You see his Shadow and his outward Looks, Such was his face, which yet is but the rind: To know him better you must read his Books, You'll wonder at his gifts, and noble mind. portrait of Bricius Bauderon THE Expert physician: Learnedly treating of all AGVES and fevers. Whether Simple or Compound. Showing their different Nature, Causes, signs, and Cure, viz. A feverish Heat. The differences of fevers. A Diary fever. A Burning fever. A continual Putrid. A continual Tertian. A continual Quotidian. A continual Quartan. An intermitting Quartan. Fevers annexed to Quartans. A Semitertian fever. An hectic fever. Confused erratic fevers. Malignant pestilent fevers, &c. Written originally by that famous Doctor in physic, Bricius Bauderon, and Translated into English by B. W. Licentiate in physic by the University of Oxford. Published for the general good of this Nation, and may be put in practice with facility and safety. Printed at London by R. I. for John Hancock, and are to be sold at the first shop in Popes-head Alley, near the Exchange. 1657. The Epistle to the Reader▪ Courteous Reader▪ THere are no Diseases more frequent in this Nation, none more difficult of Cure, than Agues and fevers, so that they are Proverbially called, The Scandal of physicians: Fernelius, who was thought to have writ best against them, was himself destroyed by one; neither hath there yet been published any remedy so saving, as their fiery darts are killing. Accept then of this balsam, gathered from the choice Gardens of the Greeks, Latins, Arabians, by the hands of that incomparable Dr. Bricius Bauderon, whose age and experience works more on my faith, than the unfathomed Arcana of the modern Febrifuga; he was eighty years aged when he writ this Tract, and had fifty years confirmed by his practice, what in one months' time thou mayest now be master of; his painful long-teeming Birth wants nothing but thy embraces to cherish it, it hath been for many years cloistered up in the French and Latin tongue, though desired by ambitious heads as a choice purchase; few private Studies could boast of its possession, which encouraged me to set it forth in this English Garb, in which it is entire, though not so splendid; more profitable, though not so beauteous: Such emunct nostrils as shall snuff at it, are like those my Author speaks of, that will swoon at the smell of a Rose; suburban wits, that breath best in the worst Air; or like some unclean Creatures, that thrive best in standing Pools; but I leave them, and commend the ingenious to the Work itself, methodical, facile, and perspicuous enough to benefit the meanest capacity, yet satisfy the highest; read and be convinced. Thine, B. W. The Contents of every Chapter. Chapter 1. TReateth of a feverish heat. Chap. 2. Of the differences of fevers. Chap. 3. Of the Division of fevers. Chap. 4. Of the Circuit of fevers. Chap. 5. Of the Constitution of fevers. Chap. 6. Of the Four times of Diseases in special. Chap. 7. certain Physical Rules for practice Chap. 8. Of a Diary fever. Chap. 9 Of an unputrid Synochus. Chap. 10. Of a continual putrid fever. Chap. 11. Of a burning-fever, and continual Tertian. Chap. 12. Of the Cure of these fevers. Chap. 13. Of a continual Quotidian fever. Chap. 14. Of a continual Quartan. Chap. 15. Of an intermitting Tertian. Chap. 16. Of the Cure of a spurious intermitting Tertian. Chap. 17. Of an intermitting Quotidian. Chap. 18. Of a Quotidian fever from salt phlegm. Chap. 19 Of an intermitting Quartan. Chap. 20. Of fevers annexed to Quartans. Chap. 21. Of confused, compounded, and erratic fevers. Chap. 22. Of a Semitertian fever. Chap. 23. Of a hectic fever. Chap. 24. Of Malignant and pestilent fevers. Chap. 25. Of the Cardiacal fever. Chap. 26. Of the fever from Crudity. Special observations for the Readers more easy apprehension. REader, for thy better understanding of the quantity of Weights used in this, and other physic Books, in Compounding of Medicines, observe this brief direction; That, A grain is the quantity of a Barley Corn. A Scruple is twenty Barley corns. Three Scruples contain a Dram. Eight Drams contain an Ounce. The expert physician, Learnedly treating of all Agues, and fevers, whether Simple, or Compound, CHAP. I. Of a feverish heat. A fever is so called from the Latin word Forveo, Of the Name. because it is a fervour or Heat affecting the Body; the Gr●eks call it {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is to be inflamed or taken with a fever, sometimes it is called {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is a fiery habit, or fiery disposition of the Body, and by Hippocrates in the first Book Epidem comen. 3. text 18. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}▪ that is, fire itself. It is a praeternatural heat kindled in the heart, The definition of a fever. as in its proper subject, primarily and per se hurting our actions, which heat by the mediation of blood and spirits, through the veins and Arteries, is diffused through the whole body. Now, The division of heat. all heat is either Natural, or ascititious, the Natural is either implanted and fixed, or elementary and fluid, and a fever cannot consist in either of these, because the implanted is fomented by the primogenious moisture, whose original is heavenly, and once depeculated or wasted, cannot be repaired; nor in the elementary, because this by its temper doth help and cherish the implanted, and further it in concocting and assimilating the nourishment which is to be converted into our substance; this heat physicians call influent, because with the spirits and blood from the heart, it is carried by the veins and Arteries to all parts of the body; a feverish heat than is in the ascititious saith Galen, Comment. on the sixth book, Epidem. Hippo. text the 28. An ascititious heat is threefold; The division of ascititious heat. the first in respect of the other is said to be simple, that is a bare exuperancy of heat, which is thus engendered▪ the Elementary or fluent heat by a daily increase receding from its temper and mediocrity becomes excessive, so that that which was natural, by degrees becomes unnatural, and therefore vicious, and offensive to nature, doth hurt her operations; and in this ascitious heat are your Ephemerae or Diary fevers, and unputrid Synochus. The second heat different from the former is acrid and mordent, arising from putrified matter, which though it be not very burning hot, yet favouring of the condition of the matter from whence it proceeds, is praeternatural and burdensome to the implanted heat, and in this are putrid fevers both continual and intermitting, compound, erratic, and confused. The third ascitititious heat is wholly malignant and pernicious, caused from some venenate or pestilent matter, not from the exuperancy of its quality, as the first, nor from putrefaction, as the second, but is substantially different, and inimicous to the vital and implanted heat. CHAP. II. Of the differences of fevers. SEeing that all fevers are caused by an ascititious heat, and not by a natural, as was said before, it is necessary we take their differences first from the essence of heat, then from the subject in which the fever is, or from the manner of the motion of heat, or from the cause of the Disease, or from the matter, or symptoms. The first difference than is from the essence of the praeternatural heat, From the essence. by which some action is always hurt, because there is a recession from the natural state, and by how much the greater and more vehement this heat is, by so much the greater ought the fever to be accounted; as for example, a {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, a Burning fever may be said to be greater than any other fever, because its heat being more intense it appears more acrid and mordent than any other humoral fever; but on the contrary, if you compare it with an hectic, it is less than that, because this possesses the very substance of the heart, but that the Humours near unto it. Another difference may be taken from the subject wherein the fever is, From the subject. as for example, by how much the nobler the part affected is, by so much the more vehement the fever, as that fever which proceeds from a frenzy, peripneumony, or inflammation of the Lungs, or from a pleurisy by reason of the parts affected, shall be far more dangerous than that which follows an inflammation of the Reins, Spleen, or Foot; besides, the fever is proportionate, or improportionate in relation to the subject, and thence shall be esteemed greater or less, as a Burning fever is proportionate in a Body hot and dry, of youthful age at Midsummer, or in a hot and dry region, and consequently less dangerous than the improportionate, which should happen to an aged body, cold and moist in the Winter season, and in a cold and moist Country, as Hippocrates doth excellently note it, Aphor. 34. Sect. 2. The Third is from the manner of the motion, From the manner of the motion. and motions here, is nothing else but a swift or slow transition from one subject to another; the swift motion is as often as the heat passeth from a crass thick subject, to a tenuous one, as for example; as oft as an intermitting fever doth pass into a continual or other putrid one; and on the contrary, the slow motion is as often as an Ephemera or putrid fever degenerates into a hectic, for the Spirits are easier set a fire than the Humours, and these easier than the solid parts of heart and body; likewise an unputrid Synochus being neglected, doth easily pass into a putrid one, and so of other sorts of fevers. The Fourth is from the efficient cause, From the efficient cause. which is threefold, the one evident, the other internal, the third occult; the evident is drawn from those Six non-natural things, as from the air, inanition or repletion, &c. the internal from fluxions on the stomach or lungs, obstruction, crudities, or putrefaction of humours, &c. The occult cause may be double, external, and internal, the external as the contact of a Torpedo, impure copulation, the use of malign and venenate medicaments, &c. from whence are fevers epidemical, endemical, sporadical, and pestilential, saith Hippocrates and Galen, the internal cause is hard to be discovered, because besides the putrefaction, there is a certain venenate air, or breath, which is for the most part unknown to us, whether it depend on the element of Stars, and therefore is called by Hippocrates, Quid divinum, as was that sweating sickness in Britain, which did not only depopulate England, but Germany and France. The Fifth difference is from the matter, From the matter. which consists either in the spirits, or the humours, or the solid parts, and these three Hippocrates in the sixth of his Epidem. last Section, text 19 calls {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, containing, contained and impetuous bodies. The containing, The containing. are the solid parts in which are caused hectic fevers, both universal and particular, they first invade the substance of the heart, then equally the other parts: these primarily and per se, possess the substance of some private part, from whence they are communicated to the heart, and to the rest of the solid parts, as to the Lungs, Midrist, Stomach, or Liver, &c. The contained, The conta●n●d. are the four Humours which offend either in quantity or quality, in quantity as often as these Humours are more or less inflamed in the heart without putrefaction, and hence are the Epacmastical, Acmastical, and Paracmastical fevers; in quality, in relation either to touch, sight, or taste, according to Hippocrates, as by the touch of the Pulse, some are judged mordent, others mild, and temperate in comparison with others; others appear moist as bilious fevers, such as are your continual tertians, or burning fevers, all which are mordent, especially about the state of the Disease, and before the Crisis; the m●lde ones are such as the true Diary fever, which ends with a sweat or moistness, and your unputrid Synochus, and {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is moist, of which Galen makes mention against Lycus; for these in respect of other fevers are called mild and temperate. To the sight are referred the red ones, as the unputrid Synochus, which is from a more fervid blood, the white ones as Quotidians, the livid as Quartans, Syncopal, or Pestilential fevers; others are arid and horrid to the eye, as the colliquating hectic, and that of the second or third degree. In relation to taste, some are said to be sweet, as those from natural phlegm, and many bloody ones, which even after putrefaction retain some sweetness; others are bitter as the bilious, others salt, as those from salt phlegm, and the hybernal causes, or winter burning fever. The impetuous are the vital, The impetuous. animal, and natural spirits; in the vital spirits is caused a Diary of one day, if the spirits be tenuous, of more days, If they be crass; but more of this in its proper place. Some fevers are long, others short; some diurnal, others nocturnal; some ordinate, others inordinate; some periodical, others erratical, according to the condition of the Sick, the quality of the morbous matter, or its quantity and motion. The Sixt difference of fevers is taken from their symptoms, From the Symptoms as often as a part is possessed with an inflammation, and these fevers are always continual, whether blood, choler, or phlegm superabound; if blood, the fever is called Phlegmonodes, if choler, Erysipelatodes, and Typhodes, or burning; and they have another name or appellation from the part affected, as from the Liver Hepatica, from the Spleen Splenica, from the Bladder Cystica, from the Throat Cynanchica, from the Head Phrenitica, Lethargica, Comatosa, from the Lungs Pneumonica, from the Side Pleuritica, from the Midriff Diaphragmatica, from the womb Hysterica, from the Stomach Stomachica, &c. CHAP. III. Of the division of fevers. ALL fevers of what sort soever are either Essential, or Symptomatical, the Essential is either simple, compound, confuse, erratic, pestilent, or of malignant nature. The Simple is either in the spirits, The simple fever. or humours, or solid parts; chiefly in the vital spirits, then in the animal and natural (if there be any such) is the true Ephemera which lasts but one day, but longer if the spirits be crass. In the Humours are engendered divers fevers, of which some are continual, others intermitting, and of the continual some are from the Humours not putrefied, others from putrid humours, and these either from the humours equally, or inequally putrefied. Those which are from the humours not putrefied are from the blood inflamed in the heart by a preternatural heat, An unputrid Synochus. which by the greater veins diffused into the habit of the body, doth primarily, and per se hurt our actions. These differ from an Ephemera nominally, and in respect of the matter not really, nor in way of cure, because the one is in the spirits inflamed, the other in the blood unputrefied; both may proceed from the same external causes, and the same method and remedies serve for the cure of both, they are continual, and have but one accession, although there be three sorts of them distinguished by their several names. The first is, The Homotonos. when the heat remains equal and alike to itself, through the whole course of the fever, and how much is inflamed anew, so much is presently dissipated, and this the Greeks call Homotonos, or of equal tenor. The second is, The Epacmastic●. when the late inflammation is greater than the dissipation, and then the heat gathers strength, and grows stronger, and this is called Epacmastical, or increasing. The third is, The Paracmastical. when there is more dissipated, than is afresh inflamed, and it sensibly declines till it end, and by the same Greeks is called Paracmastical, or declining; and this Synochus may last seven days, but an Ephemera transcends not the third day unless the spirits be crass; full bodies which abound with blood, and fare deliciously and live idly, and those in hot and moist, or temperate regions, are most subject to the unputrid Synochus, for the most part it ends with sweating or moistness, as an Ephemera, which wants not its danger, if you neglect bleeding. Fevers which are in the putrid Humours are either from equal, The putrid Synochus. or inequal putrefaction; if the Humours be equally putrefied in the great veins, the fevers are continual, and are threefold distinguished by the same names as the unputrid Synochus; for the first is Homotonos, when the putrefaction remains equal and alike to itself through the whole course of the Disease, and how much putrefies so much is emptied; the second Epacmastical, when the putrefaction from the beginning to the end increaseth; the hast Paracmastical, when the morbifical humour is from the beginning to the end by degrees diminished. The●● three have no remissions, or exacerbations apparent at intervals (because the Humours are equally putrefied in the great Vessels) as are in those which proceed from the Humours inequally putrefied in the same Vessels, of which in their proper place; neither have they any intermissions as are in the exquisite intermitting fevers, but last till the whole putrefaction is discussed; their signs are like to those of the unputrid Synochus, but more conspicuous, because they are from putrid matter, but those from the effervescency of heat. The latter physicians use the word {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, The Synechis. for every continual fever caused from the Humours inequally putrefied in the great veins, to difference it from {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, which signifies the same, if you respect the etymology of the word. This Synechis, or continual fever, hath divers appellations according to the site of the Humour which doth unequally putrefy; if in the great veins near to the heart, a {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} or burning fever is engendered, but if in the other veins further off, a continual fever is caused, which hath its denomination from the predominant humour, viz. if Natural choler putrefy, there will follow a bilious Synechis, which every other day shall have its exacerbations and remissions, and in the morning especial shall be most remitted, but without intermission, from whence is a continual tertian; if Natural phlegm putrefy in the veins, there shall be a continual quotidian, which likewise every day at set hours shall have its remissions and exacerbations; if a melancholy humour putrefy, there shall be a continual quartan, which every fourth day shall have its intention and remission, but no intermission. Amongst those fevers which are caused from Humours inequally putrid, Intermitting fevers. there are some others which differ from the continual, both in matter and site, and are called intermitting, for the matter of continual fevers is natural, but that of intermittings is excrementitious; the seat and matter of the continual, is in the great veins, but that of the intermitting without them, as in the Liver, Stomach, Spleen, Intestines, Mesentery, and habit of the body, so that if excrementitious choler putrefy, it is called an intermitting tertian, because it recurres every third day, begins with rigour, and sometimes with vomiting, if it be exquisite, whose fit is twelve hours, or less, according to the quantity of choler producing it, and is terminated with Sweats, than ends in an apyrexy, or perfect infebricitation, and the fuel of this Disease is principally in the Liver; likewise if excrementitious phlegm putrefy, out of the great Vessels is caused an intermitting quotidian, whose fit is eighteen hours by reason of its coldness, crassness, and clamminesses, and it begins with a coldness of the Nose, ears, Hands, and Feet, and is terminated with a moisture, and not with sweat as a tertian, the fountain of this is the Stomach, if glassy phlegm putrefy in the same place; there is another kind of fever which the Greeks call {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, the word is derived from {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, which is mild, and {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} the Sea, because as that at first seems smooth to the mariner, and by and by is tossed with most horrid Tempests, so this fever at first invasion is gentle, and so takes root, and a little while after precipitates the sick into most desperate dangers, or as Aegineta would have it, it is derived from the Adverb {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, gently, and {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, heateth; to this kind may be referred those from rheum, and that which accompanies the Green Sickness, but of them in their place. If a melancholy excrementitious Humour putrify there, it begins with horror, and sometimes with vomiting, as a tertian, and the fit is twelve hours, or more, or less, according to the quantity of the Humour, and recurres every fourth day, and therefore is called a quartan, which is the longest of all fevers, and hath its seat in the Spleen; and so much for fevers in the Humours inequally putrified, whether continual, or intermitting; and though Hippocrates and Galen make mention of a Quintan, Sextan, Septan, and Nonan, we must not think they proceed from any next kind of Humour, but are to be referred to a Quartan, and to be cured by the same method, only the difference is that a Quintan is caused from an atrabilarious humour, and is the worst of all, fullest of danger, and of the greatest essence, saith Galen, comen. on the third Section of the first Book Epidem▪ but the rest are from a melancholy humour. A hectic fever (although it be in the solid parts) is to be reckoned amongst the Simple fevers, A hectic it differs from a pestilential, in that it is free from any venenate or malign quality, from the Humoral, that is free from putrefaction. A Pestilent fever is likewise numbered amongst the Simple, though it differ from them by its venenate, contagious, and pernicious quality, by which it contaminates our substance, and amongst malignant fevers may be numbered, those from vitellinous, aeruginous, and prassinous choler, according to Galen, and Hippocrates, and Avenz●ar in his Theisir, A Leipyria is placed also amongst malignant fevers by Hippocrates, in his Epidem. and Progno. 2. Lib. 3. and by Galen in his Comments upon those Books, it differs from an exquisite cause by its malignity, and is always deadly, according to Galen's comen. on Aph●ris. 48. Sect. 4. and c. 4. of his Book of Inequal Distempers, it kills the fourth day, or sooner, and follows great inflammations of the Viscera, so much of Simple fevers. A Compound fever is that which is made either of two intermittings mixed, Compound fevers. as a double tertian, a double and triple quartan, or of a continual and intermitting, as a hemitritaean, or a hectic with a putrid make a Compound fever, and so likewise of many others. The confused is as often as two or three Humours do putrefy together, The Confuse. whether in the great veins, or out of them▪ and in the same place begin together, and end together, for this mixion engenders no compound but a confused fever, and the one cannot be known from the other, because the signs are so confused from whence it hath its name, as for example, if Choler and phlegm putrefy together in the great veins, there shall be two continual fevers in the same place, which make a confuse, and no Compound fever; on the other side, if the same Humours putrefy with melancholy in the lesser veins altogether, and in the same place, there shall be two or three intermittings, which mixed do likewise produce no compound, but confused fever; so a double continual tertian will be confused, and not compound, because the putrid matter is contained in the same place. The erratic, The erratic. or inordinate fever is that which observes no type, or order of other Simple fevers, whose humour putrefies in divers places, and moves from one place to another, from whence is the diversity of the fits; sometimes it intermits four days, sometimes eight, and sometimes more, and then recurres; sometimes it comes sooner, and is called praeoccupant; sometimes moves slower, and is called retardant; and so much for essential fevers. A Symptomatical fever, though it be continual, yet differs from the former, because its matter is not contained in the greater veins, neither hath it any exacerbations, or remissions, but depends on the inflammation of the part which it possesses, from whence it hath its name, as is observed in the second Chapter. CHAP. IV. Of the Circuit of fevers. TO find out the Reason of the Circuits of intermitting fevers is of no small moment amongst the Learned, for what one allows, another reprobates, every one applauding his own fancy; leaving then their niceties, I shall declare my own opinion, having premised somewhat for elucidation of what shall follow; all the parts of the body are endued with four Faculties, to wit, the Attractive, Retentive, Alterative, and Expulsive, and as long as these are free from any fault, man lives in perfect health, and when one of these is too strong for the other, he is affected with various Diseases▪ as if an excrement be inherent to any part, and cannot be expelled from it by reason of its weakness, it becomes burdensome to it, because it is neither discussed nor removed; or if by reason of its coldness, crasseness, or clamminesses, it obstruct the passages through which it ought to be expelled, it putrefies, and causeth a Disease, and the heat contracted by putrefaction is very offensive to the heat, and first of all occupies and infests the Spirits, because they are tenuous, than the Humours, because they are more cra●●e; and last of all the solid parts, and this heat from the heart through the Arteries dispersed to the whole body generates a fever▪ and hurts our actions. The cause then of the shortness or length, of the anticipation or tardation of the Circuits, may be taken from these Six things viz. From the Species of the Humour, from the quantity, quality, habit of the Body, disposition of Strength, and complication of fevers. There are four Humours in the Body, From the Humour. one of which exceeds the other in quantity and quality, as if pure blood putrefy in the great veins, (which is hot and moist) it begets a continual Synechis, if out of those veins, it produces an intermitting, it's thinner part is turned into choler, and the crasser into melancholy, as Alexan. Aphrodis. learnedly notes. Another cause of the circuits is from the quality of the Humour, From the quality. and weakness of the part where the excrement is heaped up; as phlegm next to blood exceeds other Humours in quantity, and being cold of quality, and moist, crass, and clammy, by its frigidity it resists putrefaction, and by reason of its crasseness and clamminesses is not so easily resolved as blood, and hence are the length of its fits, and by reason of the relics and imbecility of the part, new excrement is heaped on it, thence are new fits which recur every day; and if yellow choler putrefy in a part, it causeth the like, though more difficultly than phlegm, by reason of its dryness, by which it more powerfully resists putrefaction, and because it is a tenuous humour, and not crass, it is far more easily resolved than phlegm, and leaves less relics behind it in the affected part; and hence is it that its fits (which it causeth) do sooner end in an infebricitation, and greater time or interval is required for a new accession, but because the part is debilitated by the former excrement, it readily receives the new, which putrefying as before causeth a new fit, neither sooner nor later than the third day, and lasts twelve hours, and is therefore called a tertian, because it recurres every third day. The melancholy juice retained in a part doth not so easily putrefy as other Humours, by reason of its two qualities which resist putrefaction, viz. frigidity and siccity, and therefore it intermits two days, and returns every fourth day; and though the former matter be emptied, yet there is a weakness and disposition of the part (as in the other) to receive a fresh humour, from whence follows a new fit, which for the most part lasts twelve hours, sometimes more, sometimes less, according to the quantity of the humour oppressing the part. The quantity of the Humour, Object. against this opinion. whether much or little, cannot of itself be the cause of the longitude, or brevity, anticipation, or tardation of the fit, it is true, a great quantity doth oppress the part, and a small is quickly resolved; but that alone cannot be the efficient cause, because the same motion is observed to be from a small and great quantity, and that it is so, let choler or melancholy be found in any part of the body putrefied, it is most certain that choler will move neither sooner nor later than the third day, nor melancholy than the fourth, therefore the quantity of the Humour alone cannot be the cause of the circuits, or of the longitude, or etc, of feverish fits. But rather the quality is the cause of the length or shortness of the anticipation, From the quality. or post-position of the fits, which your epileptical insults seem to manifest, for they proceed not so much from the quantity of the humour, as from the quality offensive to the brain, and thus womens' courses flow at set months and days, not by reason of the quantity of the blood, but quality, whether they be much or little, unless somewhat intervert the course of Nature; and so we must judge of the Humours, in which there is a certain occult quality, unknown to us, which causes phlegm every day, yellow choler every third day, and melancholy every fourth, to grow furious, and be moved; Hippocrates seems to favour this opinion in his Proaemium to the first Book of prognostics, where he thus Prophecies, {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. whether there be nor somewhat Divine in the Disease, which according to Aristotle, in proportion answer to the Element of Stars; now the starry Element is said to be that which operates beyond the order or power of the Four Elements, and is scarce comprehensible. The habit of the body whether dense or rare, From the habit of the body. may be the cause too, of the length or shortness of the fits, but the anticipation or tardation may be referred to the substance of the matter, or to the multitude or paucity; the substance is either crass or tenuous, if crass and clammy the fits shall be longer, if tenuous shorter; if to the multitude, or paucity, a little is easier dissipated and resolved than a great deal, from these two then, the anticipation or tardation of the fits may be caused. The Fifth cause of the Circuits may be from the strength, From the strength. for if the alterative and expulsive faculty of every part be strong, they will cast off all the excrement to the parts destined for it by Nature; contrariwise, it they be both weak, that remaining doth by degrees putrefy, because it is not discussed, and so it moves sooner or later according to its quantity, or quality, or both together, and the paroxysms are longer, or shorter. The complication of fevers may change the course of Circuits, From the complication. because some are from a cold Humour, creass and clammy, others from a hot and tenuous; so the one is moved, corrupted, and resolved sooner, the other later, from whence is the shortness or length of the fits; besides our diet, whether good or bad, if in tempestivous doth help or hurt much, or the patient's intemperancy, and irregularity. The efficient cause of putrefaction is either external, The cause of putrefaction. or internal; the external doth chiefly depend on corrupt meats, or evil juice, which can no way be corrected by the help of Nature, and which are apt to corrupt and affect the Viscera; the internal cause is either from obstruction, or the occursion of putrid things, for obstruction, caused by crass & viscid Humours hinders perspiration, and so the Humours retained, and neither discussed, nor cooled, do easily putrefy though they be good, and hence a fever; of the same force is that obstruction which proceeds from a plenitude of the Vessels, which is above our strength; for they therefore putrefy because they cannot be concocted, nor governed by our enfeebled strength. The occursion of putrid things doth first corrupt the Spirits, than the Humours, as the filthy exhalations, and putrefaction of vapours, drawing in the Air from the Gallical Elephantiacal, and of those infected with a putrid or pestilent fever. CHAP. V. Of the Constitution of fevers. SEntentious Hippocrates in the 12th. Aphorism of the first Section, reduces the times of Diseases to two, viz. the {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} and the {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that according to Galen in the first Book of Crises, What the catas●a●●● it. chap. 4. is the constitution of the whole Disease, or its duration conscribed within its four times, viz. the beginning, increase, state, and declination, the knowledge and distinction of which times is so necessary for a physician, that without it he can neither prognosticate aright, nor prescribe proper diet or remedies. The signs of these four Universal times are taken from the idea, From whence are the signs of these tim●s. or species of the Disease, from its motion, from the nature of the fits, from the figure of the body, from the strength of the Patient, from the season of the year, and age of the Patient, from the pulse and rigor, from the hour of the fit, and the vehemency of the symptoms, from the length or shortness of the fits, from the nature of the evacuations, from the crudity or coction of the Urine, and of the Humours causing the Diseases. The idea or species of the Disease is chiefly taken from its motion: From whence is the idea of the Disease. for a swift motion shows that the state will be quickly, and a slow motion that it will fall out later. Thus a burning fever by reason of its essence is said to be vehement, and quickly comes to its state; and a pestilent fever by reason of the governing faculty it affects, is vehement, and hath a speedy state, and an inflammation of the Lungs, by reason of the dignity of the part, speeds to its state. From the nature of the fits you have these signs, 2 From the fits. if they be short, the state is near; if long, afar off. From the Figure of the body, 3 From the figure. if the face with the Hypochondria be suddenly extenuated, it denotes the fever to be acute, and of swift motion, but if the body be not impaired, it is a sign of its longitude. If at the beginning the Sick be more than ordinarily weakened, 4 From the strength. it shows the Disease to be acute, and of swift motion; if otherwise, to be diuturnal. If the season, 5 From the season. age, region, custom, and diet of the Patient be all agreeing, the Disease shall be short; if otherwise, long; as for example, if a young choleric body at Midsummer, in a hot Country, feeding high, on meats of good juice, and drinking pure wine, should be taken with a tertian, it shall sooner leave him, than if he were an old man in a cold Country, and Winter season, fed with cold and moist meats, and seized on by the same Disease, and thus a Winter quotidian would be longer to him than a Summer one. If the pulse be frequent, 6 From the pulse. swift, and great, it declares an acute fever of quick motion. If the rigour be long, 7 From the rigour. it shows the length of the Disease, because the Humour is putrefied out of the great Vessels, if short, it shows the contrary. If it always invade at the same hour the Disease will be long, 8 From the hour. because it shows the Humour to be fixed, and hardly to be eradicated, but if it anticipate, or come later, it will be shorter, and be more easily extirpated; sometimes the quantity of the matter is the cause of the anticipation, as the paucity is of the tardation. The vehemency of the symptoms in the fit doth indicate the vehemency and velocity of the morbifical matter. 9 From the symptoms. If the later fit last longer than the 10 From the duration of the fits. former, it shows the augment, if shorter, the declination of the disease. If in a former fit there was an evacuation made by sweat, 11 From the evacuation. and yet the next fit be as long, it denotes the length of the Disease from the quantity of the matter. If at the beginning, 12 From the urine. the Urine be coct, the fever will be short; if crude, long; for the Urine is of good judgement in fevers continual, or intermitting. That water is tenuous in which appear no contents, but is of white colour, and denotes crudities; but if it be meanly crass with white contents, smooth, and equal, it shows coction, and the brevity of the fever. If the matter be not contained in the greater or lesser veins, signs when the matter is out of the veins. but in the Stomach, than the signs are to be taken from the dejections or stools, if in the instruments of respiration, from the spital; if in the habit of the body, from the sweat; Hippocrates in the first and second Book of prognostics; but that these four times may the better be distinguished, we shall set down some examples of particular Diseases, by which you may guess of the rest. The beginning of a fever is then said to be, How to distinguish the four times of fevers. when the humour in which the fever doth consist is crude, the augment when it begins to be concocted, the vigour or state of the Disease is most vehement when it appears most concoct, the declination when all symptoms do abate; or in a word, an obscure concoction determinates the beginning, a manifest, the augment, a perfect the state. The beginning of a Phlegmon is, The fo●● times of a Phlegmon. when the part is filled with blood, the augment when the fluxion ceases, and the blood collected putrefies, from which putrefaction is caused a heat, and from that heat a greater diffusion, distending the part more, though there be no new afflux, the vigour is when it is turning to pus, the pain and hear being greater, the declination when the pus flows forth, or is digest and resolved. The beginning of an Ophthalmy is, when there is a deflux of a thin, signs of the times of an Ophthalmy crude, copious humour to the eye, the augment is when the humour is more crass, and hath some signs of coction, the state is when it is yet crasser, and less, when the eyelids are glued together like to those that sleep, the declination when all things are more gentle, without the distinction of these times, the remedies reckoned up by Hippocrates, Apho. 31. Sect. 6. would little avail this Disease. The beginning of an Ulcer is, when the sanies is watery thin and incoct, The four times of an Ulcer. the augment when it is less and thicker, the state when the Pus is tenuous, white, and equal, when crass and little, the declination; these four universal times of Diseases are not always equal, nor comprehended within a set number of days, not only in divers Diseases, but in the same, one is sometimes longer, sometimes shorter, and not always equal. Besides these signs, the anticipation of the fit doth declare the augment of the Disease, as the tardation doth declination, though it is not universally so; for some quotidians, tertians, and quartans (by a certain propriety of the Disease) have from the beginning to the end always anticipated, as others have always been more tardant. If the fit anticipate, and be longer than usually, and more vehement, and the intermission shorter, more impure, and the feverish heat increased, and the Symptome● 〈…〉 it more grievous, they denote the state; but if it be shorter, slower, more simple, and the symptoms less, they argue a declination of the whole Disease. The like observation may be made of Symptomatical fevers, which arise from the inflammations of the Viscera, whose times are the same with those of Phlegmons. All this is to be understood of 〈◊〉 Diseases, and not of those lethal which run not through all these times manifestly, because some kill in the beginning, others in the augment, others in the state, and seldom or never in the declination, unless the Disease be malignant, and the strength so deject, that it cannot expel the morbifical humour though it be concoct. CHAP. VI. Of the four times of Disease● in special. IN the former Chapter we treated in general of the constitution of the whole Disease, now of the paroxysm or Fit, having first told what time is, and what a paroxysm; a Period, or Circuit, and what a Type, and wherein they differ. Time is the number or measure of motion according to priority, What time is. and posteriority, saith Aristotle in the fourth of his physics, but Galen in his Book to Thrasybulus describes it otherwise, for he says. Time is an alteration of the morbifical matter, made either by the natural or preternatural heat, since the times of Diseases are essentially measured by the mediate passions caused in the living parts of our bodies, and those in relation to coction. A Period is the time of intermission and remission, What a period is. when a fever returns from one place to the same again, as for example, if a Tertian Ague begin the tenth hour with rigour, and the third day return the same hour with rigour, it shall be an intermitting tertian; if a fever begin with cold, it shall be an intermitting quotidian; if with horror, a quartan. In the Period, What is the type. paroxysm, or Circuit is concluded the Type, which is nothing else but the order of intention, or remission, comprehended in the period, which denotes both the time and species of the Disease, saith Galen. The matter of intermitting fevers is sometimes moved from one place to another, The time of intermitting fevers from movable matter. sometimes moves not, but rests quiet in a part, now when the matter is moved the times of intermitting fevers are Six, viz. The beginning, the inequality, the increment, the state, declination, and integrity, or interval. The Fit or Paroxysine is divided into the accession, The division of the fit. which is the worser part of the whole Circuit, beginning from the first invasion and lasting to the state, and remission, which is the more benign part, saith Galen in his Commentary on Aphoris. 12. Sect. 1. and Chap. 3, 4, 5. of the times of Diseases; now to the accession belong the four first times, to the remission, the two last, which are now to be explained. The beginning is, The first time. when the matter begins to be moved, and Nature hath not yet begun to work upon the matter. The inequality, The second time. when the matter begins to putrefy, and putrid vapours assault the heart, and a feverish heat is diffused without the heart, which whiles it is expanding, Nature gives battle against the matter. The augment is, The third. when the heat is equally expanded throughout all parts, and the heat is more intense, and Nature reacts on the morbifical matter. The state is, The fourth when there is an omnimodal equality in the feverish heat, that is when the heat is extended through all parts in an equal degree. The declination is, The fifth. when there is a gradual inequality of heat, or when the heat is diminished, and Nature overcomes, and the seaverish heat forsakes the heart, and invades the extreme parts and feet. The integrity is, when the fever is quite off The Sixth. but these Six may very well be reduced to Four, because the former of the inequality is reduced to the beginning, the latter part to the augment, and the integrity is no time of the fever, but of the Period; and so much of fevers, whose matter is movable from place to place. Now let us speak of that matter which is not moved, but remains in a part, by reason of its weakness, that it cannot expel it, and therefore putrefies, and causeth a putrid fever, which the matter being emptied doth intermit, but because the imbecility of the part is still remaining, and certain seminaries of the former matter, therefore a new excrement is easily received, which being corrupted causeth a new fit. The beginning of these fits is, when the superfluity begins to putrefy, The times of these putrid are but four. the augment when the fuliginous putrid matter assaults the heart, and the humours contained in it are inflamed, so that its innate heat is made fiery hot, the state is when this fiery fervour is brought to the height, and the debate is strongest between the feverish heat and Nature, the declination is, when Nature overcomes the fiery heat, and expels it (if the matter be tenuous) by sweat if the pores be open, and the expulsive faculty strong, or by Urine if those passages be open, or by the stool if the matter be crass, which is the way appointed by Nature for such excrements. The beginning of these Diseases is known from the pulse rare and slow, The signs of the times of these fevers. from a plumbeous or sublivid colour, a coldness of the extreme parts, ssoath, sadness, pain, and profound sleep, the heat being retracted to the heart, and the brain refrigerated, from their eyelids scarce movable, the matter moving outwards and molesting them, from their salivation caused by the concussion of the rigour or horror, the salival matter residing in the glandules about the root of the tongue, being expressed by it. When a dry Cough is caused, The augment. the thinner part of the moisture falling into the rough Artery, it being ineffectual and vain, the sick is worse affected, and then is the augment with a great pulse frequent, and the heat expanded to all the parts. The state follows when the heat is consistent at its height, The state. neither increased nor diminished, the symptoms vehement, the Pulse greater, swifter, and more frequent than ordinary. If the declination tend to death, (which is very rare) the pulse is weak, The declination. unequal, and inordinate, but if to health, than all symptoms are remitted, and strength daily increased. These Four times are to be observed both in sal●brous fevers, and mortal, but in different respects; in the third Chapter we told you, that salubrous fevers were either in the Spirits, or in the Humours, or in the solid parts. In the Spirits is a Diary, From whence the times of a Diary. whose times are not taken from the matter, nor from the symptoms, but from the essence of the preternatural heat kindled in the vital spirit of the heart. The whole fit of this fever is twenty four hours, sometimes shorter or longer, according to the quantity of the febrish heat, crasseness of the spirits, the strength of the sick, or thickness of the skin, but if it be exquisite, it speedily runs through its four times. The Humours may be inflamed without putrefaction, fevers without putrefaction of the Humours. and cause a continual fever, which hath but one fit, and that longer than a Diary, whose four times are taken from its essence, and from the matter, viz. (the fervid blood hurting our actions) whether it be homotonous, epacmastical, or paracmastical; and these four times may be distinguished though short, and the matter not movable from place to place. Next, let us examine the Sings by which the Four times of fevers which arise from the Humours equally putrefied, whose matter is quiet and immovable may be distinguished, and afterwards of those inequally putrefied; we will speak first of those whose matter putrefies in the great veins, and if equally there shall arise a threefold continual fever, which come not alike to the integrity or interval, and end with one fit, and has no periods, yet hath its four times distinguishable; The first is, when through the whole course of the Disease, the measure of putrefaction is alike, and the Greeks call this Homotonos; the second is, when the putrefaction is greater than the dissipation, and this is called Epacmastical; the third is, when the dissipation is greater than the putrefaction, and is called Paracmastical, and their four times are distinguished by their intention, and remission, and putrefaction; if the Humours which are contained in the great veins do unequally putrefy, it is either the thinner part of the blood, or choleric blood which putrefies, and it causes a continual tertian, or phlegm, or the cruder part of the blood, and causes a continual quotidian, or the crasser part, of the blood, and maketh a continual quartan, of which more at large in their proper places; the times of these fevers may be distinguished from what is aforesaid, if the Humours putrefy out of those greater veins, the fevers shall be intermitting, and their four times shall be more evident than those of continual, because the matter moves from place to place, and they are terminated by urine, sweatings, vomitings or looseness. Mortal fevers seldom have four times, The times of mortal fevers. for some kill in the beginning if they be pe●acute, and the Patient weak; others kill in the augment, when the Sick is stronger; others in the state, when they are yet stronger, and the fever is less acute, as Galen shows in his first Book of Crises, chap. 2. and Hippocrates in the first Book of his Epid. Sect. 2. Text 45. saith, No man dies in an universal declination, for coction signifies a speedy indication, and security of health; the reason is, because in the declination of a paroxysm, or fit, the morbifical matter may not be overcome, and so death may follow, either from the weakness of the faculty, or from the malignant quality, or from the quantity of the Humour wherewith Nature is overwhelmed, or by some error of the physician, though signs of coction do appear; to prove this, Avicen in Book 4. fen. 2. tract 1. chap. 98. brings for an example the small Pox of Children, in the declination of which sometimes death follows, not by reason of the pocks which are in declination, but by reason of the fever, and malignant quality annexed. Another example there is, that a man may die in the declination of a Synochus, not by reason of the essence of the fever, but by neglect of the malignant matter the cause of it, or being preposterously handled, as Galen notes in his third Book of Crises; these four times of Diseases according to Hippocrates and Galen can no more be described by a certain number of days, and hours, than the decretory days can, by reason of the various temper of the Humours, and the diseased, as shall further appear in the next assertion, for an acute Disease hath shorter times and a Chronical longer. The four times of a hectic fever are not taken from the matter, The times of a hectic. nor from the symptoms, but from the essence of the preternatural heat which works upon the primogenious humidity of the heart, whose beginning is when the feverish heat begins to work on the rorid substance of the heart; the augment, when it begins to consume it; the state, when the humidity is consumed; the declination, on, when that native humidity begins to be restaurated. CHAP. VII. Certain Physical Canons, or Rules for practice. ALL Rules for Curing are taken either from the Disease, or from its Efficient cause, or from the nature and situation of the affected part, or from the symptoms; from the Disease, as a fever, whose preternatural heat is in the Spirits, Humours, or solid parts, and is not simple, but conjugate, viz. hot and dry, which according to Hippocrates axiom, {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, things are cured by their contraries; that is, by coolers, and moistners, and this is the first Canon. The second is taken from the morbifical putrid matter, which requires an ablation, or removing. The third from the nature and site of the affected part, as if the brain be affected, it requires other remedies than the Lungs, and this other than the stomach, Liver, Spleen, Guts, reins, Bladder, or womb, from the symptoms, if they be great with imminent danger of life, as if a Syncope be accidental to a fever, we must oppose that, omitting for a while the cure of the fever; but if they be small, we must respect both, so that we principally attend the Disease. The feverish beat both of continual and intermitting fevers arising from a putrid filth, cannot safely and wholly be extinguished, before the putrefaction be repressed, and the impurity taken away, for the method of curing requires this, that first we remove the cause, than the effect, unless something more urgent forbid it; the impure Humour then is first to be purged forth, and then if any extraneous heat be left, either in the Humours, or parts, it is to be extinguished, and by preparatives, and things opening obstructions to be removed; but against this Doctrine it is objected, That things cooling do per se increase obstructions, incrassate the matter, and hinder its evacuation, and the stipation being increased, and the fuliginous vapours included, the putrefaction is doubled. On the other side, aperient, detergent, and purging Medicines are all almost hot, and therefore per se are bad, and intend the fever; In this difficult case we must use the temperate roots, such as are the sharp Dock, grass roots, butcher's Broom, and Asparagus, which open obstructions without any manifest heat, and do not increase the feverish distemper, and so the worst is prevented, If the body be strong this method is strictly to be observed, that is, to remove the efficient cause, and thoroughly to open the obstructions with the aforesaid aperitive means, and then the putrid humour is to be purged, although the fever be a little exasperated by the Medicine that does it; but when by the fire of the fever the strength is much resolved, than we are to use cooling Medicines both inwardly and outwardly as Juleps, Epithems, &c. which with all possible speed may extinguish the heat, omitting a while the cause, for it is not safe to increase the fever by such things as cut off the cause, lest life depart with the Disease, but it is better in my judgement to extinguish the burning fever, though you somewhat transgress against the cause, but in curing of putrid fevers, the first place is due to the cause, that part of the matter be emptied, then to imitate Nature by preparing it, which when by her assistance it shall appear to be coct, than it possible to eradicate it, that the fever be not diuturnal; the emptying of the matter may be either by bleeding, or purging at the very beginning if nothing hinder. Bleeding in all putrid fevers, Of Bleeding. especially the continual, is not to be neglected, saith Galen, in the eleventh of his Method of curing, having premised a cooling Glister, or Suppository, if the Patient were bound; nor in intermitting fevers when there is a plenitude, or pulsative pain in the head, or tossing of the body with a suffocating heat, lest it degenerate into a continual fever, or the putrefaction spread wider, and it is to be done on the intermitting day, or at the time of remission in a continual fever, provided age and strength allow it; if the fever be very vehement and urgent, to let blood in that violence is to kill the Patient, saith Celsus; and if the body be weak, let blood a little at a time, so the strength will not be impaired, because part of the burden with which Nature was oppressed being taken off, she doth the more easily bear the rest, and with less force tame and subdue it, saith Galen; and we ought not so much to estimate the years as the strength of the diseased. A late Writer hath published, that Bleeding aught to be celebrated in all Diseases, which I cannot allow, though I admit it in most, but more sparingly when the fever is from a cold humour, lest by its refrigeration the crudity be doubled, and do not easily admit of concoction, if the Disease will suffer it, the best time for bleeding is the Spring, if not, it may be administered at any time of the year, if strength permit, especially if there be a plenitude, suppression of the Courses, or Hemorrhoids. If the Sick be bound in body, before you let blood, give a Suppository, or Glister, or eccoprotical Medicine that is gently purging, lest that the putrid matter should be rapt, or forced from the first region of the body into the greater veins, and so inquinate the blood, and make it more impure; the same is to be observed before we give a peritive medicines. Purging is to be used at the beginning, Purging▪ if the matter be turgid, Aphor. 10. Sect. 4. in Diseases very acute; purge the first day, if the matter invite to excretion, for delays in such cases are dangerous, and it must be done by some minorating Medicine, that part of the impurity being taken away, the remainder may the more easily be concocted, for according to Hippocrates Aphoris. 22 Sect. 1. we ought to move that which is concoct, and not the crude matter, nor at the beginning unless it be turgid, and for the most part it is not, and afterwards to purge with a stronger Medicine, unless it be done by the benefit of Nature; neither are we always to wait for the concoction of the Humours, especially where the matter is turgid, and with its fluctuating motion running from place to place perturbes the whole body, as it happens in the most acute Diseases. If the fever be continual it is better to purge at the time of remission, whethe it be in the morning or evening, than at the time of its exacerbation, or upon an odd or decretory day, if strength give leave, otherwise they are first to be refreshed with nourishments of good juice, and those rether liquid than solid, because those are of easier distribution, and then we are to use meanly purgers appropriate to the humour; but if the fever be intermitting, then purge on the day of rest, or upon the fit day, if the fit come not till after Dinner, at which time the humour is moved by Nature to expulsion, the strength having first been repaired by nourishments, for than it is easier, and with less pains driven forth, being in motion, as I have found by experience in curing of Quartans, as oft as I gave physic on the fit day; besides, it may be confirmed by reason, for that purging be instituted according to Art, we must consider the motion of Nature, whether she tends upwards or downwards, and the season of the year, and the inclination of the Sick, for if it be Winter, and the Patient aged, and vomit easily, and his stomach be full of crude clammy phlegm, He ought to have a Vomit, saith Polybius, in his Book of good Diet, which is falsely ascribed to Hippocrates the Great; for the Six Winter months purge by the upper parts: on the other side, If he vomit not easily he is not to be forced, saith Galen, and after him Aetius, but is to be Purged downwards, by some Medicine accommodate to the morbifical humour, at first purging those purgers which have an astriction with them ought not to be used as Myrobalans; juice of Roses, and the syrups compounded of them, especially if there be obstructions which usually accompany putrid fevers; and in purging of the humours we must be careful to use such preparation, that the passage be made open, Hippo. Aphoris. 9 Sect. 2. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. that is, when we would purge a Body, we must make it fluxil, that the humour to be emptied may yield, and be obedient to the traction of the medicament, for if the passages be obstructed, and putrefaction caused for want of ventilation, then before we purge we are to use incisive Medicines for the crass humours, detergent for the clammy, and so to clear the obstructions; and sometimes we are to appease and allay some heady humour (which ought not to have been purged) that by its furiousness and fervour, it rush not on some principal part, or by its acrimony exulcerate where it passes. The manner then of preparation, is to be proportioned to the humour, for the mitigation of the Disease; as for example, in acute fevers we use syrups and Apozems, which are made of such things as are attenuating and cooling, or which are detersive, and not very hot, as you may see in the second part of my Enchiridion, but in diuturnal slow fevers, which phlegm or melancholy engenders, stronger and hotter means are required; and those fierce humours which bleeding will not temper, nor purging carry away, we must bridle, and obtund with refrigerating Medicines, not of thin substance lest they be more exagitated, nor of crass because they hinder evacuation, but of a middle nature, which have a little austerity, or acidness, or both joined with them, such as are your Omphacium, juice of Sorrel, pomegranate, or Citron, by which the acrimony and putrefaction of choler may be retunded, and the heat kindled in the humours, be impeded from spreading any further. If besides the putrefaction there shall be any suspicion of venenosity, we must mix with the former such things as by a similitude of substance do repress it, whether inwardly or outwardly applied, which shall be described in our Tract of malignant and pestilent fevers; detergent and attenuating Medicines are to be fitted both for preparation of hot and cold Humours, because both Humours by their clamminesses, or crasseness may obstruct, as is manifest in vitellinous choler; if a detersive, and attenuatory faculty be joined with a cold quality, as in Succory, it is the more efficacious, and of more frequent use than that joined with a hot quality, as in wormwood, hyssop, Origanum, and that is to be used in hot Diseases, these in cold with mulse, and not with plain water, especially when the heat is sluggish, and the means not easily inflamed; but on the other side, with cooling Medicines we at once resist both the fervour of choler, and heat of the fever, and prepare the vicious humour which doth foment it before we purge, by a diverse quality▪ as more at large in the Second part of our Enchiridion. There are some that stoutly maintain the opinion of Avicen, That thin choleric humours ought to be incrassated before they be purged; which opinion seems to contradict Hippocrates and Galen, and may thus be reconciled. If sincere, or excrementitious choler be thin, it is not to be incrassated before purging, but presently to be cast forth, for so it easily yields to the attraction of the Medicine, and thus the opinion of the Greeks is true; but if the same choler be crass and tenacious, as the vitellinous is, than it is to be attenuated and deterged, as Avicen would have it, otherwise it cannot be driven forth, but by force and damage to the Patient; but if it be mixed with blood, than we are to expect concoction from the benefit of Nature, but the Fautorers of Avicen object against the opinion of the Greeks, That unless the thin humours be incrassated, they will be fixed in our members, penetrating into the most retired parts of our bodies; to which objection some answer, If the choler be infixed it will grow thick, and cause obstructions, and then extenuating and detergent, and not incrassating Medicines are necessary, or by attenuating remedies Nature is helped to excerne the noxious humour by urine or sweat; neither doth the strength of this Argument reach to preparation before purging; shall that which is crass then be attenuated, and that which is tenuous incrassated? Galen's opinion is, that That which may return to its natural state be altered, as by incrassating the thin (viz. in Diseases of the Breast) and attenuating the crass, but not so in preparation, or alteration before purging; and by this distinction the Greeks and Avicen may be made friends. Others give other Reasons against Avicen thus, The first Natural action is Attraction, to which thin Humours are most obedient, and most readily follow the medicament; the second is a kind of violent expulsion, by which also thin Humours are most easily driven forth, therefore they are not to be incrassated. There are three sorts of purging Medicines, some purge by Traction, such as Hippocrates, and the ancient Greeks used, as Euphorbium, Lathiris, Elaterium, Scammonium, Colocynthis, Helleborus, &c. which we use not now, unless in great Diseases, or in small quantity mixed with other things, and corrected, and on rustic bodies, whom gentler Medicines will little or nothing move, and not in continual fevers sprung from a hot cause. Others purge by smoothing, or suppling, as Manna Cal. Cassia Egypt, Sena, Polypody, syrup of Violets, &c. Others purge with astriction, as Rhubarb, all the Myrobalans, juice and syrup of Roses, which we use when the parts are to be strengthened, and there is no obstruction which they may prejudice; he that is to take a Purge in them morn, let him not take syrup of Poppies over night, or dissolve Treacle, or new Mithridate in it, because the cold quality they have from Opium doth hinder purging, according to the experience and authority of Galen in his twelfth Book, De Theria. to Piso. In the state of the Disease abstain from purging, that Nature be not called from her work, but commit the whole business to her, because then all symptoms are most violent, otherwise you add evil to evil, especially if a Crisis be near, Hippoc. Aphor. 29. Sect, 2. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. at the height is is best to be quiet; and in the next Aphoris. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. at the state of Diseases all things are most vehement, and therefore abstain from medicaments, or any way to move or irritate Nature, &c. Aphor. 20. Sect. 1. If the Crisis be perfect all is safe, and no more is to be done, but if there be any thing left, it is to be removed by Medicine for fear of a relapse, Aphor. 12. Sect. 2. that of Diseases which is left within after Judgement, does usually cause a return of the Disease; upon a critical day if there appear no signs of coction, but of crudity, though there be an excretion even in the state of the Disease, it is not to be trusted to, neither ought we to fear those evil accidents which happen not according to reason, but the noxious humour is to be emptied that the Disease return not, Aphoris. 27. Sect. 2. if any light thing happen besides reason in acute Diseases, we are not to trust to it, nor to be diffident if a greater business happen not according to reason, for such things are very uncertain, and of no long continuance, the whole matter of a Disease than cannot be rooted out, unless concoct and after the state, when those preter-rational symptoms are abated, and Nature is assisting to us; on the contrary, if there appear signs of a vasal plenitude, or of crudity, we must abstain from purging, and neither provoke sweat, nor urine, lest the vicious humours, so moved, be carried into the greater veins, and exasperate the fever, and make it more contumacious; by what remedies urine and sweat are to be moved, I have taught in my Enchiridion, in the first, second, and third Chapters of the Second part. These are the chief and general Canons to be observed in curing of fevers, whether continual or intermitting; other rules we shall set down in their proper place, now for their cure in special. CHAP. VIII. Of a Diary fever. THis fever Hippocrates calls {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} that is, flatuous, Of the name. and the other Greeks {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, because it continues but a day, rather than from a Fish Aristotle makes mention of in his Fifth Book of Animals, about the end of the nineteenth Chapter, but the Latins call it a Diary, which sometimes is extended to more days, when the spirits inflamed are crass, which if not resolved it degenerates sometimes into a putrid fever, sometimes into a Hectick● or malignant fever, saith Galen. The causes of this fever are either external, Of the external causes. or internal; the external are taken from the Six Non-natural things, as from the Air too hot and dry in the Summer, or the heat of the Country, or the hot and dry temperament of the Patient, as the Picrocholous or choleric natures, whose spirits are easily inflamed, from whence is an Ephemera; sometimes by the cold air, or use of aluminous baths, the skin is condensed, so that the fuliginous exhalations which should be excerned through the skin are repressed, and so the spirits are easily inflamed; sometimes it is from drinking of Wine, Drunkenness, long sleeps, or continual Watchings, overmuch labour, hard riding, idleness, or want of exercise, from the motions of body or mind, as from Anger, Fury, Hunger and thirst, Suppression of some hot humour, as of the Courses, or Hemorrhoids, from the contract of some feverish body, from an actual or potential cautery applied to a choleric or plethoric body, from hot meats, acrid Medicaments, salt things, and the like. The internal causes are obstructions, Of the internal causes. whether caused from without, or within; from an external cause, as from the thickeness of the skin, from within, as when a sharp distillation from the brain falls upon the heart through the Arterial veins, which inflames the vital spirit, whence is a Diary fever. Sometimes other viscera are obstructed, as the mesentery, Liver, Spleen, Reins, Bladder, womb, and when these are obstructed first of all, the Natural spirits not being ventilated grow hot, and by their power alter the spirits of the heart, and increasing their heat beyond the bounds of Nature cause a fever. Another internal cause is the inflammation or swelling of the Glandules, which makes a Diary, Hippocrates Aphoris. 55. Sect. 4. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. that is, all fevers from swellings are bad, except the Diary, and he saith the same, Epid. 2. Sect. 3. The signs are taken from the efficient causes, Of the sings. whether they be originated from things external, or internal; if it proceed from an external cause, you may know from the relation of the sick; if from the internal causes, by the heat, pulse, and urine, Hippo. 6. Epid. Com. 1. text 29. and Galen in the first to Glanc. chap. 2. and 9 and 10th. Method of Curing, chap. 4. for if it be exquisite the heat is mild, and gentle to the touch, which ends with a madidness or sweat; the pulse is swift and frequent, but equal and temperate (in case it be not joined with a putrid or hectic fever) except in that which proceeds from anger, sadness, hunger, crudity, thickness of the skin caused by cold, for then the diastole is greater, and swifter than the systole, the substance, colour, and sediment of the urine differ little from that which is Natural, Galen to Glan. And its fits are very easy, if it arise from the inflammation of some Bubo, or from the suppression of some humour, the urine shall be higher, and thicker, with a little sediment, and that crass and crude; it invades with rigour, and easily degenerates into an unputrid Synochus, if the Sick be plethorical; or into a Synechis, if he be Cacochymous, or into an hectic, if it be neglected, or ill cured. Such are most subject to it, Who are subject to it. as are picrocholous and of a hot and dry temperament, and in the Summer time; if it be exquisite, it is cured by the benefit of Nature alone, and for the most part its fit is twenty four hours, but sometimes lasts till the third day, when the vital spirits are most crass, if it be prorogued longer it is not exquisite, but is either an unputrid Synochus, or joined with a putrid fever, into which it easily degenerates. The rule for Cure is not taken from the matter, The Cure because there is none, but from the essence of the fever, which consists in the preternatural heat, which ought to be remedied by coolers, and moystners, for the faults of the spirits cannot be taken away by purging or bleeding, because here is neither cacochimy nor plenitude; Hippocrates in the Fourth part of his Book of diet in acute Diseases, and Galen in his Book of Procatarctical Causes, cured Menander sick of a Diary caused by heat, with Paregorical, and Diaphoretical Medicines, as Baths, Frictions, and ointments. We use Baths when we intend to relax the skin, The profit of Baths. call forth tenuous fullginous vapours, and change the habit of the body, but in the declination of the fever, with gentle friction, that we may cause sweats, and the fumid excrements may be discussed, and then especially when there is no crudity in the chief Vessels, nor inveterate obstruction of the viscera, nor hardness or weakness, lest that the crudity be carried into all parts of the body; if none of these things be, than the Sick may safely wash, otherwise not, lest that the obstruction and weakness of the viscera be increased, and the tumour, if there be any. It is good against the thickness and obstruction of the skin, from cold or astringent causes; if a Diary have its rise from dryness and heat, let the Bath be lukewarm, and not hot, having first emptied the belly if it were costive with a Suppository, or cooling and moistening Glister, lest it degenerate into a hectic, or Synochus. If from the thickness of the skin by reason of too great cold, or by use of aluminous Baths, Diaphoretical, and Paregorical Medicines must be boiled in the water, for those take away obstructions, and provoke sweats, being of a hot and tenuous substance, and cause the cooleness of the water to penetrate the deeper, but these being temperate or hot in the first degree, and of thin substance, as the Roots of Marsh Mallows, Fenugreek, Flowers of Camomel, Melilot, and Elder, by these means the closeness of the skin is to be made open, least perspiration being hindered, the Humours be inflamed together with the Spirits, and so a putrid fever ensue to the great damage of the diseased. The ancients used Bathing more for delight than health, which custom is now out of use. We in France use Baths of plain water, or with a decoctron of Plants, not for pleasure, but for the cure of an Ephemera, because they moisten, contemperate the feverish heat, and empty acrid vapours. To wipe off the sweat is good, with gentle frictions with warm oil, because it opens the pores of the skin, and calls forth the spirits from the centre to the circumference, but too vehement doth stop them up. Ointment and Frictions are not good for such Diaries as proceed from tumors inflamed, or from labour, because there is no need of evacuation; Frictions are good in those from obstruction and repletion, but not in those from inanition, though Galen did use gentle frictions in all Ephemeraes before the Bath or ointment, that the discutient water or oil might pierce the deeper; and the same Galen in other procatarctical causes uses contrary remedies, as for labour he commands rest, for watchings sleep, for anger calmness, for sadness joy, and for venery chasteness; these have no need of Frictions, only anoint them with oil of Violets, and smooth over the body in the remission, and before meats▪ If it be from Drunkenness, command a Vomit, if from cold, use Diaphoreticks; if from obstruction of the viscera, incisive and aperient Medicines; if from a catarrh, purge next day; if from an Ulcer or Bubo, we must attend the cure of Ulcers and tumors, and so of the rest. The Diet is to be ordered according to the variety of the cause, if hot weather be the cause of the Diary, and the Patient be young, and his viscera good without obstruction, plethory, or cacochymy, of soluble body, and choleric constitution, at the declination of the fever, he may be cured with plentiful drinking of cold water, if otherwise the Cure is to be altered; you must not nourish him in the augment or vigour of the Fit, but in the end, or out of it, Hippo. Aphor. the 11. Sect. 1. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. If you weigh the cause of the Disease, the strength of the sick, the age and sex, you must nourish him with meats of good juice, altered with cooling Herbs, which nourish speedily, oppose the feverish heat, but stick not in the pores of the skin, for the whole body ought to be fluxil and transpirable, Hippoc. at the beginning of the sixth Book of his Epidem. Sect. 6. and for this the chief thing is the juice, or cremor of Barley. If it proceed from anger, watchings, labour, immoderate venery, hunger, sadness, than we must nourish the sick with flesh broths, &c. if from crudity, gluttony, or from suppression of some Natural excrement, constipation of the skin, ulcer, tumour, or great pain, then let the diet be thinner; and if with the fever there be a plethory, or cacochymy, that must be taken off by bleeding, this by purging, not for any urgency of the present fever, but for fear of a putrid; in brief, in all Diaries, whatsoever is the cause, the nourishment must be Medicamental, and if the body be bound it must be thus loosened. Take of boiled honey an ounce, Mouse turd, powder of Hiera, and salt gem, each two scruples, and make a Suppository; or else make this Glister. Take of Mallows, Violet leaves, Borage lettuce, each one handful, Prunes twelve, of the four greater cold Seeds each two drams, water-Lilly-flowers, and Roses, each a small handful, boil them in water to a pint, strain it, and dissolve in it Cassia, with sugar, and the Simple Diaprunes each six drams, or as much of Galen's Hiera and Diaphaenicum, if the Patient be a seaman, Porter, Carter, &c. and the Diary proceed from cold, with honey of Violets, Roses, or Mercury, and oil of water-lilies, each an ounce and half, and give the Glister; after this, if the sick be plethoric, or full of blood and young, or the Haemorrhoids or Courses be suppressed, draw six or eight ounces from the right axillary vein, as strength shall allow; but if the Patient refuse a Glister, then in the declination of the fever give this following potion. Take of Melon-seeds peeled one dram, of Tamarinds two drams, Cassia nexly drawn one ounce and a half, infuse them in the common purging decoction all night over warm embers, strain it, and dissolve with it Sirup of Violets or Roses of nine infusions one ounce, and give this potion betime in the morn. Or instead of this you may give an ounce and a half of Manna of Calabria, dissolved in a little fresh broth. It the Diary flow from the thickness of the skin, or the use of Alume-baths, than this following Bath made of Paregorical, and Diaphoretical things will be good. Take of Mallows, Violets, saponary, Succory, wild Endive and lettuce, each six handfuls; new Roses if it be spring, or dried, if summer, four handfuls of Wormwood, and Centaury the greater, each two handfuls, Marsh-mallow roots sliced, or bruised a pound, of Fenugreek-seed, and Salt-nitre, each two ounces, boil them in a hundred pints of water for a Bath, into which let the sick enter at the declination of his fever, and drying his body let him go to bed, and there sweat an hour or two after. CHAP. ix.. Of an unputrid Synochus. AN unputrid Synochus hath no small Analogy with an Ephemera, for both are without putrefaction, and have but one Fit until their end; but they differ thus, an Ephemera is essentiated in a preternatural heat inflaming the vital spirits, and an unputrid Synochus in the blood preternaturally calified in the heart without putrefaction; is is differenced from a hectic, because this it in the solid parts, from a putrid fever by its putrefaction. The heat of a Synochus if compared with that of an Ephemera is acrid, if with that of the putrid, gentle, because the blood is of a temperate nature; the conclusion than may be, What a Synochus is. that a Synochus is a continual fever, proceeding from redundancy of blood, heated beyond measure by a preternatural heat, but without putrefaction hurting our actions. The causes are not unlike those of an Ephemera▪ but more vehement; the principal are the denseness of the skin, or filth obstructing the pores, and incarcerating fuliginous excrements, &c. which prohibiting the eventilation of the blood, do so inflame it, or the suppression of some evacuation, as of the Courses, Haemorrhoids, or from excess and fury; thus the vital spirits are first inflamed by reason of their tenuity, than the blood, which inflammation the Greeks call a Phlogosis; but under the name of blood you are to understand the four Humours contained in the greater veins, which as often as they are inflamed without putrefaction they cause this Synochus, full bodies that fare well, and live idly, are most subject to it, &c. This fever for the most part lasts till the seventh day begins with a coldness, The signs and ends with sweat, with a red urine, the pulse strong and swift, there is no danger in it unless some error be committed, and then it degenerates into a putrid Synechis, whence follows death, unless prevented by large bleeding; the whole body; but especially the face is dyed with blood, weariness possesses the limbs, the veins are turgid, the temples beat, the head aches, and often a deep sleep surprises, with difficulty of breathing; the skin is soft, perfused with moisture, and a gentle heat. The cure is taken from the essence of the fever, The Cure. and cause of the Disease; the essence being hot and dry indicates contrary remedies, and the cause, its removal; First then, let the diet be thin, cooling, and moistening Hippoc. Aphoris. 16. Sect. 1. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} a moist diet is good for all feverish bodies, especially for Children, and those accustomed to such diet, as Cock broth, or of lamb, or Veal, altered with cooling Herbs, and Barley waters, &c. or some acid syrups, as of lemons, Citrons, pomegranates, &c. Galen reckons amongst the chief remedies of this Disease bleeding till we faint if the body be open, otherwise to premise this Glister. Take of the leaves of Violets, borage, lettuce, purslane, each a handful, Prunes sixteen, of the four greater cold Seeds each two drams, boil them in water to ten ounces, the dissolve of simple Diaprunum and Sugar each six drams, honey of Violets, and oil of water-lilies each an ounce and half, and make a Glister, it cools, moistens, purges, and prevents a putrid fever, then let blood, for the veins being emptied that attract much cold art (to avoid a vacuum) into the room of the blood, by which the rest of the blood is cooled, and reduced to its ancient state, the fire extinguished, and the putrefaction inhibited, because both the Natural and preternatural heat are seated in the blood and spirits: then use this apothegm. Take the Roots of Sorrel, grass, butcher's Broom, & Asparagus, each an ounce (these roots resist putrefaction, and by their tenuity of parts open obstructions without any manifest heat) of both Succories, lettuce, borage, Purslane, or Liverwort, each a handful, Prunes sixteen, Endive seeds half an ounce, of the four greater cold Seeds each two drams, of Violet, and Water-Lilly-flowers each a small handful, boil them in three pints of Water to a pint and half, strain it, and add of the compound syrup of Endive, or of Oxysaccharum simple four ounces, and Aromatize it with white sanders for four or five days. After the seventh day you may give this Purge; A Cholagoge. Cinnamon a scruple, Rhubarb four scruples, Try pherae, Persicae three drams, Cassia newly drawn an ounce, infuse them one night in part of the Apozem over warm embers, than strain it, and add of syrup of Violets of nine infusions an ounce and half. CHAP. X. Of a continual putrid fever. A Synechis, fevers from Humours equally putrefied. or a continual putrid fever is twofold, the one where the Humours are equally putrefied in the great veins, the other when inequally; from those equally putrefied arise three sorts of fevers, as did in a Synochus unputrid, viz. the Homotonous, Epacmastical, and Paracmastical, and these have no manifest intermissions, as intdrmitting fevers, nor remissions, and exacerbations, as those which proceed from the Humours unequally putrefied in the great veins. When the Natural Humours do unequally putrefy in the great veins, it is either natural phlegm (which is nothing else but the cruder part of the blood) which as often as it putrefies it causeth a continual fever, which is every day at set hours intended and remitted, from whence it hath its name of a continual quotidian. If natural choler putrefy in the veins near to the heart, it causeth a {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, or burning-fever; if in places more distant, either upward or downward, a continual tertian is produced, which every third day is intended and remitted, but intermits not, because the putrid matter is contained within the great veins, and not out of them. Lastly, if a melancholy humour putrefy there, every fourth day it hath its remissions and exacerbations. The external causes are like those of an unputrid Synochus, The Causes. but stronger; the internal are obstructions, either in the greater veins, or in the skin, or in the small veins of the Liver, or habit of the body, which hindering perspiration the Native heat is extinguished, and hence putrefaction, the parent of this fever. The sig●es are taken from the mordent heat, The signs urine, and pulse; the urine is crass, red, turbid, fetid, and without sediment, the pulse not only great, vehement, and quick, but unequal and inordinate. A Crisis does usually happen in all Diseases one of these six ways, viz. How many ways a Crisis may be. by bleeding at the Nose, or by Vomiting, or by looseness, or by sweats, or by urine, or by parotides in malignant and pestilential fevers; if by chance Nature attempt a Crisis on the sixth day, although signs of coction appeared in the urine on the fourth, yet it is dubious, and foretells a relapse; but if with signs of coction the Crisis be with fainting, or any other grievous symptoms it portends death; or if a looseness seize at the beginning, and the fever continue in the same state with signs of crudity, it presages death, because Nature is overwhelmed with the plenty of matter; on the other side, if the fever be abated by the looseness, the sick well enduring it, and breathing freely, he shall escape; if spots appear the fourth, day, either black or livid, death is at hand, for they denote some malignant quality, which had they been red only, and the Patient strong with signs of coction, there were good hopes; this fever is most gentle in the morn. The Cure consists in evacuation, The Cure. and alteration; evacuation is to be made by bleeding, and that at the beginning for fear of suffocation or swoonings, but if the Patient sweat, or have the Haemorrhoids, or a Haemorrage, or the Courses appearing, than the whole business is to be committed to Nature, but if they flow but sparingly, and the fever be not mitigated bleed notwithstanding; the second part of the Cure consists in alteration of the Humours, by cooling and opening without any manifest heat, and restraining putrefaction, as with the forementioned apozem; besides, use this cordial powder. Take of red coral, The cordial powder. and the fragments of the five precious Stones finely powdered each a scruple, the bone of the heart of an Hart, or of an ox, (for they are both of the same virtue) half a dram, of Pearl a dram, sugar of Roses a sufficient quantity, and four leaves of Gold, let it be dissolved in broth or ptissan, or in the decoction of Sorrel roots. Take of the powder of Balm and Saffron each a scruple, An Epithem for the heart. Water-Lilly-flowers, red Roses, and Grana Tinctorum, each two scruples, powder of Diamargaritum frigidum four scruples, red Wine two ounces, Scabious, Bugloss, and Purslane-water each five ounces, apply it to the region of the heart, with a thick red cloth. Take of the Conserve of borage and Marigold flowers each an ounce, A plaster▪ confection of Alchermes a dram, spread them on a scarlet cloth, and apply it after the Epithem. Take of the Cerot of Saunders, A lineament for the Liver. and ointment of Roses by measure each an ounce, oil of Roses an ounce, then wash them often with Rose-water, adding half a scruple of Camphore, bath the part with a linen cloth, let it be cold in Summer, lukewarm in Winter, with three ounces of the white ointment of Galen, and half a scruple of Camphore, anoint the reins and loins once an hour. CHAP. XI. Of a burning-fever, and continual Tertian, THese fevers differ not in matter nor cure, fevers from humours unequally putrefied. but in their name and seat; both are caused by a choleric blood, putrefied in the great veins, the Viscera being well; that in the veins nearer to the heart, as in the ascending trunk of the Vena cava, and in the arterial vein, and coronal of the heart; this likewise in the great veins, but more distant from the armpits to the groin. A burning-fever is so called {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} by way of eminency, because it is so great a fire in the heart. This burning-fever, The division of these fevers. as also a continual Tertian is twofold, exquisite, and not exquisite; the exquisite is from choleric blood putrefied as afore, the non-exquisite is, when besides choler, salt phlegm, or ichors are putrefied with it, and this causus happens two ways, the one when the veins dried by the heat of Summer do attract to themselves choleric ichors which are acrid, as we being destitute of good food, make use of worse; the other way is, when ichors and other humours are cast from some strong part upon a weaker, and not ventilated, do putrefy; thus likewise a continual tertian is twofold, the exquisite from choleric blood, the non-exquisite from the admission of phlegm, melancholy, or ichors. The external causes are the hot air, The external Causes. inspiration of putrid vapours, a choleric distemper, drunkenness, sadness, by calling the heat from the circumference to the centre, &c. The internal are either antecedent, Causes internal. as obstructions from crass and viscid humours which hinder perspiration, by which means even good humours putrefy; or a plenitude, either quoad vasa, which distends the Vessels, or ad vires, which cannot be concocted and governed by nature. Or continent, as the putrid humour itself, which inquinates the pure blood of the heart, not the whole mass at once, but that which is next it, and so by order of succession. The cause of a not exquisite continual tertian is the mixture of salt phlegm, The causes of a not exquisite continual Tertian. or ichors, putrefying in the veins of the midriff, which proceed from the ascending Trunk of the Vena cava, or from the veins of the mouth of the stomach which flow from the Splenical trunk of the Porta, and make the stomachical coronary, or else it flows from the hungry Gut, or the simous part of the Liver; the signs of both legitimate, and illegitimate, are almost alike. The pathognomonical are taken from the burning heat which choler produces, Signs Pathognomonical of a causus. and the unspeakable thirst, the acrimony of the humour continually molesting the heart and stomach, unless by chance a thin humour fall from the brain, and moisten the tongue. Signs assident or concurring are the dryness, signs assident. blacknness, and roughness of the tongue from the adustion of the humour pain of the stomach, Dreams, delirations, difficult breathing, the Lungs or midriff being inflamed, &c. sometimes it begins with a gentle rigour, sometimes with Vomiting, sometimes with sleepiness if it be exquisite, sometimes with horror, if it be spurious by reason of the mixture of choler and phlegm, at the beginning the urine is crass and turbid, the pul●e small and unequal. The signs of an exquisite tertian have great analogy with those of an exquisite causus, signs of exquisite Tertian. only they are more mild; the not exquisite are distinguished by rigour, not by reason of the fever, but the expulsive faculty of the greater veins, which empty themselves into the less, and these into the habit and sensible parts; this fever because its morbifical matter, is more distant from the heart, then that of a Causus, doth not with equal force and assiduity afflict it, but hath its exacerbations and remissions every other day. If the parts about the heart be distended without pain, prognostics they signify an inflammation; if with pain at the beginning, death. If the signs be grievous, it kills the fourth or seventh day; if good, security is promised the same days; if a rigour happen on the critical day, the Patient being weak it is death, but if strong, the Disease shall end with sweat. CHAP. XII. Of the Cure of these fevers. LEt it be temperate, The air. or if too hot, be cooled with irrigations on the floor, and spreading cool Herbs, as lettuce, Vine leaves, Willow, oak, Rushes, &c. with green flowers of water-lilies, Roses, Violets, let vinegar of Roses dilute with Rose-water, sucked up by a sponge be often ●eld to the Nose; let the linen contrary to the vulgar opinion be often changed, lest its filth foment the fever. Let his drink be boiled water, His Drink. with syrup of Vinegar, or ptissan, or water and sugar, with a little juice of pomegranates, Citron, or Lemons; if you fear a Delirium, use the Alexandrine Julep, or syrup of Violets, and water-lilies. If the fever be spurious, and the Patient aged and weak in a cold air, a little Wine dilute, with boiled water and sugar, with a toast may be allowed; let his food be liquid, cooling, and moistening, as Chicken, veal, or lamb broth altered with Purslane, lettuce, Sorrel, borage, Bugloss, Violets, Marigolds, with the greater cold Seeds, and white Poppy-seed, or barleywater, acid fruits, as Barberies, strawberries, raspberries resist putrefaction; if he be much enfeebled, jellies, and Analepticks must be used. Let blood as soon as you can, Bleed. but if he be bound in body give this Glister first. Take of Violet leaves, A cooling Glister. Mallows, lettuce, Gourds, borage, each a handful, Prunes sixteen, of the four great cold Seeds each two drams, red Poppy-flowers, or Water-Lilly, and Roses, each a small handful, boil them in Whey or Water to a pint, strain it, and dissolve of Diaprune simple, and Cassia newly drawn (if it be exquisite, if not of Diaphenicum, each six drams, honey of Violets, and oil of water-lilies, each an ounce and half, or so much of oil of Cammomel if it be not exquisite, and make a Glister. Take of Melon-seeds one scruple, A Bole. Rhubarb gross powdered, if you would purge choler by stool, or fine powdered if by urine, four scruples, Cassia newly drawn six drams, let him take it with Sugar, and an hour and half after take fresh broth. As often as Cassia, A Rule to be observed. or any other purging Medicine is infused, the Dose is to be doubled, and where you fear obstructions, never purge with those things that have an astriction, as Myrobalans, Roses, and the syrups made of them; but instead of them use Manna, Cassia, or syrup of Violets of nine infusions; next, alter the humour, with Juleps which inhibit putrefaction. As take of syrup of Endive compound three ounces, A Julep. Succory and Purs●ane water each half a pint, but if they be spurious take of Oxysaccarum compound, which hath the opening roots in it, and a little juice of pomegranates, after signs of coction, purge forth the humour thus. Take of Cinnamon a scruple, A Purge for Choler Rhubarb four scruples, Tamarinds two drams, Diaprune solutive six drams, infuse them all night on warm embers in a decoction of the opening roots, strain it, & add syrup of Violets of nine intusions, or of Roses solutive, with Agaric; if the fever be illegitimate, an ounce and half, and give the potion▪ in a Spurious causus, take so much Diaphaenicum which purges phlegm and choler; but if the Patient have a pain in the stomach, and be nauseative, let him take a Vomit so he be not tabid, or narrow chested. CHAP. XIII. Of a continual Quotidian fever. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} and {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} the Juniors call it, Of the Name. because it hath no intermission, and to distinguish it from {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, which is, an intermitting quotidian. This fever differs from an intermitting both in matter and seat where the phlegm putrefies, because a continual one proceeds from Natural phlegm contained in the great veins, which is nothing else but crude blood, which in time may be changed into good blood, How a continual and intermitting differ. being of taste sweet, or insipid, arising from the cold and moist part of the chyle, and as oft as this blood is putrefied by a preternatural heat in those veins, the other humours incorrupt is caused a continual quotidian; but an intermitting is caused from excrementitious phlegm, putrefied by a preternatural heat out of those great veins, viz. in the veins of the habit of the body, in the Liver, Spleen, mesentery. The external causes may be taken from the air, External causes. cloudy, cold and moist, from a phlegmatic nature, the winter season, drunkenness, ill diet, as entrails of Beasts, &c. The internal causes are a cold, distemper of the stomach, and of the meseraic veins, which send the chyle incoct to the Liver, old age, cold humours falling from the head to the stomach. This fever begins not with coldness, The Signs. as an intermitting, because the matter is putrefied in the great veins, but with vaunings and stretchings, for the most part it invades at night, the heat is less acrid and mordent than in a continual choleric fever, because the humour is colder, the urine at first is white, crude, and crass, the pulse slow, and rare, being oppressed with a crass vapour raised from the phlegm; the sick are sleepy, their Hypochondria stretched with wind, their stools white, their sweat none, or very little, and clammy, this fever is usually lasting, being from a cold tough humour, often brings to a Cachexy, or dropsy; if the beginning be long, so will be the increment, and whole progress of the Disease; for the Cure, let him use a good diet, shunning those things which engender crass juices, then purge the first region of his body with these following remedies. Take of Barley, A Glister. Mercury, Violets, and Mallows, each a handful, Fennel, and Carret-seeds, each three drams, the tops of Dill, and flowers of Cammomel each half a handful, boil them in water to a pint, strain it, and dissolve of Galen's Hiera, and Benedicta Laxativa, each six drams, honey of Rosemary, and oil of Camomel, each an ounce and half, and so give it. If the Sick be apt to Vomit, let him take this. Of the juice of Radish roots, A vomit and honeyed water each two ounces, powder of Asarum a dram, let him drink it warm. Take of Succory, A Purge for the phlegm. Barley, and all the capillary Plants, each half a handful, Raisins stoned eight, four Prunes, of the Cordial flowers a small handful, boil them in water to two ounces, then infuse the Electuary of Diacarthamum half an ounce, Cassia newly drawn an ounce, Agaric Trochiscate a dram, strain it, and dissolve of syrup of Roses solutive an ounce, give the potion. Take of Agaric Trochiscate a scruple, of imperial Pills a dram, with honey of Roses, make eight Pills to be given after midnight. The first region of the body being thus cleansed, Bleed. open the basilick vein of the right arm, and draw blood according to the strength, age, season, region, and impurity of it, because this being a continual fever, bleeding is good for this as well as others. Then give this Julep, A Julep. Oxymel simple, and syrup of maidenhair, each an ounce and half, Fennel, and Endive water each half a pint, condite it with cinnamon. Take of Fennel, An Apozem. and Parsley roots cleansed from the pith, butcher's Broom and Asparagus each an ounce, of Maudlin, Succory, Endive, the common capillary Plants each one handful, the less Sea Wormwood half a handful, Raisins stoned twenty, figs twelve, Endive seed half an ounce, Aniseeds two drams, Bugloss and French Lavender Flowers each a small handful, Rosemary half a handful, Water and honey two quarts, boil away half, then clarify the colature with honey of Roses, and syrup of the juice of Endive each two ounces, and condite it with cinnamon. The matter being thus coct, Pills▪ give Pills of Agaric, and simple Hiera each two scruples, and Trochiskes of Alhandal two grains, if they want a quickener make them up with honey of Roses, and gild them; give them after the first sleep; next day give this Bolus three hours before dinner, old Mithridate two scruples, conserve of Rosemary flowers two drams with sugar. CHAP. XIIII. Of a continual Quartan. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, a quartan fever so called, Of the Name. because every fourth day it is exasperated, and remitted if it be continual; but if intermitting, recurs every fourth day; these two differ both in matter and seat, the matter of a continual quartan is Natural melancholy putrefied in the great veins, the other humours remaining good; but the matter of an intermitting, is excrementitious melancholy, putrefied out of the great veins in the Spleen, or mesentery. A continual quartan is twofold, exquisite, or spurious; exquisite, when Natural melancholy putrefies alone; spurious, when other humours putrefy with it in the great vessels, and this is most frequent. The causes are either from a laborious life, The Causes. a cold and dry temperament, a declining age, the autumn, or an unequal air, and meats producing melancholy, as swine's flesh, Hares, Salt Fish, Oysters &c. The chief signs are taken from the substance of the fever, The Signs. or nature of its heat, from the actions hurt, which appears by the inequality, swiftness, slowness, or rarity of the pulse from the excrements and urine, this fever begins without horror, because the peccant matter is contained within the great veins, the urine is various, but for the most part crude, by reason of the coldness of the morbifical humour, little or no sweat, by reason of the paucity of the matter, little thirst, and the tongue inclining to black. A continual quartan, prognostics. whether exquisite or spurious, is deadly in old men, especially if it follow an intermitting one, or a burning fever illcured, a spurious quartan if it take in the Summer is for the most part short, but if in the Autumn it is long; for the Cure, first use meats of good juice, rather liquid than solid, altered with borage, Bugloss. &c. Use currants, Pine Nuts, The Cure. figs, Vinegar, though it be incifive is not good in this fever, because by its coldness and dryness it conduplicates the humour, but were it in the Spleen it were commodious. At the beginning use gentle Purgers, A Rule for purging. because by the strength of strong Medicines the humour grows thicker, and the thinner part being dissipated, the terrene faeces remain indissoluble, but in the declination use stronger; if the body be bound give first this Glister. Take of Mallows, A Glister. Violets, Orech, borage, Bugloss, each a handful, Flax and Fenugreek-seed each half an ounce, of the four great cold seeds, and Fennel-seed, each two drams (for melancholy people are windy) of the tops of Dill, Camomel, Melilot, Elder, each a small handful in the colature, dissolve of Catholicum and Diasena, each six drams, honey of Violets, and oil of lilies each an ounce and half, give the Glister. Take of Polipody of the oak six drams, A purge for melancholy. wild Saffron seeds and Sena each three drams, Dodder of time two drams, Anni-seeds four scruples, Cloves two, boil them in Whey to three ounces, then infuse of Diasena, or Diacarthamum six drams, strain it, and add syrup of Violets of nine infusions, or syrup of Apples an ounce and half, and give it. The body being thus emptied, let blood at the left basilick vein, with a large Orifice. If the sick be inclined to Vomit, A Vomit▪ then give him of the powder of the middle rind of a Walnut, or of Broom-seeds, or of the roots of Asarum four scruples, with the decoction of Reddish roots make a vomit, or Nettle-seed powdered given in Mulse or Whey will do the like; some give three or four grains of Stibium prepared, which I allow not but in rustic bodies. Take of the syrup of the juice of Fumitory three ounces, An altering Julep. Endive, and borage-water each half a pint. Take of the roots of Bugloss two ounces, An Apozem. sharp Dock-grass, butcher's broom, Asparagus, and Liquorice, each an ounce, of the middle rind of Tamarisk, and Ash, or Elder, each half an ounce, of Fumitory, Hops, common Endive, Succory, miltwaist, balm, each a handful, Prunes fourteen, Cuscute and Purslane-seeds, and the four great cold Seeds each two drams, flowers of Tamarice, Broom, borage, Elder, each a handful, boil them in order in a sufficient quantity of water, then add the juice of sweet Apples three ounces, a sufficient quantity of Sugar, Aromatize it with a dram and a half of the powder of Galen's Laetificans, with part of this decoction, you may make a magistral syrup by adding Purgers of melancholy, by which the Morbifical humour may be purged epicrastically; to strengthen the viscera use this. Take of the Electuary of Hyacinth, Lozenges. or confection of Alkermes half a dram, powder of Diatriasantali, and Galen's Laetificans each a dram, white sugar dissolved, and boiled in Fumitory water four ounces, and make it into Lozenges of two drams weight, with the conserve of Succory flowers, and Milt waist each three drams, and give one, three hours before Dinner. If the Spleen require it, use this ointment. Take of Gum Elemi, The ointment for the Spleen and juice of Tobacco each an ounce, oil of St. Johns-wort, or Elder, half an ounce, of Rosen and Gum Amoniake dissolved in Vinegar of Capers, and yellow Wax each two drams, on the fire add powder of long and round Birthwort, and Cyclamen root each a dram, make an ointment. CHAP. XV. Of an intermitting Tertian. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} is taken by the Greeks in general for every intermitting putrid fever, which ends, and returns again, but Hippocrates especially calls this fever of which we now treat, {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, because it recurs every third day, it differs from the continual, of which we have spoken, not essentially, but in matter, seat, because their matter putrefies not everywhere, but in the lesser veins which are in the stomach, liver, mesentery, guts, spleen, womb, and habit of the body; an intermitting Tertian is twofold, exquisite or spurious, the exquisite is from excrementitious choler, which being manifold, there are many differences in Tertians. The matter of an exquisite tertian offends either in quantity or quality; the quantity is either great or small, if great, either it putrefies in one place, or in divers at once; if but in one place, it causes an exquisite tertian, which exceeds not seven Fits; but if the quantity be small, it shall end the fourth or fifth fit. If the matter offend in quality, as the choler is more or less hot, the whole constitution of the Disease and the fits shall be longer or shorter, milder, or more tedious, for pale or excrementitious choler is sarre more mild than yellow, and this, then vitellinous, porracious, or aeruginous, but the ceruleous is the hottest of all. If choler putrefy in divers places together, Whence a double Tertian. and the same day, than is caused a double intermitting tertian, whose fits return every third day, and are exacerbated, although they assault every day, and intermit, because that which is putrefied is every fit emptied either by sweat, vomit, or stool. The spurious one by the mixtion of phlegm or melancholy, is longer than that from excrementitious choler only, and lasts according to the nature of the humour mixed, and by the patient's intemperance hath lasted from the Autumnal to the spring aequinox. The causes of the exquisite are all hot and dry, The Causes. as a hot Summer, hot aliments, hunger, thirst, labour, strong wines, hot liver, and temper, &c. The causes of a spurious one are idleness, effeminacy, winter season, cold and moist diet, obstructions, plenitude, &c. The heat of an exquisite Tertian is more acrid and mordent than that of the spurious, The Signs through its four times, it begins with rigour, and often with choleric vomitings, and ends with an universal sweat; when the rigour is off, the heat is like a light fire, burning with difficult breathing, the urine at first is somewhat red, of mean substance, and in the lower part seems thin, in the upper opacus. The signs of a spurious one are horror, from the mixture of choler and phlegm, a heat more obscure than that of the exquisite Tertian, and more manifest than that of an exquisite quotidian, a pulse small and slow, which if it grow daily harder, the fever shall last many months, bitterness of mouth, pain in the vertebrae, with inflation of stomach, and loathings of meat sometimes trouble them. Before we let blood let the first region of the body be emptied by a cooling Glister, A Caution. or minorating purge afore described, lest the morbifical humour be wrapped into the greater veins, and so we cause a continual fever instead of an intermitting; let blood on the intermitting day with a small Orifice, to prepare the humour. Take of Oxysaccharum simple, A Julep. and syrup of the juice of Endive, each an ounce and half, Succory, and purslane water each five ounces, then purge him thus. Take of cinnamon a scruple, A Purge for choler. Rhubarb four scruples, Tamarinds two drams, Diaprune solutive, or Electuary of Psyllium six drams, infuse them all night over warm embers in an opening decoction, then add syrup of Roses an ounce, give it on the intermitting day, or these pills. Take of Diagridium four grains, Pills▪ Rhubarb a scruple, of Pills Aureae a dram, make them up with syrup of Succory, and give them after the first sleep Take conserve of Succory flowers, A Bolus. and of Violets, or water-lilies each two drams▪ powder of Diatriasantalum scruple, with Sugar make a bowl to give next morn to allay the fire in the bowels. CHAP. XVI. Of the Cure of a spurious intermitting Tertian. THis fever is more frequent than the exquisite, because men indulge too much to their Genius, and its Fits and whole constitution is longer, by reason of the mixture of tough, crass phlegm, or melancholy, the Fits are sometimes twenty, twenty four, or forty hours, and then it is called an extense tertian; let the diet be incisive, and detersive, and somewhat refrigerating, the broths be altered with Endive, borage, Parsley, Wood-sorrel, Purssaine, and a fourth part of Hissop or Savoury, give jellies which nourish much in small quantity, and because they are quickly excerned, repeat them often, and sometimes give this powder. Take of Galen's Laetificans two drams, A Cordial powder. the analeptic or Resumptive powder half an ounce, pure Sugar six ounces, leaves of Gold six, dissolve it in broth it wonderfully restores strength, if the Patient be nauseative. Take of nettleseeds a dram, A Vomit. syrup of Tobacco, or simple Oxymel an ounce, give it warm in mulse after meat, because it troubling the aeconomy of the stomach, it better exonerates itself with the meat, if occasion be for a Suppository. Take of Honey boiled an ounce, salt gems, and Mouse-turd each two scruples. Take of cinnamon a scruple, A Suppositary. agaric Trochiscate two scruples, Rhubarb four scruples, simple Oxymel and Diaphaenicum each six drams, infuse them all over warm embers in a fresh infusion of Damask Roses, strain it and give it. If strength and other things allow it, A Purge let blood on the intermitting day. Blood, saith Avicen, is a brideler of choler, both in respect of its quantity and quality, for there is more or it, and being temperately hot and moist, it doth moderate the acrimony of choler, and experience tells us, that those that are sick of a continual tertian, and the phrenitical, are best towards morning, because blood hath then the dominion, and worst towards night when phlegm rules, and therefore in Asia those that were let blood presently became phrenitical, or delirious, and not those which were not; but that region is far hotter and drier than Europe, then give this Julep. Syrup of Vinegar compound, A Julep. and honey of Roses, each two ounces, Endive, Succory, and Agrimony water, each half a pint. Take of the five opening roots cleansed and bruised each an ounce, An Apozem. infuse them in a small quantity of simple Oxymel on the embers four hours, the herbs Succory, Endive, Liverwort, and the cappillary Plants each a handful, Penni-royal, Origanum, or calamint, each half a handful, Liquorice scraped and bruised two drams, Raisins stoned twenty, Prunes eight, Endive seed three drams, Melon, Anise, and Fennel-seed each a dram and half, the three Cordial flowers, and Chamomel, each a small handful, Time half a handful, boil them all in order with the Oxymel and roots in two quarts of water till a third part be wasted, clarify it, and aromatize it with cinnamon. Take of Cloves half a scruple, A Purge. agaric Trochiscate two scruples, Rhubarb and Tamarinds each four scruples, Diaphaenicum six drams, infuse them in part of the apozem and give it. Take of conserve of Succory flowers, Citron Pill candied each two drams, old mithridate half a dram, give it with Sugar three hours before meat. Take of Pills Imperial, A bolus. a dram, of Agaric a scruple, Diagridium four grains, make them up with honey of Roses. To strengthen the Liver, Lozenges for the Liver. take of the powder of Diatriasantalum two drams, conserve of Succory-flowers, and Citron pill condite each three drams, pure Sugar dissolved and boiled in Agrimony water, four ounces, make Lozenges of two drams weight, and give one every morn; if melancholy be joined add those things afore mentioned for it, instead of Phlegmagoges. CHAP. XVII. Of an intermitting Quotidian. THis fever is caused from excrementitious phlegm putrefied, and every day hath new fits with a refrigeration or chillness, the place of putrefaction is the smaller veins and habit of the body, and chiefly the stomach, which is always almost affected in this fever; sometimes it is in the mesentery, the simous part of the Liver, Spleen, or womb; but if it putrefy out of the smaller veins, it doth not cause a fever, but some other Malady, as if it be putrid and stinking in the brain, or in the Lungs after Cathars, and Astma's, or in the womb, from whence is a woman's Flux; or in the Guts, from whence are Worms, or in the bladder or reins, where it is dried into stones of divers colours. By phlegm is here meant any cold and moist humour produced in us, which may be putrefied from a hot or cold cause, that putrefied from heat, or the mixture of a serous moisture becomes salt, from cold if remiss is caused acid phlegm, if intense, the glassy or albugenious, from these several sorts of phlegm are engendered various fevers. A Quotidian fever is twofold, The division of this fever. the one from excrementitious phlegm which is of sweet taste, or insipid for the most part produced in the stomach, which when it putrefies in the lesser veins makes an exquisite Quotidian; the other is, when some other humour besides phlegm putrefies with it, and it is called a bastard quotidian; let the physician be careful he coufound not a bastard Tertian, or double intermitting Tertian, or a triple Quartan, which have their fits every day with an intermitting quotidian, for their cure is far different, and distinction difficult. The causes of this fever are not unlike those of a continual quotidian; The Signs gapings and wretchings precede this fever, with a coldness of the external parts, as of the Nose, Fingers, Ears, Hands, and Feet: with a pain in the stomach, seldom with rigour, but with a gentle horror, the pulse inequal, inordinate, slow, and weak at first, afterwards more vehement and swift; the urine first thin, white, and crude, afterwards thick and turbulent; sometimes they vomit phlegm, have acid belchings, swellings of the Hypochondria, pale faces, and little thirst; it usually seizes after noon, towards the evening or night; its fits are for the most part eighteen hours, and therefore it is called {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} that is, partaking of both day and night, its intermission is impure by reason of the quantity, crasseness, and clamminesses of phlegm which is left by the former fit, and is the cause of the following, because it is not breathed forth by sweat as in a tertian; this pituitous humour is hardly inflamed and moved, but the matter being coct, the vehemency of the fits cease, as in all other wholesome sicknesses, its heat is not burning, but meanly acrid. The signs of a bastard quotidian are confused, signs of a bastard Quotidian by reason of the excrementitious choler, or melancholy putrefying with it, but if choler be mixed, you may know it from the Vomitings, stools, urine, pulse, and a more acrid and mordent heat, for some choler will be cast up, the excrement will be yellow, and the water tinct with choler, the pulse inequal and more frequent than in the exquisite, the fits shorter, with thirst and bitterness of mouth; if melancholy be mixed consider its signs, with the Spleen ill-affected. Let the diet be hot and drying, The Cure. incisive and detersive; let the drink be decoction of Sarsa Parilla root, syrup of Vinegar, or Hydromel; moist meat that is substantifically moist is good for all fevers, saith Hippocrates, as broths of euchymous flesh altered with Parsley, Fennel, Hyssop, Savory, Margerum, Sage, Time, with a little Endive, purslane, or borage, if it be spurious, the meat is easily corrupted by a feverish heat, as milk by the hot air; let them sleep in the declination, and not in the beginning of the fit, if the sick be nauseative give a vomit, and than what followeth. Take of soap an ounce, A Suppositary. powder of simple Hiera, Agaric, and Salt Gemmious each a dram, seeds of Coloquintida a scruple, beat them in a mortar with juice of Mercury, make suppositories, and dry them up for your use. Take of Origanum, A Glister. pennyroyal, Calamint and Mercury each a handful, seeds of Dill three drams, Agaric two drams, Chamomel and Dill flowers each half a handful, boil them in water to a pint, honey of Roses, oil of Nuts, each an ounce and half, Benedicta Laxative, and Hiera, or Diaphaenicum each half an ounce, make a Glister. Take of Polipody of the oak bruised half a dram, A purging Potion. wild Saffron seeds, and Sena each two drams, Calamint half a handful, aniseed a dram, two figs, flowers of Time a small handful, boil them in water to three ounces in the Colature, infuse of Diacarthamum six drams over warm embers, syrup of Roses solutive, with Agaric an ounce, and give it; if it be Spring time, and the body young, or any evacuation suppressed, open the right axillary vein, then give this Julep. Oxymel compound four ounces, A Julep. Sage, Betony, and Succory water (if choler be mixed) each five ounces. Take of Cocheae Pills, Pills. and of Agaric each half a dram, powder of Hiera a scruple, Agaric Trochiscate four grains, Trochiskes of Alhandal two grains, or if choler be mixed, of Diagridium two grains. Take of Diarrhodon and Galangal each a scruple, A Condite Trochiskes of Wormwood two drams, Citron pill condite with Honey an ounce, Conserve of Sage, and Rosemary flowers each two ounces, cover it with Gold, let him take half an ounce three hours before dinner. Take of oil of Wormwood, A lineament. and mastic each an ounce, oil of Nutmeg half an ounce, mix at the time of use a few drops of red Wine, and anoint the stomach. Take of the plaster of mastic two ounces▪ A plaster. of laudanum an ounce, powder wormwood two drams, red Roses a dram, Mace two scruples, reduce them to a mass, and make a scutiforme plaster for the stomach, an Epiala being from glassy acid phlegm requires the same Cure, only stronger remedies. CHAP. XVIII. Of a Quotidian fever from salt phlegm. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, Of the Name. that is, a salt or salsuginous fever, is of the nature of Quotidians, so called because it is caused by salt phlegm, as a Winterburning fever is, according to Hippocrates, but according to Galen's explication of that place, it is so called in relation to touch, and not unto taste, because like Salt it causes an itching mordency both in the body of the sick, and the hand of the physician touching it, which is thus, when fuliginous and very adust excrements are cast forth through the habit of the body and skin, it is distinguished from other fevers by its horror, thirst, and salt taste, by urine and pulse, and continuance of the fit, saith Hippocrates, by reason of its heat from putrefaction, or the mixture of some serous humour which is salt, rather than of choler which is bitter, and not salt, as Avicen thought. It is cured by the same remedies as an intermitting quotidian, The Cure. tempering them with Succory, Hops, Fumitory, the four great cold seeds, &c. with incisive, attenuating, and detersive things, as syrup De Bisantiis, and compound Oxysaccharum; we are not to expect concoction for purging the morbifical humour, which is so crass and tough that it will be a long time first; purge therefore in the augment and state, but gently premising to every Purge its preparative, your Catarrhall fever is of the kind of quotidians, and is cured almost with the same medicines. CHAP. XIX. Of an intermitting Quartan. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, or a Quartan fever, is so called, because it returns every fourth day, it is twofold, exquisite or spurious; an exquisite intermitting, differs from a continual, both in matter and seat, because this is from a Natural melancholy putrefied in the greater veins, and that from an excrementitious melancholy, cold and dry, putrefying, chiefly in the Spleen, then in the Liver, mesentery, and habit of the body; a spurious one is as often as excrementitious, melancholy putrefies with choler, or phlegm in the same place, and sometimes choler and phlegm putrefy apart, and degenerate into a quartan. The chief signs are a rigour at the beginning and augment, The Sign● and horror, with a shaking of the whole body, as if the flesh and bones were broken; the urine at first white, thin, crude, and various, afterwards crass and black. This fever is the longest of all intermitting fevers; prognostics. the Falling-sickness is cured by a quartan, if neglected it causes a schirrus of the Spleen and dropsy; if it degenerate into a double or triple quartan it is bad, but if into a continual it is lethal. The sum of the Cure consists in gentle Medicines, The Cure. whether Glisters or Purges often repeated, and by degrees ascend to stronger, for he that acts otherwise from a simple or double quartan, makes a triple or continual one, whence is death; this is confirmed by Galen's story, who contrary to the opinion of the physicians of his time, in the midst of winter, cured Eudemus the Philosopher of a triple quartan by the use of Treacle, by which Medicine preposterously used be fell into it, for as long as signs of crudity appear, we are not to use diuretics, nor Sudorificks, lest by that means the corrupt humour be forced into narrower passages, from whence it is not easily removed, but grows more furious; such excretions than are not to be used but in the declination. If the quartan be from choler adust, then to the following remedies add things cooling, but if from phlegm, than things incisive, attenuating, and detersive. If the fever be exquisite, the melancholy humour diffused through the whole body, vinegar and its syrups are nought, but if it be contained in the spleen only, it is good. Take of Mallows, A Glister Violet leaves, borage, Fumitory, Hops, each a handful, Prunes twelve, Endive seeds half an ounce, of the four great cold Seeds each two drams, Violet and Elder flowers each a small handful, boil them in water to a pint, in the colature, dissolve of Cassia, with sugar and Diaprune simple, each six drams, honey of Violets, and oil of lilies each an ounce and half, give it. Take of the pulp of Cassia six drams, A Bole so melancholy. powder of Sena a dram, of Aniseed, a scruple, of Cloves two grains, with sugar make a bowl. Take of Polipody of the oak bruised six drams, A Purge for melancholy▪ Fumitory, Hops, borage, each half a handful, Prunes four, figs two, the seed of Dodder, of Vetches, Anise, and Purslane each half a dram, boil them in water to four ounces, in the colature, boil of Sena leaves two drams, Aniseed a dram, whole Cloves two, express it, and infuse of Catholicum, and Diacarthamum each three drams, again express it, and dissolve syrup of Fumitory, or Epithimum an ounce, give this potion four hours before in broth, upon the fit day rather than on the other, because the matter being terrene and sluggish, will hardly yield; but on the fit day the humour being in motion, it is then most easily expelled, I speak by experience, contrary to the common opinion. Take of pills of Fumitory a dram, Pills. powder of Sena, and Agaric Trochiscate, each half a scruple, with syrup of Fumitory, make pills. If Nature tend upwards give of Antimony prepared and powdered three grains, Vomit. Conserve of Violets three ounces, with Sugar make a bowl to be taken on the fit day; or infuse six grains of it in White-wine all night over warm embers, strain it, and give it before the horror. Amatus Lucitanus boasts, he hath cured many with a draft of Rose-water warmed, and given at the insult of the fit, and some with happy success give at the insult five or six grains of Pepper in a cup of generous Wine; if the Patient be young with full veins, and it be spring time, let blood of the axillary vein in the left arm. Take of the roots of sharp Dock two ounces, An Apozem for choler adust. butcher's broom, Asparagus, Grass, and Liquorice each an ounce, the middle rind of Ash and Elder each half an ounce, Succory, Endive, Hops, Fumitory, borage, Agrimony, Burnet, Miltwaist, Mercury, each a handful, Prunes twelve, new figs eight, Endive, purslane-seed, and the four great cold ones, each two drams, the three Cordial flowers each a small handful, boil them in two quarts of water till a third part be consumed, clarify it with syrup of pomegranates, and Endive compound, each two ounces, and aromatize it with yellow sanders. Take of Succory roots an ounce and half, An Apozem for salt phlegm. Grass, butcher's Broom, Asparagus, each an ounce, infuse them in simple Oxymel all night over warm embers, and then boil them in two quarts of water with borage, Endive, Hops, Fumitory, Origanum, Calamint, Agrimony, each a handful, Mercury and maidenhair, each half a handful, Liquorice scraped and bruised half an ounce, Raisins stoned twenty, figs eight, seeds of Purssane, Arise, Dodder of Vetches, and the four great cold ones, each two drams, flower of Tamarisk, Broome, and Violets, each a handful, being taken off the fire add the Oxymel, wherein the roots were infused, strain it, and clarify it with Oxysaccharum, compound two ounces, and aromatize it with powder of Diatriasantalum. Take of Polipody of the oak bruised six drams, A Purge for 〈◊〉 phlegm. Sena half an ounce, Dodder of Time two drams, Annis●ed a dram, true black Hellebore two scruples, whole Cloves two, boil them in part of the former Apozem to three ounces, then infuse of Catholicum and confection Hamech each half an ounce, in the colature dissolve syrup of Fumitory the greater, A purge for phlegm and melancholy. or of Apples an ounce, and give it. Take of Cloves three grains, Aniseed two scruples, Agaric Trochiscate a dram, Turbith bruised four scruples, Sena two drams, infuse them all in part of the Apozem, with an ounce of Oxymel simple, upon warm embers, to the expression, add of Diacarthamum, and Catholicum, each three drams, syrup of Fumitory the greater, an ounce. Take of old Treacle four scruples, A Bole Conserve of Bugloss flowers or roots three drams, give it with Sugar. Take of Cloves three grains, A Purge for choler adust. Cinnamon a scruple, aniseed half a dram, Rhubarb, Tamarinds, and Sena each a dram and half, infuse them all night in Whey over warm embers, with the Electuary of the juice of Roses half an ounce, strain it, and add syrup of Violets of nine infusions an ounce and half, give it. Take of the Conserve of Tamarisk, An Opiate or Broom flowers two ounces, Conserve of the roots of Smallage, miltwaist, or maidenhair, each anounce, powder of the Trochisks of Capers, and of Dialacca, or Diacurcuma, each a dram, make an opiate, give half an ounce on the intermediate days, drinking a little White-wine after it. Take of Trochisks of Capers, Lozenges. and Wormwood, each half a dram, root of Jallop a dram, Crocomartis two drams, Conserve of the roots or flowers of Bugloss six drams, Sugar dissolved in Milte-waist water and boiled, four ounces, make Lozenges two drams weight, take one every intermitting morn, and drink after it a little white wine. Take of Gum Elemi an ounce, A plaster for the Spleen. wax half an ounce, Colophonia, Turpentine, and powder of long Birthwort, and Caper bark, each two drams, Flower-de-luce, camels hay, Nard Indian, and myrrh each a dram, Styrax Calamite half a dram, White-wine as much as will serve to dissolve the gums, make a mass, of which spread a plaster on Leather in the figure of a neat's tongue, and apply it to the Spleen, it softens and resolves its hardness, or the chemical oil of Amoniacum, with some few drops of sharp Vinegar doth more powerfully resolve any hard tumour of the spleen. CHAP. XX. Of fevers annexed to Quartans. THe Quintan, Sextan, Septan, and Nonan fevers differ not from intermitting Quartans, either in matter or cure, but in the quantity of the humour, and disposition of the body, rather than from the rising, setting, and congression of some stars, as the Astrologers would have it; all these fevers have their name from the motion they observe returning upon the fifth, sixth, seventh, or ninth day. The cause of these circuits depends not only on disordered diet, The Causes. or the relics of the morbifical matter not emptied, nor on the quantity, quality, or crasness and clamminesses of the humour, nor on the influx of the stars, or disposition of the body, but rather from the starry Element, which Hippocrates calls something Divine, when a quartan is caused from very crass and tough phlegm, and a melancholy humour very crass, it may then be extended beyond the fourth day, saith Paulus Aegi. and Rhasis speaks of those returned every tenth day, and once a month; that the quantity and quality of both humours, and disposition of body do contribute somewhat, none will deny, but the cause of the Circuits, Histories do report to be referred to the element of Stars. Pliny speaks of Antipater the Poet who lived very long, and every year on his birthday had a fever; Galen says, he hath seen Quintans but obscurely, but Avicen boasts he hath seen many, but they are rarely contingent. Hippocrates presages thus of these fevers, Presages. the Nocturnal is not dangerous, but long; the Diurnal is shorter, and sometimes they bring to a Consumption; the reason is, because the night is likened to Winter, at which time cold humours move, and because in the night season remedies cannot conveniently be administered; a Quintan is the worst of all, for to the sound or tabid it is death, because it is vehement, proceeding from an atra-bilarious humour, and not from a melancholy juice; a Septan is long, but not lethal, and so a Nonan. The Cure differs not from that of an exquisite or spurious quartan. Take of the leaves of Sena three drams, A powder for an intermitting quartan. the roots of true black Hellebore one dram, of aniseed, Dodder of Time, Diagridium each half a dram, mastic, and salt Gemmeous each a scruple, Cloves half a scruple, make a fine Powder, give a dram in a little White-wine on the fit day in the morn early once a week. CHAP. XXI. Of confused, compounded, and erratic fevers. ALL these are of the kind of essential fevers, and differ not from the precedent, neither in matter nor putrefaction, for they are all putrid, but in the seat and motion of the morbifical humour. A confused fever is so called from the seat, Of a confused fever. when humours do equally putrefy in the greater or lesser veins; as if choler and phlegm do putrefy together in the greater veins, there shall be two continual fevers, because these two humours mixed do putrefy in the same place, beginning and ending together, and by reason of this mixtion they cannot be known distinctly, or apart, because their signs are confounded, from whence this fever hath its name; likewise if both those humours putrefy in the lesser veins which are in the habit of the body, or in the Stomach, Liver, Mesentery, Spleen, or Cuts, together in the same place, there shall be two intermitting fevers, which mixed do constitute a confuse, and not a compound fever. On the contrary, A Compound fever. A compound fever is as oft as the humours do inequally putrefy, not in one place (as the confused) but in divers places together, whether in the greater or lesser veins; and this fever hath its name from the predominant humour, as in a bastard Tertian where choler predominates; likewise if there be more phlegm or melancholy humour, it shall then be called a bastard quotidian, or quartan, which fevers are compound, and not confused, because their matter putrefies in divers places, and they begin and end at divers hours, because every one hath its several essence, seat, and motion; also two quotidians, and a double tertian, and a double or triple quartan, are Compound fevers, as often as their matter putrefies in divers places; and thus a semi-tertian which is compounded of choler putrefied in the greater veins, from whence is a continual; and phlegm out of them, whence is an intermitting fever; or of phlegm putrefied in the greater veins, and choler out of them, and is called a Hemitritaean; thus also a hectic fever with a putrid, do make a Compound fever, because the efficient cause of a hectic is in the solid parts, and of the putrid in the humours, but an Ephemera joined with other fevers makes no compound, otherwise there could be no simple fever; the symptoms also which accompany fevers constitute no compound, one because they are not of the essence of fevers, though they increase, foment, and prolong them. The erratic fever is so called, Of the erratic fever. because its fits observe no proportion, for their beginnings are inordinate, resembling no species of any certain simple, or compound fever; an erratic fever than is of no certain species, for it is neither quotidian, tertian, nor quartan, nor much less a continual, for being so called from the uncertain insult of the fits, it is plain it cannot be continual, though it may be joined with a continual, as well as other intermitting fevers; an erratic then is from no certain kind of humour as other intermittings are, but either from the humours confounded together, and unequally premixt, and putrefying in the habit of the body, or from one humour but changed from itself and passing into another, for how much the humours are changed in the body of the sick, so much are the circuits of the fits varied; and blood is most of all transmuted when it putrefies, part of it passing into yellow choler, part into black. The causes of these fevers are many, The Causes. one is the inequality of Summer and autumn; another when a humour begins to putrefy in a particular part, and another flows to it from other parts, which was before bounded in them, or was redundant in the whole body; a third is error in diet, quantity, or quality of the humour, strength of the Patient, &c. they are long, and of evil judgement; he that would distinguish them rightly must be well versed in the knowledge of simple fevers, both continual and intermitting. The signs of Compound fevers differ not from those of the simple intermitting, as a double intermitting tertian begins as a simple with rigour, and sometimes with vomiting, and ends with sweat; Compound fevers are seldom of divers intermittings, but if it happen the first days, they are scarce discernible. Compound Quartans begin with horror, as the simple intermittings, and they are the longest of all, they are thus distinguished; a double quartan grows furious two days, and is quiet the third, the fourth, and fifth; again is furious, and so consequently a triple quartan every day begins with horror, but every fourth day the fever is more grievous, as if it were a simple quartan. Every intermitting fever of divers kind may be complicate with another of the same kind, if it be in divers places, as if a quotidian be mixed with a tertian, on one day there shall be two fits, but on the next only one, that of the quotidian; and on the third day there shall be two, on the fourth but one, and so forwards, the one shall begin with coldness, the other with rigour. If a quotidian be mixed with a quartan, than the fourth day there shall be two fits, one with coldness, the other with horror, on the other days but one, that of the quotidian. If a tertian and quartan concur, the first insult shall be of the tertian with rigour, the second day there shall be no fever, the third day the tertian shall recur, on the fourth a fit of the quartan, on the fifth another of the tertian, on the sixth none, on the seventh there shall be a double fit, one of the tertian, and another of the quartan, and so on. If a putrid fever be joined with a hectic it makes a compound, because the heat of this possesses the substance of the heart, that, the humours. The signs of both are taken from the pulse hard and unequal, from the urine, mordent heat, and manner of their motion, if it be bilious the invasion will be every third day, if a quartan, every fourth, if a quotidian, every day, either with rigour, horror, or coldness; and the exacerbations, and remissions of the putrid fever will be at its set hours. CHAP. XXII. Of a Semitertian fever. THis fever Hippocrates calls the horrid fever, from its horror, or violent shaking, it is a Compound fever, and is twofold, exquisite and not exquisite, that is made up of a continual quoridian, and an intermitting tertian, for it is more easy for a quotidian to be continual than a tertian, and its fits are longer than those of a tertian. Besides, The signs of a Semitertian. the horror is not every day, but every other day, when then the fits both of tertian and quotidian meet together, and are confounded, but on the middle days there is only a refrigeration proper to the quotidian, the reduplications are every third day, not such as a tertian, but dimidiately like them, because the type of the tertian is changed by the phlegm of the quotidian. This fever is sometimes caused from a continual tertian, and intermitting quotidian, and not from two continuals, or two intermittings, as Archigenes and Celsus would have it; whose opinions were they true, it would not be horrifical, as Hippocrates and Galen describe it, for horror proceeds from rigour and cold mixed. The Non-exquisite is twofold too, signs of a non exquisite Semiter●ian. the one when choler predominates, the other when phlegm; if choler prevail, there is a rigour and no horror, and it comes sooner to its state without many reduplications, the heat is more acrid, with vomitings, and dejections yellow, &c. but if phlegm predominate, there is rather a chillness than horror, and many reduplications, with phlegmatic excretions, less heat▪ &c. these fevers are frequent in Aethiopia, Italy, and other hot Countries, the gentlest of them is twenty four hours, the middle sort thirty six, the strongest forty eight; if it be exquisite every third day it is horrifical, the pulse hard and unequal, and so the heat, the urine crass and turbulent; sweats in these fevers are bad, because they are symptomatical, and not from Nature conquering, &c. This fever is reckoned amongst the deadly, Pr●●nosti●●s. and sometimes lasts a whole month; sometimes degenerates into a hectic, sometimes to a dropsy, by reason of the many obstructions; sometimes it is shorter, when the matter is little, and contained in the common ducts. For the Cure, A Purge. if need be, first give a Glister, then take of cinnamon half a dram, Agaric Trochiscate two scruples, Rhubard four scruples, honey of Roses and Diaphaenicum each an ounce, infuse them in a decoction of Succory, Hyssop, Liquorice, Raisins stoned, figs, aniseed, flowers of Time, Bugloss, and Elder, all night over the warm embers, strain it, and give it at the time of remission. Take of the simple syrup of Vinegar four ounces, A syrup against thirst. use it with the decoction of Barley, or with Ptis●an made of Barley, Raisins stoned, figs, and Liquorish, or with a decoction of Sorrel roots, or Water and Sugar, if Vinegar displease, use syrup of pomegranates. In a spurious one if choler predominate, let your cholagoges exceed the Phlegmagoges, and so on the contrary; if the stomach be offended, give gastrical Medicines, and so of other parts. Take of Sorrel, An opening Apozem. grass, butcher's broom, and Asparagus roots, each one ounce, of both Succories, Fumitory, and the Capillary Plants each a handful, Liquorish six drams, Prunes twenty, figs twelve, Endive-seed three drams, Anise two drams, Elder and borage flowers each a small handful, Time half a handful, boil them to a pint, and add honey of Roses and Oxysaccharum simple, each two ounces, clarify it, and aromatize it with powder of Diarrodon Abbatis. In the declination provoke sweat and urine, the Disease being contumacious is exasperated by strong Purgers, and yields not to gentle, but by mean ones often repeated is overcome; bleed if the Sick be plethoric, young, and strength give leave, &c. Other Compound fevers being caused from putrid matter are cured by the same method, and the same remedies as bastard intermittings are; the confused fevers if from putrid matter in the greater veins, are cured as continual fevers, if not as intermittings; the erratic as bastard intermittings, quotidian, tertian, or quartan. CHAP. XXIII. Of a hectic fever. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, Of the Name. that is, a hectic is taken for every fever that is hard to be removed, whether it be from phlegm or melancholy, and is opposed to the Schetick fever which is easily removed, it hath its name from {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, which is a habit, because it is stable and permanent. For a hectic fever is a preternatural heat kindled in the solid parts, The Definition. which first occupies the substance of the heart, and then diffuses itself into the rest of the solid parts of the body, through the veins and Arteries. This fever is continual, The Division. and hath but one fit from the beginning to the end, without any intermission or remission, unless it be joined with a putrid fever; every hectic is Smple, or Compound, that is either universal or particular; the universal is that which first seizes on the substance of the heart, then on the other parts and this is seldom; a particular one is that which first invades the substance of some private part, and at last the heart; and this is frequent, as of the Lungs in a Ptissick, of the midriff, Liver, &c. A Compound one is that which hath a putrid fever joined with it; a Simple fever is further divided into three degrees, the first is, when the body of the heart, and the other solid parts are newly inflamed, and this degree lasts as long as the substantifical and radical moisture doth conglutinate the terrene parts, and is sufficient to nourish and foment the fiery heat, as oil doth the flame of the Cotton in a Lamp, and this is hard to be known, but easy to be cured. The third and worst sort is called {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, because it hath adjoined a hot and dry Consumption, and is then when the humour is wholly wasted, and all the solid parts are as it were burnt, and turned into ashes, as the Cotton of the Lamp is for want of the affusion of more oil, for thus the substantifical moisture being quite spent, the native heat is extinguished, and cannot be restaurated by Euchymous aliments, and this degree as it cannot be hid, so it cannot be cured. The second degree is of a middle nature between them, and how much the nigher or further to the first or last, is by so much the easier or harder to cure, they all differ only gradually. The causes external are from the Six Non-natural things as the hot Air, The Causes. long Hunger, Watchings, suppression of Excrements, &c. the internal are from a bilious temperament, a continual fever ill cured, as a causus and continual tertian, and not from a quotidian or intermitting tertian, from a Prisick lientery, or such Diseases in which the nourishment being incoct, or ill concoct, doth not humectate the solid parts, which being destitute of their aliment, and conceiving a more acrid and feverish heat, grow hot and dried. The first degree may be known by the preternatural heat, signs of the first degree. if at first touch of the Artery it be acrid and mordent; if after drink or meat a heat presently flushes in the face from the sublation of vapours, this heat is at first so gentle that the Sick deny themselves to be feverish, for things done by degrees cause no pain, saith Hippocrates; as Plants at their first sprouting are easily pulled up, but are hardly known unless by the skilful Herbarist, so this degree is easily cured, but hardly discovered, unless by the learned physician. The signs of the second kind are not only from the mordent heat of the pulse being felt, signs of the second degree. but in the soles of the feet, and palms of the hand; besides, the pulse is harder and drier than in the former, because the feverish heat works not only on the rorid substance of the heart, but on its primogenious humidity, whence nourishment failing, the Sick necessarily falls away, the urine is higher coloured by reason of the intense heat, depopulating not only the heart, but habit of the whole body, but less high than if a putrid were joined with it; this degree hath a great latitude, and so is accordingly known, or cured. Signs of the last degree are a weak pulse, signs of the third degree. small, and frequent, and hard from dryness, the urine hath some fatty substance swimming in it like to Cobwebs, which denotes a quolliquation of the similar parts, the eyes are hollow, their humours being wasted, the temples fallen, the substantifical humour of the muscles being consumed, the forehead dried, the nails crooked, the eyelids scarce movable, the Hypochondria distended, the skin hard and dry, cleaving to the bones, the fleshy substance being wasted. A hectic seldom possesses Children, often young choleric bodies, and old men that are of a hot and dry temper, and those that are long necked, and narrow breasted, &c. those that have a Hippocratical face are past cure, and such as have a looseness. The cure of the first degree differs little from that of a Diary, The Cure. for it proceeds from the same manifest causes, but more vehement, which are inherent in the habit of the body, and therefore requires stronger remedies; let the diet be euchymous, liquid, cold, and moist, and incrassating to hinder dissipation, as Broths altered with lettuce, Purslane, Marigolds, Violets, borage, Wood-sorrel, spinach, &c. let the drink be ptissan, or water boiled with sitrup of maidenhair, or the Alexandrine Julep with a little Vinegar, if it proceed from an Ephemera; old age may be allowed a little small Wine at meals. Take of the leaves of Mallows, Violets, borage, A Glister. lettuce, each a handful, Prunes twelve, the four great cold Seeds each three drams, Water-Lilly-flowers and Violets each a small handful, boil them in water, and in a pint of the colature dissolve of simple Diaprunes, and Cassia with sugar each six drams, honey of Violets, and oil of water-lilies each an ounce and half, make a Glister, if you would have it nourishing too, then boil them in the broth of a wether's head, or in Capon broth, with the yolks of eggs. If the stomach be foul, A Potion. take of Manna of Calabria an ounce and half, syrup of Roses solutive, with Rhubarb if choler abound, or with Agaric if phlegm, and give it in a little Chicken-broth, or ptissan, stronger remedies must not be used. To correct the acrid heat, and dryness. Take of syrup of Vinegar simple, or Oxysaccarum, or of the juice of Endive, or Poppy, if the Patient rest not, three ounces, Bugloss and Wood sorrel water each six ounces, make a Julep. Baths are good which by their warmth open the passages, Baths. and draw the blood to the habit of the body, if you give a cup of ass's milk with sugar of Roses to them whiles they are in it; then to prevent sweating anoint the back bone, and the emunctories, and extreme parts with this lineament. Take of oil of Violets, A lineament. or water-lilies, or sweet Almonds, and oil of Roses, or Myrtells, each three ounces, mix them for your use. If you mix in broth a little of this condite, A Condite and give it before meat, you will profit much, viz. Conserve of Violets, and water-lilies, and the bark of the roots of Bugloss, condite each an ounce, of the resumptive Powder newly prepared three drams, or instead of it Melon and Cowcumber-feeds each a dram and half, powder of Diatriasantalum, and Diamargaritum Frigidum, each half a dram, sugar of Roses sufficient, make a condite and cover it with gold. The second degree is also cured by euchymous diet and alteration, The Cure of the second degree. with liquids, because they are sooner and easier distributed into the habit of the body, and do more plentifully nourish, saith Hippocr. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. if the hectic proceed from the ptissick, or continual fever, you must recur to their proper Chapters, likewise i● from the inflammation of some viscus, or the guts, &c. Take of the resumptive ointment two ounces, An ointment for the breast. oil of sweet Almonds one ounce, powder of Florentine, Flower-de-luce four scruples, Saffron a scruple, anoint the breast and back warm; if there be a looseness anoint the belly with Unguentum Comitissae: all this while let him take every morn at four of the clock half a pint of ass's milk warm from the Teat, with two spoonfuls of sugar of Roses powdered, wash his mouth and sleep upon it, if he stepped not afore. This milk because it is more serous, The choice of Milks. deter●ive, and cool, is best in a Ptissick, but if you would nourish, woman's milk is best; if consolidate an ulcer, than Cowes or sheep's milk because it is more cheesy and butyrous. The third degree being incurable by the consent of all, The third degree. I shall speak but little of it, let their Chamber be large that they may breathe the cool air, let their meat be very nourishing and often taken in small quantity, especially womens' milk, let the drink be ptissan, or small Wine, cause rest, with Diacodium, or a Pill of Cynogloss, or Laudanum, use cooling moistening, and nourishing Glisters, and Juleps, to moderate, if not extinguish the fire in the solid parts. Take of the confection of Hyacinth, or Alkermes four scruples, Pearl two scruples, fragments of the Five precious Stones, and red coral finely powdered each a scruple, powder of Diapenidium without the species the weight of them all, of the finest Sugar an ounce, fix leaves of Gold, make a powder, and dissolve a spoonful in every small quantity of ptissan, or what else you give, it wonderfully restores the lost strength. A Compound hectic is hard to know, A short cure of a Compound hectic. unless to the Learned, who can distinguish the form and type of every fever; this is cured by bleeding, if there be a plenitude, or the Courses, or Hemorrhoids be suppressed, or by gentle Purgers if there be a cacochymy no ways respecting the Consumption, but the Plethora, or Cacochymy, saith Hippocrates and Galen. CHAP. XXIV. Of Malignant and pestilent▪ fevers. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, The division and difference of malignant fevers. that is, of malignant fevers, some are essential, others symptomatical; the essential have a great analogy with putrid fevers, from which they differ not in matter, but only by a malignant quality venenate and contagious, either produced in us, or induced into us; they differ also from hectics, not by macilency, which in these is caused by degrees in them speedily, which variously waste the substance of the body, as the Leipyria, Syncope, &c. of which in their place. The Symptomatical fevers are those which follow the inflammations of the Viscera, and Burning-feavers, from which they also differ by their malignant quality, as the essential also do. A Leipyria is twofold, Of a Leipyria fever. the one essential, the other symptomatical; the essential is caused from glassy phlegm cold in the third degree, collected in the bowels, though with some mixture of choler, yet notwithstanding that it may putrefy, the heat is called from the external parts, to the internal, in which is kindled no small fire, hence it is that the innards burn, and the outward parts are cold, from whence if a thirst follow, it is deadly the fourth day, or sooner, saith Hippocrates. This is cured as a continual quartan, The Cure. and if symptomatical as a causus, or continual tertian, with this caution, that to all remedies both internal and external, we mix something cordial, which may retund the venenate and malignant quality without any manifest heat. A Syncopal fever hath its name from the symptom, A Syncopal fever. because the diseased are troubled with faintings and swoonings; by reason of the exact sense and hurt of the mouth of the Stomach. The efficient cause is either crass phlegm putrefied in the stomach, The Cause with some malign or venenate quality, which carried upwards to the mouth of the stomach doth 〈◊〉 and wound it, from whence is pain and faintings, and sometimes a Syncope, that is, a sudden loss of strength, with sweats more or less; sometimes it is from aeruginous choler which is wholly pernicious, whose vapour carried to the mouth of the stomach doth wound it, from whence are faintings, Convulsions, and death, unless it be vomited up, as Galen mentions in a young man; this fever is very rare, and observes the type of a quotidian, which is worst towards the evening. If it come from prassinous or aeruginous choler, The signs from prassinous choler. the signs are taken from a hot and dry season of the year, from a young, mac●lent, and bilious body, or from a continual burning fever, or tertian, with a malignant quality, which usually kills before the fourth fit; that from aeruginous choler is worse, the pulse is swift, from the abundance of heat, inequal from the multitude of the obnoxious humour oppressing Nature, hard from the dryness of the Humour and Vessels, small from the weakness; the parts about the heart and whole body seems puffed up, and tumid, the colour is vitiated, in some white, in others livid or black, the belchings are acid if from phlegm, bitter from porraceous choler, the eyes prominent, the tongue acid and black, they are best when quiet and unmoved. The humour is to be carried away by gentle clysters, The Cure. and purged epicrastically, always adding Cardiacal Medicines against the malignant and venenate quality, and if the Patient be nauseative give a vomit. Take a sufficient quantity of broth, A Glister for phlegm. and boil in it Mercury, balm, and borage, each a handful, the tops of Dill, with Cammomel, and Me●●lot-flowers each a smalhandful, course Bran two pugils, figs twelve, Aniseed two drams, strain it, and dissolve of Hiera an ounce, honey of Mercury, and oil of Cammomel, each anounce and half, the yolks of two Eggs, and give the Glister. Take of Mallows, Violets, Barrage, A Glister for ae●uginous choler. Purslane, balm, each a handful▪ Prunes sixteen, of the four greater cold Seeds each two drams, Water-Lilley-flowers a handful, dissolve in the colature Diaprunum simple, and Cassia with Sugar each six drams, honey of Roses, and oil of Roses, each an ounce and half, give it at the time of remission. Take of Manna of Calabria, A minorating Purge for phlegm. and syrup of Roses solutive, with Agaric, each an ounce and half, drink it in a little fresh Chicken broth, boil in the broth three drams of Citron pill. Take of Cinnamon a scruple, A purge for choler. Rhubarb four scruples, Tamarinds two drams, Cassia newly drawn an ounce and half, infuse them all night over warm embers in Chicken-broth, in the decoction of Succory, Purslane, Citron-seeds, Bugloss, and Water-Lilly flowers, strain it, and add syrup of Violets of nine infusions, or of Succory, with a double quantity of Rhubarb, or of Roses solutive an ounce and half, give the potion. Take of Agaric Trochiscate for phlegm, Rhubarb for choler, Pills. half a dram, imperial Pills a dram, with honey of Roles, or syrup of Violets, make them up. Take of the syrup of Citron pill Conserved, A Julep for phlegm. and of sour pomegranates each two ounces, balm, and Bugloss water each six ounces. Take of Bugloss roots two ounces, An Apozem. dried Citron pill one ounce, it flagme abound, but of Sorrel, and Grass roots, if aeruginous, or prassinous choler, each one ounce, Succory, Endive, Purslane, lettuce, borage, Scabious, Devils-bit each a handful, balm, and French Lavender for phlegm, each half a handful, Raisins stoned twenty, Liquorish six drams, Prunes for choler eight, white Poppy, and the four greater cold Seeds or Cardu●s Benedictus, and Aniseed, each two drams for phlegm, the Cordial flowers a Pugil, boil them in water to a pint, add syrup of pomegranates three ounces (which is good for them both) make an Apozem, and aromatize it with a dram and half of Saxafras; if you would make a magistral syrup in one part of the decoction without syrup, infuse of Cloves a scruple, Agaric▪ Trochiscate an ounce for phlegm, or Cinnamon a dram, and Rhubard an ounce and half, for choler, strain it, and boil it gently to a syrup with Manna, and syrup of Roses, each half a pound, the dose is two ounces in a decoction of borage, or broth twice a week. CHAP. XXV. Of the Cardiacal fever. THis fever hath its name from the heart, and is of the same kind with malignant and colliquating fevers, The signs and not much unlike to the Syncopall; there is a great heat with it, and the face looks red, great strivings of the heart, little and frequent breathing, insomuch that they are compelled to sit upright, like the Orthopnoical, and are pained on the region of the heart; the Disease inclining, they have a thin sweat, a cold breath, and then follow syncopes, and death. The cure is the same with that of a burning-fever, The cure. both for cooling and moistening diet, and for bleeding, premising the Glister there described, if the body be bound; in alterating the humours add a fourth, or sixth part of hot Alexipharmaca, by reason of the malignant and pernicious quality that is impressed, and then empty the humours with Manna, Cassia, etc, allay the thirst with Julep of Violets, or Poppies. Amongst malignant fevers are reckoned also those that do variously impair the substance of the body, whether by degrees or speedily, Typhodis fever. as the {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, &c. the {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} is a kind of fever, in which by reason of the excessive heat, the sick seem to be suffocated, and may be called an crysipelatose one, and is cured as a continual tertian. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, the moist fever is so called, because presently after the first day the sick begin to sweat, and by sweating their strength is so wasted, The moist fever. that they find little or no benefit by it, in the year 1528. this fever spread itself from England into France, and in short space killed the stoutest men by sweating, all remedies against it being invalid the French named it Suette and numbered it amongst the Pestilential, by reason of its malign and venenate quality, the Greeks call it {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} is called by Hippocrates, The restless fever. the restless implacid fever; in this the sick are always tossing, changing their posture of lying, loathe all things, are distended in the Hypochondria, thirst, watch, or are delirious in their sleep. The internal cause is a crass, The signe●. acrid, and bilious humour, imbibed in the coats of the stomach, sometimes it is from internal pains, The Cause. the pulse suddenly fails, and the use of all remedies is prevented; let the diet be incisive, refrigerating, and moistening, and if occasion be, give this Glister. Take of Violet leaves, Gourds, Purslane, and Nettles, each a handful, the four great cold Seeds, and Nettle-seed, each two drams, Camomel and Violet flowers, A Glister. each a pugil, boil them in water to a pint, and in the colature dissolve Diaphaenicum, honey of Roses, and Oxymel simple each an ounce, oil of water-lilies an ounce and half. To allay the thirst, use the juice of pomegranates, or Citrons, or the syrups made of them, &c. Take of cinnamon a scruple, Rhubarb four scruples, Cassia newly drawn an ounce and half, A Potion. infuse them in the infusion of Damask Roses, or in the decoction of Succory, Marigolds, borage, Prunes, with Nettle-seed, and the Cordial flowers, strain it, and give it; procure sleep with syrup of Poppy, and a little Diamargaritum frigidum. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman} is called by the Latins the Colliquating fever, The Colliquating fever. by whose vehement heat not only the fat, but the flesh and substance of the solid parts are melted away, & this is of the kind of malignant fevers; it is caused two ways, the one when the colliquationis by degrees, as in hectics, and the Marasmus; the other, when both fat and solid parts are suddenly dissolved, and this is a most grievous and dangerous disease, it differs from a Marasmus because in this, that portion of flesh which is colliquated is always like a vapour, breathed forth by insensible transpiration, but in the colliquating fever it flows to the belly in the species of a bilious stinking crass humour, the external causes are, watchings, sadness, malignant Medicines, &c. and this is not lethal. The cause. The internal cause is a fervid heat with a malignant quality which doth not always dissolve the body by insensible transpiration, but sometimes by manifest excretions. The signs are rusous, The signs crass, stinking dejections, sometimes fat and viscid, with a spume or froth which indicates heat, the nose grows sharp, and the eyes hollow, which latter signs if they appear at first, we are not to meddle; Hippocrates proposes two remedies, the one the cremor of Barley, the other cold Water, with acid syrup made up with Sugar, and not with Honey; give Glisters if occasion be, or eccoproticks, for the first region of the body, with opening and cooling decoctions, if there be obstructions, and condites, and cardiacal powders, as are described in the Chapter of a continual tertian. CHAP. XXVI. Of the fever from Crudity. {non-Roman} {non-Roman} {non-Roman} {non-Roman} {non-Roman}, that is, a fever from Crudity, Of the Name. though the word Crude be applied to various things, yet in this place it is taken for a raw cold humour, contained in the first passages, or in the whole body; this fever differs from an Epiala, not in matter, nor in the place of putrefaction, but in malignity, and therefore is not void of danger, especially if it be joined with an inflammation of stomach or liver, for sometimes it is without them. If the crude humour putrefy in the first passages there will be a nauseousness, The Signs. sour belchings, with idleness, or unseasonable exercise, as Venery presently after meat, &c. if it be in the whole body the urine will be thin, and watery, the contents divulsed, the colour pallid, plumbeous or livid, the whole bulk somewhat swelled, the pulse unequal, obscure, with a dulness of the senses; make a Glister with Hiera Catholicum, honey of Roses, oil of Camomel, decoction of Mallows, Mercury Origanum, Dill, &c. Take of Catholicum an ounce, A minorating purge. infuse it all night in the infusion of Damask Roses, strain it, and add syrup of Succory, with Rhubarb duplicated, an ounce and half, give it in the morn; if strength and age permit, and a high tinct urine require it, let blood in the axillary vein in small quantity, with a narrow Orifice. All attenuating things used must not be very hot, A Rule. lest the fever be increased. Take of syrup of vinegar, A Julep. and juice of Endive, each two ounces, Succory & Wormwood-water each six ounces. Take of Grass-roots, An Apozem. butcher's Broom, and Asparagus, each an ounce, of Succory, Agrimony, Endive, the Capillary Plants, & Sea-wormwood ache a handful Origanum, and Balm each half a handful, seeds of Carduus Benedictus, Citron, and Anise, each two drams, flowers of Bugloss and Time, each a pugil, boil them in water to a pint, with Oxymel simple three ounces, make an Apozem, and aromatize it with cinnamon. Take of cinnamon a scruple, A Purge. Rhubarb four scruples, Catholicum half an ounce, Cassia newly extracted an ounce, infuse them in part of the Apozem, and to the expression, add syrup of Roses, with Agaric an ounce and half, give the potion, and give no stronger; take of the Conserve of Citron pill three drams, old Mithridate, or Treacle, or Aurea Alexandrina, a dram with Sugar, give the Bolus next day three hours before meat. Books printed, and are to be be sold by John Hancock, at the first shop in Popes-head-Alley next to Cornhill. A Book of Short-writing, the most easy, exact, lineal, and speedy method, fitted to the meanest capacity; composed by Mr. Theophilus' Metcalse, professor of the said Art. Also a schoolmaster, explaining the Rules of the said Book. Another Book of new shorthand, by Thomas cross. A copy-book of the newest and most useful hands. Four Books lately published by Mr. Thomas Brooks. Preacher of the Gospel at Margaret's New Fish-street. 1 Precious Remedies against Satan's Devices; or, Salve for believers and unbelievers Sores, being a companion for those that are in Christ, or out of Christ, that slight or neglect Ordinances, under a pretence of living above them, that are growing in Spirituals, or decaying, that are tempted, or deserted, afflicted, or opposed, that have assurance, or want it, on 2 Cor. 2. 11. 2 Heaven on Earth; or, A serious Discourse, touching a well-grounded Assurance of men's everlasting happiness, and blessedness; discovering the nature of Assurance, the possibility of attaining it, the Causes, Springs, and Degrees of it, with the resolution of several weighty Questions, on Rom. 8. 32, 33, 34. 3 The unsearchable Riches of Christ; or, Meat for strong men, and Milk for Babes, held forth in two and twenty Sermons, from Ephes. 3. 8. preached on his Lecture Nights at Fish-street-hill. 4 His Apples of Gold, for young men, and Women; and, A Crown of Glory for Old Men and Women; or the happiness of being good betimes, and the Honour of being an old Disciple, clearly and fully discovered, and closely and faithfully applied: The Godly man's Ark, or City of refuge in the day of his Distress. Discovered in divers Sermons, the first of which was preached at the Funeral of Mistress Elizabeth Moor. Whereunto is annexed Mistress Moor's Evidences for Heaven, composed and collected by her in the time of her health, for her comfort in the time of sickness. By Ed. Calamy. B. D. and Paster of the Church at Aldermanburic. The Covenant of God's Free Grace unfolded, and comfortably applied to a disquieted or dejected soul, 2 Sam. 23. 5. By that late Reverend Divine, Mr. John Cotton of New England. The ruin of the Authors and Fomenters of Civil War; as it was delivered in a Sermon before the Parliament at their monthly Fast, by Mr. Samuel Gibson, sometime Minister at Margaret's Westminster, and one of the Assembly of Divines. The New Creature, with a description of the several marks and characters thereof, by Richard Bartlet. FINIS.