fevers , than he that thinks he has cur'd the Gout , when he has only labour'd to restrain the Symptoms ; for by this means he has only made the cure of it more difficult ; for the more he eases the Pain , the more he obstructs the Concoction of the Humours , and the more he takes off the Lameness , the more he hinders the expulsion of the Morbifick Matter . Moreover the more the fury and the sharpness of the Fit is suppress'd , 't will not only last longer , but the space betwixt the Fits will also be shorter , and less free from every degree of the Symptoms which accompany this Disease ; which no one will deny that has well consider'd what I have treated of above concerning the History of this Disease . But now though no great Matter must be attempted during the Fit , only the removing those Symptoms , which a false method of cure sometimes occasions , yet seeing all allow that this Disease proceeds from an abundance and an exuberancy of Humours , it may perhaps be convenient for the Patient to abstain from Flesh for some Days when he 's first seiz'd , and instead of it , to use Simple Barly Broth , or some such kind of Food , which sort of thin Diet conduces much towards the lessening the Morbifick Matter , and will give Nature an opportunity to digest it sooner . But forasmuch as there 's a vast difference betwixt the Body of one Person and another , some not bearing abstinence from Flesh , but by reason of it are seiz'd with a confusion of the Animal Spirits , with Fainting , and other Symptoms which are wont to befal Women that are subject to Hysterical Fits , these People are injur'd if they forbear Flesh any longer than their Stomachs loath it , which seldom lasts beyond the first or second day of the particular Fits , all which join'd together as I mention'd above , make a whole Fit ; but whether any one eat Flesh sooner or later , great care must be taken , that they eat no more during the Fit than is necessary to sustain Nature . Nor is less care to be taken about the quality of the Diet ; for as in the intervals of the Fits , so more especially when the Fit is present , the Sick ought to take the greatest care , that he don't at all err in the quality or quantity of his Meat or Drink . And moreover , more than ordinary care must be taken in observing every other Regimen , as well as this in the intervals ; and though the pain as well as the unfitness for motion , may seem to contraindicate Exercise which I have commended above all others things , yet this labour must be undertaken . For though at the beginning of the Fit it may seem impossible that the Sick should bear to be carried into a Coach , and to be sure he 's much less able to bear the motion of it , and yet if he try it , he will soon perceive that he 's less pain'd by such a motion , than when he keeps at Home in his Chair . And moreover he has this advantage , if he ride some Hours in his Coach , in the Morning , and after Dinner , that whereas when he sat at Home all day , he lay awak'd the greatest part of the Night , now he can sleep away the pain a great part of the Night ; for very moderate Exercise does so weary a Gouty Man , that he falls asleep : And besides the same Exercise does somewhat prevent the Stone , which an easie Life most commonly occasions . But what is most considerable , the total impotence of the Limbs for motion , is help'd by constant Exercise , which happens to many after the First or Second Fit , the Tendons of the Hams and Heels being contracted ; for when by reason of the tormenting Pain they have allow'd themselves to lye still a long time ( being unwilling to extend their Legs when the Pain has seiz'd their Knees , ) at length they are depriv'd of the motion of their Legs and Feet all the rest of their Lives , as well when the Fits are off , as when they are on , for they are not freed from them . Furthermore in Old Men , whose Concoctions are much vitiated , and who by reason the Disease has afflicted them many Years , have as it were the very substance of their Bodies turn'd to the Gout , 't is not to be hop'd that the Disease without Exercise , can ever be brought to Digestion ; for when the Disease is too strong for Nature , they often dye by Fainting and Sickness , which the abundance of the furniture for the Disease that can't be concocted produces , and they are destroy'd by this matter , that can't be concocted as by Poyson . But notwithstanding what has been said of the Utility of Exercise in the Fits of the Gout , yet if the Sick by reason of the violence of the Fit , is as it were overwhelm'd presently by the first assault of it , ( which happens to those for the most part in whom the Gout has now come to its height , nor is yet grown gentle by a course of many Years , ) in this case if the Sick is confin'd to his Chamber , 't will also be convenient that he keep his Bed for some of the first Days , 'till the violence of the Pain is abated , for the Bed does somewhat supply the want of Exercise , for the continual use of it does more powerfully digest the Morbifick Matter in a few Days , than keeping up in many , especially at the beginning of the Disease , if the Sick can abstain from Flesh without Fainting or other ill Symptoms , and can be contented only with Barly Broth , Small Beer , and the like . But we must take notice that if the Gout is inveterate , and inclines the Sick to Fainting , Gripes , a Looseness , and such kind of Symptoms , he will scarce avoid being destroy'd by one of the Fits , if he don't use Exercise in a free and open Air : For a great many Gouty People have perish'd by these Symptoms , to whom they have been obnoxious by being confin'd to their Chambers , and especially to their Beds ; whereas had they bore the fategue of riding in a Coach the greatest part of the Day , they had not died so soon . For though he that is troubled with Pain only in one of his Limbs , may confine himself to his Chamber , yet another that instead of violent Pain is afflicted ▪ with Sickness , and the other foresaid Symptoms , should he do the same , wou'd endanger his Life ; and indeed 't is well for the Sick when the pain is so violent , that he can't bear motion , for then there 's no great need of it , the very pain which is the bitterest Remedy in nature , securing his Life . But as to the Symptoms of the Gout , we must apply our selves to those whereby the Life of the Patient is indanger'd ; the debility and faintness of the Stomach , with Gripes of the Belly as from Wine , is the most frequent of these which befalls those who either have been subject to the Gout many Years , or those who though they have not been long afflicted with it , have notwithstanding invited this mischief too early , by suddenly changing Spirituous Liquors for those that are thin and much cooling , or by applying repelling Plasters , and other cooling Medicines to the Parts affected , to asswage the Pain ; upon which account the material cause of the Disease which ought to have been put off upon the Joints , is cast upon the Bowels . I have tried many things for the Fits of the last Years to lessen this Symptom ; but nothing did so much good as a small Draught of Canary Wine taken now and then , when the Sickness and Faintness afflicts the Sick : Nor is Red French Wine , nor Venice Treacle , nor any other Cordial thing which I have yet known , so effectual . But we must imagine that neither this Wine , nor any other Cordial if Exercise be not us'd , can wholly preserve the Patient . But if any great Symptom scarce bearing a Truce comes suddenly by reason of the striking in of the Gouty Matter , and threatens Death , we must neither trust to the Wine , nor to the Exercise above commended ; but in this case , if it does not fall upon the Head , but upon the Natural or Vital Parts , we must presently fly to Laudanum , namely , give Twenty Drops of Liquid Laudanum , mix'd with a small Draught of Epidemick Water , and let the Patient compose himself to rest in his Bed. But if the Matter occasioning the Gout produces a Diarrhaea , because 't is not yet cast upon the Limbs , if it be not the Crisis of a particular Fit , and if notwithstanding Laudanum above commended , and Exercise of all sorts , ( for this must be first used for the Cure of the Diarrhaea , ) the Looseness continues , accompanied with Sickness and Gripes , there 's only one Remedy that I know of , viz. to provoke Sweat , by a Method and Medicines design'd for this use , which if it be done Two or Three Days , Morning and Evening , for Two or Three Hours at a time , it most commonly stops the Looseness , and forces the Fomes of the Disease upon the Limbs . I cur'd my self by this Method some Years ago , after I had imprudently cast my self into this Disease by Drinking Water for my ordinary Drink , when I had us'd Cardiack and Astringent Medicines of various sorts in vain . There is another Symptom not so frequent , though I have seen it divers times , viz. a translation of the ●eccant Matter upon the Lobes of the Lungs , when a Winter Cough by reason of Cold taken in the time of the Fit , has by degrees drawn the Matter upon the Lungs , the Limbs in the mean while being wholly or almost freed from the Pain and Swelling , by reason of the translation of the Morbifick Matter upon another region ; in this one case the curative indication is not to be directed to the Gout , but this Symptom is to be treated as a true Peripneumonia , viz. by Bleeding repeated , and Cooling and Thickening Remedies and Diet ; for the Blood drawn in this Symptom especially , is exactly like the Blood of Pleuriticks . Moreover the Sick must be Purged betwixt the Bleedings , whereby the Filth that 's fallen upon the Lungs may be carried off . But Sweating how powerful soever 't is in forcing the Fomes of the Disease upon the Limbs , does hurt in this case , by hardening the Matter that 's thrust upon the Lungs ; upon which account small abscesses are generated , and at length the Sick certainly dies . Moreover 't is to be noted , that almost all Gouty People , when they have conflicted a long while with this Disease , are subject to the Stone of the Kidnies ; and that they are wont to be troubled with Nephretick Pains , either in the state , but most commonly at the declination of a general Fit , which don 't only torture him much , but also weakens him much , whereas he was but too much weaken'd and worn out before . In this case , setting aside all other Medicines , let him presently take a Gallon of Posset-Drink , wherein ℥ ij of the Roots of Marsh Mallows has been boyl'd , and let the following Clyster be injected . Take of the Roots of Marsh-Mallows , and Lillies , each ℥ i , of the Leaves of Mallows , Pellitory of the Wall , Bears Breach , and of the Flowers of Chamomel , each M i , of Flax and Fennugreek Seeds , each ℥ ss , boil them in a S. Q. of Water to lb iss , dissolve in the straining of Brown Sugar and Syrup of Marsh-Mallows , each ℥ ij , mingle them , and make a Clyster . As soon as he has render'd all the Posset-Drink by Vomiting , and has rejected the Clyster , let him take a large Dose of Liquid Laudanum , viz. to xxv Drops , or xv Grains of Mathew's Pill . If any one inquires for External Remedies to ease the Pain of the Gout , I have hitherto known none , ( though I have tried many in my self and others , ) excepting things meerly cooling and repelling , the use whereof I have shew'd above is dangerous . And I considently affirm , that the greatest part of those who have perished in the Gout , have not so properly been kill'd by the Disease , as by an improper use of Medicines . But if any one will try the vertue of External Remedies , which are certainly accounted Anodines , don't let him impose upon himself , by applying them at the declination of a particular Fit , at which time the Pain is about to cease of it self ; but rather let him use them at the beginning of a Fit , and then he will soon perceive how fruitless they are , and how vain his hopes . For indeed these Epithems may do hurt sometimes , but they can never do any good . For which reason I have us'd no External Remedies many Years . The Pultis made with White Bread and Saffron boil'd in Milk , adding Oyl of Roses in small quantity , did heretofore do me more good than other things , and yet this signified nothing at the beginning of the Fit. Therefore if the pain be very violent , 't will be better for the Sick to keep himself a Bed , 'till the Pain is a little abated , than to use external Anodines . But 't will not be amiss to take a little Laudanum in the Evening , if the Pain is intollerable , otherwise 't will be better to omit it . But seeing I am now speaking of External Remedies , I must say something of the Indian Moss , call'd Moxa , greatly esteem'd of late for the cure of the Gout , if it be burnt a little upon the part affected . Though this kind of Remedy is said to be receiv'd from the Oriental Indians , being wholly unknown by the Europeans ▪ yet 't will appear to be known among us many Ages , to him that shall consult the Writings of Hippocrates , published above Two Thousand Years ago . He says in his Excellent Treatise of Diseases , That if the Pain continues obstiuate in any one part , and can't be expell'd by Medicines , in what ever part it is , you must burn it with crude Flax. And afterwards speaking of the Gout , he says , the same things are good , which are proper in the Diseases of the Joints ; and indeed this Disease is long and grievous , but not deadly . But if the Pain remains in the Fingers , burn the Veins in the Fingers , above the Joints , with crude Flax. Now I suppose no one will think that there 's any Specifick difference betwixt the Flame rais'd by Flax , or by this Indian Moss , no more than he can suppose that a Fire kindled with pieces of Oak , can do any thing more than the Wood of the Ash-Tree . This Burning of the part affected may be useful for mitigating the Pain , the most Spirituous part of the Morbifick Matter cast off upon the Joints , being drawn out by it ; but the benefit obtain'd by this means , forasmuch as it does not any way cure Indigestion , the antecedent cause of the Gout must needs be very short and fading , and to be used only when the Gout is beginning . For when the Gout , as it sometimes happens , is turn'd inward , either by its long Continuance , or by an unseasonable and undue use of Medicines , and so afflicts the Patient rather with Sickness , Gripes , and a great many other Symptoms of this kind than with Pain , I suppose no one will think that Fire is to be used . CHAP. V. Of the Bloody Urine from the Stone in the Kidnies . THough it may seem imprudent to publish an Observation , whereof I have had only experience in my self , yet I suppose no unprejudic'd Person will be angry with me , who have been so much and so long troubled with a Bloody Urine , occasion'd by the Stone in the Kidnies , for commiserating those that are afflicted with the same Disease , and for discovering those Remedies that have eas'd me ; though they are vulgar perhaps , and lightly accounted of . In the Year 1660 , the Gout seiz'd me more violently , and continued longer than ever ; and when on this account I lay'd continually for Two Months in the Summer-time , either in or upon a soft Bed ; towards the latter end of the Fit I began to feel a dull and heavy pain , especially in my left Kidney , and sometimes , though rarely , in my right . And when I recover'd from the Gout , yet notwithstanding the Pain of the Kidnies remain'd , which made me fear the Stone , though the Pain was not at all Acute , but tollerable enough ; for I had not yet had a Nephretick Fit , which is accompanied with violent Pain , stretching it self through the Passage of the Ureters , and with violent Vomiting . But though these signs of the Stone in the Kidnies did not appear , yet I had good reason to believe , that I had a large Stone in the Pelvis of the Kidnies , which because 't was too large to pass into the Passage of the Ureters , did not occasion the foresaid Symptoms . And many Years after I found I was not mistaken ; for when in the Winter , 1676 , presently after the breaking of a violent Frost , I had walk'd much and a long time , I immediately render'd Urine mix'd with Blood , and so I did as often as I walk'd much , or rode in a Coach in Pav'd Streets , though the Horses went gently ; but this did not happen to me , how far so ever I travell'd in the great Roads that are not pav'd The Urine that I voided then , though it look'd terrible as I render'd it , almost like pure Blood , yet soon after 't was limpid and like it self at the top , the Blood clodding by it self at the bottom . For the cure of this Disease , I bled largely in the Arm , and after general Purges , I us'd cooling and incrassating Medicines of various kinds , and a Diet agreeable to these things , and carefully avoided Acid and Acrid and Attenuating Liquors . But these and many other things which it would be tedious to mention , doing no good , and fearing to provoke the Stone forward , which I suspected was too big to be expell'd by Chalybeat Waters , at length I left off all hopes of doing any good by them , and chiefly because I had observ'd , that some Old Men of my acquaintance had hasten'd their end , while they were attempting in vain to cure this Disease by such Remedies . Wherefore I resolv'd to try no more , only by avoiding as much as I cou'd the motion of the Body , to prevent this Disease . But at length considering how wonderfully some praise the Lithontriptick Vertue of the Seed of the Ash-Tree , I imagin'd that if the Seed of it had so much Vertue , 't was very probable that the Manna of the Ash , shou'd have more ; that as the Excellent Botanist Mr. Ray , and many other Writers say , not being airy Hony or coelestial Dew , but rather a Liquor sweating out of the Leaves , the Trunk and Branches of Ash-Trees in Calabria ; the Truth whereof , was confirm'd to Mr. Ray , ( when he travel'd Italy , ) by a Learned Physician , who oft-ten gather'd Manna from the Branches and Leaves , when they were exactly cover'd with Linen Cloaths ▪ See Ray's Catalogue of English Plants . Therefore being about to make the Experiment , I drank ℥ ijss of Manna dissolv'd in lb ij of Whey , swallowing now and then a little of the Juice of Lemons , while I was purging , to quicken this Cathartick , which us'd to work slowly , and to render it more pleasing to the Stomach . It can scarce be said how much Ease I receiv'd about the Region of the Reins , by the use of this Remedy ; for tho' before they did not alwas ake , yet they were affected with a heavy and troublesome Pain . And because it succeeded so well with me , I took the same Cathartick on a set Day once a Week , for some Months ; and after every Purge , I plainly found my self better and could bear the shaking of a Coach when it went fast , and was indeed wholly freed from this Symptom till the last Spring , at the approach whereof , having been miserably afflicted with the Gout all the foregoing Winter , and by reason of my unfitness for motion , having liv'd without Exercise more than I us'd to do , the Bloody Urine return'd again ; and now I doubted whether I shou'd betake my self again to purging , because of late years , the whole substance of my Body being as it were , turn'd into the Fomes of the Gout , the gentlest Purge did most certainly occasion a Fit of the Gout ; at length I consider'd , that if I gave a Paregorick every Night after purging , to quiet the Tumult the Purge had rais'd , I might safely resume my old method of taking Manna once a Week . Therefore in the Morning I took ℥ ijss of Manna in lb ij of Whey , and in the Evening xvi of liquid Laudanum in Small-Beer , repeating the Manna and Laudanum in the said manner , twice a Week for Three Weeks ; afterwards I us'd the Manna only once a Week , the Filth of the Humours being so copiously discharg'd by the Cathartick , that the Gout was not greatly to be fear'd , and my reason telling me , that if the Manna was endow'd with any Faculty that is dissolving , or any other way Lithontriptic , to be sure the Vertue and Efficacy of the Remedy I trusted in , wou'd be somewhat lessen'd by such an astringent Medicine as Laudanum is ; and therefore I thought it better to omit the Hypnotic , seeing I purg'd only once a Week . I continued this method some Months , always purging of the same day of the Week ; nor wou'd I break this Custom , upon any account whatever . Tho' the pain of the Back remitted after the first Dose of this Remedy as formerly , yet soon after purging repeated , made the Gout appear , threatning War sometimes in the Limbs , and sometimes in the Bowels ; but Laudanum strongly repress'd these Motions of the Disease : And this method succeeding well hitherto , I thought I ought to continue it , both to prevent the return of the Bloody Urine , and to lessen somewhat the Matter that generates the Stone , which answer'd according to my desire , this Hemorrhage wholly vanishing from the time I first publish'd this Treatise , and therefore I quite left off the Manna . Therefore as to purging , ( if there is a Bloody Urine , and if Manna be only us'd according to the method above deliver'd ) I must retract my opinion which I publish'd concerning the Gout , viz. that 't is no way fit that People subject to the Gout , shou'd be purg'd either at the beginning , or at the declination , or in the Intervals of the Fit. For then it did not come into my Mind , that the Fit occasion'd by the Purge , cou'd be restrain'd , by giving an Hypnotic at Night . Yet with respect only to the Gout , all Evacuations do much hurt , and therefore are not to be admitted , unless the foresaid Symptom requires the use of them . I will add these things concerning the Regimen and manner of Diet , which seems to me , proper for those that are troubl'd with either of these Diseases ; for I wou'd by no means pass by any thing that may be of use to those that are afflicted with the same Diseases I am . In the Morning when I rise , I drink a Dish or Two of Tea , and then ride in my Coach till Noon ; when I return home , I moderately refresh my self with any sort of Meat of easie Digestion that I like ; ( for Moderation is necessary above all things ) presently after Dinner every day , I drink somewhat more than a quarter of a Pint of Canary Wine , to promote the Concoction of the Meat in my Stomach , and to drive the Gout from my Bowels : When I have dined , I betake my self to my Coach again , and when I have leisure , I ride into the Country Two or Three Miles for good Air. A Draught of Small-Beer , is to me instead of a Supper , and I take another Draught when I am in Bed and about to compose my self to Sleep , that by this Julap I may cool and dilute the hot and acrid Juices lodg'd in the Kidnies , whereof the Stone is generated . And I prefer at this time , and at Dinner-time , Small-Beer that has Hops in it , before that which has none . For tho' that which is not hopt , is smoother and softer , and so fitter to carry off the Stone from the Kidnies , yet that which is hopt , by reason of the stiptic quality which the Hops impart to it , is not so apt to generate sandy and stony Matter , as that which is not hopt ; the Substance whereof , is more viscous and slimy . I take care to go to Bed early , especially in Winter , than which nothing is better to render the Concoctions perfect , and likewise to preserve that Form and Order which of right , belongs to Nature . Whereas on the contrary , Night-works lessen all the Concoctions of Old Men that labour with any Chronical Disease , and dangerously wound their Vital Principle . And to prevent a Bloody Urine by reason of the Stone , I take great care that as often as I am to ride a long way upon the Stones , ( for if I travel never so far in a Coach in the common Roads , I receive no damage ) to drink a large Draught of Small-Beer before I go into the Coach , and also before my Return , if I have been abroad a pretty while , whereby I secure my self very well from the Bloody Urine . But as to the Gout , I will add this one thing , of late Years by reason of some Errors about the Six Non-naturals , the Gouty Matter sometimes strikes in , the Signs whereof are violent Sickness with Vomiting , and some pain of the Belly , the Limbs in the mean while are suddenly free from Pain , and more fit for motion than is usual . In this case I drink a Gallon of Posset-Drink , or Small Beer , and as soon as 't is all rejected by Vomiting , I drink a small Draught of Canary Wine , with Eighteen Drops of Liquid Laudanum in it to compose me to rest ; and by this means I have divers times rescued my self from imminent Death . Though perhaps it may seem ridiculous , ( especially for one who 's being well or dead , is scarce of any consequence , ) to make such frequent mention of one's self , yet these things are said , to the intent others may be benefited thereby , whose Lives or Health are of greater value or moment . Lastly , 't is to be noted into what great danger some that are afflicted with the Gout and Stone cast themselves , by taking unadvisedly Manna dissolv'd in Purging Mineral Waters ; for though when 't is taken this way , it works quicker , and is not so nauseous , yet these little Conveniencies can't equal an Injury occasion'd by the Waters on another account . For if the Stone in the Kidnies is so large , that it can't pass through the passage of the Ureters into the Bladder , these Waters most commonly occasion a Fit , which indures to the great hazard of the Patient's Life , till the Stone returns into the Pelvis . Nor can the Sick safely venture upon Chalybeat Waters , unless he can can certainly know first that the Stone is not so large , but that it may either find or make a way through the Ureters , which so far as I understand , can be known only certainly this way ; viz. If before he has been seiz'd with a Nephritick Fit , ( with violent pain in either of the Reins , stretching it self through the passages of the Ureters with violent Vomiting , ) he has found that there is not so properly a large Stone in the Pelvis , as a heap of small Stones , whereof one will now and then fall into the Ureter , and so cause a Fit , which does not go off 'till the Stone is thrust down into the Bladder . When the case is so , there 's no more effectual Remedy , either to prevent the increase of small Stones , or to drive them from the Reins , than the Drinking freely of Chalybeat Waters a long while every Summer . But because it often happens , that one is seiz'd with a Nephritick Fit , when these Mineral Waters are not to be got , or when the Season of the Year is not favourable for drinking of them . In this case you must proceed in that short Method for the Stone in the Kidnies , mention'd at the latter end of the foregoing Chapter . But if the Sick is of a Sanguine Constitution , and not Antient , ℥ x of Blood must be first taken from the Arm of the same side with the affected Kidney . But Old Men worn out by some Chronical Disease , and Old Women subject to Vapours , ( especially if at the beginning they void a black and Sandy Urine , ) must not bleed ; but as to other things , they must proceed wholly according to the Method now deliver'd . But to return to the Stone when 't is large , the business in Hand , if the Nephritick Person was never seiz'd with a Fit of the Stone , that being too large to fall out of the Pelvis , Iron Waters can't be us'd for Reasons above-mention'd , without present danger . Nor does the use of Mineral Waters prove better in Gouty People , if they are old , as they are most commonly , and of a Weak and Phlegmatick habit of Body , for in these the strengh of Nature is so much lessen'd , that 't is greatly to be fear'd that such a quantity of Water may wholly overwhelm it . But whether this is the cause of the Injury that falls upon Men of such a habit of Body or Constitution or not , I am sure many whose Bodies have been much broken by this Disease , have been kill'd by these Waters . FINIS . Publish'd by the same Author , and Sold by Henry Bonwicke at the Red Lion in St. Paul's Church-Yard , COllections of Acute Diseases , in Five Parts : 1. Of the Small Pox and Measles . 2. Of the Plague and Pestilential Fevers . 3. Of Continual Fevers . 4. Of Agues , a Pleurify , Peripneumonia , Quinsey , and the Cholera Morbus . 5. And last , Of the Bloody-Flux , Miscarriage , of Acute Diseases of Women with Child , a Rheumatism , Bleeding at Nose , Apoplexy , Lethargy , and of several other Diseases . Notes, typically marginal, from the original text Notes for div A53910-e3190 The Cure. The Hysterick Colick .