SOME REFLECTIONS UPON THE Modern Practisers OF PHYSICK, In Relation to the
SMALL POX.
Written for the particular Use and Perusal of the NOBILITY and GENTRY.
By
WALTER LYNN.
Filii Magnatum frequentius ex inutili remediorum copia, quam ex vi morbi pereunt, praesertim si àcutè laboraverint, &c. Paucis utaris, & cum prudentia.
Bagliv.
LONDON:
Printed for R. KNAPLOCK, at the
Bishop's Head
in St.
Paul
's Church-Yard. 1715.
THE PREFACE.
I Publish'd an Essay on this Subject the last Year; upon which some of the Faculty were pleas'd to pass this Judgment, That it was only written on purpose to diminish the Practice of the Physicians and Apothecaries in Town.
I here declare, That it was not written with that Design; tho' if it had, I believe it would not have been the less esteem'd by most Persons.
I have used in that Piece all Deference and Respect to the Good and Worthy Practisers of Physick at least: And if by Accident it may prove detrimental to the rest of the Faculty, or those that depend upon it, or rather (to take it in a right Sense) whom those latter Gentlemen are too much depending upon, it ought not, I presume, to be reckon'd as a Fault of mine.
The Reosons and Design of that Piece I have deliver'd very plainly in my Preface to it; and how far suiting to such a Design the Work it self was, is given in the Judgment of those two very
Learned
and
Unprejudic'd
Persons I have mention'd towards the latter End of this.
The Fault, as I am inform'd, of that other Piece, was, in my not being open and plain enough: But from henceforward I shall be more free in declaring my own, and others Sentiments, upon this Subject; of which I here give the Reader the following short Specimen.
SOME REFLECTIONS UPON THE
Modern Practisers of Physick,
In Relation to the SMALL POX.
S YDENHAM
Sydenham
was both a great Admirer and Follower of
Hippocrates.
The first is most apparent in those Passages of his Preface, where he tells us,
That
Hippocrates,
who arriv'd to the Top of Physick, laid the solid Foundation upon
Nature cures Diseases. And again,
'Tis from the Ancients, and chiefly
Hippocrates,
we have receiv'd the best part of the
Therapeuticks; that is [the Art of administring to, or healing of the Sick:] So that both the true Theory and Practice of Physick was chiefly this great Writer's, in
Sydenham
's Opinion; and still more so, I judge, in his we are going to recount.
was a great Admirer of
Hippocrates;
nevertheless, we must not allow him to have been either the closest, or the most successful Follower of him; as will appear by the following Account I shall give of one that was his great Crony and Cotemporary; I mean the good Dr.
Mapletoft.
I had Occasion to wait upon this Reverend, and very Venerable Person the last Year, and to discourse with him something about the Small Pox, which was no uncommon Subject then, nor now, in
London.
He told me, That
he once thought he understood that Distemper himself;
for
in Six Years that he was a Practiser
(of considerable
He was President of the
College of Physicians.
Eminence in
London
)
he lost not one Patient by the Small Pox.
At length, he said, two or three died under his Hands; which (tho' there were other Physicians, whom he nam'd, employ'd with him in those Patients) it gave him that Concern, as to hasten the leaving off his Practice of Physick; which was gainful enough to him, being better worth than a Thousand Pounds a Year, as he assur'd me; and which he did not probably expect the same Profit from his Pains in Divinity, to which Calling nevertheless he said he had a greater Inclination than to the other: and during his Employment in Physick, was as constant in Publick Acts of Devotion as since.
This whole Relation was very much surprising to me; especially from one of his Character: The perfect Veracity of whose Words I could no ways scruple or make a Doubt of. And it gave me Occasion to enquire of him, what were his Ways or Methods in the Cure of the Small Pox. He very frankly told me, That his general Way, was to do nothing at all; That a Patient of his, when his Apothecary's Bill was brought in, it came but to Three Pence; another's, (which was accidently view'd by him at the same Time,) amounting to Ten Pounds: that Person died. This last Account was not altogether so surprising. But that the Doctor's good Success should continue for so many Years, when 'tis probable there were different Seasons and Constitutions of those Years, and some more dangerous than others to this Distemper, as well as has been since; that the Doctor's Method, the same I presume with
Hippocrates's, viz.
a proper
Diet was the first, the principal, and oftentimes the only Remedy, that
Hippocrates
made use of, to satisfie the greatest part of the Intentions we have touch'd upon. By these means he oppos'd moiss to dry; hot to cold: He added or supply'd what was deficient; and took off from what was superfluous,
&c.
And that that was to him the most considerable Point he supported Nature, and assisted it to overcome the Cause of the Malady▪ and in a word, put it in a Condition to do of it self what was necessary for the Cure of Distempers, says
Le Clark,
p. 273. of the
History of Physick;
and 'tis confirm'd in
Hippocrates
's Books
De Morbis,
and in his
Epidemicks,
which were his Practice.
Diet prescrib'd, and a Regulation in the other
The Non-Naturals are Diet, Air, Sleeping or Watching, Evacuation or Retention of Excrements, Exercise or Rest, and Passions of the Mind.
Non-Naturals, should so infallibly succeed, when a Multitude of Medicines then and since given by others has prov'd either ineffectual, noxious, or deadly, deserves a thorough Consideration: And before my Departure I could not forbear telling the Doctor my Sentiments, That the Practice of the Town seem'd to be far different from his. He confess'd it was so; and that the Physicians now made use of Bleeding, Blistering,
&c.
by which, they told him, they sav'd the Lives of many. I answer'd him, that I thought Matter of Fact was too plainly against their Practice; and if they sav'd the Lives of many, they destroy'd far more.
To all this, and likewise what
Sydenham
mentions concerning the Poor's generally escaping well in this Distemper, there can be, I think, but one plausible Answer given: which tho' it may be so to this latter of
Sydenham
's, yet can scarce be allow'd to the foregoing. 'Tis this; That whoever concerns himself with Physick, ought always to consider, that there is a very great difference in the Constitutions of most Persons, which makes the very same Distemper severe and dangerous to one, yet mild and very easy to to be born in another: that nothing appears more plainly than this Observation in the Small Pox. And from hence we are told, we ought to infer for a generat Reason, why the Poor, who use little or no Physick in this Distemper, yet commonly escape well in it: That it is from the lowness of their Diet, and their different ways of Living from the Rich; which causes their Bodies to be of another Nature, and not liable to the Virulency, or high Malignity of the Disease: But the Rich are subject to it, and therefore they must use Means, and all the Powers of Art to quell, lessen and destroy it in their Bodies, or to prevent it. And after all that can be done for them, if great Numbers of these latter miscarry in the Hands of their Physicians, notwithstanding their utmost Care and Medicines, 'tis not to be imputed to their Fault: for they cannot alter Nature so very speedily, and create a good and strong Constitution or Habit of Body, where it was not at all to be found in the Patient before. This has pass'd, with many, for a good Answer to what
Sydenham
has said, relating to the Poor's escaping better than the Rich, tho' they us'd no Physick, nor Methods of Art in the Small Pox; but will not serve, I think, to what Dr.
Mapletoft
's constant Practice prov'd,
viz.
that the same Methods being us'd to both, were successful alike; except we suppose he had no Rich Patients: which, after what I have but now related of him, 'twere a mere Absurdity to imagine.
This therefore is some Proof of what I hinted at in my Title-page and Preface; but shall make out more fully in a larger Piece concerning Physick's being grown in this Age too much an Art or Craft, it being us'd too much, and not to a right Intention, in the present Case before us.
But least I should be any ways mistaken, in either the receiving, or delivering of these Matters; or I may seem to my Reader to have over-weighted them with Consequences, which, in his Opinion, they will not so very well bear, I shall go on; and take a View of the other part of
Hippocrates
's Practice, in the Exceptions against his general Rule of Diet only. For so we may properly call them; Exceptions; being but few, and not to be met with in many Pages of his Works, especially of his Practice. 'Tis certain however, that he made use both of Evacuations, and other Means or Medicines, in Acute and Chronical Distempers: tho' not near so often in the former, as the latter: Nature being generally better able, of her self, to bring Matters to a Crisis without them. I design to consider several of these, but at present can only go upon one of them, without swelling this Piece to too large a Bulk: But 'tis pretty material, namely, the Evacuation of Bleeding; to see upon what Reasons or Tokens (scarcely upon slight ones)
Hippocrates
made use of it.
The first Indication in him, taken notice of by a certain Author
Le Clarke.
, who has undertaken to put them in Order, is a Plethora, or over-fulness of the Blood Vessels, in which Case, he used Bleeding to evacuate, or take away the Superfuity of what was in them.
This I own is highly requisite, where the Case by certain or very numerous Indications, is manifest. But where not, 'tis as indispensibly necessary to let alone or omit it: for by Bleeding we most certainly weaken Nature, if we do not relieve her. Nay, tho we do, as is most certainly known in many Cases, and ought to be well noted in Distempers that are both long and violent, as this we are now treating of, at present most commonly is.
But, say some of our Modern Practisers in defence of their own Ways and Methods, tho' not successful; The Gentry or rich Persons who have Plenty of every thing, are apt to indulge themselves to excess, and so must needs be full of Blood and Humours, which renders Evacuations necessary to them.
This Assertion I hold to contain very considerable Falsities; and to be most pernicious in its Consequences, as I shall make appear both by Reasons and Facts themselves. And for that purpose, shall enter upon a brief Consideration and Account of the general ways of living, both of the Rich and Poorer Sort, and what are the common Diet and Delights of both.
The common Diet both of those whose Circumstances are good and plentiful, as also of almost the meanest Mechanick here in
London,
is Butchers Meat, little differently dress'd, excepting some few, who delight in made Dishes, Sauces,
&c.
but neither in this nor in the variety of Courses, do the Generality of Wealthy Persons exceed those of the Poorer, or Commonalty, who dine at the Cooks Shops in
London.
This then can make no great Difference in their Constitutions, either for good or bad. We shall descend therefore to the
Deliciae,
the Entertainments of the Gentry, or richer Sort, amongst one another. In this there is a considerable Difference and Distinction of them from the meaner sort. The Entertainments of the First, where they give any in their Visits, being with Coffee, Tea, Chocolate, a Cup of Cordial Waters, or a single Glass of Wine, and the like. Now whoever considers these, and compares them with the good roast Beef, Ale and Cheese which the meaner sort, both in City and Country, are apt to set before their Friends or Visitors at all Hours, will think, there is no Comparison in the Substantialness of the Treat, and that the latter is much more likely to fill the Body with Blood and Humours, than the former. For to consider of Coffee, 'tis a noted Dryer up of the Blood and Humours; of Tea, the Green first, 'tis an Evacuator both by Urine and Sweat; this last by its own Heat, and by being drank in a fashionable manner, that is, in large Quantities and excessive hot. The Bohea Tea is something of another Nature, being reckon'd good in Consumptions by many: Yet no Person that I have met with, has complain'd of their growing too gross, bulky, or Plethorick by feeding on it, or that it put too much Blood in their Faces, as is the Complexion of those who too much abound with it. This might make it become altogether an unfashionable Liquor, which I do not hear that it is at least upon this account.
The third thing I have mention'd is, Chocolate; which tho' not so often us'd in Visits, is yet drank constantly by many; and this to be sure will be reckon'd an high Diet; Yet I cannot find, that those Persons, who take it (even in Bed, which way it should be most nourishing) are obliged to make use of any Evacuations, as bleeding, purging, vomiting once a Month, or Quarter, upon that account.
I need not mention the Nature or Effects of the other two Liquors, which People of Fashion and Sobriety, especially the Ladies, tho' they may taste of, yet we must believe 'tis sparingly enough. And as for those Genlemen, who make too free with their own Constitutions by an over-liberal Use of Wine and other Liquors, this does not always render them Plethorick, or too abounding with Blood, Spirits and Humours in their Veins and Nerves: such Persons rather wanting them, and even a natural Heat in their Bodies upon any Intermission of their usual Debauch. To these the greatest
This must not be taken to extend to an accidental Debauch or Excess, where it is not customary in young Persons; for in these latter the Blood is apt to swell and boyl up upon it, which may endanger bursting of the Vessels. In this Case we must use Bleeding, tho' with Caution.
Caution therefore ought to be us'd, how we too much impair their Spirits by any Exhaustion; when nothing but even a Riot can repair them again; so much is Custom a second Nature, and as hardly to be put off as the first.
These are but short Hints, which might be clear'd and enlarg'd upon very much: but such as they are at present, they are enough to shew, That this Supposal of a Plethora, or fulness of Blood in rich Persons, rather than in the poor, or middle sort, has no good Foundation. And another thing that may plainly convince us of this Mistake is, the very Countenances, as well as Shape of Body, of such as live nicely and delicately in the City, compar'd with those who live more hardily and in the Country: For in the first 'tis thin, pale, and without Colour; but in the other Sanguine and full: which made one of our best Poets, when he brings in two City-Ladies ridiculing the Country-Gentleman's ill-bred Daughters, to mention their being
Congreve's Old Batchelor,
Act 4. Scene 3.
Plump, Cherry-Cheek'd, and Fat as Barn-Door-Fowl:
which none doubts was naturally, tho' satyrically express'd in him.
I shall go not much farther, nor use many more Arguments at present in this thing; being not so far sway'd in my own Judgment and Opinion, (tho' grounded upon Reason and Observation) as to disbelieve there are any Plethorick Persons at all amongst the Rich; who may need Evacuations in the very beginning of this, as well as other Distempers: but I am nearly of Opinion, that there may at least as many be found among the poorer or middle sort of People, and of such as live upon a plainer Diet too, than any I have yet mention'd. I shall give the following Instances.
There was, some Years since, living in
Cotherstock,
near
Oundle
in
Northamptonshire,
a Family of the
Whiteings,
consisting of the Grandmother, three Grandsons and a Daughter. The four young Persons were pretty well grown up, when the eldest of them, about Nineteen, and a very lusty Youth, fresh and sanguine, fell ill of a Cold or Cough only; which being neglected, presently turn'd to a Consumption. Advice was at length call'd for him, when it was too late; but who gave it as their Opinion, That if he had been let Blood early enough, when he had only a Cough, and not a Consumption, or wasting of the Lungs and other Parts, he had avoided this fatal Distemper; which, in a short Time, carried him off.
About a Year after the second Brother, of much the some Habit of Body, and not yet quite at his full Growth, fell ill of the Small Pox, and was taken with an inward Bleeding, before the Distemper well appear'd; which carried him off speedily. The third Brother caught them of this last; and with the same Symptoms,
viz.
voiding bloody Urine, died likewise. Whilst he was yet unburied, the only now surviving Child, the Grand-daughter, of a clear, florid, and something sanguine Complexion, fell ill: and her they got presently blooded in the Arm; notwithstanding which, she had a most violent [Haemorrhage, or] Bleeding at the Nose; which lasted so long, till her Friends about her thought she would have expir'd by it; they having try'd several Things in vain to stop it. At length they bethought themselves of a very good Bloodstone; which being apply'd, the Bleeding immediately staid. The Small Pox however, notwithstanding this (one would think) cooling of the Blood by emptying, prov'd of the worst and most confluent Kind; yet she escaped with great Difficulty, and is alive at this Day.
What I introduc'd these Examples for, is to shew, that Persons either of a mean Estate, or that live almost as frugally as possible, may be over full of Blood and Humours. The Grandmother of these Persons, who was Manager and Provider of the Family, being noted for her Parsimonious Temper; and tho', I suppose, the House did not want for Necessaries, having Means to provide them, yet she allowed very little Superfluities either to her self, or Grand-children; their Diets being both plain and common. And as for those Refreshments of Coffee, Tea, Chocolate,
&c.
they were scarce at that time known in the Family, no more than Wine or Brandy, commonly us'd or permitted in it; yet these Persons seem'd manifestly Plethorick in their Constitutions, as I have shew'd; and perhaps they were the more inclin'd to be so, for living after their plain manner, and upon a low Diet. For I remember, that communicating these Cases, and some others, to an old Physician of my Acquaintance, he ask'd me if the foremention'd Persons fed upon a Milk-Diet. I told him, I could not directly affirm that was their constant Food: But that the Family kept a Dairy, and I suppos'd it might be a considerable part of it. This Physician told me, the Reason of his asking was, that he had observ'd Persons who voluntarily chose a Milk-Diet, and liv'd upon it, were generally more turgid and fuller flesh'd than others: which we may commonly observe of the poorer sort, who are not over-labour'd, and especially of their Children.
Another common Diet of the meaner sort is Cheese, which tho' reckon'd by some not to be a nourishing nor good Food, yet has been reputed otherwise by the most judicious. For we find there were so long since as in
Hippocrates
's Days, various Opinions about this Edible, as to the Wholefomness or Unwholesomness of it: which in one Place he ridicules, as only given by ignorant People at random, without considering the different Constitutions of Persons, who may feed upon it and find different Effects,
viz.
an Agreeableness or Disagreeableness of it. And he tells us, that for many
De Veteri Medicina, part. 37.
thin and lean Persons 'tis found good and wholesom Food: which argues that it someways nourishes, and fills up such Bodies.
Thus we see, that notwithstanding the suppos'd luxuriant and riotous living of the Rich, the Poor or Meaner Sort, both may and do, abound with Blood and other Juices, at least as much, or rather more, and as often as the former: and consequently may have as great Occasion for Bleeding, and other Evacuations, as those first. But that they do make very seldom any use of them, especially of Bleeding, I am pretty throughly persuaded; not only from their general and natural abhorrence to it, but a particular one in this Distemper of the Small Pox; which is so great, that I have heard more than one Person affirm, they would sooner admit a Dagger to their Hearts, than suffer it to be done upon any account in this Disease. Yet these are the same Persons that scape the best, as
Sydenham
observes, and suffer the fewest Miscarriages by it.
There is one thing however, which my most timorous Readers will be too apt to conclude from the foregoing particular Cases (two of which having prov'd mortal to all appearance for want of this Precaution of Bleeding, before Nature had forc'd her way by the secret Passages) which is that this inward Bleeding, being both a very common and dangerous Symptom, we ought to use a Fence and Precaution against it; and that nothing is so Good and safe as Bleeding at the Arm. I can agree with such a Person in none of these things. For first, were this both a very common and very fatal Symptom, Dr.
Mapletoft
must no doubt have often met with it, and not knowing how to cure, would have lost some of his Patients by it; which we do not find that he did, or by any other means, of a long time,
viz.
Six whole Years. If he had a certain Remedy for this Symptom, I do not question but he would have communicated it to the Publick long e're this; especially when he had left off his Practice. If we suppose he us'd the foremention'd Precaution, and blooded all his Patients in the beginning, the Supposition is very unreasonable; for this is far from doing
See P. 2.
Nothing.
'Tis too frequently doing Mischief, as I have shewn by some
See my Essay, p. 76, 77,
&c.
Arguments, and mean to do hereafter by more; but in the mean time shall consider something farther of this Symptom, and of a way to prevent or cure it.
This bad Symptom, as 'tis commonly and truely accounted, seems most incident to Persons of a pretty full, but lax Habit of Body; whose Fibres have not a true Strength, Tone, and Resistance, when any thing of Force or Violence is impress'd upon them. It seems to require too, that their Blood and Humours be not only pretty much abounding, but that they should be of a thin and watery Consistance. I speak this as not only knowing one of the three Persons aforemention'd, who had been my Patient, to have been of this Constitution, from certain Tokens plainly discovering both the Solids and Fluids to be so constituted; but the other two were in outward appearance, and upon this Tryal of the Distemper, as we see, inwardly affected almost the same. These things, together with another Remark I shall mention by and by, have made me take some notice of a Reflection Dr.
Lister
has thrown upon
Sydenham,
for his Method of using Dilutives,
viz.
Quantities of thin and small Liquors in this Distemper. He tells us, that this celebrated Author carried it to an Excess in that Point, and the Effect of it was, to his Knowledge, very often a voiding of bloody Urine. Dr.
Lister
was a Person of some considerable Practice, tho' far inserior to
Sydenham,
and upon whom he is too severe in his Reflections. Yet if his Experience (or rather
The Passage in Dr.
Lister
is,
Salivatio, addis, promovetur multa & tenui potatione; ita quidem, & interdum diarrhaea funesta, & micturitio tua mortifera: haec tibi in medicina facienda, scio saepius accidisse: at causam non vidisti; tantus tuarum hypothesium amer est.
prying Temper into the Miscarriages of others) discover'd this to him, 'twas very well the discovering it to the World; especially when
Sydenham
plainly shews himself at a loss upon this Symptom.
I cannot say my self that I have seen this Effect upon any one in the Small Pox: but I have seen a very sudden and apparent Diabetes, caus'd by a Person's only drinking a very large Quantity of Small Beer in the Paroxism or Fit of an Ague; which failing to be discharg'd by Vomit, as it had us'd to have been to the same Person, presently turn'd downwards, and the Patient had at least twenty discharges by Urine in less than twelve Hours: and with such a Prostration of Strength and Spirits, that Life seem'd to be in danger, before we could get proper Remedies in a Country-Village; which nevertheless this Distemper soon yielded to, when receiv'd; and the Person recover'd from the Ague and Diabetes, thus accidentally attending it, in a very few Days; there being no contrariety in the two Methods that I us'd for both. However, I have reflected upon it since; That if in such a Distemper as a common Ague, a Diabetes succeeded, by only thinning the Blood with too much Liquids, as is mention'd; In the Small Pox, which has a much greater Acrimony, the Blood it self, by corrosion of the Vessels, might be carried down with those Liquids the same way. I am therefore altogether for a Moderation in this, as well as in other Methods or Administrations for this Distemper, and not for large Quantities of Liquors to be given, except the Patient has been long and injuriously detain'd from them, so that the excessive Heat and Drought of his Body does absolutely require them: for then only they are both safe and useful. All this is by way of Precaution only against this Symptom of inward Bleeding; which, if due Care be taken, I mean, if no violent Methods, or ill Regimen has been us'd, in, or immediately before the Distemper, few Persons Constitutions, in my Opinion, would make them directly liable to it.
As for the Cure of it, I shall advise but to a seemingly slight and easy Method at Present, which was recommended to me by a Lady; one of a very generous and charitable Disposition, who visits equally both Rich and Poor in any Distress; and in one that her own tender Sex is only lyable to, when she makes a ready Visit, she tells me, she never goes unfurnish'd with an Herb call'd
Rosfolis,
or
Sun-dew;
which has this powerful Virtue to stop immediately the greatest Hoemorrhages or Fluxes of Blood, that often happen in those Cases, by hanging it in a Bag upon the Breast of the Person: and that its Force is so great, as to hinder the Evacuation of what is necessary and natural afterwards, if it be not removed in time: For which reason, she takes it off at the end of twelve or four and twenty Hours at farthest. This she assures me she has likewise made use of in those inward Bleedings of the Small Pox, and with perfect good Success; it stopping them immediately, as she had clearly experimented more than once, and does not doubt but it will always answer the same. However, there is one thing to be taken care of, that this Herb be pretty fresh and good, for if it be either decay'd, or has been too long or too often us'd, its Virtue is then lost; as she particularly prov'd upon Persons who have bled at the Nose habitually: For tho' it will both stop and prevent such Bleedings while worn upon the Person, yet it must be renewed at the end of two or three Months at farthest. I have seen my self some Effects of it in this latter Case: but have not had Opportunities of the former. However, I am far from discountenancing the Tryals of it, as some, I question not, will do, who are of another Temper, as well as intellect from their great Master
Hippocrates;
who says,
"That a Physician ought not to be asham'd to inform himself, tho' by the meanest People, of Remedies confirm'd by Experience. By this means, in my Opinion, the Art of Physick grew up by degrees, that is, by amassing and collecting Observations of the several particular Cases one by one, which being all put together, make one entire Body."
But to return (from this something long, tho' not useless Digression) to the Examination of
Hippocrates
's other Reasons for Bleeding. This first and chiefest of a Plethora suppos'd, being not so common or probable a Case (especially among the Rich) as has been mistakenly imagin'd.
A second Reason in
LeClark
's Collection of them was,
"to
divert
or
Recall
the Course of the Blood, which was going where it ought not to be."
This might probably have been useful in those Cases I lately mention'd: but we are not to suppose a Necessity for a thing, where there is none. For this would be, like a Person, who having seen another die of an Apoplexy, and hearing it after reported, that if the deceas'd had us'd Bleeding, Vomiting, and Blistering, he had escap'd his Death; this should make him upon the first time he was dozie, or his Head ach'd, send for an Apothecary and a Surgion, and order himself to be immediately Blooded, Blister'd,
&c.
by way of Prevention: Which, if not the first time, yet if this Humour often took him, would infallibly ruine the best Constitution in the World, and bring upon him such Weaknesses and Disorders, as he would never have been attack'd with, had he forborn those Methods.
That this is a parallel Case, and that there is as great Hazards, and commonly as little Necessity (bating perhaps a little present Ease, (which might happen too in both Cases, it commonly causing an Enlivening or Briskness) for such a Practice in the one Case as in the other; I appeal to the experienc'd and successful Dr.
Mapletoft
abovemention'd, p. 1, 2. But to proceed.
A third end of Bleeding was,
to procure a free Motion of the Blood and Spirits:
which, tho' Dr.
Le Clarke
has quoted in his History of Physick a long Case, that will not much resemble the Small Pox, nor any Distemper known in
England
at this Day: Yet since there are Disorders of the Nerves, and there may be Stagnations both of the Blood and Spirits in this present Distemper, I shall be told, that we are not to take these as slight Indications, or Symptoms; and I confess they are not, being such as put not only
Sydenham,
but many others, I believe, upon forcible Methods to remove them. Yet if we have shew'd that there are very great Hazards in going that way to work for the Relief of the Patient; and that there is a safer and better way, and one more peculiarly adapted to this Distemper, and that carries several great Advantages with it, of use in the whole course of it after: This is certainly to be prefer'd before any precarious or hazardous Method: And such an one I publish'd in my last Treatise or Essay, which had so far the Approbation of two of the Greatest Men in this Nation, one for his unparallel'd Skill in Mathematicks and natural Philosophy. The other for his equal Reading and Experience too in the practical part of Physick. That the
Sir
Isaac Newten.
first of them told me upon his through Perusal of my Tenth Experiment or Case, with what follows upon it,
It was a better way than any thing else in the beginning;
and in a second Visit he terth'd it,
A very fair Proposal and Design.
The other
Late Bishop of
Ely.
Dignified Person, perusing and approving my whole Book through, told me upon the same Passage or Experiment, That he thought long till he could trye it himself: so much was he satisfied with the apparent Safety, and more than probable Efficacy, of it.
However, I have not yet attain'd my end of publishing that Piece, which was, to have the fore-mention'd, and some other things, fully try'd for publick Use. Nor have I yet, on the contrary, receiv'd an account of any the least Matters of Fact, nor so much as Arguments (except what I have mention'd in my Preface, which I really receiv'd) urg'd against the whole or a part; so true is it (what that highly skilful Person in a Profession scarce less
See
Hippocrates
's
Divine Character of a Physician;
Lib.
De Decenti Ornatu;
and
Le Clarke
's
History of Physick,
p. 99. where he tells us, that in the most Ancient Times none but Kings, Priests, and Grandees, were allow'd the Study and Practice of
Physick.
sacred than his own, and therefore worthy of his Study and Practice) told me,
viz.
That I should find it an hard Matter to introduce a new Invention in Medicin: The Physicians of the Town, as he had experienc'd, being all inclin'd tenaciously to follow their own way; at least not to admit of any that was more plain and easy. What Alteration this second Treatise of mine (which I design'd to have been much longer) will make, I must wait a little while to know.
One thing more I shall mention here; which is, that when I last paid my Duty to his Lordship, he gave me fresh Assurances of the Goodness of his own plain Medicine, or that I call his own, he having recommended it to me: he now again commended the same: and told me he had done good things with it.
This I speak, because its having been laid aside in common Practice, seems to me for little other Reason, but, because it did not suit the Humour of the Town when formerly publish'd: tho' 'tis far more safe, and commonly effectual too, than those in present vogue, which I have given Reasons for in that Essay. But to return.
A Fourth Intention of
Hippocrates
in Bleeding, was, for
Refreshment
or Ease. The Instance there is in the Iliack Passion. But I have given an Instance where
Sydenham
hath us'd both that and Vomiting for the same Intention of acquiring Ease and Refreshment only, in the Small Pox; which is very often better procur'd another way. See p. 81, 82,
&c.
of my before-mention'd Essay.
In the next Paragraph he tells us, That the Conduct of
Hippocrates
was much the same in Bleeding, as Purging, in respect of
Time and Persons. We ought,
says he,
to let Blood in acute Diseases, when they are violent, and if the Party be lusty, and in the Flower of his Age.
In those Instances I have given, pag. 11, 12. of an excessive Athletick [or full] Habit of Body, the Flower of Youth,
&c.
I should not have been against Bleeding, but for it, for the speedy taking off a Plethora, and for turning the Course of the Blood as speedily as might be: But that this is to be done always, and to all Persons indifferently who have this Distemper, and are in Youth, I must deny; and once more appeal to the safer and better Practice of Dr.
Mapletoft,
who generally omitted this, as we may most reasonably infer from pag. 4. As for those Circumstances of
Diseases acute and violent,
tho' the Small Pox is both, yet we must not falsely, or upon ill grounds, draw in
Hippocrates
's Advice or Authority, even tho' the Distemper be attended with Pain too; which is another of his Indications for Bleeding; those Distempers he directed it for, being Quinzies, Pleurisies,
&c.
(as is plain in the Original) which, we know by Experience, not only admit of Alleviation or Abatement of their Pain by Bleeding, but very often of a most speedy Cure too by that alone. But the Case of the Small Pox is widely different: For the greatest Progress we can make towards its finishing its Course by this, or using other Evacuations, is only to bring it into Act, or to make its plain, and too commonly very evil Appearance; but the Patient is obliged to undergo almost the whole Course of it afterwards, which how tedious and harassing, as well as dangerous a one it is frequently in those Cases, I my self have sufficiently felt as well as seen. These last therefore are no Precedents to go by; and I wish all who have to do in directing for the Cure of this Distemper, would not insist upon the Precepts, (especially as collected by others, or taken from particular Cases in
Hippocrates,
no ways parallel to ours) but would rather follow the Practice of this sage and well experienc'd Physician, (which would most exactly suit this Distemper, as plainly appears by
See again, p. 1, 2.
Fact) and in it they would find, that he used the greatest Caution against Evacuations in the Beginning of all acute Distempers, this of bleeding especially, which
Le Clark
tells us he very seldom used; and that in his First and Third Book of Epidemicks, (which he calls the most finished of his Works) we find but one single Instance, and that in a Pleurisy. So much did he trust to the Power of Nature, whom he endeavour'd always to support, and not, by the too often false Reliefs of Art, to weaken and destroy.
There is one thing still to be consider'd, with relation to the first Question started to my Best, most Honourable, and I presume now, Impartial Readers, which was,
Whether the Rich in this Distemper, did, or did not, require different Methods of Cure from the Poor in it?
The Question it self supposing them of something different Constitutions, and that the Rich are not quite so strong and hardy to endure its Force as the Poor: which is the Reason given why they cannot likewise go through this Distemper, but fail commonly before the end of it (even when Appearances have been good, or made so seemingly by Art, in the beginning); which Supposition Of their being not quite so strong naturally to bear it, we must perhaps grant: but then it makes highly against the present ordinary Practice, which is opposite to the Authority of the Great
Hippocrates
too; this Passage from him, warning or instructing in all violent Methods
De Locis in homine,
Part. 46.
,
Si vero morbum fortiorem, aegrotum autem debilem acceperis, debilibus pharmacis curabis, quae ipsum morbum superent & abducant, verum aegrotum nihilo debiliorem reddant.
Which plainly signifies, I think, thus much,
That if we meet with a strong Disease in a weak Patient, we ought to use milder
'Tis such safe and easie Remedies I attempted to bring in Practice, and should still farther promote others of the like Kind, could I see any Possibility of having repeated and fair Tryals made of them. The Causes of opposing those Tryals, appear, many of them, in this and in my other Essay.
Remedies, which may diminish or overcome the Distemper, but not weaken the Patient's Strength.
Now 'tis to the Rich, who are either confess'd, or demonstratively ('tis thought) of a weaker Nature, that we see daily violent and exhausting Remedies are used; and not to the Poorer, but more robust and stronger sort of Persons, who might perhaps bear them better, but do not at all care for the Tryal; as we find by their not only avoiding, but even detesting the Physicians as much as may be in this Disease. And for what too apparent Reasons they do both, is in part shew'd.
Tantum.
BOOKS Printed for
R. Knaplock
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Bishop's Head
in St.
Paul
's, Church-Yard.
AN Essay towards a more easie and safe Method of Cure in the Small Pox; founded upon Experiments, and a Review of Dr.
Sydenham
's Works. To which is prefix'd so much of the Author's own Case as relates to this present Tract. By
Walter Lynn,
M. B.
Originei Ecclesiasticae:
Or,
The A
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Vol. I. In two Books, whereof the first treats of Christians in general; their several Names and Degrees; of Catechumens, Laity and Ciergy: And the second gives a particular Account of the several Superior Orders and Offices in the Primitive Church. The Second Edition.
Origines Ecclesiasticae:
Vol. II. giving an Account, I. Of the Inferior Orders of the Ancient Clergy. II. Of the manner of their Elections and Ordinations, and the particular Qualifications of such as were to be Ordain'd. III. Of their Privileges, Immunities and Revenues. IV. Of the several Laws relating to their Employment, Life and Conversation. The Second Edition.
Origines Ecclesiasticae:
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The
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