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.
PRACTICAL RULES OF DIET In the various Conſtitutions and Diſeaſes OF HUMAN BODIES.
THE PREFACE.
[]THE former Part of this Trea⯑tiſe has been cenſur'd for two Faults; firſt for being obſcure; ſecondly, for not being ſo practi⯑cal 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, Eu⯑clid'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, under⯑ſtood 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 ſuffi⯑ciently practical, I have endeavour'd to re⯑pair, 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, be⯑ſides 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 per⯑haps be more uſeful than the firſt, it being much ſuch a Work as an Almanack, of pub⯑lick Benefit, but from which no body I be⯑lieve 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 Con⯑ſtitutions of Human Bodies. I have ſtill follow'd the Method of the learned and in⯑duſtrious Boerhaave, who has certainly ſtu⯑died 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 fol⯑lowing Reaſons: Firſt, Becauſe the Parts of any Art or Science are often beſt under⯑ſtood when they are treated ſeparately: Se⯑condly, Becauſe the Practitioners in Phy⯑ſick and Chirurgery are often fruſtrated in their Intentions by Errors in Diet com⯑mitted [] by their Patients, a Misfortune that I my ſelf have felt ſeveral times, and, as I ſuppoſe, in common with others of the Pro⯑feſſion. 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.
[]- ALimentary Subſtances, auſtere and aſtrin⯑gent. 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 Sub⯑ſtances. 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 Bo⯑dies. 275
- Thoſe things which produce Cold in animal Bo⯑dies. 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
- 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
- Fevers, with their various Symptoms. 303
- Intermitting Fevers. 323
- A Phrenſy, or Inflammation of the Brain. 327
- Quincy. 328
- Inflammation of the Lungs. 332
- Pleuriſy. 339
- Paraphrenitis, or Inflammation of the Dia⯑phragm. 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
- 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, ve⯑getable 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 Cher⯑ries, 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 a⯑ſtringent Quality offend ſome Sto⯑machs.
[245] There are Wines of the ſame Qua⯑lity, 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 cool⯑ing, and laxative to the Bowels; their Kernels are good for the Gravel in the Kidneys.
Strawberries, which by their fra⯑grant Smell ſeem likewiſe to be cor⯑dial. 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 Se⯑ville 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 re⯑laxing Quality very much, they be⯑ing ſomewhat ſtyptick.
Apples, which are likewiſe pecto⯑ral, cooling, and lenitive; they dif⯑fer conſiderably as to the Kinds of them, and their Qualities may be eaſily known by their Taſte.
Pears have moſt of the ſame Qua⯑lities; ſome Kinds by their high Fla⯑vour 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 ra⯑ther ſomewhat ſtyptick.
Gooſeberries, extremely ripe, are le⯑nient; unripe, they are ſour, and ra⯑ther aſtringent.
Currants are good in Spitting of Blood, extremely cooling, and ſome⯑what aſtringent. The Jelly or Rob of Currants, mix'd with Water, is a moſt excellent Drink in bilious Fe⯑vers.
Grapes taken in moderate Quanti⯑ties 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 Acri⯑mony, uſeful in Hoarſeneſs and Coughs, extremely emollient, and by relaxing the Urinary Paſſages, diu⯑retick, 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, Cucum⯑bers, 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 purga⯑tive. Cucumbers are uſeful in bloody Urine.
All Fruits which contain a ſub⯑acid eſſential Salt, much Phlegm, and a ſmall Quantity of Oil, have this lenient Quality; as likewiſe the emol⯑lient 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 me⯑lancholy 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 agree⯑able to the Stomach, and not heat⯑ing. 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 Co⯑licks; the Plant from which Apopo⯑nox is taken, is a ſort of Parſnip.
Skirrets, uſeful in bloody Urine, and Spitting of Blood.
Scorzonera, demulcent in the Small⯑Pox, 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 Scorzo⯑nera.
Emollient likewiſe are all farinace⯑ous or mealy Subſtances.
Barley, which is deterging, tho viſcous in a ſmall degree; the De⯑coction and Cream of Barley are proper in inflammatory Diſtem⯑pers.
Rice, nouriſhing, good in Hae⯑morrages, or Fluxes of Blood.
Mays is not ſo eaſily brought to Fermentation as other Grains, there⯑fore 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 out⯑wardly 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 ex⯑tremely demulcent, and temper Acri⯑mony.
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 ſe⯑dentary [252] Life ſhould not feed much upon them.
The Animal Oils; Cream, Butter, and Marrow, are all lenient and nou⯑riſhing: 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 De⯑coctions 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 ſapona⯑ceous, or contain Salt and Oil; therefore moſt ripe Garden Fruits [253] have this Quality, and Honey moſt of all vegetable Subſtances. Mere dilu⯑ting diſſolves and carries off Salts.
4. Anti-acid, or contrary to Acidity or Sourneſs, are,
All Animal Diet in general, be⯑cauſe 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 accord⯑ing as they are terreſtrial, aquatick, or amphibious. Fiſhes contain much [254] Oil, and amphibious Animals par⯑ticipate 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 ani⯑mal Diet may be diſcovered by Taſte and other ſenſible Qualities, and ſome of thoſe general Rules above-men⯑tion'd, without particular Diſquiſi⯑tions upon every Kind.
Eggs are perhaps the higheſt, moſt nouriſhing and exalted of all animal Food, and moſt indigeſtible, be⯑cauſe 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 Ani⯑mal Diet is Anti-acid or Alkaleſcent.
Vegetables uſed in Aliment anti⯑acid 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 hurt⯑ful 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 Diu⯑reticks may be ſafely us'd, are very effectual: Garlick has been found by Experience to be a very excellent Re⯑medy 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 ſe⯑veral 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 Conſtitu⯑tions, 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 An⯑ti-acids of a milder Kind.
Nettles, good againſt Haemorra⯑ges.
Such as abound with a ſoft Oil, which operate by blunting the Acri⯑mony of the Salts, as moſt ſorts of Nuts; moſt of which are hard of Digeſtion, yet poſſeſs ſome good me⯑dicinal Qualities.
Walnuts are cordial, anti-hyſterick, and gently ſudoriſick.
Hazle-Nuts, good againſt Spitting of Blood.
[258] Cheſnuts are good in Female Weak⯑neſſes, and afford a very good Nou⯑riſhment.
Almonds, Pectoral.
Piſtachos, nouriſhing and ſtimu⯑lating.
Olives are anti-acid by their Oil, but all oily Subſtances beget an Acri⯑mony of another ſort.
Truffles, which have an exalted Oil, and a volatile Salt of a grateful Sa⯑vour, 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 ope⯑rate by a ſort of Suffocation, in which the beſt Remedy is Wine or Vine⯑gar and Salt, and Vomiting as ſoon as poſſible.
[259] Acidity is likewiſe cur'd by dilu⯑ting, therefore Water is an Anti-acid.
5. Acid Subſtances are,
Moſt ripe Garden Fruits, fermen⯑ted Liquors, ſmall Wines, with lit⯑tle Oil, and much Tartar, Vinegar, ſour Milk, Butter-Milk. Several Plants known by their Taſte, as Sor⯑rel, &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, Nut⯑meg, 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; Gin⯑ger is perhaps one of the beſt of [260] them. All Spices are bad for me⯑lancholy People.
Of the ſame nature are the Vege⯑tables uſed in Seaſoning, as Thyme, Savory, Marjoram, Roſemary, Mint, Orange and Limon-Peel, Fennel, which contains a ſubtil Spice, balſa⯑mick, warm, and ſtimulating; Cher⯑vil, of the ſame nature; they are good in phlegmatick cold Conſtitu⯑tions: Sage is ſtimulating, drying, aſtringent; us'd in great Quantities it will produce Temulency, or Drunk⯑enneſs.
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 men⯑tioned 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 ſedenta⯑ry. 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 Secre⯑tions, eſpecially Sweat, produce this Effect at laſt.
9. What renders the Blood acrimonious or ſharp
Are ſuch things as increaſe its Ve⯑locity; for by mutual Attrition Salts are produc'd.
Whatever attenuates the Humours.
Whatever reſolves Concretions, and turns them fluid; for whatever putri⯑fies, is acrid.
Acrimony is threefold: Acid, which is produc'd from Vegetables lying long in the Stomach; no animal Sub⯑ſtance 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 vo⯑latile Alkalis, taken in great Quanti⯑ties; and by eſſential Salts of Vege⯑tables, 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 Muſ⯑tard, 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 Al⯑monds, 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 Sub⯑ſtances not high ſeaſoned, acid Sub⯑ſtances in reſpect of alkaline, and al⯑kaline in reſpect of acid.
Fermented burning Spirits ſubdue Acidity, and are very often a preſent Remedy when the Stomach is affec⯑ted with it. Spirit of Wine dulcifies Spirit of Salt, Nitre, or Vitriol; but then thoſe Spirits have other bad Ef⯑fects.
Abſorbents, as Chalk, Crabs Eyes; but theſe are not alimentary, except calcin'd Hartſhorn, which has ſome⯑thing 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 alka⯑line, 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 incraſ⯑ſating, 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 at⯑tenuating Subſtances; what relaxeth the Veins, as Frictions, Bathings, [266] Compreſſions by Ligatures often re⯑mov'd, Sneezing, Coughing, Laugh⯑ing, and ſeveral other natural Mo⯑tions.
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, Pa⯑nadas, 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 Al⯑monds or Olives; ſoapy Subſtances, [267] eſpecially Honey; Emulſions of fari⯑naceous Subſtances, Decoctions of e⯑mollient 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 Me⯑ſentery; 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 Inte⯑ſtines; ſome ſaponaceous Subſtances [268] which ſtimulate gently, as Honey, Hy⯑dromel, or boil'd Honey and Water, and even Sugar it ſelf, eſpecially unrefin'd.
Such lenitive Subſtances are pro⯑per 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 Sub⯑ſtances; and even common Water or Whey, drank in cool Air, and walking after it; ſour Milk and But⯑ter Milks have the ſame Effect.
There are other Subſtances which ſtimulate more, even new Milk, eſ⯑pecially 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 ammonia⯑cal 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 immo⯑derately, 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 Re⯑medy after a Surfeit of Fruit. The expreſs'd Juices of ſeveral Vegetables, becauſe of their eſſential Salts, ſtimu⯑late 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 diu⯑retick.
Soaps which reſolve ſolid Subſtances, any Salt, Oil, Salads of pungent Herbs, with Oil of Olives, and Vi⯑negar, 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, de⯑mulcent, and laſt of all the ſtimu⯑lating.
The Blood may be cleans'd, and the Salts of it carried off perhaps better by Urine than any other Se⯑cretion.
17. Sudorificks.
Such things as relax the Veſſels of the Skin, by which Quality many things which are diuretick, are like⯑wiſe 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 Hip⯑pocrates; 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 vio⯑lent Exerciſe, all Cordials, Spices, thin and ſharp Wines, Juices of Li⯑mon, 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 diſ⯑ſolves it.
[273] Sudorificks are to be varied ac⯑cording to the Cauſe of the Diſeaſe which it is deſign'd to remove.
18. Diaphoreticks or Promoters of Perſpiration.
What helps the Organs of Dige⯑ſtion, becauſe the Attenuation of the Aliment makes it perſpirable.
Such things as conſtrict the Fibres, and ſtrengthen the ſolid Parts; Exer⯑ciſe to a degree leſs than what pro⯑vokes 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 Ful⯑neſs of the Veſſels, conſequently ſuch as ſtrengthen the Organs of Di⯑geſtion, [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 ex⯑alted Oil, as thoſe us'd in ſeaſoning Aliment, Savory, Thyme, Marjo⯑ram, 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 Rub⯑bing of the Fluids and Solids, to which Heat is proportional.
Therefore whatever increaſeth the Velocity of the Blood, by ſtimula⯑ting, heateth, as ſpirituous fermented Liquors, and when the Heat is in⯑creas'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 Atro⯑phy, 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 for⯑mer, viz.
By whatſoever diminiſheth the projectile Motion of the Blood, by weakening the Force of any Stimu⯑lus; 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 Sub⯑ſtances in reſpect to acid, and acid Subſtances in reſpect of alkaline; and ſoapy Subſtances, if the Heat pro⯑ceeds 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 Ve⯑getables, 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 com⯑preſſeth 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 Mar⯑joram, Balm, Sage, Roſemary.
Thoſe things which affect the Noſe with a grateful Smell, and are not [278] hot, by their Odour promote the Se⯑paration of the Animal Spirits.
23. Cordial
Are all ſuch things as increaſe and facilitate the animal or natural Mo⯑tions, 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 in⯑creaſing the projectile Motion of the Blood, the Strength may be dimi⯑niſhed.
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 facili⯑tates the animal and natural Mo⯑tions.
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, nou⯑riſhing, of a Flavour grateful to moſt Palates.
Such as determine and ſettle the irregular Motions of the Animal Spi⯑rits; therefore, anodyne Subſtances, and what abate Spaſms and Convul⯑ſions, 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 open⯑eth 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 occa⯑ſion'd by ſome acrimonious Sub⯑ſtance which conſtringeth the Fibres of the affected Part; whatever is con⯑trary 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 pow⯑der'd.
Thoſe things which purge and ex⯑pel them out of the Body, of which kind there are ſeveral alimentary Sub⯑ſtances.
26. Anodyne, or Abaters of Pain of the Alimentary Kind.
Such things as relax the Tenſion of the affected nervous Fibres, as Decoc⯑tions of emollient Subſtances; thoſe things which attenuate and remove the Obſtruction, or deſtroy the par⯑ticular Acrimony which occaſions the Pain, or what deadens the Senſation of the Brain by procuring Sleep; ſome Alimentary Subſtances are en⯑dued with this Quality, as Saffron, [282] Lettuce, Cichory, Wine, and inflam⯑mable Spirits.
This being a ſort of a compendi⯑ous Alimentary Diſpenſatory, makes it unneceſſary in the following Rules to repeat conſtantly the ſame things, it being ſufficient to mention the In⯑tention or Deſign to be purſued in the Diet.
When there are Contra-indications, that is, when different Symptoms de⯑mand oppoſite Methods one muſt a⯑dapt the Method to the moſt urgent Symptom.
When the Diſeaſe is complicated with other Diſeaſes, one muſt conſi⯑der that which is moſt dangerous. Theſe may ſerve for general Rules.
CHAP. II.
Rules of Diet in the different Conſtitu⯑tions of Human Bodies.
[283]Lax and weak Fibres.
PAleneſs, a weak Pulſe, Palpita⯑tions of the Heart, flabby and ſlack Fleſh, Lazineſs, Laſſitude, Bloat⯑edneſs, ſcorbutical Spots are Symp⯑toms 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, eſpe⯑cially Letting of Blood, Subſtances viſcous, and hard of Digeſtion, a ſe⯑dentary Life, and moiſt Air.
They ought to take Aliment fre⯑quently, in ſmall Quantities, nouriſh⯑ing, [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 Prompt⯑neſs in Animal Actions, are Signs of ſtrong, rigid, and elaſtick Fibres.
Such Conſtitutions are ſubject to inflammatory Diſtempers.
They ought to avoid the Diet pro⯑per in the contrary State.
Their Nouriſhment ought to be emollient and cooling, the Pulps, Juices, Jellies, Mucilages, and De⯑coctions of Vegetables mentioned [285] No 2. animal Oils, and all things which relax and increaſe Fat, avoid⯑ing all things ſeaſoned with Spice and Salt: Their Drink, Water, Bar⯑ley-Water, Whey; and eſpecially to avoid fermented Spirits, which to ſuch are extremely hurtful.
Bathing in tepid Water is benefi⯑cial to ſuch Conſtitutions, and im⯑moderate Labour or Excerciſe hurt⯑ful.
Plethorick Conſtitutions.
The Signs of a Plethorick Con⯑ſtitution, or of ſuch as abound with laudable animal Fluids, are evident.
The Cauſes of it are a good Sto⯑mach, nouriſhing Diet, a good Di⯑geſtion, 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 ſub⯑ject to a Stoppage of the Circula⯑tion, and conſequently to Suffoca⯑tion, 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 thick⯑ens the Fluids; frequent Blood-let⯑ting, in ſmall Quantities, often in⯑creaſeth the Force of the Organs of Digeſtion, fattens, and increaſeth the Diſtemper.
They ought to avoid oily and nouriſhing Subſtances; watery Ve⯑getables, as being leſs nouriſh⯑ing than animal Diet, are proper; and Fiſh rather than Fleſh: In a Lent Diet People commonly fall a⯑way.
Sanguineous Conſtitutions.
[287]Such are known by their Com⯑plexion, or Colour of their Counte⯑nance and Skin: They are ſubject to Haemorrages, Inflammations, eſ⯑pecially of the Lungs, Impoſtuma⯑tions, and often to ſcrophulous Diſ⯑tempers.
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 a⯑bound 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 Appe⯑tite 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 Sub⯑ſtances, 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 an⯑ti-acid, as ſeveral Birds, and Water-Fowl; tho' thoſe are offenſive to the Stomach ſometimes, by reaſon of their Oilineſs. Vegetable and ani⯑mal 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 Ali⯑ment.
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 alka⯑line Cauſe, one muſt attend to the previous Diet and the concomitant Symptoms; (Children, by eating un⯑ripe Fruit often, have Eruptions up⯑on 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 alka⯑line Salts.
Conſtitutions abounding with a ſpon⯑taneous Alkali.
This Conſtitution is more natural to Human Bodies, becauſe all animal Subſtances are alkaleſcent.
Heat, Thirſt, hot nidoroſe Belch⯑ings, Foulneſs of the Tongue and Pa⯑late, 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 Hu⯑mours of the whole Body to Heat, Inflammations, and Putrefaction, hin⯑ders 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 a⯑bound 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 Na⯑ture, rather increaſe the Diſeaſe; Salt-Petre is the moſt cooling and pro⯑per.
[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 Wa⯑ter, 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 ſub⯑ject to fall into this alkaline State of the Fluids, which is more dangerous than that which proceeds from Aci⯑dity, for the Bile (which is here re⯑dundant) is the ſtrongeſt Anti-acid, [293] and when it is highly exalted, and acrimonious, is capable of producing all the dreadful Symptoms of malig⯑nant and peſtilential Fevers, as is evident from the Experiments that were made in the Plague of Mar⯑ſeilles. 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 ple⯑thorick, 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 Reme⯑dies, many dangerous and fatal Di⯑ſeaſes 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 eſpecial⯑ly tough Phlegm frequently rejected by Vomiting, Inflations and Tu⯑mors 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 paſ⯑ſing: Perſons of ſuch Conſtitutions ought to avoid mealy Subſtances un⯑fermented, 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, be⯑cauſe whatever brings them into an alkaline State, is a proper Cure for [295] the Diſeaſe; therefore ſoapy Sub⯑ſtances, 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 bi⯑lious 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 diſ⯑ſolves Phlegm, but it relaxeth too much.
Thickneſs of Blood.
Thirſt, Leanneſs, Exceſs of ani⯑mal Secretions, as of Urine, Sweat, liquid Dejections, too ſtrong a Per⯑ſpiration, [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, eſ⯑pecially 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, ſti⯑mulating 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 ſea⯑ſon'd with Salt, Pepper and Vinegar, are all proper, and diſſolve Fat; they have only one Inconvenience, that they create Thirſt, and great Quan⯑tities [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 con⯑ſiſt of Oil and Salt, are proper, be⯑cauſe 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 di⯑lute and ſtimulate moderately, are uſeful; great Quantities of oily fer⯑mented Liquors increaſe Fat; mere Water relaxeth too much; moiſt Air is hurtful to fat People, by relaxing the Fibres, and ſtopping Perſpira⯑tion.
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 Applica⯑tion 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. Nouriſh⯑ment 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 Con⯑dition.
Aſtringent auſtere Aliment, men⯑tion'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, eſpecial⯑ly 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, Ci⯑chory, Dandelion, and Honey moſt of all.
There is one Caution to be ob⯑ſerv'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 Mo⯑tion, which may be either too flow, too quick, or in ſome of the Veſſels totally obſtructed.
Thoſe who have too ſlow a Circu⯑lation, 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 in⯑flammatory, the Aliment ought to be cool, ſlender, thin, diluting, a⯑voiding the copious uſe of Subſtan⯑ces of a ſaline Quality, which ſti⯑mulate, and conſequently may in⯑creaſe 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 In⯑tention is to diſſipate and attenuate, the Diet ought to be diluting and ſtimulating, conſiſting of ſuch Sub⯑ſtances 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 Sub⯑ſtances, of eaſy Digeſtion, of ſuch ſort as keeps the Humours from Pu⯑trefaction, and renders them oily and balſamick.
When a Suppuration is to be pro⯑moted, the Aliment ought to be [302] more copious and warm, becauſe ſuch induceth a Putrefaction.
When a Sore is healing, the Pa⯑tient 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 Chi⯑rurgeon 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 hurt⯑ful.
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 Regi⯑men 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 ſtag⯑nates in the Extremities, and preſ⯑ſing upon the Heart creates great Anxieties, and may produce Con⯑cretions 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 pro⯑ceed from a Rigor of long Dura⯑tion.
In ſuch Rigors, all warm Cordials and ſtimulating Subſtances are im⯑proper, 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 con⯑ſtringing 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 Fric⯑tions of the Extremities relieve.
Anxieties. In Anxieties which at⯑tend 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 Sub⯑ſtances 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 conſtring⯑ing 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 Spi⯑rit of Nitre mix'd with Water, is very proper in this Caſe; ſo are Barley⯑Water and Emulſions, except in great Weakneſs and Flatulencies of the Sto⯑mach, 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 at⯑tending 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 pro⯑moting the Vomiting for a while by tepid Water.
During the Symptom, acid Li⯑quors, 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 co⯑vet 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 ſome⯑times coveted odd things which [307] have reliev'd them, as Salt, Vine⯑gar, &c.
Vomiting, from a bilious Cauſe, is cur'd by ſubacid Liquors; Vomit⯑ing, 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 bit⯑ter things will relieve. The Counter⯑poiſon muſt be adapted to the Cauſe; for Example, in Poiſon from Subli⯑mated 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 ex⯑tremely dangerous.
Wind and Spaſms are occaſion'd by the feveriſh Heat expanding the ae⯑rial Particles in the Fluids.
Whatever is anodyne and quiets Convulſions, and what abates the Heat, relieves this Symptom.
Weakneſs, or the Impotence of ex⯑erciſing animal Motion which attends Fevers, proceeds from too great Ful⯑neſs in the beginning, and too great Inanition in the latter end of the Diſeaſe; for whatever ſtops or re⯑tards 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 Me⯑thods, in the firſt emptying and dilu⯑ting; [309] in the latter, a more plentiful Nouriſhment, the uſe of Wine dilu⯑ted with Water, and Spices in ſmall Quantities, Jellies, Broths, the alka⯑leſcent Quality of which may be cor⯑rected 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 re⯑lieve 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 fever⯑iſh 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 Fe⯑vers, 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 Li⯑quors are not the beſt Remedies for this Debility, tho' they increaſe the Force of the Heart, and are neceſſa⯑ry 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 Cor⯑dial.
Heat; the Degree of which may be known by the Thermoſcope, the [311] Senſation of the Patient, the Intenſe⯑neſs of the red Colour of the Urine, the Sizeneſs of the Blood, the Diſſi⯑pation 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 pro⯑portional, 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 Rea⯑ſon, retard the Circulation; of ſuch ſort is dry Cupping, bathing the lower Parts, watery Liquors for Drink, not cold, but tepid; ſubacid, as Jel⯑ly of Currants diſſolved in tepid wa⯑tery Liquors; Decoctions of mealy Subſtances acidulated, Subſtances a⯑nodyne, 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 de⯑mulcent and relaxing Subſtances, cooling the Air in the Room, open⯑ing the Curtains, and removing too thick Bed-clothes; all ſtimulating and ſlyptick Subſtances to be avoided, be⯑cauſe they increaſe the Force of the ſolid Parts.
Delirium. Too great Alacrity and Promptneſs in Anſwering, eſpecially in Perſons naturally of another Tem⯑per, is a Sign of an approaching De⯑lirium: 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 Ho⯑ney, Aloes, and Rock-Salt, ought [313] to be try'd, relaxing by emollient and watery Subſtances, both in Drink and Clyſters, eſpecially Bar⯑ley-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 Ina⯑nition.
Old Men are ſubject to Comas by the Tenacity of the Fluids circula⯑ting in the Brain, which being re⯑ſolved 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 Sleepi⯑neſs, and is perhaps the moſt ill-bo⯑ding Symptom of a Fever.
The Expedients in ſuch a Caſe are extreme Care to keep the Pa⯑tient from Noiſe, and what makes any ſtrong Impreſſion upon his Senſes, ſome of thoſe Helps us'd in a Deli⯑rium, becauſe this is an Approach to⯑wards it; a moiſt ſoftening Diet; all Preparations of Barley, Emulſions of Poppy Seeds, and Almonds, Ali⯑ment of ſome lacteſcent Plants, eſpe⯑cially Lettuces, Decoctions of Scor⯑zonera 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 mecha⯑nical 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 Flow⯑ers.
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 of⯑ten obſcure.
In Infants they commonly pro⯑ceed from Acidity in the Stomach, and are cured by terreſtrial Abſor⯑bents; 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 Inflam⯑mations of the Membranes of the Brain are commonly fatal: The Symptoms attending them are a great Heat, a hard Pulſe, and a De⯑lirium: The Remedies, and even thoſe from Diet, are to be us'd ac⯑cording to the Seat of the Diſeaſe.
If from the Stomach, ſuch Ali⯑ments as are contrary to the par⯑ticular 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 re⯑lax 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 vehe⯑ment 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 re⯑ſtore the Liquid which the Blood loſeth, and to uſe the Methods ad⯑viſed in too great Heat, by taking away ſome of the Coverings of the Bed, and admitting of cool Air, and uſing a Diet moderately aſtrin⯑gent; Wine, Spices, and ſpirituous Liquors, in this Caſe, have often a [318] good Effect; ſpirituous Liquors thick⯑en the Fluids; Sage is a good Re⯑medy in the Caſe of profuſe Sweats.
A Diarrhoea Looſeneſs proves often a dangerous and fatal Symptom in Fe⯑vers, 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 in⯑curring 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 pro⯑voke Diarrhoeas, they only lubricate or make the Bowels ſlippery. Diar⯑hoeas ariſing from Quantities of Fruit are often cur'd by Emulſions.
[319] Vomiting, by evacuating the irri⯑tating Cauſe, often cures ſuch Diar⯑rhoeas.
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 Sudo⯑rificks, which puſh out too great a Quantity of the Matter upon the Skin; to uſe cooling and temperate Diluents, which keep the Matter flu⯑id 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 Symp⯑toms, 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 In⯑flammatory 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 ſe⯑veral Days, and is not putrid, or attend⯑ed 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 Mo⯑tion. 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 en⯑dured 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 breath⯑ing; great Thirſt; Loathing, Sick⯑neſs of the Stomach, and Vomiting; Anxiety, Reſtleſneſs, Wearineſs; ſome⯑times a Cough and Hoarſeneſs; Watch⯑fulneſs and Delirium, and Exacerba⯑tion 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 cri⯑tical Day reſolv'd by Sweating, Vo⯑miting, 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, Trem⯑bling, 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 Con⯑traries offend them.
Their Drink ought to be cool, mild, ſubacid, tepid, given in moderate Quantities, and often, as Water with Juice of Limon or Tama⯑rinds.
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 lit⯑tle [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 Sub⯑ſtances as gently ſtimulate the Belly, are uſeful, as ſome ripe Fruits, Straw⯑berries, Currants, Mulberries.
The Symptoms increaſe by the Uſe of hot things given either as Ali⯑ment or Medicine.
Intermitting Fevers.
They are (at leaſt in this Country) very obſtinate, often return in ſpite of all Remedies, and by long Con⯑tinuance they degenerate into Hepa⯑tical Fevers, and many chronical Diſ⯑tempers, as Jaundice, Dropſy, Schir⯑rus's, and Scurvies; therefore in this Diſeaſe a right Method, both of Me⯑dicines and Diet, is of great Impor⯑tance. [324] There is a great Variety in theſe Diſeaſes, as to the Intervals of Times between the Paroxyſms; Ter⯑tians ſometimes redouble their Paro⯑xyſms, 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 Fever⯑iſh Rigors, is proper in all Fevers, and Care is to be taken by all pro⯑per Methods to ſhorten that Period as much as poſſible, and by tepid Di⯑luents to bring on the Sweat ſoon, but not to puſh it beyond its due Meaſure, becauſe an intermitting Fe⯑ver [325] relaxeth and weakens the Body extremely.
Between the Paroxyſms, too great Abſtinence is hurtful as much as too great Repletion; as intermitting Fe⯑vers are often of long Continuance, extreme Abſtinence is impractica⯑ble, and would reduce the Pa⯑tient to a Condition not to be able to ſuſtain the Shock of the next At⯑tack.
Between the Paroxyſms, ſuch Sub⯑ſtances as temper, correct, and ſub⯑due the bilious Alkali, as acid Sub⯑ſtances, 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 ex⯑preſs'd Juices of them cure intermit⯑ting 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 Con⯑dition of the Patient is to be conſi⯑der'd in this Caſe.
Intermitting Fevers have been ob⯑ſerved to free from ſome Chronical Diſtempers, as the Gout and Con⯑vulſions, but they often induce great ones themſelves.
INFLAMMATORY DISEASES.
[327]A Phrenſy, or Inflammation of the Brain.
This Diſeaſe, of all others, re⯑quires the ſpeedieſt Applications, profuſe Haemorrages from the Noſe commonly reſolve it, and copious Bleeding, by opening the temporal Arteries, are the moſt effectual Re⯑medies: 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 Di⯑ſeaſe. [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 Deli⯑rium and Watchfulneſs in this Chap⯑ter.
Quincy.
The Tumour of the Throat, which occaſions the Difficulty of Swallowing and Breathing, attending this Diſ⯑temper, may be of various ſorts: Sometimes it proceeds from a Seroſi⯑ty obſtructing the Glands, which may be watery, aedematoſe, ſchirrous, [329] according to the ſeveral degrees of the Viſcoſity of the Humour; ſome⯑time inflammatory, which Inflamma⯑tion will ſometimes end in a Suppu⯑ration, or Gangrene.
The Difficulties of Breathing and Swallowing, which happen without any Tumour outward or inward, af⯑ter long Diſeaſes, proceed commonly from a Reſolution or paralytical Diſ⯑poſition of the Parts, and is the im⯑mediate Forerunner of Death.
The Regimen in thoſe Quincies which proceed merely from the Ob⯑ſtruction of the Glands, muſt be to uſe ſuch warm Liquors as gently re⯑lax, ſoften, and moiſten thoſe Glands, ſuch as carry off the redundant Se⯑rum by Stool, Sweat, and Urine; or by ſtimulating, open the Emuncto⯑ries 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 Inflam⯑mations 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 ſtimula⯑ting Aliment or Medicine, and vio⯑lent 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 Di⯑arrhoea relieves; therefore Aliments which promote it are uſeful, as Ta⯑marinds infus'd in Whey. Decoc⯑tions and Emulſions of farinaceous [331] Vegetables moderately acidulated, and ſuch as abound with a cooling ni⯑trous Salt, are proper; it is com⯑monly thought that Punpenella, Saxi⯑fraga, or Burnet, is a Specifick in this Caſe: Every body knows the Be⯑nefit of Mulberries, taken all man⯑ner of ways. All Acids, as Sorrel, Juice of Limon, &c. abate Inflam⯑mations.
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 nou⯑riſh'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 Inflam⯑mation 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 particu⯑larly, are a bad Conformation of the Lungs and Thorax commonly atten⯑ded with an Aſthma, Air too hot, cold and moiſt, abounding perhaps with cauſtick, aſtringent, and coa⯑gulating Particles; the Lungs, pro⯑perly 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 a⯑long the Surfaces of the Air-Bladders, and I believe the Qualities of the Air are the general Cauſe of the In⯑flammation of the Lungs which hap⯑pen 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 oc⯑caſion this Inflammation; too great an Exerciſe of the Lungs, ſo as to occaſion a ſhort and laborious Breath⯑ing, or keeping them too long upon the Stretch by Vociferation, or loud Singing, may produce the ſame Ef⯑fect: 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 a⯑voiding thoſe Cauſes is the beſt Rule of Diet to prevent the Diſeaſe; be⯑ſides, 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 Symp⯑toms, viz. the Fever, Difficulty of Breathing, Thirſt, Anxiety, Reſtleſ⯑neſs, 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 ef⯑fectual Remedy in the beginning of the Diſeaſe; but when the Expecto⯑ration goes on ſucceſsfully, not ſo [335] proper, becauſe it ſometimes ſuppreſ⯑ſeth it, and in that Caſe Sudorificks thicken the Matter that is expectora⯑ted. 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 Di⯑ſeaſe whatſoever, common Whey be⯑ing ſufficient to preſerve the Strength of the Patient; watery Liquors, and even the Steam of warm Water ta⯑ken in by the Breath, attenuates the impacted Matter. Relaxing Ali⯑ment, 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 re⯑lieve 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 Cly⯑ſters.
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 be⯑ing upon the affected Side; a continual Lent-Fever, with Rigors invading with uncertain Periods; Exacerbations af⯑ter 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 Impoſt⯑hume 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 Dan⯑ger to the Lungs.
Tho' ſuch a State is extremely dan⯑gerous, it is not quite deſperate; the Aliment ought to be Milk; the Drink, Milk, and Barley-Water, and ſuch alimentary Subſtances as are ex⯑pectorating and cleanſing, with gen⯑tle 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 Pe⯑ripneumony, not inflammatory; when the Veſſels are obſtructed with a viſ⯑cous Pituite that mixeth with the Blood, and invades in cold Weather, it is dangerous, and often ſuffocates; it is incident to weak and old Peo⯑ple. In this, ſome of the Methods uſed in the Inflammatory are pro⯑per, but not ſo copious Bleeding, Clyſters frequently injected; Ali⯑ment more generous, Broths, and Jellies with Juice of Limon, Hydro⯑mel, 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, be⯑ſides thoſe common to all Inflamma⯑tions, are often a particular Diſpoſi⯑tion to inflammatory Diſtempers, a Straitneſs of the Arteries of the Pleu⯑ra, a Calloſity of that Membrane, an Adheſion of the Lungs, the ſud⯑den Admiſſion of cold Air by too thin clothing, too hot a Regimen, and eſpecially the copious uſe of ſpi⯑rituous Liquors, cold Liquors drank when the Body is very hot, a Tranſ⯑lation [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 ta⯑ken in the Regimen by way of Pre⯑vention.
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 in⯑creaſe 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 a⯑gainſt all Remedies, a ſudden Abate⯑ment of the Pain, a quick weak Pulſe, ſometimes intermitting, ſhort Breath and cold Sweats are Symp⯑toms of a Gangrene, and approach⯑ing Death.
Paraphrenitis, or Inflammation of the Diaphragm.
The Symptoms of this Diſeaſe (which is often miſtaken) are a vio⯑lent Fever, a moſt exquiſite Pain in⯑creas'd upon Inſpiration; by which it is diſtinguiſh'd from a Pleuriſy, in which the greateſt Pain is in Expi⯑ration.
This Pain is increas'd by Sickneſs, Vomiting, Repletion of the Sto⯑mach, or any Compreſſion of the Muſcles of the Abdomen, by render⯑ing the Faeces or Urine. The Breath⯑ing is extremely quick, ſuffocating, [342] and ſeems to be perform'd only by the Motion of the Breaſt: It is like⯑wiſe attended with a Delirium, Fury, and an involuntary Laughter, the Convulſion emulating this Mo⯑tion.
This Diſeaſe terminates as Pleuri⯑ſies and Peripneumonies, but is ge⯑nerally 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 ſuc⯑ceſsful, 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 Mo⯑tion 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 dange⯑rous, 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 Fat⯑neſs. Fat diſſolv'd by Heat and In⯑flammations obſtructs the Veſſels of the Liver very ſuddenly. Cattle fat⯑ted by good Paſturage, after violent Motion, ſometimes die ſuddenly; in ſuch the Liver is found to be in⯑flamed and corrupted. An atrabila⯑rian aduſt Temper of the Blood and Gall, an acrimonious or purulent Matter, ſtagnating in ſome other Or⯑gan, 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, be⯑ing ſuddenly chill'd by cold Air, cold Water, or drinking cold Liquors after great Heat; Vomits given injudi⯑ciouſly, when the Liver is already unſound, which if they do not re⯑move the Obſtruction, exagitate the Liver too much; inveterate hypo⯑condriacal Diſtempers. All theſe Cauſes may produce Inflammations of the Liver.
In ſuch a Caſe, the Liver being ſwell'd compreſſeth the Stomach, Dia⯑phragm, and the neighbouring viſ⯑cera of the lower Belly, ſtops the Circulation of the Juices, the Gene⯑ration and Excretion of the Gall, and all Digeſtion; produceth an In⯑finity of bad Symptoms, the Jaun⯑dice, 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 Dige⯑ſtions which are made there. A Fe⯑ver, 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 inflammato⯑ry Diſpoſition of the Liver.
This Diſeaſe ends as other Inflam⯑mations, being cur'd either by Reſo⯑lution, Concoction, and Excretion of the morbid Matter, terminates in an Abſceſs, Schirrus, or Gangrene.
During the firſt State, a warm Re⯑gimen 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, Bath⯑ing and Frictions, relax, and render the Matter fluid; Honey, with a lit⯑tle [346] Rheniſh Wine, or Vinegar; the Juices and Jellies of ſome ripe Gar⯑den Fruits; and thoſe of ſome lacteſ⯑cent papeſcent Plants, as Endive, Dandelion, Lettuce, are reſolvent.
Violent Purging hurts, gently re⯑laxing the Belly relieves, Diluents with nitrous Salts are beneficial, or Tamarinds boil'd in warm Water or Whey; bloody Stools, not in an ex⯑treme 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 car⯑ried off by Urine, and therefore Di⯑ureticks not highly ſtimulating, are proper.
Sweating ought not to be promo⯑ted by warm Cordials, but encourag'd by warm diluting Liquors.
It is a deplorable Caſe when the Inflammation terminates in a Suppu⯑ration, unleſs the Abſceſs points out⯑wardly, [347] ſo as it may be opened; for if the Pus be evacuated into the Ab⯑domen, it produceth diſmal Symp⯑toms, Putrefaction, or an incura⯑ble 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 cada⯑verous Smell, attended with great Thirſt; if it is carried downward, it occaſions a purulent colliquative Di⯑arrhoea; acid Subſtances relieve moſt in this Caſe.
This Diſeaſe may happen to pro⯑duce a Cancer, or Schirrus; one can⯑not ſay that the laſt is abſolutely in⯑curable, 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 neceſ⯑ſary 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 ſwallow⯑ing any thing, ſucceeded with Vo⯑miting; a painful Hickup, and great Anxiety. The Cauſes of theſe Symp⯑toms are thoſe common to all In⯑flammations, 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 Reſo⯑lution 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 be⯑neficial in other Inflammations, ir⯑ritate too much; Vomits, all Cor⯑dials 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 Inflamma⯑tion; a thin Gruel of Barley, Oat⯑meal, 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 Impoſt⯑hume, Honey, and even Honey of Roſes, taken inwardly, is a good Cleanſer, and Decoctions of Com⯑frey Roots, healing; ſpeedy and plentiful Bleeding, Fomentations, and Clyſters, have the ſame good Effect as in other inflammatory Diſtem⯑pers.
The ſame Regimen is neceſſary in a Schirrus, or Cancer of the Sto⯑mach; though nothing will be quite effectual.
The ſame Regimen is to be ob⯑ſerved in the Inflammation of the Spleen, Caul, Pancreas.
Inflammation of the Guts.
The Inteſtines or Guts, moſt fre⯑quently the ſmall ones, may be in⯑flam'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 Stop⯑page of the Paſſage; a vehement fix'd burning Pain, irritated by things ta⯑ken inwardly, when any thing touch⯑eth the affected Part, it excites Vo⯑miting, ſharp griping Pains, with Wind in other Parts of the Bowels; the Conſequences of ſuch an Inflam⯑mation are an Ileus, what is com⯑monly called the Twiſting of the Guts, but is really either a Circum⯑volution or Inſertion of one part of the Gut within the other. All theſe Symptoms are attended with a Fe⯑ver.
It is of the utmoſt Importance to know what the Cauſes of Colicks are; for as they are various, the Re⯑medies in one Caſe are quite oppo⯑ſite 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 Poi⯑ſon in an inflammatory one; they may be diſtinguiſh'd by the Fever, high Pulſe, Thirſt, and flame-co⯑lour'd Urine attending the Inflam⯑mation, as to the Heat, tho' it is great likewiſe by the Violence of the Pain, the Extremities grow cold; be⯑ſides, 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 Bow⯑els very ſoon.
Beſides a copious Bleeding, there is hardly any other Method but fo⯑menting and relaxing the Bowels by emollient tepid Liquids, both taken by the Mouth and by Clyſters, in⯑jected hourly; yet it has been known by Experience, that Acids have re⯑lieved 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 ſuppu⯑rates, it admits of a Cure, then it can be reach'd by proper Medicines in the Form of Clyſters; in the lat⯑ter end of ſuch a Caſe Chalybeat Wa⯑ters 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 Abdo⯑men, producing all the Symptoms which happen in the Impoſthumation [354] of the Liver, or into the Cavity of the Inteſtines, and cauſing a puru⯑lent Bloody-Flux, and often a Con⯑ſumption, 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 Excre⯑ments, as Broths of Fleſh-Meat, with Scorzonera, Parſley, or Fennel boil'd in them; Goats Whey is likewiſe ex⯑cellent; fat and oily Subſtances ge⯑nerally hurt.
The Continuance of the Fever, clammy Sweats, Paleneſs, an ichoroſe Diarrhoea, foetid, black, or like the Waſhings of Fleſh, a ſmall intermit⯑ting Pulſe, and at laſt a total Ceſſa⯑tion of Pain, are Signs of a Gan⯑grene 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 increaſ⯑eth 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 Hu⯑mour, they may affect every Part of the alimentary Duct, except the thick Guts; they often ſucceed Fevers, eſ⯑pecially thoſe that inflame the Inte⯑ſtines, or are attended with a Looſe⯑neſs; 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 begin⯑ning 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; after⯑wards the Food ought to be nouriſh⯑ing, detergent, Panadas with Bread and Water, Bread and Milk, Ho⯑ney 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 Sub⯑ſtances.
Inflammations of the Kidneys.
[357]The Kidneys are ſubject to Inflam⯑mations 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 ſome⯑times totally ſuppreſs'd, in ſmall Quantity, high colour'd; and which is worſe, ſometimes quite pale, with⯑out 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 vio⯑lent [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 Uri⯑nary Canals, Heat, hard Riding, too great Fulneſs of Blood, but eſpecially ſharp and forcing Diureticks: Laſt⯑ly, Spaſms and involuntary Contrac⯑tions of the Veſſels of the Kidneys.
Coffee-colour'd Urine is not a dan⯑gerous 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 Expul⯑ſion of Gravel or a Stone after great Pain; pale Urine is a Symptom of a more laſting and dangerous Di⯑ſeaſe.
After plentiful Bleeding, and a careful avoiding of all ſtimulating Diureticks, which in this State of the Diſeaſe will increaſe it, the Expul⯑ſion of the obſtructing Cauſe muſt [359] be promoted by emollient and ſoft Liquors drank plentifully, by Cly⯑ſters of the ſame frequently injected, by Bathing and outward Fomenta⯑tions, by opiat and anodyne Sub⯑ſtances, which ſtupify and relax the Fibres; thoſe Liquors muſt be ſwal⯑low'd down notwithſtanding the con⯑tinual 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 Sub⯑ſtances, as with Juice of Limon, Ju⯑niper-Water, [360] and ſome diuretick Syr⯑rup; 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 incu⯑rable.
It happens ſometimes to end in a Fiſtula, with which the Patient may live many Years in no great Uneaſi⯑fineſs. 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 inter⯑mitting Pulſe, Hickup; no Urine, or in ſmall Quantity, black and foe⯑tid, are Signs of a Mortification and approaching Death.
The Regimen of ſuch as are ſub⯑ject to nephritick Symptoms may be in ſome meaſure taken from what is above-mentioned.
Such ought to be extremely care⯑ful of the choice of their Liquors; ſharp Wines which abound with Tartar, are hurtful; Malt Liquors, not hard, nor ſtale, are certainly bet⯑ter to make uſe of; ſome of the ſofteſt Diureticks mentioned Chap. I. No 15. to avoid acrimonious Sub⯑ſtances in their Aliment, uſe mode⯑rate 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 inter⯑nal, 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 Peo⯑ple are ſubject to Conſumptions, and ſhort-neck'd to Apoplexies, tho' this Rule is not generally true; a groſs, ple⯑thorick, fat, phlegmatick Conſtitu⯑tion; [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 momenta⯑ry Loſs of the Eye-ſight; an inflam⯑matory and coreaceous Thickneſs of the Blood, preceded by a Fever, at⯑tended with the Head-ach, Redneſs of the Face and Eyes; Old Age, at⯑tended with a glutinous, cold, ca⯑tarrhous, leucophlegmatick Conſtitu⯑tion; in ſuch, the Forerunners of an Apoplexy are Dulneſs, Inactivity, Drowſineſs, Sleepineſs, Slowneſs of Speech and giving Anſwers, Verti⯑goes, Tremblings, Oppreſſions in Sleep, Night-Mares; Weakneſs, Wa⯑teryneſs, and Turgidity of the Eyes; pituitous Vomiting, laborious Breath⯑ing upon the ſmalleſt Motion; what⯑ever 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, Tu⯑mours 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 Ven⯑tricles of the Brain (which is the moſt common and immediate Cauſe of Apoplexies) violent Paſſions and Affections of the Mind. The im⯑mediate Forerunners of an Apo⯑plexy are commonly a Vertigo, Staggering, Loſs of Memory, Stu⯑por, Sleepineſs, a Noiſe in the Ears, and a more deep and laborious Breathing; thoſe laſt Symptoms com⯑monly precede an Apoplexy, but they are likewiſe common to it with other nervous and hyſterical Diſtem⯑pers.
Attention to the foremention'd Symptoms affords the beſt Cautions and Rules of Diet by way of Pre⯑vention; [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 impoſ⯑ſible to reſolve a great one, the gen⯑tleſt Kind of this Diſeaſe is often ta⯑ken 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-men⯑tion'd; frequent and copious Bleed⯑ing; 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; Vomit⯑ing may prove extremely pernicious, but the Regimen is to be varied ac⯑cording 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 Conſtitu⯑tions is proper; fat and phlegma⯑tick People, who are very ſubject to this Diſeaſe, ought to attend to the Rules preſcribed in their Caſe; and as there are Apoplexies from invete⯑rate Gouts, the Regimen of ſuch muſt be different from both, the Intention being to tranſlate the mor⯑bifick 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 Fe⯑ver, 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 Mo⯑tion, and remains in the ſame Po⯑ſture [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 Lethar⯑gy is a lighter ſort of Apoplexy, and demands the ſame Cure and Diet as an Apoplexy from a phleg⯑matick Caſe, ſuch being the Conſti⯑tution of the Lethargick.
CHAP. IV.
Rules of Diet in CHRONICAL DISEASES.
Palſy.
A PALSY is an Immobility of a Muſcle from Relaxation, in⯑ſuperable by the Will or any Endea⯑vour 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 In⯑eptitude to Motion from too great Tenſion, and a Relaxation of a Muſcle, muſt produce a Spaſm in its Antagoniſt, becauſe the AEquili⯑brium 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 Apo⯑plexy, an Epilepſy, extreme and laſt⯑ing Pains, the Suppreſſion of uſual Evacuations either natural or mor⯑bid, Tranſlations of morbific Mat⯑ter in acute Diſtempers; whatever diſtends, diſtorts, compreſſes, or contracts the Nerves; ſtrong and [369] ſtrait Ligatures, Luxations, Frac⯑tures, any Inflammation in the Inte⯑gument, or membranaceous Sheath of a Nerve, eſpecially in the Ganglia, where they are tied together; Serous Defluxions, Exceſs in aſtringent Ali⯑ment, eſpecially unripe Fruits; drink⯑ing too much warm Water, which is weakning and relaxing; Exceſs in Coffee, or Tea; extreme Heat; extreme Cold; poiſonous Vapours of Arſe⯑nick 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, be⯑cauſe [370] ſuch is neceſſary to diſpel the Viſcoſity. Of Vegetables, ſoapy; of ſuch as conſiſt of an acrid, vola⯑tile Salt and Oil, Muſtard, Horſe-Radiſh, &c. ſtimulating by Vomits, Sneezing, relaxing the Belly, purg⯑ing 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 ſome⯑times an hereditary or family Diſpo⯑ſition from Parents; a ſudden Fright of the Mother when with Child of the Patient; an Affection of the Brain by a Contuſion; Abſceſs, acri⯑monious 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 Ir⯑ritations of the Nerves in any Part of the Body; eſpecially by ſomething acrimonious in the Stomach or Bow⯑els, by Worms, by Teething, and Acidity in the Stomach in Infants; by ſome Contagion or purulent Mat⯑ter after acute Diſeaſes; Suppreſſion of uſual Evacuations, the Menſes, Haemorroids; hyſterical Affections con⯑tracted 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 Symp⯑toms and Effects, the worſt of which are a weakening and perhaps an A⯑bolition [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, accord⯑ing to the Cauſe; Bleeding, and plentiful Evacuations, when there is a Plethora or inflammatory Diſpoſi⯑tion in the Brain; Aliments without Acrimony, demulcent, avoiding every thing which ſtimulates, taking ſuch things as are oppoſite to the particu⯑lar Acrimony which cauſeth the Diſ⯑eaſe, relaxing the Belly without irri⯑tating; 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 Sto⯑mach, generally anti-acid Subſtances relieve; if they are not flatulent, ſe⯑veral 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 era⯑dicate it by Suppuration.
The common Cuſtom of apply⯑ing ſtimulating things, as volatile Salts and Spirits to the Noſe, during the Fit, is generally ſpeaking perni⯑cious.
Epilepticks ought to breathe a pure Air, unaffected with any Steams, even ſuch as are very fragrant. Their Diet ought to be nouriſhing, of ea⯑ſy 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 un⯑uſual thing is a Stimulus; but of all things the moſt neceſſary is the avoiding the Occaſions of violent [374] Paſſions, and keeping themſelves chear⯑ful.
Melancholy, Madneſs.
The Conſtitution which diſpoſeth to ſuch a State, the Cauſes, Symp⯑toms and proper Regimen in it is deſcrib'd Chap. II.
This being a Diſeaſe more terrible than Death, extremely obſtinate, in⯑vading ſometimes by inſenſible de⯑grees, and hard to be cur'd when it has taken place, the Approaches to⯑wards it ought to be carefully ob⯑ſerv'd.
Theſe are commonly obſtinate Watchfulneſs, or ſhort Sleeps, trou⯑bleſome 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 Taciturni⯑ty; 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 Se⯑cretions difficult and ſparing; the Intention therefore ought to be to render the Humours fluid, move⯑able, 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; where⯑ever there is any Uneaſineſs or Sen⯑ſation 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 Purg⯑ing.
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 Inhabi⯑tants of cold Countries, and amongſt thoſe, ſuch as inhabit marſhy, fat, low, moiſt Soils, near ſtagnating Water, freſh or Salt; invading chief⯑ly in the Winter ſuch as are Seden⯑tary, or live upon ſalted and ſmoak⯑ed 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 Quan⯑tities, 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 Co⯑lours, red, violet-colour'd, yellow, livid; ſometimes an ill Smell in the Mouth, painful and bleeding Ero⯑ſions of the Gums, and by theſe the Teeth growing bare and looſe; Hae⯑morrages of all kinds, Ulcers; un⯑tractable, eſpecially in the Legs, with a gangrenous Appearance in the Skin; the Itch; a dry cruſty Eruption, and ſometimes a ſmall degree of Lepro⯑ſy in the Skin; the Blood, when let, black, grumous, the red part without a due Conſiſtence; the Serum ſaline, and of a yellowiſh Green; wander⯑ing 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 ac⯑cording to the Cauſe, demands very different and oftentimes oppoſite Re⯑medies. See Part Firſt, of acid and alkaline Conſtitutions.
The Scurvy of Mariners is gene⯑rally 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 Symp⯑toms are attended with a Foetor of any kind, either in the Urine, Mouth, Breath, with Drought, Heat, Hae⯑morrage 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 ef⯑fectual.
[380] If the Scurvy be entirely muria⯑tick, 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 Suc⯑ceſs, but tempered with Acids, as the Juice of Oranges and Limons; and the Pot-Herbs which are anti⯑acid in this Caſe are a proper Diet; but if there be a high degree of Heat and Inflammation, the hot An⯑tiſcorbuticks will do hurt.
If the Patient be pale, cool, with⯑out Thirſt, with pale or natural co⯑lour'd Urine, with a previous Diet of aceſcent Subſtances, the Erup⯑tions not of a high inflammatory or livid Colour, the warm Antiſcorbu⯑ticks, 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 ſcor⯑butick Conſtitutions; lenitive Sub⯑ſtances 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, pro⯑ceeding from Weakneſs of the Fi⯑bres, and an Abuſe of the Non⯑naturals, and often from ſevere acute Diſtempers: It ſometimes diſpoſeth to Conſumptions, ſometimes to Leu⯑cophlegmacy, [382] Bloatedneſs, and Drop⯑ſies; it is attended often with Palpi⯑tations 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 pre⯑vented, 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 Acrimo⯑ny, and too great a projectile Mo⯑tion, 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 cor⯑roding 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 Extravaſa⯑tion 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, Short⯑neſs of Breath, Fluſhing in the Face, a Cough, hectick Fever, but eſpeci⯑ally Rigours and Chillineſs invading irregularly, with Weakneſs, one may be ſure that there is a Suppura⯑tion.
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 in⯑craſſating and ſtyptick Subſtances work univerſally, but they would hurt the Lungs if given before the Veſſels are empty'd. Balſamick Sub⯑ſtances 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 vio⯑lent Motion, or any thing that puts the Lungs upon a Stretch. Acri⯑mony [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, gene⯑rally ſpeaking, proceed from a ſcro⯑phulous Diſpoſition; in the firſt Ac⯑ceſs 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 Inflam⯑mation of the Lungs, which may be known from a Weight upon the Diaphragm, Oppreſſion of the Lungs, a Difficulty of Breathing, and Ina⯑bility to lie on one Side (which is that which is found) a perpetual Cough and Fever, with Thirſt, Fluſh⯑ing of the Cheeks, Weakneſs, and Decay of Appetite.
The Cure of ſuch a Caſe is chi⯑rurgical, by opening the Side; if the [387] Ulcer is not broke, it is com⯑monly call'd a Vomica, attended with almoſt the ſame Symptoms as an Empyema, becauſe the Vomica com⯑municating 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 in⯑to the Larynx, with the danger of Suffocation; or inwardly, and the Matter may by degrees be expectora⯑ted. The Event of the Diſeaſe de⯑pends upon the Symptoms, eſpeci⯑ally 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, vulnera⯑ry, and not drying or hot, but con⯑ſiſting 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, Vine⯑gar, and Honey, is proper and deter⯑gent; 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 attend⯑ing Conſumptions are generally fatal Symptoms, but muſt be reliev'd by a Diet proper in theſe Caſes, not in⯑terfering with what is formerly ad⯑vis'd.
[389] Conſumptions are induc'd by Pu⯑rulency in any of the other Viſcera; the Regimen muſt be very near the ſame as in the Pulmonary.
Dropſy.
This Diſeaſe is commonly an Ex⯑travaſation of Serum receiv'd in ſome Cavity of the Body; I ſay com⯑monly, for there may be a Dropſy by a Dilatation of the ſerous Veſ⯑ſels, as that in the Ovarium, where⯑in 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 gene⯑rally fatal in Infants, when the Su⯑tures [390] are clos'd, and the Skull will yield no more.
A Dropſy of the Breaſt is attend⯑ed 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, extrava⯑ſated 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 Wa⯑ter in the Abdomen. 1. In the Du⯑plicature of the Peritonaeum. 2. Be⯑tween the Peritonaeum and the Bow⯑els. 3. When the Water is contain⯑ed 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 Ten⯑ſion [391] is from Air, it is eaſily diſtin⯑guiſh'd by the Specifick Gravity of the Patient, and ſo is Water.
When the Lymph ſtagnates, or is extravaſated under the Skin, it is cal⯑led 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 ex⯑hal'd, produceth a Dropſy: Any Stoppage of the Circulation will pro⯑duce a Dropſy, as by ſtrong Liga⯑ture, or Compreſſion.
The moſt common of theſe Cauſes are an hereditary Diſpoſition; ſwil⯑ling down great Quantities of cold watery Liquors, which are not void⯑ed; violent acute Diſtempers; ſtub⯑born Obſtructions of the Viſcera; the Jaundice, obſtinate intermitting Fevers, Bloody-Fluxes; great Evacu⯑ations, eſpecially of Blood; Aliment [392] viſcous and of hard Digeſtion; inve⯑terate Scurvies; but the moſt com⯑mon of all is the habitual and co⯑pious Uſe of fermented and ſpiritu⯑ous Liquors.
The Effects are a Swelling of the Legs at Night by degrees, ſtill aſ⯑cending 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 Bow⯑els, producing moſt diſmal Symp⯑toms.
The beſt Cautions and Rules of Diet may be taken from the Enu⯑meration of theſe Cauſes and Ef⯑fects.
The Intentions to be purſued are, removing the Cauſes, as Ob⯑ſtructions, [393] diſſolving the Viſcoſity or Tenacity of the Lymph, and eva⯑cuating 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 Sub⯑ſtances; 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 indi⯑cate the Uſe of Acids, Juice of Li⯑mons, 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 Putre⯑faction, which is the Effect of acri⯑monious Serum.
The Drink ſhould be ſparing; but foraſmuch as the Thirſt is ſometimes intolerable, the Patient may be in⯑dulg'd [394] the free Uſe of Spaw-Water and Rheniſh Wine.
The Aliment ſhould be dry, diu⯑retick. 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 Phyſi⯑cian.
Nothing is more beneficial than ſtrong Frictions of the Skin, which attenuate and promote the Circula⯑tion of the ſtagnating Serum.
Vomiting, in ſtrong Conſtitu⯑tions, has prov'd often very effec⯑tual, for the Concuſſion of the ſolid Parts diſſolves and diſpels the ſtagna⯑ting Humours; and even Clyſters of proper Ingredients are very benefi⯑cial.
Violent Purgers, by diſſolving the Blood, have prov'd often pernicious.
Many have been cur'd by Abſti⯑nence from Drink, eating dry Biſ⯑cuit, 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, allow⯑ing Spices and generous Wine, and eſpecially the Uſe of Chalybeat Wa⯑ters, Abſtinence from other Sorts of Liquids, dry Food and Vegetables, aſtringent, Exerciſe, eſpecially Riding; and in general, ſuch a Diet as ge⯑nerates 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 Symp⯑toms, as they are oppoſite to that alkaline Putrefaction.
Gout.
This is a Diſeaſe which may affect any membranous Part, but common⯑ly 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 great⯑eſt, and the Senſation of Pain by the Obſtruction of the ſmall Veſſels and Dilaceration of the nervous Fibres ex⯑treme.
The moſt common Seat of it is in the Foot, its Tendons, Nerves, Membranes, Ligaments, and Perio⯑ſtea, or Membranes inveſting the Bones.
The moſt common Cauſes of it are an hereditary Diſpoſition (which operates more ſtrongly in this Diſ⯑eaſe than in any other) a too rich and high Diet, and too copious Uſe of Wine and other ſpirituous Li⯑quors, 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 be⯑ing 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 ſeden⯑tary 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 Fi⯑bres 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 ne⯑ceſſary 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 con⯑ſtant and regular Returns of it in ſome People, and their Freedom from it after the Morbid Matter is ex⯑hauſted; it looks as there were regu⯑lar Accumulations and Gatherings of it, as of other Humours in the Bo⯑dy, growing perhaps in ſome People as Corns.
As one of the Cauſes of the Gout is the Suppreſſion of Sweat and Per⯑ſpiration, the procuring a due de⯑gree of theſe ſeems to be the beſt Pre⯑ventive 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 ſup⯑preſs Perſpiration.
Violent Purging, in Abſence of the Paroxyſm, by agitating the Hu⯑mours often hurts, and during the Paroxyſm, may draw the Gout in⯑wardly.
The beſt Diet is Abſtinence from acid Subſtances; the moderate uſe of [399] ſuch as promote Perſpiration, as Sub⯑ſtances 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; Modera⯑tion 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 Ap⯑plication 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 Evacu⯑ations, us'd in an original Diſ⯑eaſe, 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 Ca⯑taplaſms and Plaiſters; therefore when any Gouty Perſon is diſappointed of a Paroxyſm which he expected by the Seaſon, or the previous Symp⯑toms, and inſtead of it is ſeiz'd with another Diſeaſe, let him ſpeedily conſult his Phyſician.
If a Gouty Perſon can bring him⯑ſelf intirely to a Milk Diet, he may ſo change the whole Juices of his Bo⯑dy as to eradicate the Diſtemper.
The Approach of a Fit of the Gout is eaſily known by the inward Diſorders, as Wind, Sickneſs, Cru⯑dities in the Stomach, a Drowſineſs, [401] theſe join'd with the Seaſon or Wea⯑ther, if ſuch a one by a ſtatical En⯑gine could regulate his inſenſible Perſpiration, he might often by re⯑ſtoring of that, foreſee, prevent, or ſhorten his Fit.
Greenſickneſs, Obſtructions.
The Symptoms of this Diſeaſe are evident, a due Age of the Pa⯑tient, with an Obſtruction of the Menſes, a Fulneſs, ſometimes Pains about the Loins, a Lazineſs, Inac⯑tivity, 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 up⯑on the leaſt Motion, a livid Circle about the Eyes, Dizineſs of the Head, ſometimes an Appetite of odd things, as Chalk, Tobacco⯑Pipes, proceeding from an Acidity [402] in the Stomach, a Paleneſs of the Face and Skin, unnatural Haemor⯑rages 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 ob⯑ſtructed have not always the fore⯑mention'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 ma⯑ny other dangerous Diſeaſes, and af⯑ter ſix Months hardly to be cur'd.
What is to be conſider'd in this Caſe, is chiefly, if there be a ſuf⯑ficient 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; Ex⯑erciſe, Frictions, Bathings, Clyſters, [403] Fumigations often repeated are ve⯑ry beneficial.
Subſtances abounding with vola⯑tile oily Salts, Subſtances ſaponace⯑ous, aromatical, as thoſe Vegetables which abound with a volatile Oil.
When there is not a ſufficient Plethora, a Diet wholeſome, plenti⯑ful, and nouriſhing, at the ſame time ſtrengthening the Organs of Digeſtion, is often effectual.
After Relaxing, ſuch Subſtances as ſtrengthen the ſolid Parts in ge⯑neral, are beneficial; it is by this Quality that Steel operates ſo ſtrong⯑ly 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 Mat⯑ter; and Secondly, by expelling it out of the Body; it may be digeſt⯑ed by the Infant by Abſtinence from Sucking for ſeveral Hours; Honey and Water, with a little Wine, at⯑tenuate and diſſolve; and ſome gen⯑tle purging Syrup, as Syrup of Ci⯑chory with Rhubarb, expels the pec⯑cant [405] Matter; oily Subſtances are apt to turn rancid on the Stomachs of Infants; Clyſters and warm Fomen⯑tations, and other Applications of aromatical Subſtances to the Sto⯑mach and Belly, are uſeful in this Caſe.
Antiacids, eſpecially the Abſor⯑bents, are more effectual in the Diſ⯑eaſes of Infants than in any other.
Opiats and anodyne Subſtances are dangerous.
Volatile Salts are hurtful to Infants, being too active, and operate ſome⯑times 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, Vomit⯑ing, 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 up⯑on Subſtances on which Infects de⯑poſite their Eggs, eſpecially Fruits, they are often troubled with Worms, for want of a ſufficient Force of Di⯑geſtion to deſtroy theſe Eggs.
The moſt common Sort in Chil⯑dren 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 Fea⯑ther in the Throat, a Vomiting, Looſeneſs, Fainting, a feveriſh Diſ⯑poſition, 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 perfo⯑rate the Guts.
Children ſubject to Worms ought not to live much upon Milk, Cheeſe, or ripe Fruits, nor take much Su⯑gar; ſome Inſects lay their Eggs in Sugar.
The Gall of Animals, and Mer⯑cury, 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 a⯑mong 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, Cora⯑line, Coral powdered, Fiſh Bones. See Chap. I.
[408] Above a tenth Part of Infants die in Teething, by Symptoms pro⯑ceeding 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 Teeth⯑ing appear, the Gums ought to be relax'd by ſoftening Ointment, the Jaws fomented with emollient De⯑coctions, and the whole Head to be kept warm; when the Teeth is rea⯑dy 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 plen⯑tiful Diet, without Exerciſe; and Children born healthy, often con⯑tract the Diſeaſe from an unwholſome Nurſe.
A Diet of farinaceous Subſtances infermented, as of Pudding, much Butter, wet or ill-air'd Linen, cuta⯑neous 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 en⯑large, and ſo does the Head it ſelf, the Bones grow crooked; theſe are the outward Appearances, the Con⯑ſtitution of the inward Parts is often much worſe.
It is highly probable that this Diſ⯑eaſe proceeds from a redundant Aci⯑dity, becauſe Vinegar will ſoften and crook tender Bones; and this Symp⯑tom 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 fermen⯑ted Liquors, but it is not an Experi⯑ment that I would adviſe.
Frictions of the Back-bone and Joints with Flannel, ſmoak'd with pe⯑netrating aromatical Subſtances, and fomenting the Joints with old Malaga Wine, have prov'd often very effec⯑tual.
[412] They ought to uſe as much Exer⯑ciſe as they are capable of, but eſpe⯑cially by Voiture or Carriage. Care muſt be taken to open the Obſtruc⯑tions 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 Sub⯑ject 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 Pa⯑tient, 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; ma⯑ny 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 dan⯑gerous as the Fluids are more ex⯑alted and diſſipated, and the So⯑lids more ſtrict and compacted, and conſequently more ſo as People are advanc'd in Age.
[414] This Diſeaſe may be eaſily com⯑municated by the Contagion or Steams of an infected Perſon ſwim⯑ming 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 Quanti⯑ty of the Matter mix'd with the Blood produceth the Diſeaſe, tho' not ſo quickly as thoſe volatile Steams.
The firſt Symptoms are a Chil⯑neſs, Rigor, ſucceeded by a Fever and conſtant Heat, a certain Splen⯑dor 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, notwithſtand⯑ing 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 com⯑ing, and the ſmaller when it comes, the Diſeaſe is leſs dangerous; there⯑fore all the Methods prractis'd in the beginning of inflammatory Diſ⯑eaſes are here neceſſery, with a par⯑ticular Care of cleanſing the ali⯑mentary Duct by Vomiting and Clyſters, the Impurities of which will be carried into the Blood.
There is not yet found any par⯑ticular 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 Ul⯑cerations are very manifeſt.
Bleeding, which is extremely uſe⯑ful in the beginning of the Diſeaſe, is not ſo proper and uſeful when it is advanc'd.
In the firſt Stage the whole Ha⯑bit of the Body ought to be re⯑lax'd, a free Perſpiration thro' the Skin, without violent Sweating, pro⯑moted; the Viſcoſity or Toughneſs of the Fluids taken off by diluents; the alkaleſcent State of the Salts cor⯑rected; 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 Sub⯑ſtances, 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 Cover⯑ings of the Bed ſo thick as to pro⯑mote Sweat.
The Greatneſs and Danger of this Diſeaſe is eſtimated by the Quan⯑tity 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 Fo⯑mentations, 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 Acri⯑mony; and where the Circumſtances of the Patient require it, a Spoon⯑ful 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 Symp⯑toms of the Diſeaſe, as cleanſing, attenuating, expectorating; to pro⯑mote the Spitting, diuretick; when that is ſuppreſs'd, and Clyſters dilu⯑ent, without any Stimulus, frequent⯑ly injected, are beneficial in every Stage of the Diſeaſe.
When the Age, Temperament, high Pulſe, and eſpecially a Watch⯑fulneſs 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 im⯑pervious [419] by the Fluids; thoſe who die of this Diſeaſe have inward In⯑flammations, eſpecially in the Lungs; thoſe Reaſons ſeem to juſtify Bleed⯑ing.
Indeed the gangrenous Diſpoſi⯑tion which appears in the malig⯑nant 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 Hu⯑mours and increaſe the Fever.
Gravel, Stone.
A Stone or ſtony Matter may grow in any Part of a Human Bo⯑dy; 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 Evapora⯑tion 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 Chy⯑mical Trial, tho' in an inverſe Or⯑der.
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 in⯑ſpected 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 Concre⯑tions [421] happen in the Kidneys, and are expell'd or drop into the Ure⯑ters, it makes what we call Gra⯑vel; 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, vio⯑lent Motion, Pain in Stooping; Pain in the Thigh, Sickneſs in the Sto⯑mach, Colical Pains, various Changes in the Colour of the Urine, black, bloody, pale, occaſion'd by ſome⯑thing ſharp or ſcabrous wounding the ſmall Blood-Veſſels; if the Stone is ſmooth and well bedded, per⯑haps 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 on⯑ly 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 pro⯑ducing [423] this Effect has been try'd upon a Dog; and ſuch an Acci⯑dent 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 Blad⯑der, a Dribling, Difficulty, and a momentary Suppreſſion of Urine by the Stone, ſhutting up the Orifice of the Bladder, attended with a Te⯑neſmus, 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 gent⯑ly reſolve, as Parſley, Fennel, Scor⯑zonera, Saſſafras, Mallows, and Tea, Dandelion, Cichory, Oats, Barley, Honey, Honey and Vinegar; Ni⯑trous Salts, as Spirit of dulcify'd Nitre; the moſt ſoft cooling Dilu⯑ent of all, is Whey; the beſt Emol⯑lients are Decoctions of Marſhmal⯑lows, 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 Kid⯑neys too violent Exerciſe is dange⯑rous.
During the paſſing of a Stone, one ſhould avoid at firſt all ſtrong Stimulating; relaxing and lubrica⯑ting the Paſſages, and quieting the Spaſms by Opiats is certainly the beſt Method; and where Bathing cannot be conveniently had, Ox⯑Bladders, half full of warm Water, apply'd conſtantly to the affected Part may be uſefully ſubſtituted. Letting of Blood taketh off a Ten⯑ſion better than any thing, and is very neceſſary where the Symptoms are violent; when the Parts are ſuf⯑ficiently relax'd, ſtimulating Diure⯑ticks may be us'd more ſafely, eſpe⯑cially 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 bet⯑ter Diſſolvent.
The ſureſt way to hinder the Generation of a Stone, is to pro⯑cure a Diarrhoea by Whey, Broth, and a liquid Diet; and indeed what would not one do to prevent ſo pain⯑ful 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 cer⯑tain 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, in⯑to the Bladder.
Such as are ſubject to the Gravel or Stone ought to be careful of their Diet, to uſe ſuch Aliments as gene⯑rate 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 ſeve⯑ral 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 Ure⯑thra, 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 Diſ⯑eaſe, if not extracted. The Diet of a Patient in ſuch a Caſe is ſuch as of a wounded Perſon, nouriſhing, with⯑out Acrimony.
Let the Reader look into the Ar⯑ticle of Inflammations of the Kid⯑neys, where there are ſome Direc⯑tions proper for all who are ſubject to the Stone or Gravel.
Rheumatiſm.
The Diſeaſe ſeems to be an in⯑flammatory Diſpoſition in the ſerous Part of the Blood, affecting the lym⯑phatick Arteries, and therefore af⯑fecting thoſe Parts where the Veſſels are the narroweſt. The Blood, as in other inflammatory Caſes, is ſizy, the alkaleſcent Salts in the Se⯑rum [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 Vegeta⯑ble.
If there be a ſpecifick in Aliment is certainly Whey; I knew a Per⯑ſon ſubject to this Diſeaſe who could never be cur'd by any other Me⯑thod 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 alka⯑leſcent Salts in the Blood.
[430] In obſtinate Sciatical Pains, Bliſ⯑tering 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 Sub⯑ject in this Article, becauſe of many common People who cannot always have good Advice.
[]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
- Citation Suggestion for this Object
- 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