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PRACTICAL RULES OF DIET In the various Conſtitutions and Diſeaſes OF HUMAN BODIES.

By JOHN ARBUTHNOT, M. D. Fellow of the College of Phyſicians, and of the Royal Society.

LONDON: Printed for J. TONSON in the Strand. MDCCXXXII.

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PRACTICAL RULES OF DIET In the various Conſtitutions and Diſeaſes OF HUMAN BODIES.

THE PREFACE.

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THE former Part of this Treatiſe has been cenſur'd for two Faults; firſt for being obſcure; ſecondly, for not being ſo practical as it ought to be: As to the Firſt, I anſwer, That Obſcurity may be taken in two Senſes, as Real, or as Relative to the Underſtanding of the Reader; if Obſcurity is taken in the firſt Senſe, I will venture to affirm, That it is unjuſtly blam'd upon that Account: Perhaps it may not be all true, but I am ſure it is intelligible. If Obſcurity is taken in the ſecond Senſe, Euclid's Elements may be ſaid to be obſcure: I freely own that I had made too partial a Judgment of the Capacity of ſeveral of my Readers; and yet it is true, That many, not bred up in the Profeſſion of Phyſick, underſtood the Whole; many, a great Part of it; [] and it was not poſſible to write it down to the Capacity of every Body.

The ſecond Fault, of its not being ſufficiently practical, I have endeavour'd to repair, by the Addition of this Second Part, which I was oblig'd to write in haſte, when the Diſtreſs both of my Mind and Body, beſides Buſineſs, render'd me very unfit for ſuch an Undertaking: All I can ſay for it is, That tho' it be leſs accurate, it may perhaps be more uſeful than the firſt, it being much ſuch a Work as an Almanack, of publick Benefit, but from which no body I believe ever propos'd any Reputation. It is a Collection of the ſcattered Precepts of the Firſt Part, and other new Rules, extended to the moſt common Diſeaſes as well as Conſtitutions of Human Bodies. I have ſtill follow'd the Method of the learned and induſtrious Boerhaave, who has certainly ſtudied and taught this Part of the Profeſſion more than any that ever were before him.

I cannot think it trifling nor unneceſſary to treat this Dietetick Part of Medicine by it ſelf with ſome Accuracy, for the following Reaſons: Firſt, Becauſe the Parts of any Art or Science are often beſt underſtood when they are treated ſeparately: Secondly, Becauſe the Practitioners in Phyſick and Chirurgery are often fruſtrated in their Intentions by Errors in Diet committed [] by their Patients, a Misfortune that I my ſelf have felt ſeveral times, and, as I ſuppoſe, in common with others of the Profeſſion. Thirdly, Becauſe ſome practical Rules of this ſort may be uſeful to ſuch as are remote from good Advice; and likewiſe to ſome coarſe Practitioners which they are obliged to make uſe of: By the Methods preſcrib'd in this ſhort Treatiſe, which are almoſt within the Reach of every Body, more Good and leſs Miſchief will be done in acute Diſtempers, than by Medicines improperly and unſeaſonably adminiſtred; and great Cures may be effected in Chronical Diſtempers, by a proper Regimen of the Diet. I hope I have done with this Subject. I was drawn in to write the Firſt Part by Accident, and to write the Second by ſome Defects in the Firſt; theſe are the cumberſome Perquiſites of Authors.

THE CONTENTS.

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CHAP. I. Of the different Qualities and Effects of Alimentary Subſtances.
  • ALimentary Subſtances, auſtere and aſtringent. Page 243
  • Alimentary Subſtances, ſoftening and relaxing. 245
  • Diluting Subſtances. 252
  • Anti-acid, or contrary to Acidity or Sourneſs. 253
  • Acid Subſtances. 259
  • Thoſe things which reſolve glutinous and fat Subſtances. ibid.
  • Stimulating. 260
  • Incraſſating, or Thickeners of the Humours. 261
  • What renders the Blood acrimonious, or ſharp. 262
  • Abaters of Acrimony, or Sharpneſs. 263
  • Coagulators of the Humours. 265
  • Thoſe things which accelerate the Motion of the Blood. ibid.
  • Thoſe things which increaſe Milk. 266
  • Subſtances expectorating. ibid.
  • Lenitive, or laxative of the Belly. 267
  • Diuretick. 269
  • Sudorificks. 271
  • Diaphoreticks, or Promoters of Perſpiration. 273
  • Emenagogues. ibid.
  • [] Thoſe things which produce Heat in animal Bodies. 275
  • Thoſe things which produce Cold in animal Bodies. 276
  • Cephalick. 277
  • Cordial. 278
  • Carminative, or Expellers of Wind 279
  • Anthelmintick, or contrary to Worms 280
  • Anodyne, or Abaters of Pain of the alimentary Kind. 281
CHAP. II. Rules of Diet in the different Conſtitutions of Human Bodies.
  • Lax and weak Fibres. 283
  • Too ſtrong and ſpringy Fibres. 284
  • Plethorick Conſtitutions. 285
  • Sanguineous Conſtitutions. 287
  • Conſtitutions ſubject to Acidity. 288
  • Conſtitutions abounding with a ſpontaneous Alkali. 290
  • Phlegmatick Conſtitutions. 293
  • Thickneſs of Blood. 295
  • Oily or fat Conſtitutions. 296
  • Melancholy or atrabilarian Conſtitutions. 298
  • Faulty Motion of the Fluids. 300
  • Wounds. 301
CHAP. III. Of Acute Diſeaſes.
  • Fevers, with their various Symptoms. 303
  • Intermitting Fevers. 323
Inflammatory Diſeaſes.
  • A Phrenſy, or Inflammation of the Brain. 327
  • Quincy. 328
  • Inflammation of the Lungs. 332
  • Pleuriſy. 339
  • Paraphrenitis, or Inflammation of the Diaphragm. 341
  • Inflammation of the Liver. 342
  • Inflammation of the Stomach. 348
  • Inflammation of the Guts. 350
  • A Thruſh. 355
  • Inflammations of the Kidneys. 357
  • Apoplexy. 362
CHAP. IV. Rules of Diet in Chronical Diſeaſes.
  • Palſy. 367
  • Epilepſy, Convulſions. 370
  • Melancholy, Madneſs. 374
  • Scurvy. 377
  • Cachexy, or ill Habit of Body. 381
  • Conſumption pulmonary. 382
  • Dropſy. 389
  • Gout. 395
  • Greenſickneſs, Obſtructions. 401
  • Diſeaſes of Infants. 404
  • Small-Pox. 412
  • Gravel, Stone. 419
  • Rheumatiſm. 428

[]PRACTICAL RULES OF DIET In the various CONSTITUTIONS and DISEASES of HUMAN BODIES.

CHAP. I.
Of the different Qualities and Effects of ALIMENTARY SUBSTANCES.

1. Alimentary Subſtances, auſtere and aſtringent.

AUSTERE, aſtringent, vegetable Subſtances, are ſuch as contain an acid eſſential Salt, combin'd with Earth, and very little Oil; as,

[244] Several ſorts of Plumbs, and ſome ſorts of Pears, diſtinguiſhable by their rough ſtyptick Taſte.

Quinces, which by their Quality are often uſeful to weak Stomachs, and in ſtopping of Fluxes of Blood.

Pomegranates, which contain a Juice ſtyptick, and extremely cooling.

Barberries, Medlars, Cornelian Cherries, all beneficial in Bloody-Fluxes.

Sorrel, uſeful in Spitting of Blood, and Stinking Breath.

Purſlain, ſucculent, ſubacid, with a cooling nitrous Salt.

Burnet, aſtringent, with a gentle ſpicy Quality, vulnerary.

Tamarinds, cooling, aſtringent, yet laxative to the lower Belly.

Capers, aſtringent and diuretick.

All Pickles, eſpecially Samphire, which is ſtimulating. Such ſort of Subſtances by their Acidity and aſtringent Quality offend ſome Stomachs.

[245] There are Wines of the ſame Quality, known by their rough auſtere Taſte; as likewiſe all acidulated and chalybeat Waters.

Strong Waters or ſpirituous Liquors contract and harden the ſolid Parts moſt of all.

2. Alimentary Subſtances ſoftening and relaxing.

The Juices of moſt ſorts of ripe Garden Fruits, as Cherries, are cooling, and laxative to the Bowels; their Kernels are good for the Gravel in the Kidneys.

Strawberries, which by their fragrant Smell ſeem likewiſe to be cordial. The Seeds, which are obtain'd by ſhaking the ripe Fruit in Water, are an excellent Remedy againſt the Stone: The Juice of Strawberries and Limons in Spring-Water is an excellent Drink in bilious Fevers.

[246] Oranges, thoſe that are ſweet are more relaxing than the bitter or Seville Oranges, which nevertheleſs are not heating; theſe are an excellent Remedy againſt the hot Scurvy.

Citrons and Limons, their Juices more cooling than that of Oranges. Sour Limons do not poſſeſs this relaxing Quality very much, they being ſomewhat ſtyptick.

Apples, which are likewiſe pectoral, cooling, and lenitive; they differ conſiderably as to the Kinds of them, and their Qualities may be eaſily known by their Taſte.

Pears have moſt of the ſame Qualities; ſome Kinds by their high Flavour ſeem to be more cordial than Apples.

Peaches, which are likewiſe cordial and pectoral.

Sweet Plumbs, thoſe of the auſtere Kind are aſtringent.

Mulberries, pectoral, corrective of the bilious Alkali.

[247] Apricocks, unleſs mellow, are rather ſomewhat ſtyptick.

Gooſeberries, extremely ripe, are lenient; unripe, they are ſour, and rather aſtringent.

Currants are good in Spitting of Blood, extremely cooling, and ſomewhat aſtringent. The Jelly or Rob of Currants, mix'd with Water, is a moſt excellent Drink in bilious Fevers.

Grapes taken in moderate Quantities help the Appetite and Digeſtion; in great Quantities, they reſolve the Bile too much, and produce Fluxes; dry'd, they are pectoral.

Figs are great Subduers of Acrimony, uſeful in Hoarſeneſs and Coughs, extremely emollient, and by relaxing the Urinary Paſſages, diuretick, uſeful in bloody Urine; it has been always believed that the immoderate uſe of them generates Lice.

[248] Plants of the low pomiferous Kind, as Melons, Pompions, Gourds, Cucumbers, contain a cooling Juice, with a nitrous Salt; that of Melons and the Ananas is rich and cordial; they are diuretick; and there are Inſtances, when eaten in great Quantities, they have produced bloody Urine; they ought to be taken faſting. The Juice of Cucumbers is too cold for ſome Stomachs, and ought not to be taken by ſuch as have thin and poor Blood; if the Stem upon which they grow be bruiſed, the Pulp of the Fruit grows bitter, and has the Effect of Coloquintids. The Juice of an unripe Cucumber is purgative. Cucumbers are uſeful in bloody Urine.

All Fruits which contain a ſubacid eſſential Salt, much Phlegm, and a ſmall Quantity of Oil, have this lenient Quality; as likewiſe the emollient Pot-Herbs; as,

[249] Cole, Cabbage, Coleworts, which are ſoft and demulcent, without any Acidity. The Jelly or Juice of red Cabbage, bak'd in an Oven, and mix'd with Honey, is an excellent Pectoral.

Lettuce, which has a milky Juice, with an anodyne or opiate Quality, reſolvent of the Bile, proper for melancholy People, diuretick, and good in Stranguries, eſpecially when eat raw; it is reckoned to increaſe Milk.

Cichory and Dandelion have ſome of the ſame Qualities, with a ſmall degree of Bitterneſs extremely agreeable to the Stomach, and not heating. The Juice of the Dandelion is a Remedy in intermitting Fevers.

Spinage, emollient, but not very nouriſhing; it is reckoned good in Inflammations of the Bowels.

Beets, emollient, nutritive, and relaxing.

Carrots, good in nephritical Caſes, antiacid, and fattening.

[250] Parſnips, uſeful in phlegmatick Colicks; the Plant from which Apoponox is taken, is a ſort of Parſnip.

Skirrets, uſeful in bloody Urine, and Spitting of Blood.

Scorzonera, demulcent in the SmallPox, Meazles, and peſtilential Fevers, and for Gouty People; the expreſs'd Juice better than the Decoction.

Goats-beard, an alimentary Root, has moſt of the Qualities of Scorzonera.

Emollient likewiſe are all farinaceous or mealy Subſtances.

Barley, which is deterging, tho viſcous in a ſmall degree; the Decoction and Cream of Barley are proper in inflammatory Diſtempers.

Rice, nouriſhing, good in Haemorrages, or Fluxes of Blood.

Mays is not ſo eaſily brought to Fermentation as other Grains, therefore more viſcous.

[251] Wheat, the propereſt of any Grain for Bread, which, when not entirely purged from the Bran, is laxative, and ſtimulating to the Bowels.

Rice, the Bread, more aceſcent and leſs nouriſhing than that of Wheat.

Oats, cleanſing, reſolving, and pectoral; Oatmeal and Butter outwardly apply'd dry the Scab on the Head.

Millet, diuretick, cleanſing, and good in Diſeaſes of the Kidneys.

Panick, aperient, boil'd with Milk, demulcent, temperating Acrimony.

Peaſe contain a ſoft Oil, without any ſpicy Quality; therefore are extremely demulcent, and temper Acrimony.

Beans and Kidney-Beans have the ſame Qualities; they are reckoned diuretick, and good for the Stone.

It has been commonly reckoned, becauſe of the Viſcoſity of Peaſe and Beans, that People who live a ſedentary [252] Life ſhould not feed much upon them.

The Animal Oils; Cream, Butter, and Marrow, are all lenient and nouriſhing: Marrow is excellent in the dry Scurvy with crackling of the Bones, where it performs its natural Office.

Of all Drinks, Whey is the moſt relaxing, ſo are warm Water and Decoctions of mealy Subſtances, and Panadas, or Bread boil'd in Water.

3. Diluting Subſtances.

Water and watery Liquors, without any ſaline Subſtance; Decoctions of mealy Subſtances; Robs and Gellies of Garden Fruits in Water.

Reſolving is bringing a Fluid which is new concreted into the State of Fluidity again. Such are

All Subſtances which are ſaponaceous, or contain Salt and Oil; therefore moſt ripe Garden Fruits [253] have this Quality, and Honey moſt of all vegetable Subſtances. Mere diluting diſſolves and carries off Salts.

4. Anti-acid, or contrary to Acidity or Sourneſs, are,

All Animal Diet in general, becauſe no Animal has any acid Salt in it, eſpecially Fleſh roaſted; tho' not ſo eaſy of Digeſtion as boil'd.

The Animals which feed on other Animals muſt have this Quality ſtronger than thoſe who feed on acid Vegetables; ſuch are moſt Fiſhes, all Birds which feed upon Worms and Inſects, ſeveral Kinds of Water-Fowl, Woodcocks, Snipes, and ſeveral Kinds of ſmall Birds, which for that Reaſon afford a higher Aliment than thoſe that feed upon Grains or other Vegetables.

The Fleſh of Animals differs according as they are terreſtrial, aquatick, or amphibious. Fiſhes contain much [254] Oil, and amphibious Animals participate ſomewhat of the Nature of Fiſhes, and are oily; and the ſame Species of Animals differs according to the Soil and Air it lives in, and the Nouriſhment which it takes, as thoſe in Marſhes and Mountains; the Fleſh of Oxen, Sheep, Deer, in different Paſturage; and this is in none more ſenſible than in Hogs Fleſh.

Young Animals from their Age and the Nature of their Aliment have more tender Fibres, and more ſuperfluous Humidity than old Animals, which have their Fibres tougher, and the Juices more exalted and reliſhing.

Mutton by Experiment is the moſt perſpirable of all animal Food, and Hogs Fleſh and Oyſters the leaſt.

The Fleſh of Animals which take and digeſt a great Quantity of Food, and conſequently uſe ſtrong Exerciſe, muſt be nouriſhing, becauſe they have ſtrong Sanguification, ſuch are [255] Pigeons; and the ſame is true of ſome Fiſhes.

The Nature of moſt ſort of animal Diet may be diſcovered by Taſte and other ſenſible Qualities, and ſome of thoſe general Rules above-mention'd, without particular Diſquiſitions upon every Kind.

Eggs are perhaps the higheſt, moſt nouriſhing and exalted of all animal Food, and moſt indigeſtible, becauſe no body can take and digeſt the ſame Quantity of them as of other Food.

Shell-Fiſh are nouriſhing, and their Oil is corrected by their Salts, which make it pungent and ſtimulating.

But, as was ſaid before, all Animal Diet is Anti-acid or Alkaleſcent.

Vegetables uſed in Aliment antiacid are ſuch as of themſelves turn foetid or ſtinking, rather than four.

All the Cole or Cabbage Kind.

Aſparagus diuretick or aperient; by the foetid Smell which it gives [256] the Urine it is ſuſpected to be hurtful to the Kidneys.

Parſley and Celery, both contain a pungent Salt and Oil, diuretick and aperient, bad in Bloody-Fluxes.

Garlick, Rockambole, Onions, Shalot, Leeks, theſe abound with a pungent volatile Salt and Oil, are extremely diuretick, and, when ſtimulating Diureticks may be ſafely us'd, are very effectual: Garlick has been found by Experience to be a very excellent Remedy in Jaundices and Dropſies, and in Aſthmas proceeding from a cold viſcous Phlegm. All theſe Plants are hurtful in Caſes where the Blood is too much diſſolv'd, in Spitting of Blood, and bloody Urine.

Creſſes, Radiſhes, Horſe-Radiſhes, Muſtard, abound likewiſe in their ſeveral degrees with a pungent Salt, and as they ſubdue Acidity, are very improper where the Blood verges to the contrary State of a putreſcent Alkali; and in general they are fitter [257] for old People, and cold Conſtitutions, than the young and ſanguine. Muſtard is a very powerful Remedy in viſcous cold phlegmatick Caſes.

Dilſe, a Sea-Plant, antiſcorbutick. There are other Sea Plants us'd as Aliment, which contain a temperate Sea-Salt, very uſeful in Scurvies; as Laver, which is the Lactuca Marina, or Sea-Lettuce, and Sea-Cole, or Cale.

Carrots, Turnips, Parſnips, are Anti-acids of a milder Kind.

Nettles, good againſt Haemorrages.

Such as abound with a ſoft Oil, which operate by blunting the Acrimony of the Salts, as moſt ſorts of Nuts; moſt of which are hard of Digeſtion, yet poſſeſs ſome good medicinal Qualities.

Walnuts are cordial, anti-hyſterick, and gently ſudoriſick.

Hazle-Nuts, good againſt Spitting of Blood.

[258] Cheſnuts are good in Female Weakneſſes, and afford a very good Nouriſhment.

Almonds, Pectoral.

Piſtachos, nouriſhing and ſtimulating.

Olives are anti-acid by their Oil, but all oily Subſtances beget an Acrimony of another ſort.

Truffles, which have an exalted Oil, and a volatile Salt of a grateful Savour, are heating.

Morelles have ſome of the ſame Qualities; and ſo have Earth-Nuts and Potatoes, which are very nouriſhing.

Muſhrooms, which contain an Oil of a volatile Salt; therefore they are beſt corrected by Vinegar; ſome of them being poiſonous, make the reſt ſuſpicious; the poiſonous Kinds operate by a ſort of Suffocation, in which the beſt Remedy is Wine or Vinegar and Salt, and Vomiting as ſoon as poſſible.

[259] Acidity is likewiſe cur'd by diluting, therefore Water is an Anti-acid.

5. Acid Subſtances are,

Moſt ripe Garden Fruits, fermented Liquors, ſmall Wines, with little Oil, and much Tartar, Vinegar, ſour Milk, Butter-Milk. Several Plants known by their Taſte, as Sorrel, &c. Thoſe of the mealy Kind are aceſcent, that is, being kept they turn ſour rather than corrupted and ſtinking.

6. Thoſe things which reſolve glutinous and fat Subſtances, are

Spices, as Cinnamon, Mace, Nutmeg, Cloves, Ginger, Pepper. Theſe abounding with a high exalted Oil, and volatile Salt, by which Principles they are heating, and act ſtrongly both on the Fluids and Solids; Ginger is perhaps one of the beſt of [260] them. All Spices are bad for melancholy People.

Of the ſame nature are the Vegetables uſed in Seaſoning, as Thyme, Savory, Marjoram, Roſemary, Mint, Orange and Limon-Peel, Fennel, which contains a ſubtil Spice, balſamick, warm, and ſtimulating; Chervil, of the ſame nature; they are good in phlegmatick cold Conſtitutions: Sage is ſtimulating, drying, aſtringent; us'd in great Quantities it will produce Temulency, or Drunkenneſs.

All Soaps and Soapy Subſtances, and conſequently ripe Fruits, the Juices of pungent and aromatical Plants, all thoſe Subſtances reſolve Solids, and ſometimes attenuate or thin the Fluids.

7. Stimulating.

All Salts in general, both acid and alkaline; all acrimonious Oils, and [261] all Subſtances that abound with them, for by their Oil they obſtruct the Extremities of the ſmall Veſſels, and by their Salts they irritate the Solids, conſequently all the Subſtances mentioned in the foregoing Article are ſtimulating, and all fermented Spirits, the Effect of which is very ſudden.

Extreme Cold ſtimulates, producing firſt a Rigor and then a glowing Heat; thoſe things which ſtimulate in the extreme degree, excite Pain.

8. Incraſſating or Thickeners of the Humours, are

All things which expel the liquid Parts ſtrongly, ſo as to thicken what remains. Therefore violent Exerciſe or Labour produceth this Effect; the Blood of labouring People is more denſe than that of the ſedentary. A due Conſiſtence of the Blood is very neceſſary for Health, and this is acquir'd chiefly by Exerciſe; all [262] things which provoke great Secretions, eſpecially Sweat, produce this Effect at laſt.

9. What renders the Blood acrimonious or ſharp

Are ſuch things as increaſe its Velocity; for by mutual Attrition Salts are produc'd.

Whatever attenuates the Humours.

Whatever reſolves Concretions, and turns them fluid; for whatever putrifies, is acrid.

Acrimony is threefold: Acid, which is produc'd from Vegetables lying long in the Stomach; no animal Subſtance produceth Acidity, except Milk.

Great Quantities of Oily Subſtances, for Animal Humours, by Heat, ſtink and grow foetid, like Oil.

Expreſs'd Oils are mild.

Diſtill'd Oils turn acrid.

[263] Oils entirely deprav'd of their Salts are not acrid.

Alkaline Acrimony is produced by fix'd Salts, by fix'd Alkalis, and volatile Alkalis, taken in great Quantities; and by eſſential Salts of Vegetables, of which ſort are Sugar, Manna, and Honey.

Alkaline Acrimony is produc'd by all Vegetables which abound with a pungent volatile Salt and Oil, as Muſtard, Garlick, Onions, Horſe-Radiſh, Creſſes; and by all Spices. All things which create Pain, render the Humours ſharp.

10. Abaters of Acrimony or Sharpneſs.

Expreſs'd Oils of ripe Vegetables, and all Preparations of ſuch, as of Almonds, Piſtachos, and other Nuts.

Emulſion of the Seeds of Barley, Oats, &c.

Decoctions of farinaceous Legumes, as Peaſe, Beans, &c.

[264] Native Animal Oils, as Fat, Cream, Butter, Marrow, eſpecially the laſt, which is excellent in ſome Scurvies.

All inſipid inodorous Vegetables are demulcent.

Jellies, Broths of Animal Subſtances not high ſeaſoned, acid Subſtances in reſpect of alkaline, and alkaline in reſpect of acid.

Fermented burning Spirits ſubdue Acidity, and are very often a preſent Remedy when the Stomach is affected with it. Spirit of Wine dulcifies Spirit of Salt, Nitre, or Vitriol; but then thoſe Spirits have other bad Effects.

Abſorbents, as Chalk, Crabs Eyes; but theſe are not alimentary, except calcin'd Hartſhorn, which has ſomething of this Quality.

Nothing abates Acrimony of the Blood more than an equable Motion of it, neither too ſwift nor too ſlow; for too quick a Motion produceth an alkaline, and too ſlow an acid Acrimony.

11. Coagulators of the Humours.

[265]

Thoſe things which expel the moſt fluid Parts, as in the Caſe of incraſſating, or thickening; and by thoſe things which ſuck up ſome of the fluid Parts, as Abſorbents.

All Vegetables, which make a black or purple Tincture with the Vitriol of Mars, ſuch as Galls do. Juices of unripe Vegetables, and the juices of all auſtere Vegetables which coagulate the Spittle, and being mix'd with the Blood in the Veins would produce Polypus's in the Heart, and Death.

All burning fermented Spirits have this Quality in a ſtrong degree.

12. Thoſe things which accelerate the Motion of the Blood, are

All ſtimulating, diluting, and attenuating Subſtances; what relaxeth the Veins, as Frictions, Bathings, [266] Compreſſions by Ligatures often remov'd, Sneezing, Coughing, Laughing, and ſeveral other natural Motions.

Thoſe things which take off the Cauſes of Acceleration, retard the Motion of the Blood.

13. Thoſe things which increaſe Milk.

What generates quickly a great Quantity of Chyle, as thin Broths, Ptiſanes of Barley or Oatmeal, Panadas, but nothing more than Milk with Salt and Sugar; Cream, if the Milk be not too thick, Malt Drink, not ſtrong, or ſtale; a due degree of Exerciſe or Labour. Eating much Fleſh-Meat abates Milk.

14. Subſtances expectorating.

Such as cleanſe and open, as mild vegetable Oils, ſuch as that of Almonds or Olives; ſoapy Subſtances, [267] eſpecially Honey; Emulſions of farinaceous Subſtances, Decoctions of emollient Vegetables, Sugar.

Sometimes ſtimulating Subſtances are neceſſary to diſſolve viſcid Phlegm, and excite a Cough.

The mild Vapour of warm Liquids, eſpecially warm Water.

And ſuch things as are endued with an opiate Quality by incraſſating the Phlegm.

15. Lenitive or laxative of the Belly.

Animal Oils, freſh Butter, Cream, Marrow, Fat Broths, eſpecially of thoſe Parts which are about the Meſentery; Livers of Animals, becauſe of the Bile which they contain; the expreſs'd Oils of mild Vegetables, as Olives, Almonds, Piſtachos, and the Fruits themſelves; all oily and mild Fruits, as Figs; Decoctions of mealy Vegetables, theſe lubricate the Inteſtines; ſome ſaponaceous Subſtances [268] which ſtimulate gently, as Honey, Hydromel, or boil'd Honey and Water, and even Sugar it ſelf, eſpecially unrefin'd.

Such lenitive Subſtances are proper for dry atrabilarian Conſtitutions, who are ſubject to Aſtriction of the Belly, and the Piles, and will operate when ſtronger medicinal Subſtances are ſometimes ineffectual; but ſuch lenitive Diet hurts thoſe whoſe Bowels are weak and lax.

Lenitive are likewiſe watery Subſtances; and even common Water or Whey, drank in cool Air, and walking after it; ſour Milk and Butter Milks have the ſame Effect.

There are other Subſtances which ſtimulate more, even new Milk, eſpecially Aſſes Milk, when it ſours on the Stomach; and Whey, turn'd ſour, will purge ſtrongly.

Jellies made of the ſolid Parts of Animals contain a ſort of ammoniacal Salt; Shell-Fiſh, as Oyſters, the ſame, by which they are lenitive; [269] moſt Garden Fruits, by the Salts which they contain, produce the ſame Effect; ſome of them, as Grapes, will throw ſuch as take them immoderately, into a Cholera Morbus, or incurable Diarrhoeas; all Fruits when they have this Effect, are flatulent; Wine and ſpirituous Liquors are not ſo uſeful in ſuch a windy Colick, as Water, which is much the beſt Remedy after a Surfeit of Fruit. The expreſs'd Juices of ſeveral Vegetables, becauſe of their eſſential Salts, ſtimulate the Bowels.

All foſſil Salts, as Sea-Salt, Rock-Salt, &c. have this Quality; a Diet of ſalted Fleſh throws Ships Crews ſometimes into Diarrhoeas.

16. Diuretick.

All Decoctions, Emulſions, Oils of emollient Vegetables, ſuch relax and lubricate the Urinary Paſſages; they ought to be taken in an empty [270] Stomach, an open Air, and with gentle Exerciſe.

Diluents, as Water, Whey, Tea, ſmall Ale without Hops.

Subſtances ſtimulating, by which Quality all Salts whatſoever are diuretick.

Soaps which reſolve ſolid Subſtances, any Salt, Oil, Salads of pungent Herbs, with Oil of Olives, and Vinegar, are diuretick.

By this ſaline Quality, the Juices of Shell-Fiſh, of Oyſters, Muſcles, Crabs, Crawfiſh, and the Soups made of them, are diuretick.

Vegetables which have little Oil, and a great Quantity of eſſential Salt, are diuretick, Parſley, Celery, Sorrel, Chervil, Eringo.

Vegetables which are aromatick and balſamick, Saffron, Aſparagus, Nutmeg; theſe affecting the Urine with an Odour, have ſome ſpecifick Quality of this Kind.

[271] All anodyne Subſtances which take off Spaſms and Contractions of the membranous Parts, and all which ſubdue any particular Acrimony, are diuretick.

For provoking of Urine, one ſhould begin with the gentleſt at firſt, as the lenient, relaxing, diluent, demulcent, and laſt of all the ſtimulating.

The Blood may be cleans'd, and the Salts of it carried off perhaps better by Urine than any other Secretion.

17. Sudorificks.

Such things as relax the Veſſels of the Skin, by which Quality many things which are diuretick, are likewiſe ſudorifick; warm Water and Honey, Barley-Water, Friction, and tepid Vapours, apply'd to the Skin, operate by this Quality.

[272] Subſtances anodyne, by abating Spaſms, relax, and by that Quality prove ſudorifick.

Such things as diſſolve and dilute the Blood, thus cold Water.

Water, Vinegar, and Honey, is moſt excellent Sudorifick us'd by Hippocrates; it is more effectual with a little Mace added to it.

Thoſe things which determine the Motion of the Fluids towards the extreme Parts, increaſe the Strength and Frequency of the Pulſe, as violent Exerciſe, all Cordials, Spices, thin and ſharp Wines, Juices of Limon, operate by theſe Qualities.

The Matter of Sweat is the moſt ſpirituous and nutritious Part of the Blood, nor is it to be forced without apparent Indications. It contains the ſame lixivial Salts with Urine.

Sweating often thickens the Blood, and ſometimes thins and diſſolves it.

[273] Sudorificks are to be varied according to the Cauſe of the Diſeaſe which it is deſign'd to remove.

18. Diaphoreticks or Promoters of Perſpiration.

What helps the Organs of Digeſtion, becauſe the Attenuation of the Aliment makes it perſpirable.

Such things as conſtrict the Fibres, and ſtrengthen the ſolid Parts; Exerciſe to a degree leſs than what provokes Sweat.

Subſtances which ſtimulate in a ſmall degree.

Air, moderately warm.

There are likewiſe Aliments more and leſs perſpirable. See Sanctorius.

19. Emenagogues.

Such as produce a Plethora or Fulneſs of the Veſſels, conſequently ſuch as ſtrengthen the Organs of Digeſtion, [274] ſo as to make good Blood, eſpecially Exerciſe; ſuch as carry off the Foeces and Mucus, deobſtruct the Mouths of the Lacteals, ſo as the Chyle may have a free Paſſage into the Blood.

Subſtances ſaline or ſoapy, that is, conſiſting of Salt and Oil.

Such as relax, and take off the Reſiſtance of the Veſſels of the Womb, Fomentations, and tepid Bathings of the lower Parts of the Body.

What accelerates the Reflux of the Blood from the lower Parts to the Heart, Friction, Walking, eſpecially Dancing.

What ſtimulates and promotes the Excretion of the Blood, eſpecially ſome of the Plants which abound with a pungent Salt, and a high exalted Oil, as thoſe us'd in ſeaſoning Aliment, Savory, Thyme, Marjoram, Penny-Royal, &c. Vapours acrimonious.

20. Heat is produc'd in animal Bodies

[275]

By the Application of hot things. By increaſing of Attrition or Rubbing of the Fluids and Solids, to which Heat is proportional.

Therefore whatever increaſeth the Velocity of the Blood, by ſtimulating, heateth, as ſpirituous fermented Liquors, and when the Heat is increas'd, the Velocity of the Blood is certainly increas'd.

What increaſeth the Denſity of the Fluids, heateth, for a denſer Fluid is hotter than a rarer; and thus it is that Cold it ſelf at laſt heateth.

Whatever ſtraitens the Veſſels ſo as the Channels become more narrow, muſt heat, becauſe in that Caſe the Attrition is made greater; therefore ſtrait Clothes, thick Coverings, heavy and cold Air, but eſpecially cold Baths, heat: All who are ſubject to Haemorrages ought to avoid theſe [276] things. In Conſumptions and Atrophy, the Liquids are exhauſted, and the Sides of the Canals collapſe, therefore the Attrition is increas'd, and conſequently the Heat.

21. Cold is produc'd in animal Bodies.

By Cauſes contrary to the former, viz.

By whatſoever diminiſheth the projectile Motion of the Blood, by weakening the Force of any Stimulus; therefore diluting things are cooling, as Whey, Water, Milk and Water, both as they abate Acrimony, and relax the Veſſels.

What is contrary to any particular Acrimony, is cooling, as alkaline Subſtances in reſpect to acid, and acid Subſtances in reſpect of alkaline; and ſoapy Subſtances, if the Heat proceeds from an oily or viſcous Cauſe.

What expels any Stimulus out of the Body, cools.

[277] Thoſe things which attenuate and dilute by diminiſhing the Denſity of the Fluid; thus Nitres, and thoſe Vegetables, which have nitrous Salts in them, cool.

Tepid Baths cool by relaxing the Veſſels; and Air, when it is light, is more cooling, caeteris paribus, than when it is heavy, becauſe it compreſſeth the Veſſels leſs.

All thoſe who have lax Fibres and Veſſels are naturally cooler than thoſe that have ſtrait.

22. Cephalick.

Such things as attenuate the Fluids which circulate through the capillary Veſſels of the Brain, and abound with a volatile Oil, Salt, and Spirit, and are known commonly by a grateful Flavour and Odour, as Marjoram, Balm, Sage, Roſemary.

Thoſe things which affect the Noſe with a grateful Smell, and are not [278] hot, by their Odour promote the Separation of the Animal Spirits.

23. Cordial

Are all ſuch things as increaſe and facilitate the animal or natural Motions, the Power of, moving the Muſcles, or circulating the Fluids.

What increaſeth the Strength of the Heart, is not always a Cordial; for in inflammatory Diſtempers, by increaſing the projectile Motion of the Blood, the Strength may be diminiſhed.

What increaſeth the Force of the Heart ſo as to give a due degree of projectile Motion to the Blood, is a Cordial.

What produceth a due Quantity of Animal Spirits, neceſſarily facilitates the animal and natural Motions.

Such are all Aliments which put the nutritious Juices in ſuch a State [279] of Tenuity and Heat as approacheth to the White of an Egg, while it is hatching; thoſe are commonly Meats and Drinks of eaſy Digeſtion, nouriſhing, of a Flavour grateful to moſt Palates.

Such as determine and ſettle the irregular Motions of the Animal Spirits; therefore, anodyne Subſtances, and what abate Spaſms and Convulſions, are Cordial.

Such as ſtimulate and excite the Spirits, as Spices and Vegetables, which abound with a volatile Salt, Oil, and Spirit.

In ſhort, whatever relaxeth the too ſtrict Veſſels, or ſtraitens the too lax; what thickens the too thin, or attenuates the too thick Fluids, is a Cordial.

24. Carminative, or Expellers of Wind.

Wind is elaſtick and rarify'd, pent up in ſome Veſſel of the Body, [280] which by its Expanſion creates a Tenſion or Convulſion in that Part.

Every thing which takes off that Convulſion, is, properly ſpeaking, carminative.

Therefore what relaxeth or openeth ſo as the claſtick Air may eſcape, as warm Water drank plentifully, Bathing, Fermentations, and all things which abate Pain, and thoſe things which abound with volatile oily Salts, are carminative.

As thoſe Spaſms are often occaſion'd by ſome acrimonious Subſtance which conſtringeth the Fibres of the affected Part; whatever is contrary to that particular Acrimony, is carminative.

25. Anthelmintick, or contrary to Worms.

All things which are known by Experience to kill them, as Oils of all Kinds; Honey taken upon an [281] empty Stomach, or after ſome gentle purging Medicine.

Subſtances which by their ſmall pungent and ſharp Particles kill them without hurting the Inteſtines, as all Fiſh Bones and Hartſhorn powder'd.

Thoſe things which purge and expel them out of the Body, of which kind there are ſeveral alimentary Subſtances.

26. Anodyne, or Abaters of Pain of the Alimentary Kind.

Such things as relax the Tenſion of the affected nervous Fibres, as Decoctions of emollient Subſtances; thoſe things which attenuate and remove the Obſtruction, or deſtroy the particular Acrimony which occaſions the Pain, or what deadens the Senſation of the Brain by procuring Sleep; ſome Alimentary Subſtances are endued with this Quality, as Saffron, [282] Lettuce, Cichory, Wine, and inflammable Spirits.

This being a ſort of a compendious Alimentary Diſpenſatory, makes it unneceſſary in the following Rules to repeat conſtantly the ſame things, it being ſufficient to mention the Intention or Deſign to be purſued in the Diet.

When there are Contra-indications, that is, when different Symptoms demand oppoſite Methods one muſt adapt the Method to the moſt urgent Symptom.

When the Diſeaſe is complicated with other Diſeaſes, one muſt conſider that which is moſt dangerous. Theſe may ſerve for general Rules.

CHAP. II.
Rules of Diet in the different Conſtitutions of Human Bodies.

[283]

Lax and weak Fibres.

PAleneſs, a weak Pulſe, Palpitations of the Heart, flabby and ſlack Fleſh, Lazineſs, Laſſitude, Bloatedneſs, ſcorbutical Spots are Symptoms of weak Fibres.

Leanneſs is no Sign of weak Fibres, for though the bundle of Fibres which conſtitute the Muſcle may be ſmall, the Fibres themſelves may be ſtrong and ſpringy.

Such as have weak Fibres ought to avoid all great Evacuations, eſpecially Letting of Blood, Subſtances viſcous, and hard of Digeſtion, a ſedentary Life, and moiſt Air.

They ought to take Aliment frequently, in ſmall Quantities, nouriſhing, [284] and of eaſy Digeſtion, ſuch as Milk, Broths and Jellies of Fleſh Meat, Panadas, &c. Their Drinks ought to be auſtere Wines mix'd with Water, or any Wine mix'd with chalybeat Water; and to uſe in their Aliment ſtyptick auſtere Vegetables, ſuch as are enumerated No 1, as far as their Stomachs can bear them.

Too ſtrong and ſpringy Fibres.

A Body hard, dry, ſcraggy, hairy, warm, with firm and rigid Muſcles, a ſtrong Pulſe, Activity and Promptneſs in Animal Actions, are Signs of ſtrong, rigid, and elaſtick Fibres.

Such Conſtitutions are ſubject to inflammatory Diſtempers.

They ought to avoid the Diet proper in the contrary State.

Their Nouriſhment ought to be emollient and cooling, the Pulps, Juices, Jellies, Mucilages, and Decoctions of Vegetables mentioned [285] No 2. animal Oils, and all things which relax and increaſe Fat, avoiding all things ſeaſoned with Spice and Salt: Their Drink, Water, Barley-Water, Whey; and eſpecially to avoid fermented Spirits, which to ſuch are extremely hurtful.

Bathing in tepid Water is beneficial to ſuch Conſtitutions, and immoderate Labour or Excerciſe hurtful.

Plethorick Conſtitutions.

The Signs of a Plethorick Conſtitution, or of ſuch as abound with laudable animal Fluids, are evident.

The Cauſes of it are a good Stomach, nouriſhing Diet, a good Digeſtion, little Exerciſe, much Sleep, and Suppreſſion of uſual Evacuations, eſpecially Perſpiration; therefore the avoiding theſe, and inducing their Contraries, are the proper Cure.

[286] A plethorick Conſtitution is ſubject to a Stoppage of the Circulation, and conſequently to Suffocation, Ruptures of the Veſſels, and ſudden Death; therefore it ought to be ſpeedily broke by proper artificial Evacuations, and reſtoring the uſual natural ones.

Long Abſtinence is not proper for plethorick Conſtitutions, for it thickens the Fluids; frequent Blood-letting, in ſmall Quantities, often increaſeth the Force of the Organs of Digeſtion, fattens, and increaſeth the Diſtemper.

They ought to avoid oily and nouriſhing Subſtances; watery Vegetables, as being leſs nouriſhing than animal Diet, are proper; and Fiſh rather than Fleſh: In a Lent Diet People commonly fall away.

Sanguineous Conſtitutions.

[287]

Such are known by their Complexion, or Colour of their Countenance and Skin: They are ſubject to Haemorrages, Inflammations, eſpecially of the Lungs, Impoſtumations, and often to ſcrophulous Diſtempers.

All things which accelerate the Motion of the Blood are hurtful to ſanguineous Conſtitutions, as violent Exerciſe and Watching.

Acid Subſtances, No 5, eſpecially Vinegar, are uſeful; the copious Uſe of Vinegar brings Paleneſs.

The ſanguineous ought to avoid the copious Uſe of all things that abound with an acrimonious Salt and high exalted Oil, as Muſtard, Onions, Garlick, Leeks, the Herbs us'd in Seaſoning, mention'd No 6, and in general, all Spices.

Conſtitutions ſubject to Acidity.

[288]

Sour Belchings, a craving Appetite ſometimes of unuſual things, as in the Caſe of the Green-Sickneſs, Colical Pains, dry Gripes, change of the colour of the Bile from Yellow towards Green, a ſour Smell in the Excrements and Sweat, paleneſs of the Skin, lowneſs of the Pulſe, and ſome ſort of Eruptions of the Skin, are the common Signs of ſuch a Conſtitution.

The chief Seat of Acidity is in the Stomach and Inteſtines, from whence it will ſometimes paſs into the Blood, and other Juices.

Such ought to abſtain from the copious uſe of acid alimentary Subſtances, mention'd No 5, they ought not to eat much Bread, nor take grea [...] Quantities of mealy Subſtances, no [...] drink much of fermented Liquor eſpecially ſour and thin Wines.

[289] Their Diet ought to be rather of animal Subſtances than vegetable: The Fleſh of thoſe Animals which live upon other Animals is moſt anti-acid, as ſeveral Birds, and Water-Fowl; tho' thoſe are offenſive to the Stomach ſometimes, by reaſon of their Oilineſs. Vegetable and animal Oils are often agreeable to ſuch Stomachs, as Almonds, Piſtachos, Cream, Butter, Marrow.

Their Diet ought to conſiſt, in general, of Subſtances mentioned No 4.

Water or Wine not ſour or thin, is their proper Drink.

They ought to uſe much Labour or Exerciſe, for labouring People have commonly a good Digeſtion, and ſubdue the Acidity of their Aliment.

Acidity in the ſucking Infant is to be cured by an alkaline Diet in the Nurſe.

[290] To know whether Eruptions of the Skin come from an acid or alkaline Cauſe, one muſt attend to the previous Diet and the concomitant Symptoms; (Children, by eating unripe Fruit often, have Eruptions upon their Skin) the Lentor, itching Colour, and State of ſuch Eruptions, not inflammatory, nor tending to Suppuration, point rather to an acid Cauſe, and the Succeſs of the Cure often demonſtrates the ſame, ſuch being often heal'd by animal alkaline Salts.

Conſtitutions abounding with a ſpontaneous Alkali.

This Conſtitution is more natural to Human Bodies, becauſe all animal Subſtances are alkaleſcent.

Heat, Thirſt, hot nidoroſe Belchings, Foulneſs of the Tongue and Palate, a bitter and hot Taſte in the Mouth, Sickneſs, Loathing, bilious [291] Vomitings, Stools with a cadaverous Smell, Pains in the Belly, with Heat, are Symptoms of an alkaline State of the Humours in the Stomach and Bowels.

Such a State diſpoſeth the Humours of the whole Body to Heat, Inflammations, and Putrefaction, hinders Nutrition, and often cauſeth Eruptions on the Skin, dark, livid, lead-colour'd and gangrenous, and what is commonly called the hot Scurvy.

Such Conſtitutions ought to avoid alkaline Subſtances, mentioned No 4, viz. an animal Diet, eſpecially Fat, Spices, and all Vegetables which abound with an acrimonious Salt and high exalted Oil, and the copious uſe of Salts in general; all animal Salts are alkaline; Sea-Salt and Rock-Salt, tho' they are of a mix'd Nature, rather increaſe the Diſeaſe; Salt-Petre is the moſt cooling and proper.

[292] They ought to uſe plentifully the acid Subſtances mentioned No 15, to live much upon Aliments made of Grains or mealy Subſtances, to eat much Bread, and ſeaſon much with Vinegar; thin Wines, Wine mix'd with Water, Water with Juice of Limon, and eſpecially Milk and Water, are proper Drinks.

Thoſe who feel no Inconvenience in taking Acids, ought to take them plentifully.

People of ſuch Conſtitutions ought not to uſe violent Exerciſe, nor long Abſtinence, which diſpoſeth to ſuch a State, and after long Abſtinence they ought not to eat plentifully; they ought to uſe liquid rather than ſolid Aliment.

Plethorick Conſtitutions are ſubject to fall into this alkaline State of the Fluids, which is more dangerous than that which proceeds from Acidity, for the Bile (which is here redundant) is the ſtrongeſt Anti-acid, [293] and when it is highly exalted, and acrimonious, is capable of producing all the dreadful Symptoms of malignant and peſtilential Fevers, as is evident from the Experiments that were made in the Plague of Marſeilles. There is nothing corrects the Acrimony of the Bile ſo much as the acid Diet above-mentioned; therefore one cannot be too early and quick in diſcerning a Tendency to ſuch a State, and obſerving if the Perſon be plethorick, hot, or dry; if the Air be hot; if bilious Fevers reign; if there be any Acrimony in the Faeces, Urine, Sweat; or a yellow; Caſt in the Skin; with the Signs above-mentioned, by an early Application of proper Remedies, many dangerous and fatal Diſeaſes might be prevented.

Phlegmatick Conſtitutions.

Sickneſs of the Stomach, a Senſe of Fulneſs without eating; Crudities [294] or Meat remaining in the Stomach undigeſted, Dejection of Appetite, Wind coming upwards, but eſpecially tough Phlegm frequently rejected by Vomiting, Inflations and Tumors of the Belly (ſometimes ſhort Breath) and Paleneſs, are Signs of a phlegmatick Conſtitution; when a Child grows pale, and his Belly ſwells, as happens to thoſe that are rickety, there is certainly tough Phlegm in the Inteſtines, which commonly ſhuts up the Mouths of the Lacteals, and hinders the Nouriſhment from paſſing: Perſons of ſuch Conſtitutions ought to avoid mealy Subſtances unfermented, unripe Fruits, and all viſcous Nouriſhment; they ought not to let Blood, except upon urgent Occaſions, nor provoke Sweat, which thickens the Humours.

Their Diet ought to be alkaleſcent, of Subſtances mentioned No 4, becauſe whatever brings them into an alkaline State, is a proper Cure for [295] the Diſeaſe; therefore ſoapy Subſtances, which conſiſt of a pungent Salt and volatile Oil, Spices, Salt, Garlick, Onions, Leeks, and the warm Vegetables us'd in Seaſoning, Thyme, Roſemary, Savory, Baſil, Marjoram, and in general, every thing which exalts the Bile; for bilious and phlegmatick Conſtitutions are oppoſite; and even Children ſo diſeas'd ought to uſe a warmer Diet, than what ſeems proper to their Age without it.

Phlegmatick Perſons ought to drink fermented Liquors and generous Wines, ſuch as put the Blood in a vigorous Motion. Warm Water diſſolves Phlegm, but it relaxeth too much.

Thickneſs of Blood.

Thirſt, Leanneſs, Exceſs of animal Secretions, as of Urine, Sweat, liquid Dejections, too ſtrong a Perſpiration, [296] are Signs and Effects of too great Thinneſs of Blood.

For ſuch, the Diet preſcrib'd in Debility or Weakneſs of Fibres, is uſeful; Milk boil'd with Grains, eſpecially Rice, rather ſolid than liquid Aliment, and auſtere Wines for Drink.

Oily or fat Conſtitutions.

Fat People ought to eat and ſleep little, and uſe much Exerciſe, in which the Cure chiefly conſiſts.

Whatever heats moderately, ſtimulating Subſtances abounding with a pungent acrid Salt, as Muſtard, Horſe-Radiſhes, Garlicks, Onions, Leeks, Spices, and the aromatick Plants us'd in Seaſoning, Saffron, carminative Seeds, Meats high ſeaſon'd with Salt, Pepper and Vinegar, are all proper, and diſſolve Fat; they have only one Inconvenience, that they create Thirſt, and great Quantities [297] of Liquids increaſe the Diſeaſe, by diluting and relaxing the Solids; Salt is a great Diſſolver of Fat.

Fat People ought to avoid oily Nouriſhment; but Soaps, which conſiſt of Oil and Salt, are proper, becauſe they are reſolvent; therefore Honey, Sugar, and ripe Garden-Fruits are uſeful.

Some of the aſtringent Subſtances, mentioned No 1, are uſeful, becauſe their Fibres are commonly too lax.

Whatever promotes Perſpiration, and therefore Frictions of the Skin, are uſeful.

Their Drink ought to be thin Wines; Coffee and Tea, as they dilute and ſtimulate moderately, are uſeful; great Quantities of oily fermented Liquors increaſe Fat; mere Water relaxeth too much; moiſt Air is hurtful to fat People, by relaxing the Fibres, and ſtopping Perſpiration.

Melancholy or atrabilarian Conſtitutions.

[298]

A Tendency to this is known by Darkneſs or Lividity of Countenance, Dryneſs of the Skin, Leanneſs, a quick penetrating Genius, a ſlow Pulſe, and Reſpiration, Obſtruction of the Belly, and too great Application to one Object.

To ſuch, all things which heat and promote too great a Perſpiration, as all Subſtances that abound with an acrimonious Salt and volatile Oil, are hurtful, which the Reader may ſee in the Firſt Chapter. Nouriſhment viſcous and hard of Digeſtion, and nothing more than ſalted and ſmok'd Fleſh or Fiſh; in general, every thing that thickens the Fluids, or reduceth them to a pitchy Condition.

Aſtringent auſtere Aliment, mention'd No 1, and auſtere Wines, are hurtful.

[299] Too cold and too hot Air are both hurtful, for in ſuch States of Air, melancholy Perſons are always worſt.

Diluting is beneficial, eſpecially with Water impregnated with ſome penetrating Salt, Subſtances which cool, relax the Belly, and reſolve the Bile; Barley-Water, Whey, ripe Garden Fruits, emollient Pot-Herbs, eſpecially Lettuce, Cichory, Dandelion, and Honey moſt of all.

There is one Caution to be obſerv'd, That the Diet ought to be oppoſite to the particular Acrimony which occaſions the Diſeaſe; for if it proceeds from too great Acidity, in ſuch a Caſe an animal Diet, Broths made of Fleſh-Meat, and even Eggs, are proper; if the Cauſe be alkaline, the contrary Method is uſeful.

Faulty Motion of the Fluids.

[300]

The Blood and other Fluids of a Human Body, are often not only peccant in their Qualities, but Motion, which may be either too flow, too quick, or in ſome of the Veſſels totally obſtructed.

Thoſe who have too ſlow a Circulation, are to be conſider'd, as in the Caſe of phlegmatick and fat People; and thoſe who have too quick a Circulation are to be conſider'd, as in the Caſe of ſuch as are bilious, hot, and alkaline; and the reſpective Diets are proper.

In Obſtructions of the Veſſels inflammatory, the Aliment ought to be cool, ſlender, thin, diluting, avoiding the copious uſe of Subſtances of a ſaline Quality, which ſtimulate, and conſequently may increaſe the Inflammations, unleſs in ſome Caſes where there is hopes by [301] volatile Salts to attenuate the Fluid, and remove the Obſtruction, or where the Intention is to produce a Suppuration; but it is certain that any ſtimulating Subſtance, when it does not remove the Obſtruction, increaſeth the Inflammation.

In cold Tumors, where the Intention is to diſſipate and attenuate, the Diet ought to be diluting and ſtimulating, conſiſting of ſuch Subſtances as are of a ſoapy Nature, that is, of Salt and Oil.

Wounds.

The Aliment of ſuch as have freſh Wounds ought to be mild, that is, without ſtimulating or ſaline Subſtances, of eaſy Digeſtion, of ſuch ſort as keeps the Humours from Putrefaction, and renders them oily and balſamick.

When a Suppuration is to be promoted, the Aliment ought to be [302] more copious and warm, becauſe ſuch induceth a Putrefaction.

When a Sore is healing, the Patient is in ſome meaſure in the Caſe of an Infant that is growing, whoſe Aliment ought to be ſuch as lengthens the Fibres without Rupture, for it is by ſuch an Elongation of the Fibres that Sores heal; and indeed the Chirurgeon ought to vary the Diet of his Patient as he finds the Fibres lengthen too much, are too flaccid and produce Fungus's, or as they harden and produce Calloſities; in the firſt Caſe Wine and ſpirituous Liquors are uſeful, in the laſt hurtful.

Women in Childbed are in the Caſe of Perſons wounded.

CHAP. III.
Of Acute Diſeaſes.

[303]

Fevers, with their various Symptoms.

RIGOR, Coldneſs. A right Regimen during the Rigor or cold Fit in the beginning of a Fever, is of great Importance, and Miſtakes of dangerous Conſequence: A long continued Rigor is a Sign of a ſtrong Diſeaſe, and is in it ſelf an. Approach towards Death; during the Rigor, the Circulation is leſs quick, and the Blood actually ſtagnates in the Extremities, and preſſing upon the Heart creates great Anxieties, and may produce Concretions about the Heart, and in other Parts of the Body; therefore a Rigor increaſeth an Inflammation. Thoſe who die of Quartan Fevers, die in the cold Fit; and indeed there [304] is no Miſchief but what may proceed from a Rigor of long Duration.

In ſuch Rigors, all warm Cordials and ſtimulating Subſtances are improper, for the firſt acting with force upon the right Ventricle of the Heart, may drive the Blood with too much Force through the Lungs; and ſtimulating Subſtances, by conſtringing the Veſſels, often increaſe the Symptom.

In ſuch a Rigor, nothing is more proper than Water, which dilutes and relaxes at the ſame time, and will ſooner terminate the cold Fit, and throw the Patient into a Sweat, than the warmeſt Cordial; if a very ſmall Quantity of Rheniſh Wine be mix'd with the Water, it will be ſtill more effectual: In this Caſe ſtrong Frictions of the Extremities relieve.

Anxieties. In Anxieties which attend Fevers, when the cold Fit is over, a warmer Regimen may be [305] allow'd; and becauſe Anxieties often happen by Spaſms from Wind, Spices are uſeful.

In thoſe Anxieties, Soapy Subſtances which diſſolve the Blood, are indicated; ripe Fruits; ſome of the lacteſcent Plants, as Lettuce, Endive, &c. and eſpecially Honey, have this Quality.

Thirſt. In Thirſt attending Fevers, Liquors ſhould not be drank quite cold; for cold Liquors, by conſtringing the Glands of the Palate and Throat, do not quench Thirſt ſo well as Liquors moderately warm: In this Caſe ſubacid Liquors ſhould be drank plentifully; all Salts increaſe Thirſt, except Nitre, and dulcify'd Spirit of Nitre mix'd with Water, is very proper in this Caſe; ſo are BarleyWater and Emulſions, except in great Weakneſs and Flatulencies of the Stomach, in which Caſe Water mix'd with a ſmall Quantity of Rheniſh Wine, is beſt of all.

[306] Sickneſs, Vomiting. This is one of the moſt troubleſome Symptoms attending a Fever, becauſe it renders the Patient incapable of taking any thing.

This Symptom is often prevented by giving a Vomit; or cur'd by promoting the Vomiting for a while by tepid Water.

During the Symptom, acid Liquors, and ev'n ſuch as are auſtere and aſtringent, are indicated, becauſe ſuch ſtrengthen the Fibres of the Stomach; and indeed Nature directs Patients to ſuch a Diet, for they covet ſubacid Liquors, and abhor fat and oily things.

Diluting, and ſometimes relaxing the Belly, and carrying the bilious Salts downwards, often cures this Symptom.

Attention is to be given to the Appetites of Patients, in this and many other Caſes, who have ſometimes coveted odd things which [307] have reliev'd them, as Salt, Vinegar, &c.

Vomiting, from a bilious Cauſe, is cur'd by ſubacid Liquors; Vomiting, from ſome putrid Cauſe, by Salts of all Kinds; in ſuch a Caſe, Water-Gruel with Cream of Tartar, Rheniſh Wine and Water, Jelly of Currants, Marmalade of Quinces, Sorrel boil'd in Broths well skimm'd from Fat, are beneficial.

If the Vomiting comes from a phlegmatick Cauſe, Spices, and bitter things will relieve. The Counterpoiſon muſt be adapted to the Cauſe; for Example, in Poiſon from Sublimated Corroſive, and Arſenick.

In the Firſt, alkaline Subſtances; in the Second, oily Subſtances are proper; in both, diluent.

It is eaſy to judge of the Cauſe by the Subſtances which the Patient throws up.

[308] Whether Vomit may be ſafely or properly given, muſt be judg'd by the Circumſtances; if there be any Symptoms of an Inflammation of the Stomach, a Vomit is extremely dangerous.

Wind and Spaſms are occaſion'd by the feveriſh Heat expanding the aerial Particles in the Fluids.

Whatever is anodyne and quiets Convulſions, and what abates the Heat, relieves this Symptom.

Weakneſs, or the Impotence of exerciſing animal Motion which attends Fevers, proceeds from too great Fulneſs in the beginning, and too great Inanition in the latter end of the Diſeaſe; for whatever ſtops or retards the Circulation in the ſmalleſt Veſſels, eſpecially thoſe of the Brain (which either of theſe Cauſes will do) produceth this Symptom. Thoſe two Cauſes demand different Methods, in the firſt emptying and diluting; [309] in the latter, a more plentiful Nouriſhment, the uſe of Wine diluted with Water, and Spices in ſmall Quantities, Jellies, Broths, the alkaleſcent Quality of which may be corrected with ſome acid, unleſs there be Signs of Acidity, and in that Caſe the Diet ought to be contrary to the Cauſe of the Symptom; Viper-Broth is both anti-acid and nouriſhing.

In Debility, from great Loſs of Blood, Wine, and all Aliment that is eaſily aſſimulated, or turn'd into Blood, is proper; Blood is required to make Blood; a ſmall Quantity of Blood brings the Patient into danger of a Dropſy.

Frictions of the extreme Parts relieve Weakneſſes, as they promote the Flux of the Juices and Spirits in the Joints and Limbs.

Fat People are moſt ſubject to this Symptom of Weakneſs in Fevers, becauſe the Fat, melted by the feveriſh Heat, obſtructs the ſmall Canals, [310] and conſequently produceth this Symptom. This is evident by the great Loſs of Fat ſuch People ſuſtain in Fevers. In the latter end of Fevers, ſuch are weak by the Laxity of the Fibres, and the Emptineſs of the ſmaller Veſſels; ſuch therefore muſt be treated with particular Care, viz, after due Evacuations, diluting ſtrongly both by Drink and Clyſters, avoiding all things oily, and uſing Sugar, Honey, and ripe Fruits.

Cordials made of ſpirituous Liquors are not the beſt Remedies for this Debility, tho' they increaſe the Force of the Heart, and are neceſſary ſometimes to keep up the vital Functions, they rather coagulate the Fluid; they add Strength to the Mill, but congeal the Stream. Whatever makes the Circulation more free through the ſmall Veſſels, is a Cordial.

Heat; the Degree of which may be known by the Thermoſcope, the [311] Senſation of the Patient, the Intenſeneſs of the red Colour of the Urine, the Sizeneſs of the Blood, the Diſſipation of the fluid Parts, which renders it thicker; the Hardneſs, Strength, and Frequency of the Pulſe, which makes the Friction the ſtronger, to which the Heat is proportional, the bad Diſpoſition of the Humour, and the dry Temperament of the Body.

Feveriſh Heat is moderated by Blood-letting, by muſcular Reſt, by moderate Ligatures which compreſs the Veins only, and often removed from Joint to Joint, by a mechanical Reaſon, retard the Circulation; of ſuch ſort is dry Cupping, bathing the lower Parts, watery Liquors for Drink, not cold, but tepid; ſubacid, as Jelly of Currants diſſolved in tepid watery Liquors; Decoctions of mealy Subſtances acidulated, Subſtances anodyne, Subſtances which diſſolve Concretions, as Sugar, Honey, and [312] the ſimple Oxymel, often uſed by Hippocrates, plentiful diluting, and reſtoring as much Water to the Blood as is diſſipated by the Heat; all demulcent and relaxing Subſtances, cooling the Air in the Room, opening the Curtains, and removing too thick Bed-clothes; all ſtimulating and ſlyptick Subſtances to be avoided, becauſe they increaſe the Force of the ſolid Parts.

Delirium. Too great Alacrity and Promptneſs in Anſwering, eſpecially in Perſons naturally of another Temper, is a Sign of an approaching Delirium: In a feveriſh Delirium there is a ſmall Inflammation of the Brain; therefore any thing which increaſeth the Circulation in the lower Parts, and diminiſheth the Preſſure on the Brain, is beneficial, as immerging the Feet in warm Water; nothing relieves the Head more than the Piles, therefore Suppoſitories of Honey, Aloes, and Rock-Salt, ought [313] to be try'd, relaxing by emollient and watery Subſtances, both in Drink and Clyſters, eſpecially Barley-Cream and Barley-Gruel.

Coma Sleepineſs. A Coma will proceed either from a Preſſure upon the Originals of the Nerves, by too great Repletion; or from a Penury of Spirits by too great Inanition.

Old Men are ſubject to Comas by the Tenacity of the Fluids circulating in the Brain, which being reſolved by the Fever, obſtruct the ſmall Canals of the Brain: In young People it commonly proceeds from Fulneſs, and is beſt cur'd by letting Blood, and relaxing the Belly. The Sign of ſuch a Fulneſs is, a red Countenance, and Eyes inflamed; if it proceeds from a glutinous Oil, it ought to be attempted to be reſolv'd by Water, nitrous Salts, Soaps, and ſubacid Liquors.

[314] People recovering from Comas, muſt take at firſt ſoft Nouriſhment, and in ſmall Quantities.

Watchfulneſs. This Symptom, which is ſometimes call'd a Coma Vigil, often precedes too great Sleepineſs, and is perhaps the moſt ill-boding Symptom of a Fever.

The Expedients in ſuch a Caſe are extreme Care to keep the Patient from Noiſe, and what makes any ſtrong Impreſſion upon his Senſes, ſome of thoſe Helps us'd in a Delirium, becauſe this is an Approach towards it; a moiſt ſoftening Diet; all Preparations of Barley, Emulſions of Poppy Seeds, and Almonds, Aliment of ſome lacteſcent Plants, eſpecially Lettuces, Decoctions of Scorzonera Roots, Almond Cream, and what is call'd Winter Flummery, us'd as Aliment; Tea, made of Cowſlip Flowers, relaxing gently the Belly.

[315] Boerhaave propoſes ſome mechanical Expedients which may perhaps have a good Effect, as a ſoft Noiſe of Water diſtilling by Drops into a Baſon, and the Patient trying to reckon them.

The Air perfum'd with the Smell of ſoporiferous Plants, as Poppies, Mandrakes, Nightſhade, Bean Flowers.

Application of Cloths dipp'd in Vinegar to the Temples.

Opiats muſt never be given but after great Evacuations.

Convulſions. It is of the utmoſt Importance to know the Cauſe and the Seat of this Diſeaſe, which is often obſcure.

In Infants they commonly proceed from Acidity in the Stomach, and are cured by terreſtrial Abſorbents; in ſuch indeed Convulſions attending Fevers are not quite ſo dangerous.

[316] Convulſions ariſing from ſome Acrimony in the Stomach, or from ſomething vellicating a Nerve in its Extremity, and not in its Original where it ariſeth from the Brain, are not very dangerous.

Convulſions which ariſe from great Evacuations, as great Haemorrages attending Fevers, are dangerous.

Convulſions ariſing from Inflammations of the Membranes of the Brain are commonly fatal: The Symptoms attending them are a great Heat, a hard Pulſe, and a Delirium: The Remedies, and even thoſe from Diet, are to be us'd according to the Seat of the Diſeaſe.

If from the Stomach, ſuch Aliments as are contrary to the particular Acrimony, Acid Alkaline, or Oily, reſiding there, as in the Caſe of Vomiting.

If from ſomething impacted in the Brain, warm volatile and ſpicy Subſtances will increaſe the Diſeaſe; [317] in that Caſe, Subſtances which relax and dilute are proper, eſpecially ſuch as open the Belly; which, See in the Firſt Chapter; and in general, the Regimen preſcrib'd in a Coma, or Delirium.

Violent Sweats proceed from a Laxity of the Veſſels, and too vehement a Circulation of the Blood.

Profuſe Sweats deprive the Blood of its moſt fluid Parts, thicken, and often cauſe Obſtructions; it is not good Practice to puſh Sweating too much in Fevers, except in ſuch as are peſtilential.

In profuſe Sweats, Care at leaſt ſhould be taken, by diluting, to reſtore the Liquid which the Blood loſeth, and to uſe the Methods adviſed in too great Heat, by taking away ſome of the Coverings of the Bed, and admitting of cool Air, and uſing a Diet moderately aſtringent; Wine, Spices, and ſpirituous Liquors, in this Caſe, have often a [318] good Effect; ſpirituous Liquors thicken the Fluids; Sage is a good Remedy in the Caſe of profuſe Sweats.

A Diarrhoea Looſeneſs proves often a dangerous and fatal Symptom in Fevers, it weakens, excoriates and inflames the Bowels, occaſions Bloody-Fluxes, thickens the circulating Juices, and exhauſts the Strength of the Patient; notwithſtanding, a critical Diarrhoea is not to be ſtopt, for fear of incurring theſe Dangers.

Attention is to be given to the Cauſe of Acidity; it is to be cur'd by Anti-acids; but, as in Fevers, the Cauſe is more frequently alkaline and bilious, Acid or four things reſolve, and it happens that oily Subſtances by blaſting the Acrimony will do good in Diarrhoeas. Oily Subſtances of themſelves do not irritate or provoke Diarrhoeas, they only lubricate or make the Bowels ſlippery. Diarhoeas ariſing from Quantities of Fruit are often cur'd by Emulſions.

[319] Vomiting, by evacuating the irritating Cauſe, often cures ſuch Diarrhoeas.

Anodyne Subſtances are proper, and generally ſpeaking, ſolid and dry Aliment, rather than liquid.

Inflammatory Eruptions. In all theſe of any kind whatſoever, as Small-Pox, Meazles, Scarlet Fever, Purples, the Intention in Diet ought to be, to avoid ſtrong Sudorificks, which puſh out too great a Quantity of the Matter upon the Skin; to uſe cooling and temperate Diluents, which keep the Matter fluid and moveable, ſo that it may be ſecern'd from the Blood; to keep warm during the Eruption; and that then Diet be cool; for which Reaſon the moderate Uſe of Acids, as Juice of Limon, is indicated.

A due Attention to the few Rules above-mention'd, in the ſeveral Symptoms, will prove very ſucceſsful in the Cure of moſt Fevers. I ſhall [320] only add a few more according to the various Kinds of Fevers and Inflammatory Diſtempers.

An Ephemera, or a Fever of one Day, is cur'd by Abſtinence, Reſt, and Diluting; and the ſame Method will prove effectual if the Fever laſts ſeveral Days, and is not putrid, or attended with a greater Inflammation and Acrimony, and Obſtruction of the Veſſels in ſome Parts of the Body, amongſt which is what is commonly call'd, a Cauſus, or burning Fever.

The Cauſes of ſuch a Fever are various; Errors in the Non-Naturals, Air, Meat and Drink, Reſt and Motion. Such a Fever will be rais'd by Vehement Exerciſe or Labour, Heat of the Sun, by long Thirſt, by the immoderate Uſe of fermented and ſpirituous Liquors; and hot things, as Spices; and by great Laſſitude endured any way, eſpecially in hot Weather.

[321] Its Symptoms are a burning Heat in the Skin, a Senſation of extreme Heat inwardly; ſometimes Coldneſs in the extreme Parts; Dryneſs of the Skin, Mouth, and Noſtrils; a Dryneſs and Roughneſs of the Tongue; laborious and ſhort breathing; great Thirſt; Loathing, Sickneſs of the Stomach, and Vomiting; Anxiety, Reſtleſneſs, Wearineſs; ſometimes a Cough and Hoarſeneſs; Watchfulneſs and Delirium, and Exacerbation every other Day.

Such a Fever is often reſolv'd by a bleeding at the Noſe, which ought not to be ſtop'd unleſs it endangers Life. It is likewiſe often in the critical Day reſolv'd by Sweating, Vomiting, Looſeneſs, and Spitting of thick Phlegm. The fatal Signs are commonly bloody Urine, Difficulty of Swallowing, watery Sweats about the Head and Face, without Relief; Coldneſs of the Extremities, Trembling, too great a Looſeneſs; and [322] ſometimes an Inflammation of the Lungs.

The Regimen, in ſuch a Fever, is keeping the Air of the Room pure and cool, untainted with Fire, Smoke, or the Breaths of many People; they ought to have no more Bed-clothes than barely protects them from Cold; their Curtains ought to be kept open ſo as to renew the Air; and their Poſture in lying, as erect as they can bear; the Sick, in this Condition, covet all theſe things, and their Contraries offend them.

Their Drink ought to be cool, mild, ſubacid, tepid, given in moderate Quantities, and often, as Water with Juice of Limon or Tamarinds.

Their Aliment ought to be light, of farinaceous Vegetables, as Water-Gruel, Preparations of Barley, with ſome Juice of Limon; Rice boil'd in Whey, and ſtrain'd. Roaſted Apples in the Progreſs of the Diſeaſe; a little [323] toaſted Bread with Rheniſh Wine and Water, Jelly of Currants; Broths and Jellies made of animal Subſtances are rather too alkaleſcent, at leaſt they ought to be qualify'd with Juices of Limon, or ſome acid.

Sometimes ſuch alimentary Subſtances as gently ſtimulate the Belly, are uſeful, as ſome ripe Fruits, Strawberries, Currants, Mulberries.

The Symptoms increaſe by the Uſe of hot things given either as Aliment or Medicine.

Intermitting Fevers.

They are (at leaſt in this Country) very obſtinate, often return in ſpite of all Remedies, and by long Continuance they degenerate into Hepatical Fevers, and many chronical Diſtempers, as Jaundice, Dropſy, Schirrus's, and Scurvies; therefore in this Diſeaſe a right Method, both of Medicines and Diet, is of great Importance. [324] There is a great Variety in theſe Diſeaſes, as to the Intervals of Times between the Paroxyſms; Tertians ſometimes redouble their Paroxyſms, ſo as to appear like Quotidians. I think it may be taken as a general Rule, That the greater Diſtance of Time there is between the Paroxyſms, the Fever is leſs dangerous, but more obſtinate.

There is a different Regimen to be us'd during the Continuance and Abſence of the Paroxyſm; and in the Paroxyſm itſelf, during the Rigor or cold Fit, the Heat and the Sweat.

During the Rigor, the Regimen preſcrib'd in the foregoing Part of this Chapter, in the Article of Feveriſh Rigors, is proper in all Fevers, and Care is to be taken by all proper Methods to ſhorten that Period as much as poſſible, and by tepid Diluents to bring on the Sweat ſoon, but not to puſh it beyond its due Meaſure, becauſe an intermitting Fever [325] relaxeth and weakens the Body extremely.

Between the Paroxyſms, too great Abſtinence is hurtful as much as too great Repletion; as intermitting Fevers are often of long Continuance, extreme Abſtinence is impracticable, and would reduce the Patient to a Condition not to be able to ſuſtain the Shock of the next Attack.

Between the Paroxyſms, ſuch Subſtances as temper, correct, and ſubdue the bilious Alkali, as acid Subſtances, nitrous Salts, ſmall thin Wines with Water, Chicken Broth with Juice of Limons; Wine with Bitters infuſed, are proper; Cichory and Dandelion are uſeful, becauſe the expreſs'd Juices of them cure intermitting Fevers in warm Countries; the Phyſicians of theſe Countries likewiſe uſe aſtringent Vegetables, See Chap. I. No 1.

[326] Exerciſe, to as great a degree as the Patient can bear, is extremely beneficial between the Paroxyſms.

But the chief Remedy of all is to endeavour to prevent the cold Fit, by getting to Bed, by Frictions, and ſome ſudorifick and warm Liquor; for by putting off the cold Fit ſome Agues have been cur'd.

Letting of Blood ſeldom does good, and often a great deal of Hurt in intermitting Fevers; but the Condition of the Patient is to be conſider'd in this Caſe.

Intermitting Fevers have been obſerved to free from ſome Chronical Diſtempers, as the Gout and Convulſions, but they often induce great ones themſelves.

INFLAMMATORY DISEASES.

[327]

A Phrenſy, or Inflammation of the Brain.

This Diſeaſe, of all others, requires the ſpeedieſt Applications, profuſe Haemorrages from the Noſe commonly reſolve it, and copious Bleeding, by opening the temporal Arteries, are the moſt effectual Remedies: But to ſtick to my Subject, which is the Diet.

Subſtances which cool, and at the ſame time relax the Belly, are highly beneficial, as Tamarinds boil'd in Water, which taken plentifully may at laſt bring a Looſeneſs which is a great Relief to the Head.

Soliciting the Blood to other Parts of the Body; therefore tepid Bathings of the lower Parts, and procuring the Piles, relaxing Fomentations apply'd to the Veins, which carry the Blood from the Head, relieve in this Diſeaſe. [328] Cool Air, and Sitting up, if poſſible; for the warm Air of the Bed exagitates the Blood.

The Aliment ought to be ſlender, of farinaceous Subſtances, as Water-Gruel acidulated, or ſubacid ripe Fruits, with their Jellies; the Drink ſmall, diluting, and cooling, Barley-Water, Small-Beer, or the Decoction of Tamarinds above-mentioned. All ſuch gentle Anodynes as are to be found amongſt the Alimentary Kind, are ſafe. See the Articles of Delirium and Watchfulneſs in this Chapter.

Quincy.

The Tumour of the Throat, which occaſions the Difficulty of Swallowing and Breathing, attending this Diſtemper, may be of various ſorts: Sometimes it proceeds from a Seroſity obſtructing the Glands, which may be watery, aedematoſe, ſchirrous, [329] according to the ſeveral degrees of the Viſcoſity of the Humour; ſometime inflammatory, which Inflammation will ſometimes end in a Suppuration, or Gangrene.

The Difficulties of Breathing and Swallowing, which happen without any Tumour outward or inward, after long Diſeaſes, proceed commonly from a Reſolution or paralytical Diſpoſition of the Parts, and is the immediate Forerunner of Death.

The Regimen in thoſe Quincies which proceed merely from the Obſtruction of the Glands, muſt be to uſe ſuch warm Liquors as gently relax, ſoften, and moiſten thoſe Glands, ſuch as carry off the redundant Serum by Stool, Sweat, and Urine; or by ſtimulating, open the Emunctories of theſe Glands to ſecern the Humour*.

[330] In a more watery Tumour, the Diet may be more warm than in the inflammatory, and the moderate uſe of Wine often relieves the Patient.

The Difficulty of Swallowing and Breathing, occaſion'd by Schirroſities of the Glands, is not to be cur'd any otherwiſe than by Extirpation.

Thoſe who are ſubject to Inflammations of the Throat, ought to live temperately to prevent a Plethora; or to break ſuch a Fulneſs ſpeedily by proper Evacuations, to beware of cold Air, too aſtringent or ſtimulating Aliment or Medicine, and violent Exerciſe, which, by increaſing the projectile Motion of the Blood, heat; but eſpecially the ſwallowing of cold Liquors when they are hot.

In theſe Inflammations a ſlight Diarrhoea relieves; therefore Aliments which promote it are uſeful, as Tamarinds infus'd in Whey. Decoctions and Emulſions of farinaceous [331] Vegetables moderately acidulated, and ſuch as abound with a cooling nitrous Salt, are proper; it is commonly thought that Punpenella, Saxifraga, or Burnet, is a Specifick in this Caſe: Every body knows the Benefit of Mulberries, taken all manner of ways. All Acids, as Sorrel, Juice of Limon, &c. abate Inflammations.

The Mouth and Throat muſt be kept moiſt, and the Noſe clear, that the Air may have a free Paſſage through it; for Air drawn by the Mouth, dries.

When the Deglutition is totally aboliſh'd, the Patient may be nouriſh'd by Clyſters, which I have known to have been done for a whole Week, after which the Tumour ſuppurated.

When the Inflammation ends in a Gangrene, the Caſe generally proves mortal, except it be only in the Tonſils, Uvula, and Palate, and go no [332] further, which Parts may be ſeparated, and the Patient live.

Inflammation of the Lungs.

Such may happen either in the bronchial or pulmonary Veſſels, and may ſoon be communicated from one to the other; when the Inflammation affects both the Lobes and the whole Body of the Lungs, the Caſe is deſperate, becauſe the Circulation muſt be ſtopt, and no Blood can flow back into the Heart. Beſides the general Cauſes of Inflammations, thoſe which affect the Lungs particularly, are a bad Conformation of the Lungs and Thorax commonly attended with an Aſthma, Air too hot, cold and moiſt, abounding perhaps with cauſtick, aſtringent, and coagulating Particles; the Lungs, properly ſpeaking, are an outward Part of the Body, expos'd to the Air, which, by its immediate Contact may eaſily [333] coagulate the Blood which flows along the Surfaces of the Air-Bladders, and I believe the Qualities of the Air are the general Cauſe of the Inflammation of the Lungs which happen in the Winter time.

As the Lungs are the chief Organ of Sanguification, crude and viſcous Chyle, viſcous Aliment, Spices, but eſpecially ſpirituous Liquors, may occaſion this Inflammation; too great an Exerciſe of the Lungs, ſo as to occaſion a ſhort and laborious Breathing, or keeping them too long upon the Stretch by Vociferation, or loud Singing, may produce the ſame Effect: There are coagulating Poiſons which affect the Lungs very ſuddenly; extreme violent Paſſions, by affecting the Motion of the Heart, may do the ſame; it is a common thing to ſee People in ſudden Tranſports of Anger breathe ſhort. Inflammations are ſometimes tranſlated from other Parts to the Lungs; a Pleuriſy eaſily [334] paſſeth into Peripneumony. The avoiding thoſe Cauſes is the beſt Rule of Diet to prevent the Diſeaſe; beſides, ſpeedy and plentiful letting of Blood before it has quite taken place.

This Diſeaſe is often cur'd by the critical Reſolution, Concoction, and Evacuation of the morbifick Matter, which is either attenuated ſo as to be return'd into the Channels, and to go on in the common. Thread of Circulation, or expectorated by Coughing, which may be eaſily known by the Abatement of Symptoms, viz. the Fever, Difficulty of Breathing, Thirſt, Anxiety, Reſtleſneſs, and the Patient's falling into gentle breathing Sweats. One of the beſt Reſolvents is the Blood of the wild Goat.

Copious Bleeding is the moſt effectual Remedy in the beginning of the Diſeaſe; but when the Expectoration goes on ſucceſsfully, not ſo [335] proper, becauſe it ſometimes ſuppreſſeth it, and in that Caſe Sudorificks thicken the Matter that is expectorated. The Motions of Nature ought to be followed. This by the way.

From the Symptoms in this Stage of the Diſeaſe, and the uſe of the Lungs, it is evident the Aliment ought to be more ſlender and thin than in any other inflammatory Diſeaſe whatſoever, common Whey being ſufficient to preſerve the Strength of the Patient; watery Liquors, and even the Steam of warm Water taken in by the Breath, attenuates the impacted Matter. Relaxing Aliment, of which Barley and all its Preparations are the beſt.

In this State, Diureticks, which have not much Acrimony in them, are proper, for Fluxes of Urine relieve the Lungs; for this Intention, an Infuſion of Fenel Roots in warm Water, with Milk, is good, both as Nouriſhment and Drinks.

[336] If Nature relieves by a Diarrhoea, without ſinking the Strength of the Patient, it is not to be ſtopt, but promoted gently by emollient Clyſters.

Decoction of Cichory, Lettuce, as being anodyne and reſolvent, are proper.

If the Patient is not reliev'd nor dies in eight Days, the Inflammation ends in a Suppuration and an Abſceſs in the Lungs, and ſometimes in ſome other Part of the Body; the Symptoms of which are, an obſtinate dry Cough, increas'd by Motion and taking of Food; theeaſieſt Poſture in Lying being upon the affected Side; a continual Lent-Fever, with Rigors invading with uncertain Periods; Exacerbations after Motion and Repaſt, Thirſt, Night-Sweats, a frothy Urine, Paleneſs, Leanneſs, Weakneſs.

In ſuch a Caſe one muſt forbear letting of Blood. The Diet muſt be mild, ſoft, incraſſating, and more [337] plentiful; tepid Vapours admitted into the Lungs, of Decoctions of proper Ingredients; and when by the Symptoms and Time the Impoſthume may be judg'd to be ripe, the Vapour of Vinegar it ſelf, and any thing which creates a Cough, as Oxymel, or Vinegar and Honey, Exerciſe and Concuſſion are proper, the ſooner it is broke, the leſs Danger to the Lungs.

Tho' ſuch a State is extremely dangerous, it is not quite deſperate; the Aliment ought to be Milk; the Drink, Milk, and Barley-Water, and ſuch alimentary Subſtances as are expectorating and cleanſing, with gentle Anodynes, that the Patient may have ſome Reſt. See Chap I.

The principal Intention in every State of Inflammation of the Lungs is to promote Expectoration, and to reſtore it when it is loſt.

[338] If the Inflammation ends in a Gangrene, the Caſe is deſperate; if in a Schirrus, incurable.

There is a ſpurious ſort of a Peripneumony, not inflammatory; when the Veſſels are obſtructed with a viſcous Pituite that mixeth with the Blood, and invades in cold Weather, it is dangerous, and often ſuffocates; it is incident to weak and old People. In this, ſome of the Methods uſed in the Inflammatory are proper, but not ſo copious Bleeding, Clyſters frequently injected; Aliment more generous, Broths, and Jellies with Juice of Limon, Hydromel, or Honey and Water; for Drink, ſoft Oils, and Aliments which abound with a ſoft, not volatile Oil, are beneficial.

A Peripneumony is the laſt fatal Symptom of every Diſeaſe, for no Body dies without a Stagnation of the Blood in the Lungs; as long as [339] it circulates through the Lungs, it will circulate through the reſt of the Body. The total Extinction of Breath is caus'd by the Stagnation of Blood in the Lungs.

Pleuriſy.

There is none of the Membranes which inveſt the Inſide of the Breaſt, but may be the Seat of this Diſeaſe, the Mediaſtine as well as the Pleura.

The Cauſes of this Diſeaſe, beſides thoſe common to all Inflammations, are often a particular Diſpoſition to inflammatory Diſtempers, a Straitneſs of the Arteries of the Pleura, a Calloſity of that Membrane, an Adheſion of the Lungs, the ſudden Admiſſion of cold Air by too thin clothing, too hot a Regimen, and eſpecially the copious uſe of ſpirituous Liquors, cold Liquors drank when the Body is very hot, a Tranſlation [340] of ſome inflammatory Matter from ſome other Part, but moſt of all cold Air from a Northerly or North-eaſterly Wind; from which Cauſes proper Cautions may be taken in the Regimen by way of Prevention.

This Diſeaſe is ſometimes dry, without any Spitting, and ſometimes attended with Expectoration from the Lungs, and that is taken off by a Coction and Reſolution of the feveriſh Matter, or terminates in Suppurations, or a Gangrene.

The Regimen ought to be much the ſame as in a Peripneumony, a cool, relaxing, ſlender, diluting Diet, and avoiding all things which increaſe Heat, even too hot Air.

The Symptoms of Suppuration are the ſame as in Inflammations of the Lungs; when the Matter is made, the Side muſt be opened to let it out.

[341] When the Diſeaſe is obſtinate againſt all Remedies, a ſudden Abatement of the Pain, a quick weak Pulſe, ſometimes intermitting, ſhort Breath and cold Sweats are Symptoms of a Gangrene, and approaching Death.

Paraphrenitis, or Inflammation of the Diaphragm.

The Symptoms of this Diſeaſe (which is often miſtaken) are a violent Fever, a moſt exquiſite Pain increas'd upon Inſpiration; by which it is diſtinguiſh'd from a Pleuriſy, in which the greateſt Pain is in Expiration.

This Pain is increas'd by Sickneſs, Vomiting, Repletion of the Stomach, or any Compreſſion of the Muſcles of the Abdomen, by rendering the Faeces or Urine. The Breathing is extremely quick, ſuffocating, [342] and ſeems to be perform'd only by the Motion of the Breaſt: It is likewiſe attended with a Delirium, Fury, and an involuntary Laughter, the Convulſion emulating this Motion.

This Diſeaſe terminates as Pleuriſies and Peripneumonies, but is generally fatal if it ſuppurates the Pus, is evacuated into the lower Belly, where it produceth Putrefaction, and a moſt miſerable and painful Death.

The Regimen, if any can be ſucceſsful, ought to be the ſome as in Pleuriſies.

Inflammation of the Liver.

The hepatical Artery, and the Vena Porta, carry the Blood into the Liver; the firſt being very ſmall, and the Motion of the Blood in the laſt being ſlow, is the reaſon that Inflammations in the Liver are not ſo frequent as in [343] ſome other Parts of the Body; but when they obtain, extremely dangerous, unleſs they take up but a ſmall Part of the Liver, and ſuch happen more frequently than is commonly imagined.

Some of the beſt Cautions in Diet may be taken from the Cauſes and Symptoms of this Diſeaſe.

Which, beſides the general Cauſes of Inflammations, are extreme Fatneſs. Fat diſſolv'd by Heat and Inflammations obſtructs the Veſſels of the Liver very ſuddenly. Cattle fatted by good Paſturage, after violent Motion, ſometimes die ſuddenly; in ſuch the Liver is found to be inflamed and corrupted. An atrabilarian aduſt Temper of the Blood and Gall, an acrimonious or purulent Matter, ſtagnating in ſome other Organ, is more eaſily depoſited upon the Liver than any other Part, eſpecially if attended with the uſe of hot and ſpicy Aliments, ſpirituous [344] Liquors, great Heat, and a Fever Eroſions, by the Acrimony of the Gall, or Obſtructions by Viſcoſity; any Calloſity, Schirrus, or Stone in the Liver; Thirſt, long endur'd, being ſuddenly chill'd by cold Air, cold Water, or drinking cold Liquors after great Heat; Vomits given injudiciouſly, when the Liver is already unſound, which if they do not remove the Obſtruction, exagitate the Liver too much; inveterate hypocondriacal Diſtempers. All theſe Cauſes may produce Inflammations of the Liver.

In ſuch a Caſe, the Liver being ſwell'd compreſſeth the Stomach, Diaphragm, and the neighbouring viſcera of the lower Belly, ſtops the Circulation of the Juices, the Generation and Excretion of the Gall, and all Digeſtion; produceth an Infinity of bad Symptoms, the Jaundice, with all the Diſeaſes depending upon it; for the Liver receives the [345] refluent Blood almoſt from all the Parts of the Abdomen, and is the chief Inſtrument of all the Digeſtions which are made there. A Fever, an Inflammation and pungent Pain on the Region of the Liver and Diaphragm, a Tenſion of the Hypochondres, Yellowneſs of the Skin and Eyes, and a Saffron-colour'd Urine, are Signs of an inflammatory Diſpoſition of the Liver.

This Diſeaſe ends as other Inflammations, being cur'd either by Reſolution, Concoction, and Excretion of the morbid Matter, terminates in an Abſceſs, Schirrus, or Gangrene.

During the firſt State, a warm Regimen and Saffron, which is reckon'd a Specifick, is improper.

Cooling reſolving Liquors taken inwardly, as Whey, with Sorrel boil'd in it; outward Fomentations, and frequent Injection of Clyſters, Bathing and Frictions, relax, and render the Matter fluid; Honey, with a little [346] Rheniſh Wine, or Vinegar; the Juices and Jellies of ſome ripe Garden Fruits; and thoſe of ſome lacteſcent papeſcent Plants, as Endive, Dandelion, Lettuce, are reſolvent.

Violent Purging hurts, gently relaxing the Belly relieves, Diluents with nitrous Salts are beneficial, or Tamarinds boil'd in warm Water or Whey; bloody Stools, not in an extreme degree, or ſtreak'd with Blood, ought not to be ſtop'd, becauſe they help to reſolve the Diſtemper, and Haemorrages by the Noſe often do the ſame.

The feveriſh Matter is often carried off by Urine, and therefore Diureticks not highly ſtimulating, are proper.

Sweating ought not to be promoted by warm Cordials, but encourag'd by warm diluting Liquors.

It is a deplorable Caſe when the Inflammation terminates in a Suppuration, unleſs the Abſceſs points outwardly, [347] ſo as it may be opened; for if the Pus be evacuated into the Abdomen, it produceth diſmal Symptoms, Putrefaction, or an incurable hepatical Dyſentery, or Bloody-Flux.

The Pus, from an Ulcer of the Lungs, growing thin and ichoroſe corrodes the Veſſels (for the Liver of all the Viſcera, is the moſt friable, and eaſily crumbled or diſſolv'd) it is often carried into the Blood, and rejected by Vomiting, with a cadaverous Smell, attended with great Thirſt; if it is carried downward, it occaſions a purulent colliquative Diarrhoea; acid Subſtances relieve moſt in this Caſe.

This Diſeaſe may happen to produce a Cancer, or Schirrus; one cannot ſay that the laſt is abſolutely incurable, becauſe it has been known by Experience that Graſs and freſh Paſture has cur'd it in Cattle; and perhaps the expreſs'd Juices of Graſs, [348] and ſome opening Plants, may do the ſame thing in Mankind, as of the lacteſcent Plants above-mention'd.

The Diet preſcrib'd here is neceſſary in a Jaundice, and all Diſeaſes of the Liver; and Abſtinence from ſuch Subſtances as induce Putrefaction, eſpecially ſalted Fiſh and Fleſh, and above all, ſtrong Liquors.

Inflammation of the Stomach.

The Symptoms of this Diſeaſe are a vehement, burning, fix'd, pungent Pain in the Stomach, attended with a Fever; a great Exacerbation of this Pain the Moment after ſwallowing any thing, ſucceeded with Vomiting; a painful Hickup, and great Anxiety. The Cauſes of theſe Symptoms are thoſe common to all Inflammations, a natural Weakneſs, and perhaps Eroſion of the Coats of the Stomach, and acrid Subſtances taken as Aliment and Medicines.

[349] If this Diſeaſe is not ſpeedily cur'd, it proves fatal.

It terminates in a Cure by a Reſolution of the morbifick Matter, a Suppuration, Schirrus, Cancer, but moſt commonly in a Gangrene.

Of all Diſeaſes this demands moſt a total Abſtinence from every thing that has Acrimony in it, even the nitrous cooling Salts, which are beneficial in other Inflammations, irritate too much; Vomits, all Cordials of volatile or ſpicy Subſtances; ſpirituous Liquors are no better than Poiſon, and Milk generally curdles; Aliments muſt be given frequently, and by Spoonfuls at a time, for any Diſtenſion increaſeth the Inflammation; a thin Gruel of Barley, Oatmeal, Whey, with very little Sugar, or Honey, or Chicken-Broth, are proper Aliments; Whey, emollient Decoctions, Barley-Water, Emulſions, are proper Drinks; and it has been found by Experience, that chalybeat [350] Waters have been agreeable to the Stomach even in this inflammatory State. If there happens an Impoſthume, Honey, and even Honey of Roſes, taken inwardly, is a good Cleanſer, and Decoctions of Comfrey Roots, healing; ſpeedy and plentiful Bleeding, Fomentations, and Clyſters, have the ſame good Effect as in other inflammatory Diſtempers.

The ſame Regimen is neceſſary in a Schirrus, or Cancer of the Stomach; though nothing will be quite effectual.

The ſame Regimen is to be obſerved in the Inflammation of the Spleen, Caul, Pancreas.

Inflammation of the Guts.

The Inteſtines or Guts, moſt frequently the ſmall ones, may be inflam'd by any acrid or poiſonous Subſtance taken inwardly; from any [351] purulent Matter tranſlated upon them from ſome other Part of the Body; from Bile, extremely acrimonious, by a violent Tenſion; from a Convulſion filling them with Wind.

The Symptoms are a total Stoppage of the Paſſage; a vehement fix'd burning Pain, irritated by things taken inwardly, when any thing toucheth the affected Part, it excites Vomiting, ſharp griping Pains, with Wind in other Parts of the Bowels; the Conſequences of ſuch an Inflammation are an Ileus, what is commonly called the Twiſting of the Guts, but is really either a Circumvolution or Inſertion of one part of the Gut within the other. All theſe Symptoms are attended with a Fever.

It is of the utmoſt Importance to know what the Cauſes of Colicks are; for as they are various, the Remedies in one Caſe are quite oppoſite and deſtructive in the other; for [352] the ſpicy warm carminative things which are given in a Colick, from a phlegmatick or cold Cauſe, are Poiſon in an inflammatory one; they may be diſtinguiſh'd by the Fever, high Pulſe, Thirſt, and flame-colour'd Urine attending the Inflammation, as to the Heat, tho' it is great likewiſe by the Violence of the Pain, the Extremities grow cold; beſides, there is a ſudden Proſtration of the Strength or Weakneſs attending this Colick, more than any other.

This Diſeaſe admits of a ſpeedy Remedy, or none, for it ends in an Ileus, and Mortification of the Bowels very ſoon.

Beſides a copious Bleeding, there is hardly any other Method but fomenting and relaxing the Bowels by emollient tepid Liquids, both taken by the Mouth and by Clyſters, injected hourly; yet it has been known by Experience, that Acids have relieved in very deſperate Caſes, as [353] Juice of Limons taken by the Mouth, and Vinegar and warm Water given in Clyſters, have ſav'd the Patient, becauſe of the inceſſant Vomiting; Opiats to quiet the Convulſions are ſometimes neceſſary.

Warm Fomentations even of warm Animals to the Belly, are extremely beneficial.

If the Inflammation happens to be in the lower Guts, it is not ſo dangerous; and even when it ſuppurates, it admits of a Cure, then it can be reach'd by proper Medicines in the Form of Clyſters; in the latter end of ſuch a Caſe Chalybeat Waters are beneficial.

If the Patient ſurvives three Days, the Acuteneſs of the Pain abates, and a Chillineſs or Gruing affects the Body, it betokens a Suppuration, and in a few Days the Matter flows either into the Cavity of the Abdomen, producing all the Symptoms which happen in the Impoſthumation [354] of the Liver, or into the Cavity of the Inteſtines, and cauſing a purulent Bloody-Flux, and often a Conſumption, Sinus's, Fiſtulas.

Whey and Chalybeat Waters are often beneficial in ſuch a Caſe, as Drinks.

The Aliment ought to be of ſuch things as generate little or no Excrements, as Broths of Fleſh-Meat, with Scorzonera, Parſley, or Fennel boil'd in them; Goats Whey is likewiſe excellent; fat and oily Subſtances generally hurt.

The Continuance of the Fever, clammy Sweats, Paleneſs, an ichoroſe Diarrhoea, foetid, black, or like the Waſhings of Fleſh, a ſmall intermitting Pulſe, and at laſt a total Ceſſation of Pain, are Signs of a Gangrene and approaching Death.

If none of the foremention'd things happen, if the Fever abates, and the Patient complains of a Weight, dull Pain, Stoppage of the Excrements, [355] a Schirrus is forming, which increaſeth daily, and may terminate in a Cancer, which Purging, and indeed all Medicines irritate; the Patient in ſuch a Caſe may protract a miſerable Life with an exact thin Diet of Whey, Broths, and ſuch things as produce no Foeces, or by alimentary Clyſters.

A Thruſh.

By this Name are call'd ſmall, round, ſuperficial, Ulcerations, which appear firſt in the Mouth, but as they proceed from the Obſtruction of the Emiſſaries of the Saliva, by the Lentor and Viſcoſity of the Humour, they may affect every Part of the alimentary Duct, except the thick Guts; they often ſucceed Fevers, eſpecially thoſe that inflame the Inteſtines, or are attended with a Looſeneſs; and they are juſt the ſame in the inward Parts as Scabs in the Skin, and fall off from the Inſide of the [356] Bowels like a Cruſt: The nearer they approach to a white Colour, the leſs dangerous.

The viſcous Matter is to be puſh'd out, therefore Bleeding in the beginning is not proper, nor Sudorificks, becauſe they thicken; but Sweating is beneficial, when the Matter is quite puſh'd out; tepid, diluent and ſmall Liquors are good in the firſt State, and Bathing, if the Patient can bear it, with Gargariſms, Clyſters; afterwards the Food ought to be nouriſhing, detergent, Panadas with Bread and Water, Bread and Milk, Honey mix'd with the Aliment, when they fall, Aliment demulcent, ſoft, anodyne, and the moderate uſe of Rheniſh Wine; when they are ſeparated, lenitive, purging Subſtances.

Inflammations of the Kidneys.

[357]

The Kidneys are ſubject to Inflammations as much as other Parts of the Body.

A pungent Pain in the Region of the Kidneys, a Stupor, or dull Pain in the Thigh, Colick, Wind, Vomiting, a Fever, Urine ſometimes totally ſuppreſs'd, in ſmall Quantity, high colour'd; and which is worſe, ſometimes quite pale, without any Sediment, are Symptoms of an Inflammation of the Kidneys; as to the Senſation of outward Heat, the Extremity of Pain often creates a Coldneſs in the Extremities, but ſuch a Senſation is very conſiſtent with an inflammatory Diſtemper.

Whatever obſtructs the Blood in the Extremities of the Arteries of the Kidneys, will produce this Diſeaſe; a Wound, Abſceſs, Bruiſe, Swelling, Lying much on the Back, too violent [358] Motion, eſpecially walking in hot Weather; whatever obſtructs the Paſſage of the Urine, as a viſcous Matter, Gravel or Stone; every thing which drives the Blood into the Urinary Canals, Heat, hard Riding, too great Fulneſs of Blood, but eſpecially ſharp and forcing Diureticks: Laſtly, Spaſms and involuntary Contractions of the Veſſels of the Kidneys.

Coffee-colour'd Urine is not a dangerous Symptom; it proceeds indeed from a Mixture of a ſmall Quantity of Blood with the Urine, but often prognoſticates a Reſolution of the obſtructing Matter, and the Expulſion of Gravel or a Stone after great Pain; pale Urine is a Symptom of a more laſting and dangerous Diſeaſe.

After plentiful Bleeding, and a careful avoiding of all ſtimulating Diureticks, which in this State of the Diſeaſe will increaſe it, the Expulſion of the obſtructing Cauſe muſt [359] be promoted by emollient and ſoft Liquors drank plentifully, by Clyſters of the ſame frequently injected, by Bathing and outward Fomentations, by opiat and anodyne Subſtances, which ſtupify and relax the Fibres; thoſe Liquors muſt be ſwallow'd down notwithſtanding the continual Vomiting; for Vomiting is the Inſtrument of Nature to promote the Expulſion of the Stone Gravel, or other obſtructing Cauſe.

Whey, and in a great feveriſh Heat, Butter-Milk, Emulſions of Barley and Poppy Seeds, Honey in Whey and Water, are proper Liquors for this Intention.

When the Gravel, Stone, or other obſtructing Cauſe is ſeparated from the Kidney, ſoft expreſs'd Oils, and oily Subſtances relax the Paſſages; if the Pain proceeds only from Gravel, or a Stone, oily Subſtances may be join'd ſafely with ſtimulating Subſtances, as with Juice of Limon, Juniper-Water, [360] and ſome diuretick Syrrup; this by the way, for it is out of my preſent Subject.

Violent Motion, as jolting in a Coach, may be us'd in this Caſe.

The Pain protracted beyond ſeven Days, a Pulſation, Chillneſs, often and irregularly returning, a Heavineſs and Stupor in the Part, are Signs of making of Matter, which when made will appear in the Urine.

In which Caſe ſoft and balſamick Subſtances are beneficial, for if the Matter ſtays long, the Caſe is incurable.

It happens ſometimes to end in a Fiſtula, with which the Patient may live many Years in no great Uneaſifineſs. Butter-Milk, not very ſour, has been reckon'd a great Secret in Ulcers of the Kidneys, and Chalybeat Waters have been beneficial to ſome; Spruce Beer is a good Balſamick in ſuch a Caſe: I ſhould adviſe ſoft Malt Liquors rather than Wine.

[361] Inflammations of the Kidneys ſometimes end in a Schirrus, or great Stone in the Kidneys.

A ſudden Remiſſion of the Pain, with cold Sweats, weak and intermitting Pulſe, Hickup; no Urine, or in ſmall Quantity, black and foetid, are Signs of a Mortification and approaching Death.

The Regimen of ſuch as are ſubject to nephritick Symptoms may be in ſome meaſure taken from what is above-mentioned.

Such ought to be extremely careful of the choice of their Liquors; ſharp Wines which abound with Tartar, are hurtful; Malt Liquors, not hard, nor ſtale, are certainly better to make uſe of; ſome of the ſofteſt Diureticks mentioned Chap. I. No 15. to avoid acrimonious Subſtances in their Aliment, uſe moderate Exerciſe, and not to lie hot, ſoft, nor much upon the Back.

Apoplexy.

[362]

This Diſeaſe is a ſudden Abolition of all the Senſes, external and internal, and of all voluntary Motion, by the Stoppage of the Flux or Reflux of the Animal Spirits through the Nerves deſtin'd for thoſe Motions, commonly attended with a ſtrong Pulſe, laborious Breathing, a deep Sleep with Snorting.

There is no difference between a Perſon aſleep, and in an Apoplexy, but that the one can be awak'd, and the other cannot.

The Cauſes of this Diſeaſe are a particular Confirmation of the Body, as a ſhort Neck; for there be ſome who have fewer Vertebrae in their Necks than others; long-necked People are ſubject to Conſumptions, and ſhort-neck'd to Apoplexies, tho' this Rule is not generally true; a groſs, plethorick, fat, phlegmatick Conſtitution; [363] whatever hinders the Motion of the Blood through the Arteries of the Brain, as polypoſe Concretions, eſpecially about the Heart, attended, commonly with an unequal Pulſe, a Vertigo, and ſometimes a momentary Loſs of the Eye-ſight; an inflammatory and coreaceous Thickneſs of the Blood, preceded by a Fever, attended with the Head-ach, Redneſs of the Face and Eyes; Old Age, attended with a glutinous, cold, catarrhous, leucophlegmatick Conſtitution; in ſuch, the Forerunners of an Apoplexy are Dulneſs, Inactivity, Drowſineſs, Sleepineſs, Slowneſs of Speech and giving Anſwers, Vertigoes, Tremblings, Oppreſſions in Sleep, Night-Mares; Weakneſs, Wateryneſs, and Turgidity of the Eyes; pituitous Vomiting, laborious Breathing upon the ſmalleſt Motion; whatever compreſſeth the Veſſels of the Brain ſo as to ſtop the Flux of the animal Spirits and Blood; a great [364] Fulneſs of Blood with its Velocity, increas'd by Heat, violent Motion, a high Diet, ſpirituous Liquors, Tumours of any kind; within the Skull a partial and imperfect Circulation of the Blood towards the lower Parts. The Effuſion and Preſſure of any Seroſity or Blood upon the Ventricles of the Brain (which is the moſt common and immediate Cauſe of Apoplexies) violent Paſſions and Affections of the Mind. The immediate Forerunners of an Apoplexy are commonly a Vertigo, Staggering, Loſs of Memory, Stupor, Sleepineſs, a Noiſe in the Ears, and a more deep and laborious Breathing; thoſe laſt Symptoms commonly precede an Apoplexy, but they are likewiſe common to it with other nervous and hyſterical Diſtempers.

Attention to the foremention'd Symptoms affords the beſt Cautions and Rules of Diet by way of Prevention; [365] for when it has taken place Hippocrates's Prognoſtick is generally true, That it is very hard to reſolve a ſmall Apoplexy, and quite impoſſible to reſolve a great one, the gentleſt Kind of this Diſeaſe is often taken off by Sweating.

The Applications in the Fit are of the Medicinal Kind, it being too acute a Diſeaſe to admit of any Helps from Diet, but that may be of great uſe for Prevention; a thin, ſlender, cool, regular Diet, oppoſite to the particular Symptoms above-mention'd; frequent and copious Bleeding; keeping the Belly always open; ſtimulating Subſtances, which have been thought beneficial, in this Caſe very often hurt, by forcing the Blood too much up to the Head; Vomiting may prove extremely pernicious, but the Regimen is to be varied according to the Cauſe of the Diſeaſe, which may be collected from the Conſtitution of the Patient in theſe [366] Apoplexies, which depend upon a ſanguineous Cauſe: The Regimen preſcrib'd in ſanguineous Conſtitutions is proper; fat and phlegmatick People, who are very ſubject to this Diſeaſe, ought to attend to the Rules preſcribed in their Caſe; and as there are Apoplexies from inveterate Gouts, the Regimen of ſuch muſt be different from both, the Intention being to tranſlate the morbifick Matter upon the Extremities of the Body.

Thoſe who have a Diſpoſition to this Diſeaſe ought never to go to Bed with a full Stomach, nor to lie with their Head low.

An Apoplexy is reſolv'd by a Fever, and when not fatal terminates in a Palſy.

There is a Diſeaſe of the ſame Kind, but not ſo frequent, call'd a Catalepſis, wherein the Patient is ſuddenly ſeiz'd without Senſe or Motion, and remains in the ſame Poſture [367] in which the Diſeaſe ſeizeth him, the Muſcles remaining in the ſame Tenſion: Violent Fevers in ſtrong atrabilarious dry Conſtitutions has produc'd this Diſtemper; the Diet after the Fit is off ought to be moiſtening and relaxing. A Lethargy is a lighter ſort of Apoplexy, and demands the ſame Cure and Diet as an Apoplexy from a phlegmatick Caſe, ſuch being the Conſtitution of the Lethargick.

CHAP. IV.
Rules of Diet in CHRONICAL DISEASES.

Palſy.

A PALSY is an Immobility of a Muſcle from Relaxation, inſuperable by the Will or any Endeavour of the Patient; ſometimes the [368] Senſation or Feeling is either totally aboliſh'd, or dull, with a Senſe of Tingling: A Palſy is oppoſite to a Convulſion in the firſt; there is an Ineptitude to Motion from the too great Laxity in the Second; an Ineptitude to Motion from too great Tenſion, and a Relaxation of a Muſcle, muſt produce a Spaſm in its Antagoniſt, becauſe the AEquilibrium is deſtroy'd. The beſt Rules of Diet in this Diſeaſe are taken from the Knowledge of its Cauſes. Whatever ſtops either the Flux of the Spirits, or the Flux of the Blood to any Part, induceth a Palſy, for both are neceſſary for Senſe and Motion; ſuch are all the Cauſes of an Apoplexy, an Epilepſy, extreme and laſting Pains, the Suppreſſion of uſual Evacuations either natural or morbid, Tranſlations of morbific Matter in acute Diſtempers; whatever diſtends, diſtorts, compreſſes, or contracts the Nerves; ſtrong and [369] ſtrait Ligatures, Luxations, Fractures, any Inflammation in the Integument, or membranaceous Sheath of a Nerve, eſpecially in the Ganglia, where they are tied together; Serous Defluxions, Exceſs in aſtringent Aliment, eſpecially unripe Fruits; drinking too much warm Water, which is weakning and relaxing; Exceſs in Coffee, or Tea; extreme Heat; extreme Cold; poiſonous Vapours of Arſenick or Mercury.

A Palſy is more or leſs dangerous according to the Cauſe, the Extent, and Seat of the Diſeaſe; when the Original of the Diſeaſe is in the Brain, it is moſt dangerous; when it ſeizeth the Heart, or Organs of Breathing, fatal; becauſe Life cannot be continued a Moment without the Uſe of thoſe Parts.

The Regimen in this Diſeaſe ought to be warm, attenuating, conſiſting of ſpicy and cephalick Vegetables, ſuch as create a feveriſh Heat, becauſe [370] ſuch is neceſſary to diſpel the Viſcoſity. Of Vegetables, ſoapy; of ſuch as conſiſt of an acrid, volatile Salt and Oil, Muſtard, Horſe-Radiſh, &c. ſtimulating by Vomits, Sneezing, relaxing the Belly, purging and diluting ſtrongly at the ſame time, promoting Sweat by ſuch Motions as can be us'd, or other Means, by ſtrong Frictions, &c.

Bleeding is to be us'd or omitted according to the Symptoms which affect the Brain; it relieves in any inflammatory Diſpoſition of the Coat of the Nerve.

Epilepſy, Convulſions.

The Cauſes of which are ſometimes an hereditary or family Diſpoſition from Parents; a ſudden Fright of the Mother when with Child of the Patient; an Affection of the Brain by a Contuſion; Abſceſs, acrimonious Serum, Splinter of a Bone [371] or ſharp Inſtrument; Inflammation, Corruption, Eroſion of the Meninges or Membranes of the Brain; Fulneſs, Heat, Drunkenneſs, intenſe Study, ſtrong Paſſions, eſpecially ſudden. Terror; all violent Affections and Irritations of the Nerves in any Part of the Body; eſpecially by ſomething acrimonious in the Stomach or Bowels, by Worms, by Teething, and Acidity in the Stomach in Infants; by ſome Contagion or purulent Matter after acute Diſeaſes; Suppreſſion of uſual Evacuations, the Menſes, Haemorroids; hyſterical Affections contracted by Accidents in Lying-in; and often by too great Inanition; the ſmalleſt irritating Cauſe will induce a Fit in ſuch as are ſubject to it, and ſuch ought to be prevented with great Care.

There is no Diſeaſe which inſeſts Mankind more terrible in its Symptoms and Effects, the worſt of which are a weakening and perhaps an Abolition [372] of the Faculties of the Mind; whether the Cauſe of the Diſeaſe be in the Brain, is eaſily known from the concomitant Symptoms.

The Intentions in the Cure of the Diſeaſe muſt be different, according to the Cauſe; Bleeding, and plentiful Evacuations, when there is a Plethora or inflammatory Diſpoſition in the Brain; Aliments without Acrimony, demulcent, avoiding every thing which ſtimulates, taking ſuch things as are oppoſite to the particular Acrimony which cauſeth the Diſeaſe, relaxing the Belly without irritating; in acute and periodical Pains, anodyne Subſtances; if the Diſeaſe is the Conſequence of an hyſterical Diſpoſition, a warmer Regimen is neceſſary; if the Cauſe is in the Stomach, generally anti-acid Subſtances relieve; if they are not flatulent, ſeveral have been cur'd by a Milk-Diet, but it will do hurt when there is Acidity in the Stomach; when the [373] irritating Cauſe is in ſome outward Part of the Body, it is proper to eradicate it by Suppuration.

The common Cuſtom of applying ſtimulating things, as volatile Salts and Spirits to the Noſe, during the Fit, is generally ſpeaking pernicious.

Epilepticks ought to breathe a pure Air, unaffected with any Steams, even ſuch as are very fragrant. Their Diet ought to be nouriſhing, of eaſy Digeſtion, avoiding Hogs Fleſh, Water-Fowl, and all Vegetables that are pungent, windy, and generally ſpeaking all Fruits, eſpecially Nuts; with little Wine, and none, if they have not been accuſtom'd to it; they ought not to turn round, nor ſtand on Precipices, to keep regular Hours for Repaſt and Sleep, for every unuſual thing is a Stimulus; but of all things the moſt neceſſary is the avoiding the Occaſions of violent [374] Paſſions, and keeping themſelves chearful.

Melancholy, Madneſs.

The Conſtitution which diſpoſeth to ſuch a State, the Cauſes, Symptoms and proper Regimen in it is deſcrib'd Chap. II.

This being a Diſeaſe more terrible than Death, extremely obſtinate, invading ſometimes by inſenſible degrees, and hard to be cur'd when it has taken place, the Approaches towards it ought to be carefully obſerv'd.

Theſe are commonly obſtinate Watchfulneſs, or ſhort Sleeps, troubleſome and terrible Dreams, great Solicitude and Anxiety of Mind, with Sighing, ſudden Fits of Anger without any Occaſion given, Love of Solitude, Obſtinacy in defending trifling Opinions, and Contempt of [375] ſuch as are about them, Suppreſſion of uſual Evacuations, as of the Menſes in Women, and Haemorroids in Men; great Heat, Eyes hollow and fix'd, immoderate Laughter or Crying without occaſion; too great Loquacity, and too great Taciturnity; by Fits; great Attention to one Object, all theſe Symptoms without a Fever.

When this Diſeaſe is hereditary it is ſeldom cur'd.

The atrabilarian Conſtitution, or a black viſcous pitchy Conſiſtence of the Fluids which moſt frequently occaſions this Diſeaſe, makes all Secretions difficult and ſparing; the Intention therefore ought to be to render the Humours fluid, moveable, and carry them out of the Body, eſpecially the Bile, which is viſcous; Sudorificks indeed are [...] ſo proper, becauſe they thicken.

To uſe the Aliment preſcrib [...]d Chap. II, in atrabilarian Conſtitutions [376] Boerhaave gives an Inſtance of a Patient who by a long uſe of Whey, Water, and Garden-Fruits, evacuated a great Quantity of black Matter, and recovered his Senſes. Cold Bath, and eſpecially a ſudden Immerſion in the Sea, has done good by acting upon the Nerves and Spirits; whereever there is any Uneaſineſs or Senſation of Pain, one ought to ſolicit the Humours towards that Part, or to make the proper Evacuations from them, eſpecially (if it be poſſible) to procure the Piles, which ſeldom miſs to relieve the Head.

The Madneſs which proceeds from a Plethora, or too great Fulneſs, is cur'd by plentiful Bleeding and Purging.

The Weakneſs which ſucceeds the Madneſs requires a more refreſhing and warm Diet, eſpecially the uſe of Chalybeat Waters.

Scurvy.

[377]

This is a Diſeaſe impoſſible to be defin'd by Words containing any ſimple or diſtinct Idea; it is rather a Name us'd to denote a Multitude of Symptoms, different, and ſometimes oppoſite in their Cauſes and Cures.

It is a Diſtemper of the Inhabitants of cold Countries, and amongſt thoſe, ſuch as inhabit marſhy, fat, low, moiſt Soils, near ſtagnating Water, freſh or Salt; invading chiefly in the Winter ſuch as are Sedentary, or live upon ſalted and ſmoaked Fleſh and Fiſh, or Quantities of unfermented farinaceous Vegetables, and drink bad Water; ſuch as are Hypochondriacal and Hyſterick; and ſometimes ſuch as have taken the Peruvian Bark, either in great Quantities, or without proper Evacuations. From theſe Cauſes the beſt Rules are taken for Prevention.

[378] Its Symptoms are a ſpontaneous Laſſitude or Senſation of Wearineſs, being unrefreſh'd by Sleep, laborious Breathing upon ſmall Motion, cold Tumours in the Legs going off and returning; ſometime Paleneſs, or a livid Colour of the Countenance; Spots on the Skin of various Colours, red, violet-colour'd, yellow, livid; ſometimes an ill Smell in the Mouth, painful and bleeding Eroſions of the Gums, and by theſe the Teeth growing bare and looſe; Haemorrages of all kinds, Ulcers; untractable, eſpecially in the Legs, with a gangrenous Appearance in the Skin; the Itch; a dry cruſty Eruption, and ſometimes a ſmall degree of Leproſy in the Skin; the Blood, when let, black, grumous, the red part without a due Conſiſtence; the Serum ſaline, and of a yellowiſh Green; wandering Pains in the Limbs, increaſing by the Warmth of the Bed, ſometimes a feveriſh Heat.

[379] Theſe Symptoms proceed from an ill Temperature of the Blood, too thick or too thin, being of a ſaline Conſtitution, either from an acid, alkaline, or muriatick Cauſe, and according to the Cauſe, demands very different and oftentimes oppoſite Remedies. See Part Firſt, of acid and alkaline Conſtitutions.

The Scurvy of Mariners is generally cured by Acids, as all ſorts of ripe Fruits, Limons, Oranges, Butter-Milk; alkaline Spirits hurt them; and acid Spirits, as that of Salt, does them good; when the Symptoms are attended with a Foetor of any kind, either in the Urine, Mouth, Breath, with Drought, Heat, Haemorrage of the Gums, or of any kind, ſuch a Diſeaſe will be cur'd by aceſcent Subſtances, and none better than Whey: In this Scurvy Chalybeat Waters are generally effectual.

[380] If the Scurvy be entirely muriatick, proceeding from a Diet of ſalt Fleſh or Fiſh, the Vegetables commonly called Antiſcorbutick, as Water-creſſes, Scurvy-Graſs, and Brook-Lime may be given with Succeſs, but tempered with Acids, as the Juice of Oranges and Limons; and the Pot-Herbs which are antiacid in this Caſe are a proper Diet; but if there be a high degree of Heat and Inflammation, the hot Antiſcorbuticks will do hurt.

If the Patient be pale, cool, without Thirſt, with pale or natural colour'd Urine, with a previous Diet of aceſcent Subſtances, the Eruptions not of a high inflammatory or livid Colour, the warm Antiſcorbuticks, animal Diet, and animal Salts, are proper.

There is great Attention to be given to the Condition of the Mouth, Gums, and Teeth, in the Scurvy, from which the Nature and [381] Degree of the Diſeaſe may be gueſs'd at.

Violent Purging always hurts ſcorbutick Conſtitutions; lenitive Subſtances relieve.

Bleeding is not proper, unleſs where the Symptoms are urgent, and the Caſe is inflammatory.

A Scurvy, from an alkaline Cauſe is more dangerous than from an Acid.

Cachexy, or ill Habit of Body.

This is likewiſe a general Word to expreſs a great Variety of Symptoms; moſt commonly it denotes ſuch a Diſtemperature of the Humours as hinders Nutrition, and weakens the vital and animal Functions, proceeding from Weakneſs of the Fibres, and an Abuſe of the Nonnaturals, and often from ſevere acute Diſtempers: It ſometimes diſpoſeth to Conſumptions, ſometimes to Leucophlegmacy, [382] Bloatedneſs, and Dropſies; it is attended often with Palpitations of the Heart. The Rules for Diet muſt be drawn from the Symptoms. See Chap. I. of this Part.

Conſumption pulmonary.

This Diſeaſe is a Decay of the whole Body, from an Ulcer of the Lungs, the Matter of which is mix'd, circulates with, and infects the Blood, and by its Acrimony infects the whole Maſs of the Fluids.

This Diſeaſe makes up above a tenth part of all the Bills of Mortality about London, is often the Product of a ſcrophulous Conſtitution, or King's-Evil, ſeldom invades after Thirty Years of Age, may be prevented, but ſeldom admits of any other than a palliative Cure, and is generally incurable when hereditary, but eaſily ſo when it proceeds from an accidental Cauſe.

[383] It is often preceded by a Spitting of Blood, occaſion'd by its Acrimony, and too great a projectile Motion, with Slenderneſs and Weakneſs of the Veſſels; to which Perſons of a fair roſy Complexion, long Neck, and narrow Cheſt, are often ſubject; Aliment too viſcous, obſtructing the Glands, and by its Acrimony corroding the ſmall Veſſels of the Lungs (an Organ of a ſlender Texture, through which the Half of the whole Blood paſſeth, and which is never at reſt) after a Rupture and Extravaſation of Blood, eaſily producing an Ulcer, then a ſmall Fever, dry Cough, Heat, Fluſhing after Repaſt; when the new Chyle enters the Lungs, ſhort Breath, a Diſpoſition to Sweat after Sleep; all theſe Symptoms, when the Blood is moſt copious and hot, between the Ages of 16 and 30; ſuch a Diſeaſe may be indue'd by the Suppreſſion of Evacuations natural and artificial, by any great [384] Force upon the Lungs, from ſome accidental Cauſe; by too hot, full, and acrimonious Meat or Drink, by ſome acute Diſeaſe, the Meazles or Small-Pox.

The Blood is ejected from the Lungs with ſome ſmall Pain, Heat, Oppreſſion on the Breaſt, florid, and frothing, with ſhort Breathing, and a ſmall ſoft quick Pulſe.

If after ſuch Haemorrage from the Lungs, the Symptoms increaſe, Shortneſs of Breath, Fluſhing in the Face, a Cough, hectick Fever, but eſpecially Rigours and Chillineſs invading irregularly, with Weakneſs, one may be ſure that there is a Suppuration.

In a Haemorrage from the Lungs, no Remedy ſo proper as Bleeding, often repeated; Stypticks are often inſignificant, and if it were poſſible that they could operate immediately upon the affected Part, ſo far as to make a Scar, when that fell off [385] the Diſeaſe would return. Both incraſſating and ſtyptick Subſtances work univerſally, but they would hurt the Lungs if given before the Veſſels are empty'd. Balſamick Subſtances often hurt by their too great Heat.

The Intention here is by Diet to abate the Acrimony and projectile Motion of the Blood, after repeated Bleeding; to keep ſtrictly to a Milk Diet, with farinaceous Subſtances, as Rice and Barley, Milk with roaſted Apples, Jelly of Currants, or the Jelly of any ripe ſubacid Fruit, which is cooling, and very agreeable to the Stomach; Milk and common Water, or Barley-Water, for Drink, taking the Aliment frequently, and in very ſmall Quantities, for fear of charging the Lungs with too great a Quantity of Chyle at a time. (See Part I. Chap. II.) Avoiding all violent Motion, or any thing that puts the Lungs upon a Stretch. Acrimony [386] is likewiſe corrected by oily Vegetables, not ſuch as contain a volatile or high exalted Oil, but thoſe whoſe Oil is mild, as Almonds, Piſtachos, Dates, &c.

The Engliſh Conſumptions, generally ſpeaking, proceed from a ſcrophulous Diſpoſition; in the firſt Acceſs of ſuch a Diſeaſe any Subſtance which is deobſtruent, without much Acrimony, is beneficial, but what heats diſpoſeth to Suppuration.

There is likewiſe a Conſumption from an Empyema, after an Inflammation of the Lungs, which may be known from a Weight upon the Diaphragm, Oppreſſion of the Lungs, a Difficulty of Breathing, and Inability to lie on one Side (which is that which is found) a perpetual Cough and Fever, with Thirſt, Fluſhing of the Cheeks, Weakneſs, and Decay of Appetite.

The Cure of ſuch a Caſe is chirurgical, by opening the Side; if the [387] Ulcer is not broke, it is commonly call'd a Vomica, attended with almoſt the ſame Symptoms as an Empyema, becauſe the Vomica communicating with the Veſſels of the Lungs muſt neceſſarily void ſome of the putrid Matter into theſe Veſſels, and taint the Blood.

The Ulcer may break ſuddenly into the Larynx, with the danger of Suffocation; or inwardly, and the Matter may by degrees be expectorated. The Event of the Diſeaſe depends upon the Symptoms, eſpecially the Nature of the Pus; that which ſwims in Water, without any ill Smell, is better than what ſinks, is livid, and ſmells of putrify'd Fleſh.

There may be a Conſumption with a purulent Spitting, when the Vomica is contain'd in a Cyſt or Bag, upon the breaking of which the Patient is commonly ſuffocated.

[388] In this Caſe the ſame Intentions muſt be purſued in the Diet, as in a Wound or any other Ulcer. The Aliment cool, demulcent, vulnerary, and not drying or hot, but conſiſting of Quantities of liquid things, even though they provoke Sweat. It is a common Miſtake that acid things hurt the Lungs. The Gas Sulphuris may be given with Succeſs in any Diſeaſe of the Lungs, but at ſome diſtance of Time from Milk, Vinegar, and Honey, is proper and detergent; anodyne Subſtances relieve the Cough; gentle Exerciſe by Riding, is beneficial; by an extremely exact Regimen a conſumptive Perſon may hold out for Years, if the Symptoms are not violent.

The Sweats and Diarrhoea attending Conſumptions are generally fatal Symptoms, but muſt be reliev'd by a Diet proper in theſe Caſes, not interfering with what is formerly advis'd.

[389] Conſumptions are induc'd by Purulency in any of the other Viſcera; the Regimen muſt be very near the ſame as in the Pulmonary.

Dropſy.

This Diſeaſe is commonly an Extravaſation of Serum receiv'd in ſome Cavity of the Body; I ſay commonly, for there may be a Dropſy by a Dilatation of the ſerous Veſſels, as that in the Ovarium, wherein the very Membrane of the Ovum is extended with the Water, and at the ſame time thickened ſo as to keep it from Rupture.

Therefore this Diſeaſe may happen wherever there are ſerous Veſſels; a Hydrocephalous, or Dropſy of the Head, which is only incurable when the Serum is extravaſated into the Ventricles of the Brain, and generally fatal in Infants, when the Sutures [390] are clos'd, and the Skull will yield no more.

A Dropſy of the Breaſt is attended with almoſt the ſame Symptoms as an Empyema, and cur'd by the ſame Chirurgery.

A Dropſy of the Lungs, either by Hydatides, or by Lymph, extravaſated in the Body of the Lungs.

A Dropſy in the Forepart of the Windpipe, emulating a Bronchocele.

A Dropſy in the Ovarium, Teſtes, Scrotum, or Uterus.

An Aſcites, or Collection of Water in the Abdomen. 1. In the Duplicature of the Peritonaeum. 2. Between the Peritonaeum and the Bowels. 3. When the Water is contained in the membranaceous Coat of the Glands.

Sometimes the Air is ſo rarify'd in the Tumour as makes it hard and tight like a Drum, and from thence it is call'd a Tympany; when the Tenſion [391] is from Air, it is eaſily diſtinguiſh'd by the Specifick Gravity of the Patient, and ſo is Water.

When the Lymph ſtagnates, or is extravaſated under the Skin, it is called an Anaſarka.

Whatever hinders the Return of the Lymph into the Veins, or breaks the lymphatick Veſſels, or obſtructs the abſorbent Veſſels, ſo as the Lymph cannot be abſorb'd or exhal'd, produceth a Dropſy: Any Stoppage of the Circulation will produce a Dropſy, as by ſtrong Ligature, or Compreſſion.

The moſt common of theſe Cauſes are an hereditary Diſpoſition; ſwilling down great Quantities of cold watery Liquors, which are not voided; violent acute Diſtempers; ſtubborn Obſtructions of the Viſcera; the Jaundice, obſtinate intermitting Fevers, Bloody-Fluxes; great Evacuations, eſpecially of Blood; Aliment [392] viſcous and of hard Digeſtion; inveterate Scurvies; but the moſt common of all is the habitual and copious Uſe of fermented and ſpirituous Liquors.

The Effects are a Swelling of the Legs at Night by degrees, ſtill aſcending higher; a Swelling of the Belly increaſing; and in a Tympany founding and tenſe like a Drum; ſometimes the Senſation and Noiſe of fluctuating Water, Shortneſs of Breath, Thirſt, Urine in too ſmall Quantity, no Sweat; The ſtagnating Serum at laſt turning acrimonious, exulcerates and putrifies the Bowels, producing moſt diſmal Symptoms.

The beſt Cautions and Rules of Diet may be taken from the Enumeration of theſe Cauſes and Effects.

The Intentions to be purſued are, removing the Cauſes, as Obſtructions, [393] diſſolving the Viſcoſity or Tenacity of the Lymph, and evacuating it out of the Body.

The Viſcoſity of the Lymph is beſt corrected by ſuch Subſtances as contain abundance of alkaline and volatile Salts, Spices, acrimonious pungent Vegetables, ſaponaceous Subſtances; what they are the Reader may ſee Chap, I. of this Part.

The only Contradiction to this is too great Heat and Thirſt, to which Regard is to be had, and do indicate the Uſe of Acids, Juice of Limons, Oranges, Sorrel, &c. I think it may be taken for a general Rule, when the Urine is high-colour'd, that Acids are proper, for they are oppoſite to that alkaleſcent State of the Humours, and reſiſt the Putrefaction, which is the Effect of acrimonious Serum.

The Drink ſhould be ſparing; but foraſmuch as the Thirſt is ſometimes intolerable, the Patient may be indulg'd [394] the free Uſe of Spaw-Water and Rheniſh Wine.

The Aliment ſhould be dry, diuretick. See Chap. I. Diureticks of the acid Kind are the ſafeſt.

The Chirurgical Operations for drawing off the Waters are to be left to the Judgment of the Phyſician.

Nothing is more beneficial than ſtrong Frictions of the Skin, which attenuate and promote the Circulation of the ſtagnating Serum.

Vomiting, in ſtrong Conſtitutions, has prov'd often very effectual, for the Concuſſion of the ſolid Parts diſſolves and diſpels the ſtagnating Humours; and even Clyſters of proper Ingredients are very beneficial.

Violent Purgers, by diſſolving the Blood, have prov'd often pernicious.

Many have been cur'd by Abſtinence from Drink, eating dry Biſcuit, which creates no Thirſt, and [395] ſtrong Frictions four or five times a Day.

When the extravaſated Serum is evacuated, the Diet ought to be ſuch as ſtrengthens the ſolid Parts, allowing Spices and generous Wine, and eſpecially the Uſe of Chalybeat Waters, Abſtinence from other Sorts of Liquids, dry Food and Vegetables, aſtringent, Exerciſe, eſpecially Riding; and in general, ſuch a Diet as generates good Blood.

If the Serum ſtagnates long, it turns acrimonious, and commonly renders the Patient feveriſh and thirſty. Acid or ſour things are the propereſt both to prevent and cure theſe Symptoms, as they are oppoſite to that alkaline Putrefaction.

Gout.

This is a Diſeaſe which may affect any membranous Part, but commonly thoſe which are at the greateſt [396] Diſtance from the Heart or the Brain, where the Motion of the Fluids is the ſloweſt, the Reſiſtance, Friction, and Stricture of the ſolid Parts the greateſt, and the Senſation of Pain by the Obſtruction of the ſmall Veſſels and Dilaceration of the nervous Fibres extreme.

The moſt common Seat of it is in the Foot, its Tendons, Nerves, Membranes, Ligaments, and Perioſtea, or Membranes inveſting the Bones.

The moſt common Cauſes of it are an hereditary Diſpoſition (which operates more ſtrongly in this Diſeaſe than in any other) a too rich and high Diet, and too copious Uſe of Wine and other ſpirituous Liquors, eſpecially at Supper; Exceſs in ſome other Pleaſures; a full groſs Habit of Body; the too copious uſe of acid or ſour things, the Gout being the only Diſeaſe in which they are very hurtful to Human Bodies; a [397] ſudden chilling of the Feet after Sweat, or drying them at the Fire after being wet and cold; a ſedentary Life, with a plentiful Diet, and intenſe Study, and Application of the Mind; moſt commonly a Gouty Conſtitution is attended with great Acuteneſs of Parts, the nervous Fibres both in the Brain and the other Extremities being delicate; and there are Inſtances where Wives have got it from their Husbands by Infection, ſo Boerhaave ſays; Females and young People are not ſubject to this Diſeaſe, unleſs where it is hereditary.

A proper Regimen of Diet is neceſſary in this Diſtemper, becauſe it does not admit of very many Helps from Medicines, and there are no better Rules than Abſtinence from thoſe things which occaſion it.

It ſeems to be a Diſeaſe of the nervous Parts, which makes it ſo hard to cure; Diſeaſes are ſo as they are more remote in the Thread of the [398] Motion of the Fluids, by the conſtant and regular Returns of it in ſome People, and their Freedom from it after the Morbid Matter is exhauſted; it looks as there were regular Accumulations and Gatherings of it, as of other Humours in the Body, growing perhaps in ſome People as Corns.

As one of the Cauſes of the Gout is the Suppreſſion of Sweat and Perſpiration, the procuring a due degree of theſe ſeems to be the beſt Preventive of it; if the Feet could be made to ſweat, in due time it would prevent the Gout, which invades in ſuch Conſtitutions of the Air as ſuppreſs Perſpiration.

Violent Purging, in Abſence of the Paroxyſm, by agitating the Humours often hurts, and during the Paroxyſm, may draw the Gout inwardly.

The beſt Diet is Abſtinence from acid Subſtances; the moderate uſe of [399] ſuch as promote Perſpiration, as Subſtances aromatical, and volatile Salts, which relieve the Gouty, as they make the Body perſpirable; diluent Liquors, taken in ſuch a degree as not to hurt the Stomach; Moderation in the Quantity of Food and ſpirituous Liquors; Exerciſe without Fatigue; but eſpecially Frictions of the extreme Parts, daily, and often repeated; all poſſible Methods of making the Feet ſweat, and much Sleep.

In the Paroxyſm, as temperate and cool, and diluent a Diet as the Patient can bear; Abſtinence from Opiats, except when the morbid Matter is ſeparating (by Opiats any Irruption goes on better) the conſtant Uſe of them will hurt; keeping the affected Part warm, without the Application of Cataplaſms, ev'n ſuch as are emollient, weaken and relax too much, and have been ſometimes found to diſtort the Parts.

[400] It is of the utmoſt Importance to know if any Diſeaſe proceeds from a Tranſlation of the Gouty Matter; for the Methods, eſpecially Evacuations, us'd in an original Diſeaſe, would be very improper in a Gouty Caſe, where the Intention muſt be to draw the Gout down to the Feet, by Bliſters apply'd to the Thighs or Legs, and acrid inflammatory Cataplaſms and Plaiſters; therefore when any Gouty Perſon is diſappointed of a Paroxyſm which he expected by the Seaſon, or the previous Symptoms, and inſtead of it is ſeiz'd with another Diſeaſe, let him ſpeedily conſult his Phyſician.

If a Gouty Perſon can bring himſelf intirely to a Milk Diet, he may ſo change the whole Juices of his Body as to eradicate the Diſtemper.

The Approach of a Fit of the Gout is eaſily known by the inward Diſorders, as Wind, Sickneſs, Crudities in the Stomach, a Drowſineſs, [401] theſe join'd with the Seaſon or Weather, if ſuch a one by a ſtatical Engine could regulate his inſenſible Perſpiration, he might often by reſtoring of that, foreſee, prevent, or ſhorten his Fit.

Greenſickneſs, Obſtructions.

The Symptoms of this Diſeaſe are evident, a due Age of the Patient, with an Obſtruction of the Menſes, a Fulneſs, ſometimes Pains about the Loins, a Lazineſs, Inactivity, which is both the Cauſe and Symptom of the Diſeaſe; a quick Pulſe, often emulating that of a hectick Fever, Palpitation of the Heart, Difficulty of Breathing upon the leaſt Motion, a livid Circle about the Eyes, Dizineſs of the Head, ſometimes an Appetite of odd things, as Chalk, TobaccoPipes, proceeding from an Acidity [402] in the Stomach, a Paleneſs of the Face and Skin, unnatural Haemorrages from the Mouth, Noſe, and other Parts, hyſterical Symptoms.

Young Perſons under a womanly Age are often troubled with ſome of the ſame Symptoms, but not from that Cauſe; and Women obſtructed have not always the foremention'd Symptoms; in thoſe, the Signs of Gravidity and Obſtructions are hard to be diſtinguiſh'd in the beginning.

This Diſeaſe is the Parent of many other dangerous Diſeaſes, and after ſix Months hardly to be cur'd.

What is to be conſider'd in this Caſe, is chiefly, if there be a ſufficient Fulneſs or Deficiency of Blood, different Methods are to be taken, in thoſe two Caſes, Bleeding, which may relieve in the firſt Caſe, will do hurt in the Second Motion; Exerciſe, Frictions, Bathings, Clyſters, [403] Fumigations often repeated are very beneficial.

Subſtances abounding with volatile oily Salts, Subſtances ſaponaceous, aromatical, as thoſe Vegetables which abound with a volatile Oil.

When there is not a ſufficient Plethora, a Diet wholeſome, plentiful, and nouriſhing, at the ſame time ſtrengthening the Organs of Digeſtion, is often effectual.

After Relaxing, ſuch Subſtances as ſtrengthen the ſolid Parts in general, are beneficial; it is by this Quality that Steel operates ſo ſtrongly in this Diſtemper, and likewiſe as being an Antiacid. See Chap. I. No 18.

A Woman who by ſome unuſual Haemorrage has that natural Defect ſupply'd, is only to be cur'd by topical Remedies.

Diſeaſes of Infants.

[404]

Infants new-born, before they have taken any Aliment, often have the whole alimentary Duct filled with a glutinous cheeſy Matter, and all of them have a Meconium, or ſort of dark-colour'd Excrement in the Bowels, which ought to be purg'd off.

Moſt of the Diſeaſes of ſuckling Infants proceed from Milk growing ſour and curdling in the Stomach; the Cure of which is to be effected Firſt, By attenuating this curdy Matter; and Secondly, by expelling it out of the Body; it may be digeſted by the Infant by Abſtinence from Sucking for ſeveral Hours; Honey and Water, with a little Wine, attenuate and diſſolve; and ſome gentle purging Syrup, as Syrup of Cichory with Rhubarb, expels the peccant [405] Matter; oily Subſtances are apt to turn rancid on the Stomachs of Infants; Clyſters and warm Fomentations, and other Applications of aromatical Subſtances to the Stomach and Belly, are uſeful in this Caſe.

Antiacids, eſpecially the Abſorbents, are more effectual in the Diſeaſes of Infants than in any other.

Opiats and anodyne Subſtances are dangerous.

Volatile Salts are hurtful to Infants, being too active, and operate ſometimes as Opiats.

Gall is the greateſt Reſolvent of curdled Milk: Boerhaave has given at a time one Drop of the Gall of an Eel with Succeſs.

Gentle Carminatives, as Fennel-Water, Mint-Water, relieve.

The Colick, green Stools, Vomiting, Wind, and Convulſions, all depend upon this Acidity, and [406] when that is rectify'd the Symptoms ceaſe.

Diſeaſes of Infants, and the Cure of them, depend very much upon the Diet of the Nurſe. See Part. I. Page 93.

When Children begin to feed upon Subſtances on which Infects depoſite their Eggs, eſpecially Fruits, they are often troubled with Worms, for want of a ſufficient Force of Digeſtion to deſtroy theſe Eggs.

The moſt common Sort in Children are the round or Earth-Worms.

The Symptoms occaſion'd by the Motion and Biting of theſe Worms are Loathing as it were from a Feather in the Throat, a Vomiting, Looſeneſs, Fainting, a feveriſh Diſpoſition, with a ſmall quick pulſe, Itching of the Noſe, Grinding of the Teeth, Fits, Paleneſs, a craving Appetite, Weakneſs, and when the Worms are large they conſume the [407] Moiſture, and inſtead of Looſeneſs will occaſion Aſtriction of the Belly, with a Swelling; Worms will perforate the Guts.

Children ſubject to Worms ought not to live much upon Milk, Cheeſe, or ripe Fruits, nor take much Sugar; ſome Inſects lay their Eggs in Sugar.

The Gall of Animals, and Mercury, kill Worms, and deſtroy their Neſts; it is found by Experience that the Water in which Mercury is boil'd has this Effect; all Bitters among alimentary Subſtances; Honey and Oil given by the Mouth, or Clyſters, have a good Effect; they may be taken together faſting; any Subſtance which by its Pungency can wound the Worms, will kill them, as Steel, Hartſhorn, Coraline, Coral powdered, Fiſh Bones. See Chap. I.

[408] Above a tenth Part of Infants die in Teething, by Symptoms proceeding from the Irritation of the tender nervous Parts of the Jaws, occaſioning Inflammations, Fevers, Convulſions, Looſeneſs, with green Stools (not the worſt Symptom) and in ſome, Gangrenes: It is plain that ſuch a Caſe ought to be treated as any other inflammatory Diſtemper.

When the Symptoms of Teething appear, the Gums ought to be relax'd by ſoftening Ointment, the Jaws fomented with emollient Decoctions, and the whole Head to be kept warm; when the Teeth is ready to cut, the upper Part rubb'd with hard Subſtances, which Infants by a natural Inſtinct affect, and when there is a manifeſt Tenſion of the Gum by the Tooth, then it ought to be cut; but this Operation ought not to be perform'd too ſoon.

[409] In the Convulſions it is neceſſary to give volatile Spirits, which they can bear better than when they are new-born.

The Rickets is another Diſeaſe to which Children are ſubject: It has been reckoned a Diſeaſe unknown to the Ancients, uncommon in hot Countries, and more common in England than any other Northern Country.

Children have this Diſeaſe from ſickly Parents, and eſpecially from Mothers of a weak lax Conſtitution, living on a various, high, and plentiful Diet, without Exerciſe; and Children born healthy, often contract the Diſeaſe from an unwholſome Nurſe.

A Diet of farinaceous Subſtances infermented, as of Pudding, much Butter, wet or ill-air'd Linen, cutaneous Eruptions repell'd, or ill cur'd, expoſing their lower Parts too long [410] to cold Air, may bring, or at leaſt increaſe this Diſeaſe.

The Diſeaſe may be foreſeen by the Child's being long in taking to his Feet; when it takes place the Child grows lean, the muſcular Fleſh decays, and grows flabby, the Skin looſe and flaccid, the Epiphyſes of the Bones about the Joints of the Arms grow big, the Belly ſwells, the Blood-Veſſels about the Neck enlarge, and ſo does the Head it ſelf, the Bones grow crooked; theſe are the outward Appearances, the Conſtitution of the inward Parts is often much worſe.

It is highly probable that this Diſeaſe proceeds from a redundant Acidity, becauſe Vinegar will ſoften and crook tender Bones; and this Symptom muſt happen in Children when there is no Strength in the Muſcles to ſupport them, or they muſt be inflected to that Side where the [411] Muſcle pulls ſtrongeſt. Contrary to the common Rules for the Aliment of Children, the Diet of thoſe that are Rickety ought to be moderately warm, even making uſe of Spices or carminative Seeds. They ought to forbear unfermented farinaceous Subſtances, new Bread; and rather uſe Biſcuit. Their Diet ſhould be pretty much of fleſh Meat, ſuch as are commonly call'd White Meats, and rather roaſted than boil'd, ſuch Diet being anti-acid. They may be allow'd a moderate Quantity of Wine.

I knew a rickety Child cur'd by a very great Indulgence of fermented Liquors, but it is not an Experiment that I would adviſe.

Frictions of the Back-bone and Joints with Flannel, ſmoak'd with penetrating aromatical Subſtances, and fomenting the Joints with old Malaga Wine, have prov'd often very effectual.

[412] They ought to uſe as much Exerciſe as they are capable of, but eſpecially by Voiture or Carriage. Care muſt be taken to open the Obſtructions in the lower Belly by Vomits and proper Purgations, where the Seat of the Diſeaſe chiefly lies, and after that the Cold Bath is a very proper and effectual Remedy.

I have lanch'd out of my Subject under this Head, mentioning ſome medicinal Helps, becauſe the Nurſes in ſuch Caſes are often the Phyſicians, which nevertheleſs they ought not to be when they can get better Advice.

Small-Pox.

Though I took notice of this Diſeaſe in the Article of Feveriſh Irruptions, yet it being one of the moſt dangerous and univerſal that infeſts Mankind, I ſhall add a few [413] more Rules which may be of uſe to ſuch as have not the Advice of an able Phyſician.

The greateſt and moſt important Strokes for the Recovery of the Patient, muſt be made at the time of the Invaſion, or firſt State of this Diſeaſe; therefore it is neceſſary to know the firſt Symptoms of it; many have ſuffer'd by miſtaking it for another Diſeaſe.

In general, young Perſons who have not had the Diſeaſe ought to be extremely careful to avoid great Irregularities in their Diet, becauſe the Small-pox which are occaſion'd by ſuch often prove dangerous. This Diſeaſe is likewiſe more dangerous as the Fluids are more exalted and diſſipated, and the Solids more ſtrict and compacted, and conſequently more ſo as People are advanc'd in Age.

[414] This Diſeaſe may be eaſily communicated by the Contagion or Steams of an infected Perſon ſwimming in the Air, and drawn in by the Breath, or perhaps by the Pores of the Skin; and it is evident by Inoculation that the ſmalleſt Quantity of the Matter mix'd with the Blood produceth the Diſeaſe, tho' not ſo quickly as thoſe volatile Steams.

The firſt Symptoms are a Chilneſs, Rigor, ſucceeded by a Fever and conſtant Heat, a certain Splendor or Shining in the Eyes, with a little moiſture; this is very obſervable in Children; a great Pain in the Head, with Dulneſs, Drowſineſs, Sleepineſs, a pain in the Back in ſome, but Pains in the Limbs in all, Anxiety, Inquietude, notwithſtanding their Drowſineſs, Loathing, Sickneſs of the Stomach, Vomiting, and in Infants Convulſions ſhortly [415] before the Eruption. The Blood let the firſt time, florid; after a ſecond time ſizy.

It is evident that in this State the Diſeaſe ought to be treated as any other inflammatory Diſtemper, by ſuch Methods as if it were poſſible to hinder any Suppuration at all, and to reſolve and digeſt as much of the feveriſh Matter as we can; for the longer the Eruption is a coming, and the ſmaller when it comes, the Diſeaſe is leſs dangerous; therefore all the Methods prractis'd in the beginning of inflammatory Diſeaſes are here neceſſery, with a particular Care of cleanſing the alimentary Duct by Vomiting and Clyſters, the Impurities of which will be carried into the Blood.

There is not yet found any particular Antidote to the poiſonous Stimulus of this Diſtemper; the learned Boerhaave is of opinion, [416] that if any ſuch could be found, it muſt be in Antimony, or Mercury intirely deſtitute of all Acrimony: The Effects of Mercury on all Ulcerations are very manifeſt.

Bleeding, which is extremely uſeful in the beginning of the Diſeaſe, is not ſo proper and uſeful when it is advanc'd.

In the firſt Stage the whole Habit of the Body ought to be relax'd, a free Perſpiration thro' the Skin, without violent Sweating, promoted; the Viſcoſity or Toughneſs of the Fluids taken off by diluents; the alkaleſcent State of the Salts corrected; all theſe things are effected by emollient Fomentations apply'd inwardly in Clyſters, and why not outwardly to the Skin? Such are us'd ſucceſsfully in other Eruptions, as Eryſipelas, Shingles, by a ſlender Diet of Decoctions of farinaceous Vegetables, and copious drinking [417] of cooling Liquors, with nitrous and acid Salts, and other acid Subſtances, mix'd with them; no Fleſh, unleſs it be ſmall Chicken-Broth; no Spice; the Air ought not to be ſpoil'd by Heat, nor the Coverings of the Bed ſo thick as to promote Sweat.

The Greatneſs and Danger of this Diſeaſe is eſtimated by the Quantity of Eruptions on the Face and other Parts of the Head; therefore the Matter ought to be ſolicited by all poſſible Methods to the lower Parts, eſpecially the Legs, by Fomentations, Bathing, Epiſpaſticks, Bliſtering, and through the whole Diſeaſe keeping the Feet and Legs warm; the Breaſt and Head not any more cover'd than to keep them from the Impreſſion of cold Air.

During the Filling and Ripening of the Puſtles, the Diet may be more plentiful, but ſtill not hot or [418] inflammatory, with the due Uſe of anodyne Subſtances: In this State Demulcents, or what abates Acrimony; and where the Circumſtances of the Patient require it, a Spoonful or two of Canary Wine, twice or thrice a Day, are proper: The Diet in this State ought likewiſe to be adapted to the particular Symptoms of the Diſeaſe, as cleanſing, attenuating, expectorating; to promote the Spitting, diuretick; when that is ſuppreſs'd, and Clyſters diluent, without any Stimulus, frequently injected, are beneficial in every Stage of the Diſeaſe.

When the Age, Temperament, high Pulſe, and eſpecially a Watchfulneſs and Delirium, all would ſeem to demand it in any other Caſe, why not Bleeding in this State? which I know to have been us'd with great Succeſs; a great many Veſſels are in this State almoſt impervious [419] by the Fluids; thoſe who die of this Diſeaſe have inward Inflammations, eſpecially in the Lungs; thoſe Reaſons ſeem to juſtify Bleeding.

Indeed the gangrenous Diſpoſition which appears in the malignant Kind, is a Reaſon againſt it, but hardly any thing will do good in theſe extremely malignant Caſes.

In ſuch malignant Kinds, all that is left is at laſt to try evacuating the morbifick Matter by other ways, as Epiſpaſticks and Stools procur'd by lenitive Subſtances, not irritating, which would only agitate the Humours and increaſe the Fever.

Gravel, Stone.

A Stone or ſtony Matter may grow in any Part of a Human Body; for when any thing inſoluble ſticks in any Part of the Body, it [420] gathers a Cruſt about it; a ſmall Drop of concreted Blood may grow to be a Stone, for by the Evaporation of the moſt fluid Parts it grows hard, and by the Attraction of new Matter increaſeth Blood, and a Human Calculus, or Stone, yield the ſame Contents by Chymical Trial, tho' in an inverſe Order.

Theſe ſtony Concretions happen moſt commonly in the Kidneys and Bladder; and indeed if the Tartar and other Contents of the Urine were not conſtantly voided, ſuch Concretions would happen to every Human Creature; for the Urine of the moſt ſound Perſon being inſpected with a Microſcope, after it has ſtood a while, will diſcover a black Speck, which is Sand, and wherever this Sand ſticks it grows ſtill bigger, by the appoſition of new Matter: When ſuch Concretions [421] happen in the Kidneys, and are expell'd or drop into the Ureters, it makes what we call Gravel; when they lodge and ſtick in the Body of the Kidneys, and grow to ſuch a Bulk as not to drop into the Pelvis, or paſs by the Ureters, they make the Stone in the Kidneys: The Symptoms of which are a dull Pain in the Kidney, moſt commonly bloody Water; upon a ſudden Jolt, violent Motion, Pain in Stooping; Pain in the Thigh, Sickneſs in the Stomach, Colical Pains, various Changes in the Colour of the Urine, black, bloody, pale, occaſion'd by ſomething ſharp or ſcabrous wounding the ſmall Blood-Veſſels; if the Stone is ſmooth and well bedded, perhaps this may not happen. Fleſhy Filaments, or Matter voided by Urine, are ſuſpicious Symptoms of a Stone in the Kidney, eſpecially [422] if the Patient has been ſubject to Voiding of Gravel.

When a ſmall Stone is lodg'd in the Body of the Kidney, it does not create Pain, nor much when it falls into the Pelvis; but when it falls into the Ureter, and ſticks, the Pain is moſt acute; it often ſtops at the Flexure and Valve of the Ureter, and ſometimes in the Urethra, or Paſſage of the Urine from the Bladder; while it ſtays in the Bladder it creates no Pain, but remaining there long it grows a confirm'd Stone, too big to be paſs'd by the Urethra: The manner of its Concretion is by concentrical Rings, like an Onion, about the firſt Kernel, which ſhews the Cauſe to be Attraction. This is not only true of a ſmall Stone, but any ſolid Body lodg'd in the Bladder will make the Kernel of a Stone; the Experiment of a Bullet's producing [423] this Effect has been try'd upon a Dog; and ſuch an Accident has happen'd to a Man by a Wound, in which a Bullet has dropt into the Bladder.

The Symptoms of a Stone in the Bladder are a Titillation about the Neck of the Bladder, and the Parts thereabout; a frequent Needing to make Water; a Senſation of Weight in the lower Belly, under the Shear-Bone, with a great Pain, eſpecially upon any ſudden Motion, which cauſeth a Concuſſion of the Bladder, a Dribling, Difficulty, and a momentary Suppreſſion of Urine by the Stone, ſhutting up the Orifice of the Bladder, attended with a Teneſmus, or needing to go to Stool, and a burning Pain in the Urethra; ſometimes a white Mucus in the Urine; tho' this laſt Symptom will happen without a Stone in the Bladder.

[424] The Regimen in the Stone in the Kidneys is by diluent and ſoft Diureticks to try to expel it, if it is ſmall enough to paſs; if the Stone is brittle, it will often crumble and paſs in the Form of Gravel; if the Stone is too big to paſs, the beſt Method is to come to a ſort of a Compoſition or Truce with it; the Diet ought to be cool and diluent, as far as poſſible to hinder its Growth; to uſe Diureticks that gently reſolve, as Parſley, Fennel, Scorzonera, Saſſafras, Mallows, and Tea, Dandelion, Cichory, Oats, Barley, Honey, Honey and Vinegar; Nitrous Salts, as Spirit of dulcify'd Nitre; the moſt ſoft cooling Diluent of all, is Whey; the beſt Emollients are Decoctions of Marſhmallows, Linſeed-Tea.

Bathing in tepid Water, Clyſters, ſeaſoning the Aliment moderately with Sea-Salt, for the immoderate [425] Uſe of it is reſolving and diuretick; the Belly, in all Caſes of the Stone, ought to be kept lax and open.

In a confirm'd Stone of the Kidneys too violent Exerciſe is dangerous.

During the paſſing of a Stone, one ſhould avoid at firſt all ſtrong Stimulating; relaxing and lubricating the Paſſages, and quieting the Spaſms by Opiats is certainly the beſt Method; and where Bathing cannot be conveniently had, OxBladders, half full of warm Water, apply'd conſtantly to the affected Part may be uſefully ſubſtituted. Letting of Blood taketh off a Tenſion better than any thing, and is very neceſſary where the Symptoms are violent; when the Parts are ſufficiently relax'd, ſtimulating Diureticks may be us'd more ſafely, eſpecially if aſſociated with Opiats.

[426] As to Diſſolvents of the Stone, all that have hitherto been propos'd are chimerical; Helmont talks of Bulls Blood; Goats Blood is rather a better Diſſolvent.

The ſureſt way to hinder the Generation of a Stone, is to procure a Diarrhoea by Whey, Broth, and a liquid Diet; and indeed what would not one do to prevent ſo painful a Diſeaſe?

When the Stone is fallen to the Bladder, Care ſhould be taken to make it paſs as ſoon as poſſible, for the Reaſons above-mention'd; if all the Symptoms abate without the paſſing of the Stone, it is not certain that the Stone remains in the Bladder, becauſe a very ſmall Stone may paſs inſenſibly by Urine; if the Stone has paſs'd, it is not certain that the Fit is over, for there are often more, and the uſual Remedies ought not to be left off.

[427] The Irritations of the Membranes of the Bladder by a Stone, may be much mitigated by the Injection of the Oil of Linſeed or Almonds, into the Bladder.

Such as are ſubject to the Gravel or Stone ought to be careful of their Diet, to uſe ſuch Aliments as generate a ſmall Quantity of Foeces, or relax the Belly; Aliment demulcent, as Peaſe; a Decoction of Chick-Peaſe is a Remedy in a Fit of the Stone; they ought to drink Whey in the Spring, and take Honey in ſeveral Forms, if it agrees with them; Rice, Barley, Millet, are all good in this Caſe; nothing makes Stones or Gravel paſs more eaſily than Opiats.

If the Stone ſticks in the Urethra, emollient Fomentation of the Parts, Oil injected, or in caſe of great Extremity, an Inſtrument with a Cavity like a ſmall Spoon, [428] dipt in Oil, may fetch out the Stone.

The Stone in the Bladder is not only a painful, but a mortal Diſeaſe, if not extracted. The Diet of a Patient in ſuch a Caſe is ſuch as of a wounded Perſon, nouriſhing, without Acrimony.

Let the Reader look into the Article of Inflammations of the Kidneys, where there are ſome Directions proper for all who are ſubject to the Stone or Gravel.

Rheumatiſm.

The Diſeaſe ſeems to be an inflammatory Diſpoſition in the ſerous Part of the Blood, affecting the lymphatick Arteries, and therefore affecting thoſe Parts where the Veſſels are the narroweſt. The Blood, as in other inflammatory Caſes, is ſizy, the alkaleſcent Salts in the Serum [429] producing coreaceous Concre [...]ons.

The common Methods us'd in this Caſe are certainly proper; theſe are, repeated Bleedings and Purges, interpoſing Anodynes, and gentle Sudoriſicks; and Bliſters when the Pain is obſtinate in one Part.

As for the Diet, it ought to be cool, diluting, and chiefly Vegetable.

If there be a ſpecifick in Aliment is certainly Whey; I knew a Perſon ſubject to this Diſeaſe who could never be cur'd by any other Method but a Diet of Whey and Bread. A Milk Diet is likewiſe effectual for changing that ſaline Conſtitution of the Serum of the Blood.

Cream of Tartar in Water-Gruel, taken for ſeveral Days, will abate the Pains and Swellings conſiderably, by its Acidity correcting the alkaleſcent Salts in the Blood.

[430] In obſtinate Sciatical Pains, Bliſtering and Cauteries have been found effectual, and the moſt penetrating Medicines, eſpecially the ethereal Oil of Turpentine mix'd with Honey.

I have lanch'd out of my Subject in this Article, becauſe of many common People who cannot always have good Advice.

[]
FINIS.

Appendix A ERRATA.

Page 250, Line 3, for Apoponox read Apoponax

Page 253, Line 21, for differ read differs

Page 280, Line 9, for Fermentations read Fomentations

Page 318, Line 14, for Cauſe of Acidity, read Cauſe, if Acidity,

Ibid. Line 17, for reſolve read relieve

Page 319, Line 19, for then read the

Page 330, Line 1, for more read mere

Page 335, Line 25, for Drinks read Drink

Page 338, Line 17, for Water; read Water,

Page 342, Line 21, for is the Reaſon read are the Reaſons

Page 345, Line 15, after Matter, add or terminates

Page 347, Line 8, for Lungs, read Liver,

Page 378, Line 14, after Ulcers dele;

Page 386, Line 20, for found read found

Page 395, Line 9, after Vegetables dele,

Page 420, Line 6, after increaſeth add:

Page 424, Line 24, for immoderate read moderate

Notes
*
See Chap. I.
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TextGrid Repository (2020). TEI. 5173 Practical rules of diet in the various constitutions and diseases of human bodies By John Arbuthnot. University of Oxford Text Archive. . https://hdl.handle.net/21.T11991/0000-001A-5F27-F