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TABLES, Shewing the Doſes of purging and vomiting Medicins according to the Solution of D.R COCKBURN'S Problem.
Medicins whoſe common Doſe is ℥i.MedicinsConſtitutions Ages.Doſes
ʒGr.
Caſſia. Catholicon Diacarthamun. Elect. lenitivum. Succus radic Jrid. — Fumarioe. Syrup de Rhamno. — de Pomis magis. — Roſarcum Helleb. Tamarind. Sal cathartic. amar. — Mirabile. Mann. ℥ij. Emetica Vin. Emeticum. ſeu Bened. ſuc. Aſari. Senecionis.1623113⅓
3800
414013⅓
92220
3600
41020
62126⅔
3400
4706⅔
320213⅓
3200
43113⅓
Common Doſe ℥i.Confectio Hamech. Elect. Caryocoſtin. Diaphoenicon. & ſucco Roſcco Roſarum. Emet. Syrupus emeticus.162126⅔
3400
4706⅔
92110
3300
4510
620213⅓
3200
43113⅓
32016⅔
3100
4126⅔
Common Doſe ʒi.Agaricus. Aloe. Carthamus. Ebuli ſem. — Cortex. Harmodactylus. Mechoacanna. Pil. Aggre. gattivoe. — Coch. Major. — Foetidoe — ſine Qui bus. Pulv. Diaſennoe. Rhabarbarum. Soldanel la. Senna. Turvith.162016⅔
3100
4126⅔
92010
3025
4110
620013⅓
30110
40213⅓
32006⅔
30015
4016⅔
Common Doſe ʒi.Jalappa. Juli juglandis. Lap. Lazuli. — Armenius. Opoponax. Pil. Coch. minor. — de Gut. Gamandra. — Rudii. Pul. Warvicenſis. Sagapenum Emet. Rad Ipecacuana.1620013⅓
30110
40213⅓
920010
301
4020
62006⅔
30015
4016⅔
32003⅓
300
40013⅓
Common Doſe ℈i.Reſina jalappoe. Extr. rhabarbari. Pil. de Hermodactylis ℈ij. Pulv. Cornach. ℈ij. Emet. Gilla vitrioli.162008 8/9
3010
40115 5/9
92006⅔
30015
4016⅔
62004 4/9
30010
40017 7/9
32002 2/9
3005
4008 8/9
Common Doſe Gr. VI.Colocynthis. Ecephorbium Eſuloe Cortex. Elaterium. Gum. Guttoe. Gran. Gnid. Ricini ſem. Scammon. Tr. Alhand. Emet. Croc. Rulandi. Turbith minerale.162002⅔
3006
40010⅔
92002
300
4008
62001⅓
3003
4005⅓
3200
300
4002⅔
Common Doſe Gr. III.Emet. Hep. Antimonij. vitr. Ant. Merc. Vitoe. Tart. Emet. Merc. proec. per ſe — ſolar. — ruber. Hercules Bovij.162001⅓
3003
4005⅓
92001
3002 1/4
4004
6200
300
4002⅔
3200
300¾
4001⅓

I. The Practice of Purging and Vomiting Medicines, according to Dr. Cockburn's Solution of his Problem; with Tables ſhewing their Doſes in particular Ages and Conſtitutions. Inſcrib'd to the Learned Dr. Garth, F. R. S. by W. Cockburn, M. D.

[1]

BY my Solution of the Problem for determining the due Doſes of Purging and Vomiting Medicines, Phil. Tranſact. No. 303. in all their Caſes, it is manifeſt in general, Poſtul. that theſe Medicines operate either upon the account of their being mixed with the Blood, Schol. or by their ſtimulating the Stomach and Guts: 2. That this their Operation is more or leſs according to the Quantity and Thickneſs of Blood, h.e. Cor. 1. a greater Quantity, and the thickeſt Blood require the greateſt Doſes: And 3, Prop. 1. that when the Quantities of Blood are the ſame, the Doſes of Purging and Vomiting Medicines are in a duplicate proportion of the Bloods thickneſs. As alſo, that in every caſe theſe Doſes muſt be in a proportion compounded of the Quantity of Blood and thoſe Squares of its thickneſs. Prop. 2.

Now ſince the Operations of Purgative and Vomitive Medicines depend ſo much on the Quantity and Viſcidity of the Blood, Why the Doſes of theſe Medicines ſo hard to be found. which have not been duely conſider'd before; it is no wonder that the Practice of Phyſick in theſe Evacuations has been ſo uncertain, and that the moſt expert Phyſicians, from their moſt accurate Obſervations, could never determine the true Doſes of Medicines, which alter ſo much according to the various Subjects they work upon; they not being acquainted with the true Method of determining either the quantity of the Blood, or the degrees of its thickneſs.

[2]

Becauſe Experience is equally the Foundation and Touchſtone of all reaſoning in Phyſick, we will here ſubmit our Solution to common Obſervations, and try whether every thing propoſed in it, does not exactly anſwer Matters of Fact, and the viſible Operations of Nature.

Firſt then, The different effects of theſe Medicines upon the account of their [...] it plainly follows, that theſe Medicines always purge beſt and moſt conſtantly in a liquid form; becauſe they are more eaſily convey'd into the Blood, and can ſtimulate more parts, and that upon the account of this their Fluidity; whatever may be the way that Purges and Vomits work, or whatſoever their Nature may be. This explains very eaſily a very common Obſervation, hitherto very difficult to Phyſicians, about the different Operation of the ſame Medicine in different forms: Why, viz. the Infuſion of a due quantity of a Purging Medicine produces its effects ſooner and more conſtantly than a like quantity of the ſame Medicine in a Powder, tho' ſtill more conſtantly in a Powder than a Bolus, tho' ſtill ſooner and more conſtantly in a dry Bolus, than if it be given in Pills made into that form with Gums that do not purge; and this difference in Purging ſhall even be notable, according to the diſſolubility of the Gums.

From whence it follows, that the Evacuation made by ſuch Medicines, is in proportion to the quantity of thoſe Medicines that happens to be diſſolv'd, and not to the quantity adminiſter'd.

Secondly, Their effects different, becauſe of the different thickneſs of Blood. That purging by Draughts is the moſt excellent form, and will always have the moſt conſtant effect.

The next Conſideration is, that a certain quantity of any purging Medicine affects us after a different manner, according to the different Quantity and Conſtitution of the Blood, or its thickneſs, and it was ſhewn in the Solution, that if its thickneſs were the ſame, the Doſe [3]ſhould always be as its Quantity, but the Blood differing likewiſe in thickneſs, the Doſes of Purging and Vomiting Medicines muſt be augmented on account of its thickneſs. This is perfectly well confirm'd by daily experience; where we find, that People ſick with a manifeſt thickneſs of Blood, as in Dropſies, the Jaundice, &c. take far greater Doſes than they did at any other time when they were not ſick, or in that manner.

By a further Diſquiſition into this matter, we find that the Doſes muſt not only be greater where the thickneſs of Blood is greater; but that they muſt be encreas'd in a duplicate proportion of their Viſcidity. This is evident by the Tables in Caſſia. viz. 9:83::4:3ʒ, 1 ℈, 13⅓ gr. and therefore alternando 9:4::8 ʒ:3 ʒ, 1 ℈, 13 ⅓ gr. Therefore the Doſes are as the Squares of the Conſtitutions. So likewiſe 9:8 ʒ::16:14 ʒ, 13 ⅓ gr. and alternando 9:16::8 ʒ:14 ʒ, 13 ⅓ gr. h. e. the Doſes are as the Squares of the Conſtitutions.

The ſame is true in any other Conſtitution beſides the mean: For Example, in the loweſt and higheſt 4:16:: 213 ⅓ gr: 853 ⅓. So that by this means we are not only led directly to a right uſe of theſe Medicines, and are able to find the true cauſe why the ordinary Doſes produce ſo very different effects in different Conſtitutions; but likewiſe, A Problem. The Quantity of Blood in any Perſon being given together with the ordinary and extraordinary effect of a Doſe of a Purging Medicine, the Change of that Perſons Conſtitution, and the Nature of that Change may be determin'd.

It cannot but be a great ſatisfaction to the mind to find a Doctrine founded on a few ſimple Experiences leading us into the cauſe of many more that are very complext, This Doctrine true becauſe conform to Nature. difficult, and obſcure; which is ſufficient to prove its conformity to Nature. But my preſent endeavour being to rectify the common Practice of theſe Medicines by this Doctrine, I ſhall frame, by this Method, Tables of the [4]Purging and Vomiting Medicines in preſent uſe; better adapted to Experience than are hitherto to be found.

The Method of framing ſuch Tables, How they are made. is by ſetting off the practicable Conſtitutions in the different Ages that I have obſerv'd to take notable Quantities of Purging and Vomiting Medicines; ſo that by comparing theſe Conſtitutions with the Ages, we have the different Doſes in all thoſe caſes, which is all that is requir'd for a better practice; tho' a more proper occaſion may produce a more nice and exact diviſion of Conſtitutions, very much to the advantage of the Practice of Phyſick in all Diſeaſes.

The Ages wherein theſe different Doſes are taken, I find to be four; when a Man is about 16 or 20 Years of Age, and weighs about 12 Stone, he then takes the common Doſe: One of nine Years takes three quarters of that; one of ſix the half, and one of three Years a quarter. Moreover, [...] p. 51. Biblioth. Anatom. p. 1124. T [...]. 2. it having already been ſhewn, that the notable healthy Conſtitutions are but three, as alſo the notable Pulſes of each of theſe: Let then theſe Conſtitutions be as 2, 3, 4. That of the moſt fluid Blood as the firſt number, and ſo on; in that caſe, the Doſe of any Perſon will be found by multiplying the common Doſe for his Age into the Square of his Conſtitution and dividing by the Square of the middle Conſtitution. For inſtance, If ℥j. Caſſioe is the common Doſe, or the Doſe of the middle Conſtitution, ʒiij. ℈j. and gr. 13 ⅓ is the Doſe of the firſt Conſtitution, and ʒxiv. gr. 13 ⅓ that of the groſſeſt or laſt Conſtitution; and ſo proportionably for every Medicine in all the Ages, as appears by the Tables.

This Method ſeems to anſwer ſo exactly, Only exception. that there is not any thing neceſſary beſides, except a Perſon is more Looſe or Coſtive than ordinary (which may be known from the Patient or otherways) it is to be reputed the ſame, as if he had taken an equivalent quantity of a Medicine proper to produce theſe effects. Any Phyſician, [5]who has conſider'd this caſe in ſome People after Fluxing, will allow the juſtneſs of this Exception.

As Vomiting Medicines have the ſame common Doſes with thoſe that Purge, The Doſes of Vomiting Medicines. they admit alſo of the like divided Doſes; which, therefore may be found by the ſame Tables. Only, as People that are more Coſtive than ordinary require a proportionable greater Doſe of a Purging Medicine: So they require their Doſe of a Vomiting Medicine to be conſiderably leſs, as is very very well known in hot Countries.

But it muſt be obſerved, that in the Tables, Note [...]. Age ſtands Inſtead of Quantity of Blood; becauſe they encreaſe pretty equally, and it makes the practice more eaſie to ſuch as are not accuſtom'd to Weights and Numbers.

The more Skilful are deſir'd to obſerve, that the mean Ages, [...].multiply'd into the mean Conſtitutions, give Doſes more nicely.

The TABLES. Some Inſtances ſhewing the Defects of the preſent Practice, and how mended by the foregoing Tables.

The Doſes of the foregoing Tables, ariſing from Calculation, agree perfectly well with the common Obſervation of the beſt Authors; tho' their Obſervation is very general and ill made, if we except the very firſt Steps. For inſtance, Authors of all Countries, Engliſh, Dutch, Authors Copy, but do not Obſerve.German, Italian and French, reckon the Doſes after the ſame manner; whereas, if they had been obſerv'd, they muſt have been different as are the Conſtitutions of Men in the different Countries.

II. The defect of their Obſervation is manifeſt by the diſproportion'd Doſes of ſome Medicines, their high Doſes being ſometimes double and ſometimes triple, and [6]more of their low Doſes, which is not conform to Nature; for, let the low Doſe be what it will, the high Doſe of one Medicine muſt always bear the ſame proportion to the high Doſe of another, as did their low Doſes, viz. even in Manna, they reckon it from ℥j: commonly to ℥iij. and ℥iv. If it is ſaid that the firſt Doſe is the loweſt Doſe that is taken by a Man of a due Age, it is neither true in fact nor conform to their own way of reckoning: For inſtance, Rhubarb is ſaid to be taken from ʒj. to ʒij. No body will ſay that this is the loweſt Doſe taken by a Man of a due Age as formerly; becauſe it is not in fact true, nor that the high natural Doſe is ℥ſs; for, as I ſaid before, if ℥j. of Manna and ʒj, of Rhubarb are the reſpective low Doſes, then ℥iv and ʒij. cannot be the reſpective high Doſes. As to what concerns ſome extraordinary Doſes given by themſelves, and far exceeding the ordinary Doſe, is eaſily accounted for by the Solution. There are many Examples of this Nature: Turbith, viz. is commonly reckon'd among them from ʒj. to ʒij; yet Marggravius, and good Authors, have given it to ʒiv. So Colocynthis from gr. vi. to gr. xij. and Fulgin. Fernel. Duncan. ſay they have given it to ʒſs.

III. They have only given the Doſes for Men at full Age. Authors have been far from being exact; for they have only dos'd theſe Medicines for People of full Age; but have left the Doſes of the different Ages in ſilence; nor have they told us at what time a Man takes his higheſt Doſe, or how that alters in the Growth and Decline of Age, which is ſtill a very great difficulty for the moſt experienc'd Phyſicians to manage.

IV. Their way of determining Doſes falſe. Their general Method is founded in a Miſtake; their loweſt Doſe being really the common Doſe taken by the generality of Men, which produces a multitude of Errours in the Practice. This is manifeſt in their doſing every Medicine.

[7]

V. This ſhewn particularly. The mentioned Caſe is more manifeſt by theſe Tables, and it is two to one but that a Phyſician over Purges or under Purges any Perſon in Health; and if more Caſes in Sickneſs are ſuppos'd, the odds will encreaſe proportionably. Experience confirms this exactly: For if the middle Doſe is given to one of the loweſt Conſtitution, and the middle Doſe is to purge 7 or 8 times; in that caſe, the Perſon of the loweſt Conſtitution is purg'd near twice as much as he ought to be; and if given to one of the higheſt Conſtitution, he is purg'd but half of what he ſhould be. But if the Doſe of the higheſt Conſtitution is given to one of the middle Conſtitution, he is purg'd twice as much as he ought to be; and if given to one of the loweſt, he is purg'd four times as much, or about thirty times, as we find true by daily Experience. But if the Quantity of Blood, the Age, or Sickneſs contribute to the Errour, it may prove fatal. If this Conſideration were illuſtrated by a proper number of Examples, we ſhould find ſome hundreds of, otherways unavoidable, Miſtakes now prevented by the Practice of theſe Tables.

Laſtly, We may eaſily account, by theſe Tables, Theſe Tables ſhew how the Doſes of Children may over purge People of full Age. for the Doſes of Children over purging ſome People of good Health, and of due Age; a Phaenomenen ſo ſurprizing, that the ſmallneſs of the Doſe is commonly thought a good Excuſe for the Miſtake.

FINIS.
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TextGrid Repository (2020). TEI. 5609 The practice of purging and vomiting medicines according to Dr Cockburn s solution of his problem with tables shewing their doses in particular ages and constitutions Inscrib d to the learned Dr. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5EC7-B