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.
T HE former Part of this Treatise has been censur'd for two Faults; first for being obscure; secondly, for not being so practical as it ought to be: As to the First, I answer, That
Obscurity
may be taken in two Senses, as Real, or as Relative to the Understanding of the Reader; if Obscurity is taken in the first Sense, I will venture to affirm, That it is unjustly blam'd upon that Account: Perhaps it may not be all true, but I am sure it is intelligible. If Obscurity is taken in the second Sense,
Euclid
's Elements may be said to be obscure: I freely own that I had made too partial a Judgment of the Capacity of several of my Readers; and yet it is true, That many, not bred up in the Profession of Physick, understood the Whole; many, a great Part of it; and it was not possible to write it down to the Capacity of every Body.
The second Fault, of its not being sufficiently practical, I have endeavour'd to repair, by the Addition of this Second Part, which I was oblig'd to write in haste, when the Distress both of my Mind and Body, besides Business, render'd me very unfit for such an Undertaking: All I can say for it is, That tho' it be less accurate, it may perhaps be more useful than the first, it being much such a Work as an Almanack, of publick Benefit, but from which no body I believe ever propos'd any Reputation. It is a Collection of the scattered Precepts of the First Part, and other new Rules, extended to the most common Diseases as well as Constitutions of Human Bodies. I have still follow'd the Method of the learned and industrious
Boerhaave,
who has certainly studied and taught this Part of the Profession more than any that ever were before him.
I cannot think it trifling nor unnecessary to treat this Dietetick Part of Medicine by it self with some Accuracy, for the following Reasons:
First,
Because the Parts of any Art or Science are often best understood when they are treated separately:
Secondly,
Because the Practitioners in Physick and Chirurgery are often frustrated in their Intentions by Errors in Diet committed by their Patients, a Misfortune that I my self have felt several times, and, as I suppose, in common with others of the Profession.
Thirdly,
Because some practical Rules of this sort may be useful to such as are remote from good Advice; and likewise to some coarse Practitioners which they are obliged to make use of: By the Methods prescrib'd in this short Treatise, which are almost within the Reach of every Body, more Good and less Mischief will be done in acute Distempers, than by Medicines improperly and unseasonably administred; and great Cures may be effected in Chronical Distempers, by a proper Regimen of the Diet. I hope I have done with this Subject. I was drawn in to write the First Part by Accident, and to write the Second by some Defects in the First; these are the cumbersome Perquisites of Authors.
THE CONTENTS.
CHAP. I. Of the different Qualities and Effects of Alimentary Substances.
ALimentary Substances, austere and astringent.
Page
243
Alimentary Substances, softening and relaxing. 245
Diluting Substances. 252
Anti-acid, or contrary to Acidity or Sourness. 253
Acid Substances. 259
Those things which resolve glutinous and fat Substances.
ibid.
Stimulating. 260
Incrassating, or Thickeners of the Humours. 261
What renders the Blood acrimonious, or sharp. 262
Abaters of Acrimony, or Sharpness. 263
Coagulators of the Humours. 265
Those things which accelerate the Motion of the Blood.
ibid.
Those things which increase Milk. 266
Substances expectorating.
ibid.
Lenitive, or laxative of the Belly. 267
Diuretick. 269
Sudorificks. 271
Diaphoreticks, or Promoters of Perspiration. 273
Emenagogues.
ibid.
Those things which produce Heat in animal Bodies. 275
Those things which produce Cold in animal Bodies. 276
Cephalick. 277
Cordial. 278
Carminative, or Expellers of Wind 279
Anthelmintick, or contrary to Worms 280
Anodyne, or Abaters of Pain of the alimentary Kind. 281
CHAP. II. Rules of Diet in the different Constitutions of Human Bodies.
Lax and weak Fibres. 283
Too strong and springy Fibres. 284
Plethorick Constitutions. 285
Sanguineous Constitutions. 287
Constitutions subject to Acidity. 288
Constitutions abounding with a spontaneous Alkali. 290
Phlegmatick Constitutions. 293
Thickness of Blood. 295
Oily or fat Constitutions. 296
Melancholy or atrabilarian Constitutions. 298
Faulty Motion of the Fluids. 300
Wounds. 301
CHAP. III. Of Acute Diseases.
Fevers, with their various Symptoms. 303
Intermitting Fevers. 323
Inflammatory Diseases.
A Phrensy, or Inflammation of the Brain. 327
Quincy. 328
Inflammation of the Lungs. 332
Pleurisy. 339
Paraphrenitis, or Inflammation of the Diaphragm. 341
Inflammation of the Liver. 342
Inflammation of the Stomach. 348
Inflammation of the Guts. 350
A Thrush. 355
Inflammations of the Kidneys. 357
Apoplexy. 362
CHAP. IV. Rules of Diet in Chronical Diseases.
Palsy. 367
Epilepsy, Convulsions. 370
Melancholy, Madness. 374
Scurvy. 377
Cachexy, or ill Habit of Body. 381
Consumption pulmonary. 382
Dropsy. 389
Gout. 395
Greensickness, Obstructions. 401
Diseases of Infants. 404
Small-Pox. 412
Gravel, Stone. 419
Rheumatism. 428
PRACTICAL RULES OF DIET In the various CONSTITUTIONS and DISEASES of HUMAN BODIES.
CHAP. I.
Of the different Qualities and Effects of ALIMENTARY SUBSTANCES.
1. Alimentary Substances, austere and astringent.
A USTERE, astringent, vegetable Substances,
are such as contain an acid essential Salt, combin'd with Earth, and very little Oil; as,
Several sorts of
Plumbs,
and some sorts of
Pears,
distinguishable by their rough styptick Taste.
Quinces,
which by their Quality are often useful to weak Stomachs, and in stopping of Fluxes of Blood.
Pomegranates,
which contain a Juice styptick, and extremely cooling.
Barberries, Medlars, Cornelian Cherries,
all beneficial in Bloody-Fluxes.
Sorrel,
useful in Spitting of Blood, and Stinking Breath.
Purslain,
succulent, subacid, with a cooling nitrous Salt.
Burnet,
astringent, with a gentle spicy Quality, vulnerary.
Tamarinds,
cooling, astringent, yet laxative to the lower Belly.
Capers,
astringent and diuretick.
All
Pickles,
especially
Samphire,
which is stimulating. Such sort of Substances by their Acidity and astringent Quality offend some Stomachs.
There are
Wines
of the same Quality, known by their rough austere Taste; as likewise all acidulated and chalybeat
Waters.
Strong Waters
or
spirituous Liquors
contract and harden the solid Parts most of all.
2. Alimentary Substances softening and relaxing.
The Juices of most sorts of ripe Garden Fruits, as
Cherries,
are cooling, and laxative to the Bowels; their Kernels are good for the Gravel in the Kidneys.
Strawberries,
which by their fragrant Smell seem likewise to be cordial. The Seeds, which are obtain'd by shaking the ripe Fruit in Water, are an excellent Remedy against the Stone: The Juice of Strawberries and Limons in Spring-Water is an excellent Drink in bilious Fevers.
Oranges,
those that are sweet are more relaxing than the bitter or
Seville
Oranges, which nevertheless are not heating; these are an excellent Remedy against the hot Scurvy.
Citrons
and
Limons,
their Juices more cooling than that of Oranges. Sour Limons do not possess this relaxing Quality very much, they being somewhat styptick.
Apples,
which are likewise pectoral, cooling, and lenitive; they differ considerably as to the Kinds of them, and their Qualities may be easily known by their Taste.
Pears
have most of the same Qualities; some Kinds by their high Flavour seem to be more cordial than Apples.
Peaches,
which are likewise cordial and pectoral.
Sweet
Plumbs,
those of the austere Kind are astringent.
Mulberries,
pectoral, corrective of the bilious Alkali.
Apricocks,
unless mellow, are rather somewhat styptick.
Gooseberries,
extremely ripe, are lenient; unripe, they are sour, and rather astringent.
Currants
are good in Spitting of Blood, extremely cooling, and somewhat astringent. The Jelly or Rob of Currants, mix'd with Water, is a most excellent Drink in bilious Fevers.
Grapes
taken in moderate Quantities help the Appetite and Digestion; in great Quantities, they resolve the Bile too much, and produce Fluxes; dry'd, they are pectoral.
Figs
are great Subduers of Acrimony, useful in Hoarseness and Coughs, extremely emollient, and by relaxing the Urinary Passages, diuretick, useful in bloody Urine; it has been always believed that the immoderate use of them generates Lice.
Plants of the low pomiferous Kind, as
Melons, Pompions, Gourds, Cucumbers,
contain a cooling Juice, with a nitrous Salt; that of Melons and the
Ananas
is rich and cordial; they are diuretick; and there are Instances, when eaten in great Quantities, they have produced bloody Urine; they ought to be taken fasting. The Juice of Cucumbers is too cold for some Stomachs, and ought not to be taken by such as have thin and poor Blood; if the Stem upon which they grow be bruised, the Pulp of the Fruit grows bitter, and has the Effect of Coloquintids. The Juice of an unripe Cucumber is purgative. Cucumbers are useful in bloody Urine.
All Fruits which contain a subacid essential Salt, much Phlegm, and a small Quantity of Oil, have this lenient Quality; as likewise the emollient Pot-Herbs; as,
Cole, Cabbage, Coleworts,
which are soft and demulcent, without any Acidity. The Jelly or Juice of red Cabbage, bak'd in an Oven, and mix'd with Honey, is an excellent Pectoral.
Lettuce,
which has a milky Juice, with an anodyne or opiate Quality, resolvent of the Bile, proper for melancholy People, diuretick, and good in Stranguries, especially when eat raw; it is reckoned to increase Milk.
Cichory
and
Dandelion
have some of the same Qualities, with a small degree of Bitterness extremely agreeable to the Stomach, and not heating. The Juice of the Dandelion is a Remedy in intermitting Fevers.
Spinage,
emollient, but not very nourishing; it is reckoned good in Inflammations of the Bowels.
Beets,
emollient, nutritive, and relaxing.
Carrots,
good in nephritical Cases, antiacid, and fattening.
Parsnips,
useful in phlegmatick Colicks; the Plant from which Apoponox is taken, is a sort of Parsnip.
Skirrets,
useful in bloody Urine, and Spitting of Blood.
Scorzonera,
demulcent in the SmallPox, Meazles, and pestilential Fevers, and for Gouty People; the express'd Juice better than the Decoction.
Goats-beard,
an alimentary Root, has most of the Qualities of Scorzonera.
Emollient likewise are all farinaceous or mealy Substances.
Barley,
which is deterging, tho viscous in a small degree; the Decoction and Cream of Barley are proper in inflammatory Distempers.
Rice,
nourishing, good in Haemorrages, or Fluxes of Blood.
Mays
is not so easily brought to Fermentation as other Grains, therefore more viscous.
Wheat,
the properest of any Grain for Bread, which, when not entirely purged from the Bran, is laxative, and stimulating to the Bowels.
Rice,
the Bread, more acescent and less nourishing than that of Wheat.
Oats,
cleansing, resolving, and pectoral; Oatmeal and Butter outwardly apply'd dry the Scab on the Head.
Millet,
diuretick, cleansing, and good in Diseases of the Kidneys.
Panick,
aperient, boil'd with Milk, demulcent, temperating Acrimony.
Pease
contain a soft Oil, without any spicy Quality; therefore are extremely demulcent, and temper Acrimony.
Beans
and
Kidney-Beans
have the same Qualities; they are reckoned diuretick, and good for the Stone.
It has been commonly reckoned, because of the Viscosity of Pease and Beans, that People who live a sedentary Life should not feed much upon them.
The
Animal Oils; Cream, Butter,
and
Marrow,
are all lenient and nourishing: Marrow is excellent in the dry Scurvy with crackling of the Bones, where it performs its natural Office.
Of all Drinks,
Whey
is the most relaxing, so are warm Water and Decoctions of mealy Substances, and
Panadas,
or Bread boil'd in Water.
3. Diluting Substances.
Water
and
watery Liquors,
without any saline Substance; Decoctions of
mealy Substances; Robs
and
Gellies
of Garden Fruits in Water.
Resolving
is bringing a Fluid which is new concreted into the State of Fluidity again. Such are
All Substances which are saponaceous, or contain Salt and Oil; therefore most ripe
Garden Fruits
have this Quality, and
Honey
most of all vegetable Substances. Mere diluting dissolves and carries off Salts.
4. Anti-acid, or contrary to Acidity or Sourness, are,
All
Animal Diet
in general, because no Animal has any acid Salt in it, especially Flesh roasted; tho' not so easy of Digestion as boil'd.
The
Animals
which feed on other Animals must have this Quality stronger than those who feed on acid Vegetables; such are most Fishes, all Birds which feed upon Worms and Insects, several Kinds of Water-Fowl, Woodcocks, Snipes, and several Kinds of small Birds, which for that Reason afford a higher Aliment than those that feed upon Grains or other Vegetables.
The
Flesh
of
Animals
differs according as they are terrestrial, aquatick, or amphibious. Fishes contain much Oil, and amphibious Animals participate somewhat of the Nature of Fishes, and are oily; and the same Species of Animals differs according to the Soil and Air it lives in, and the Nourishment which it takes, as those in Marshes and Mountains; the Flesh of Oxen, Sheep, Deer, in different Pasturage; and this is in none more sensible than in Hogs Flesh.
Young Animals
from their Age and the Nature of their Aliment have more tender Fibres, and more superfluous Humidity than old Animals, which have their Fibres tougher, and the Juices more exalted and relishing.
Mutton
by Experiment is the most perspirable of all animal Food, and Hogs Flesh and Oysters the least.
The
Flesh
of
Animals
which take and digest a great Quantity of Food, and consequently use strong Exercise, must be nourishing, because they have strong Sanguification, such are Pigeons; and the same is true of some Fishes.
The Nature of most sort of animal Diet may be discovered by Taste and other sensible Qualities, and some of those general Rules above-mention'd, without particular Disquisitions upon every Kind.
Eggs
are perhaps the highest, most nourishing and exalted of all animal Food, and most indigestible, because no body can take and digest the same Quantity of them as of other Food.
Shell-Fish
are nourishing, and their Oil is corrected by their Salts, which make it pungent and stimulating.
But, as was said before, all Animal Diet is Anti-acid or Alkalescent.
Vegetables used in Aliment antiacid are such as of themselves turn foetid or stinking, rather than four.
All the
Cole
or
Cabbage
Kind.
Asparagus
diuretick or aperient; by the foetid Smell which it gives the Urine it is suspected to be hurtful to the Kidneys.
Parsley
and
Celery,
both contain a pungent Salt and Oil, diuretick and aperient, bad in Bloody-Fluxes.
Garlick, Rockambole, Onions, Shalot, Leeks,
these abound with a pungent volatile Salt and Oil, are extremely diuretick, and, when stimulating Diureticks may be safely us'd, are very effectual: Garlick has been found by Experience to be a very excellent Remedy in Jaundices and Dropsies, and in Asthmas proceeding from a cold viscous Phlegm. All these Plants are hurtful in Cases where the Blood is too much dissolv'd, in Spitting of Blood, and bloody Urine.
Cresses, Radishes, Horse-Radishes, Mustard,
abound likewise in their several degrees with a pungent Salt, and as they subdue Acidity, are very improper where the Blood verges to the contrary State of a putrescent Alkali; and in general they are fitter for old People, and cold Constitutions, than the young and sanguine. Mustard is a very powerful Remedy in viscous cold phlegmatick Cases.
Dilse,
a Sea-Plant, antiscorbutick. There are other Sea Plants us'd as Aliment, which contain a temperate Sea-Salt, very useful in Scurvies; as Laver, which is the
Lactuca Marina,
or Sea-Lettuce, and Sea-Cole, or Cale.
Carrots, Turnips, Parsnips,
are Anti-acids of a milder Kind.
Nettles,
good against Haemorrages.
Such as abound with a soft Oil, which operate by blunting the Acrimony of the Salts, as most sorts of
Nuts;
most of which are hard of Digestion, yet possess some good medicinal Qualities.
Walnuts
are cordial, anti-hysterick, and gently sudorisick.
Hazle-Nuts,
good against Spitting of Blood.
Chesnuts
are good in Female Weaknesses, and afford a very good Nourishment.
Almonds,
Pectoral.
Pistachos,
nourishing and stimulating.
Olives
are anti-acid by their Oil, but all oily Substances beget an Acrimony of another sort.
Truffles,
which have an exalted Oil, and a volatile Salt of a grateful Savour, are heating.
Morelles
have some of the same Qualities; and so have
Earth-Nuts
and
Potatoes,
which are very nourishing.
Mushrooms,
which contain an Oil of a volatile Salt; therefore they are best corrected by Vinegar; some of them being poisonous, make the rest suspicious; the poisonous Kinds operate by a sort of Suffocation, in which the best Remedy is Wine or Vinegar and Salt, and Vomiting as soon as possible.
Acidity is likewise cur'd by diluting, therefore
Water
is an Anti-acid.
5. Acid Substances are,
Most ripe Garden Fruits, fermented Liquors, small Wines, with little Oil, and much Tartar, Vinegar, sour Milk, Butter-Milk. Several Plants known by their Taste, as Sorrel,
&c.
Those of the mealy Kind are acescent, that is, being kept they turn sour rather than corrupted and stinking.
6. Those things which resolve glutinous and fat Substances, are
Spices,
as Cinnamon, Mace, Nutmeg, Cloves, Ginger, Pepper. These abounding with a high exalted Oil, and volatile Salt, by which Principles they are heating, and act strongly both on the Fluids and Solids; Ginger is perhaps one of the best of them. All Spices are bad for melancholy People.
Of the same nature are the
Vegetables
used in Seasoning, as Thyme, Savory, Marjoram, Rosemary, Mint, Orange and Limon-Peel, Fennel, which contains a subtil Spice, balsamick, warm, and stimulating; Chervil, of the same nature; they are good in phlegmatick cold Constitutions: Sage is stimulating, drying, astringent; us'd in great Quantities it will produce Temulency, or Drunkenness.
All
Soaps
and
Soapy Substances,
and consequently ripe Fruits, the Juices of pungent and aromatical Plants, all those Substances resolve Solids, and sometimes attenuate or thin the Fluids.
7. Stimulating.
All
Salts
in general, both acid and alkaline; all acrimonious
Oils,
and all Substances that abound with them, for by their Oil they obstruct the Extremities of the small Vessels, and by their Salts they irritate the Solids, consequently all the Substances mentioned in the foregoing Article are stimulating, and all fermented
Spirits,
the Effect of which is very sudden.
Extreme
Cold
stimulates, producing first a Rigor and then a glowing Heat; those things which stimulate in the extreme degree, excite Pain.
8. Incrassating or Thickeners of the Humours, are
All things which expel the liquid Parts strongly, so as to thicken what remains. Therefore violent Exercise or Labour produceth this Effect; the Blood of labouring People is more dense than that of the sedentary. A due Consistence of the Blood is very necessary for Health, and this is acquir'd chiefly by Exercise; all things which provoke great Secretions, especially Sweat, produce this Effect at last.
9. What renders the Blood acrimonious or sharp
Are such things as increase its Velocity; for by mutual Attrition Salts are produc'd.
Whatever attenuates the Humours.
Whatever resolves Concretions, and turns them fluid; for whatever putrifies, is acrid.
Acrimony
is threefold:
Acid,
which is produc'd from Vegetables lying long in the Stomach; no animal Substance produceth Acidity, except Milk.
Great Quantities of
Oily Substances,
for
Animal Humours,
by Heat, stink and grow foetid, like Oil.
Express'd Oils
are mild.
Distill'd Oils
turn acrid.
Oils
entirely deprav'd of their Salts are not acrid.
Alkaline Acrimony
is produced by fix'd Salts, by fix'd Alkalis, and volatile Alkalis, taken in great Quantities; and by essential Salts of Vegetables, of which sort are Sugar, Manna, and Honey.
Alkaline Acrimony
is produc'd by all Vegetables which abound with a pungent volatile Salt and Oil, as Mustard, Garlick, Onions, Horse-Radish, Cresses; and by all Spices. All things which create Pain, render the Humours sharp.
10. Abaters of Acrimony or Sharpness.
Express'd
Oils
of ripe
Vegetables,
and all Preparations of such, as of Almonds, Pistachos, and other Nuts.
Emulsion of the Seeds of Barley, Oats,
&c.
Decoctions of farinaceous
Legumes,
as Pease, Beans,
&c.
Native Animal
Oils,
as Fat, Cream, Butter, Marrow, especially the last, which is excellent in some Scurvies.
All insipid inodorous
Vegetables
are demulcent.
Jellies, Broths
of Animal Substances not high seasoned, acid Substances in respect of alkaline, and alkaline in respect of acid.
Fermented burning
Spirits
subdue Acidity, and are very often a present Remedy when the Stomach is affected with it. Spirit of Wine dulcifies Spirit of Salt, Nitre, or Vitriol; but then those Spirits have other bad Effects.
Absorbents, as Chalk, Crabs Eyes; but these are not alimentary, except calcin'd Hartshorn, which has something of this Quality.
Nothing abates Acrimony of the Blood more than an equable Motion of it, neither too swift nor too slow; for too quick a Motion produceth an alkaline, and too slow an acid Acrimony.
11. Coagulators of the Humours.
Those things which expel the most fluid Parts, as in the Case of incrassating, or thickening; and by those things which suck up some of the fluid Parts, as Absorbents.
All
Vegetables,
which make a black or purple Tincture with the Vitriol of
Mars,
such as Galls do. Juices of unripe Vegetables, and the juices of all austere Vegetables which coagulate the Spittle, and being mix'd with the Blood in the Veins would produce Polypus's in the Heart, and Death.
All burning fermented
Spirits
have this Quality in a strong degree.
12. Those things which accelerate the Motion of the Blood, are
All stimulating, diluting, and attenuating Substances; what relaxeth the Veins, as Frictions, Bathings, Compressions by Ligatures often remov'd, Sneezing, Coughing, Laughing, and several other natural Motions.
Those things which take off the Causes of Acceleration, retard the Motion of the Blood.
13. Those things which increase Milk.
What generates quickly a great Quantity of Chyle, as thin Broths, Ptisanes of Barley or Oatmeal, Panadas, but nothing more than Milk with Salt and Sugar; Cream, if the Milk be not too thick, Malt Drink, not strong, or stale; a due degree of Exercise or Labour. Eating much Flesh-Meat abates Milk.
14. Substances expectorating.
Such as cleanse and open, as mild vegetable Oils, such as that of Almonds or Olives; soapy Substances, especially Honey; Emulsions of farinaceous Substances, Decoctions of emollient Vegetables, Sugar.
Sometimes stimulating Substances are necessary to dissolve viscid Phlegm, and excite a Cough.
The mild Vapour of warm Liquids, especially warm Water.
And such things as are endued with an opiate Quality by incrassating the Phlegm.
15. Lenitive or laxative of the Belly.
Animal Oils, fresh Butter, Cream, Marrow, Fat Broths, especially of those Parts which are about the Mesentery; Livers of Animals, because of the Bile which they contain; the express'd Oils of mild Vegetables, as Olives, Almonds, Pistachos, and the Fruits themselves; all oily and mild Fruits, as Figs; Decoctions of mealy Vegetables, these lubricate the Intestines; some saponaceous Substances which stimulate gently, as Honey, Hydromel, or boil'd Honey and Water, and even Sugar it self, especially unrefin'd.
Such
lenitive
Substances are proper for dry atrabilarian Constitutions, who are subject to Astriction of the Belly, and the Piles, and will operate when stronger medicinal Substances are sometimes ineffectual; but such lenitive Diet hurts those whose Bowels are weak and lax.
Lenitive
are likewise watery Substances; and even common Water or Whey, drank in cool Air, and walking after it; sour Milk and Butter Milks have the same Effect.
There are other Substances which stimulate more, even new Milk, especially Asses Milk, when it sours on the Stomach; and Whey, turn'd sour, will purge strongly.
Jellies made of the solid Parts of Animals contain a sort of ammoniacal Salt; Shell-Fish, as Oysters, the same, by which they are lenitive; most Garden Fruits, by the Salts which they contain, produce the same Effect; some of them, as Grapes, will throw such as take them immoderately, into a
Cholera Morbus,
or incurable Diarrhoeas; all Fruits when they have this Effect, are flatulent; Wine and spirituous Liquors are not so useful in such a windy Colick, as Water, which is much the best Remedy after a Surfeit of Fruit. The express'd Juices of several Vegetables, because of their essential Salts, stimulate the Bowels.
All fossil Salts, as Sea-Salt, Rock-Salt,
&c.
have this Quality; a Diet of salted Flesh throws Ships Crews sometimes into Diarrhoeas.
16. Diuretick.
All
Decoctions, Emulsions, Oils
of emollient Vegetables, such relax and lubricate the Urinary Passages; they ought to be taken in an empty Stomach, an open Air, and with gentle Exercise.
Diluents,
as Water, Whey, Tea, small Ale without Hops.
Substances stimulating,
by which Quality all Salts whatsoever are diuretick.
Soaps
which resolve solid Substances, any Salt, Oil, Salads of pungent Herbs, with Oil of Olives, and Vinegar, are diuretick.
By this saline Quality, the Juices of Shell-Fish, of Oysters, Muscles, Crabs, Crawfish, and the Soups made of them, are diuretick.
Vegetables which have little Oil, and a great Quantity of essential Salt, are diuretick, Parsley, Celery, Sorrel, Chervil, Eringo.
Vegetables which are aromatick and balsamick, Saffron, Asparagus, Nutmeg; these affecting the Urine with an Odour, have some specifick Quality of this Kind.
All
anodyne
Substances which take off Spasms and Contractions of the membranous Parts, and all which subdue any particular Acrimony, are diuretick.
For provoking of Urine, one should begin with the gentlest at first, as the lenient, relaxing, diluent, demulcent, and last of all the stimulating.
The Blood may be cleans'd, and the Salts of it carried off perhaps better by Urine than any other Secretion.
17. Sudorificks.
Such things as relax the Vessels of the Skin, by which Quality many things which are diuretick, are likewise sudorifick; warm Water and Honey, Barley-Water, Friction, and tepid Vapours, apply'd to the Skin, operate by this Quality.
Substances anodyne, by abating Spasms, relax, and by that Quality prove sudorifick.
Such things as dissolve and dilute the Blood, thus cold Water.
Water, Vinegar, and Honey, is most excellent Sudorifick us'd by
Hippocrates;
it is more effectual with a little Mace added to it.
Those things which determine the Motion of the Fluids towards the extreme Parts, increase the Strength and Frequency of the Pulse, as violent Exercise, all Cordials, Spices, thin and sharp Wines, Juices of Limon, operate by these Qualities.
The Matter of Sweat is the most spirituous and nutritious Part of the Blood, nor is it to be forced without apparent Indications. It contains the same lixivial Salts with Urine.
Sweating often thickens the Blood, and sometimes thins and dissolves it.
Sudorificks are to be varied according to the Cause of the Disease which it is design'd to remove.
18. Diaphoreticks or Promoters of Perspiration.
What helps the Organs of Digestion, because the Attenuation of the Aliment makes it perspirable.
Such things as constrict the Fibres, and strengthen the solid Parts; Exercise to a degree less than what provokes Sweat.
Substances which stimulate in a small degree.
Air, moderately warm.
There are likewise Aliments more and less perspirable.
See
Sanctorius.
19. Emenagogues.
Such as produce a Plethora or Fulness of the Vessels, consequently such as strengthen the Organs of Digestion, so as to make good Blood, especially Exercise; such as carry off the Foeces and Mucus, deobstruct the Mouths of the Lacteals, so as the Chyle may have a free Passage into the Blood.
Substances saline or soapy, that is, consisting of Salt and Oil.
Such as relax, and take off the Resistance of the Vessels of the Womb, Fomentations, and tepid Bathings of the lower Parts of the Body.
What accelerates the Reflux of the Blood from the lower Parts to the Heart, Friction, Walking, especially Dancing.
What stimulates and promotes the Excretion of the Blood, especially some of the Plants which abound with a pungent Salt, and a high exalted Oil, as those us'd in seasoning Aliment, Savory, Thyme, Marjoram, Penny-Royal,
&c.
Vapours acrimonious.
20. Heat is produc'd in animal Bodies
By the Application of hot things. By increasing of Attrition or Rubbing of the Fluids and Solids, to which Heat is proportional.
Therefore whatever increaseth the Velocity of the Blood, by stimulating, heateth, as spirituous fermented Liquors, and when the Heat is increas'd, the Velocity of the Blood is certainly increas'd.
What increaseth the Density of the Fluids, heateth, for a denser Fluid is hotter than a rarer; and thus it is that Cold it self at last heateth.
Whatever straitens the Vessels so as the Channels become more narrow, must heat, because in that Case the Attrition is made greater; therefore strait Clothes, thick Coverings, heavy and cold Air, but especially cold Baths, heat: All who are subject to Haemorrages ought to avoid these things. In Consumptions and Atrophy, the Liquids are exhausted, and the Sides of the Canals collapse, therefore the Attrition is increas'd, and consequently the Heat.
21. Cold is produc'd in animal Bodies.
By Causes contrary to the former,
viz.
By whatsoever diminisheth the projectile Motion of the Blood, by weakening the Force of any Stimulus; therefore diluting things are cooling, as Whey, Water, Milk and Water, both as they abate Acrimony, and relax the Vessels.
What is contrary to any particular Acrimony, is cooling, as alkaline Substances in respect to acid, and acid Substances in respect of alkaline; and soapy Substances, if the Heat proceeds from an oily or viscous Cause.
What expels any Stimulus out of the Body, cools.
Those things which attenuate and dilute by diminishing the Density of the Fluid; thus Nitres, and those Vegetables, which have nitrous Salts in them, cool.
Tepid Baths cool by relaxing the Vessels; and Air, when it is light, is more cooling,
caeteris paribus,
than when it is heavy, because it compresseth the Vessels less.
All those who have lax Fibres and Vessels are naturally cooler than those that have strait.
22. Cephalick.
Such things as attenuate the Fluids which circulate through the capillary Vessels of the Brain, and abound with a volatile Oil, Salt, and Spirit, and are known commonly by a grateful Flavour and Odour, as Marjoram, Balm, Sage, Rosemary.
Those things which affect the Nose with a grateful Smell, and are not hot, by their Odour promote the Separation of the Animal Spirits.
23. Cordial
Are all such things as increase and facilitate the animal or natural Motions, the Power of, moving the Muscles, or circulating the Fluids.
What increaseth the Strength of the Heart, is not always a Cordial; for in inflammatory Distempers, by increasing the projectile Motion of the Blood, the Strength may be diminished.
What increaseth the Force of the Heart so as to give a due degree of projectile Motion to the Blood, is a Cordial.
What produceth a due Quantity of Animal Spirits, necessarily facilitates the animal and natural Motions.
Such are all Aliments which put the nutritious Juices in such a State of Tenuity and Heat as approacheth to the White of an Egg, while it is hatching; those are commonly Meats and Drinks of easy Digestion, nourishing, of a Flavour grateful to most Palates.
Such as determine and settle the irregular Motions of the Animal Spirits; therefore, anodyne Substances, and what abate Spasms and Convulsions, are Cordial.
Such as stimulate and excite the Spirits, as Spices and Vegetables, which abound with a volatile Salt, Oil, and Spirit.
In short, whatever relaxeth the too strict Vessels, or straitens the too lax; what thickens the too thin, or attenuates the too thick Fluids, is a Cordial.
24. Carminative, or Expellers of Wind.
Wind is elastick and rarify'd, pent up in some Vessel of the Body, which by its Expansion creates a Tension or Convulsion in that Part.
Every thing which takes off that Convulsion, is, properly speaking, carminative.
Therefore what relaxeth or openeth so as the clastick Air may escape, as warm Water drank plentifully, Bathing, Fermentations, and all things which abate Pain, and those things which abound with volatile oily Salts, are carminative.
As those Spasms are often occasion'd by some acrimonious Substance which constringeth the Fibres of the affected Part; whatever is contrary to that particular Acrimony, is carminative.
25. Anthelmintick, or contrary to Worms.
All things which are known by Experience to kill them, as Oils of all Kinds; Honey taken upon an empty Stomach, or after some gentle purging Medicine.
Substances which by their small pungent and sharp Particles kill them without hurting the Intestines, as all Fish Bones and Hartshorn powder'd.
Those things which purge and expel them out of the Body, of which kind there are several alimentary Substances.
26. Anodyne, or Abaters of Pain of the Alimentary Kind.
Such things as relax the Tension of the affected nervous Fibres, as Decoctions of emollient Substances; those things which attenuate and remove the Obstruction, or destroy the particular Acrimony which occasions the Pain, or what deadens the Sensation of the Brain by procuring Sleep; some Alimentary Substances are endued with this Quality, as Saffron, Lettuce, Cichory, Wine, and inflammable Spirits.
This being a sort of a compendious Alimentary Dispensatory, makes it unnecessary in the following Rules to repeat constantly the same things, it being sufficient to mention the Intention or Design to be pursued in the Diet.
When there are Contra-indications, that is, when different Symptoms demand opposite Methods one must adapt the Method to the most urgent Symptom.
When the Disease is complicated with other Diseases, one must consider that which is most dangerous. These may serve for general Rules.
CHAP. II.
Rules of Diet in the different Constitutions of Human Bodies.
Lax and weak Fibres.
PAleness, a weak Pulse, Palpitations of the Heart, flabby and slack Flesh, Laziness, Lassitude, Bloatedness, scorbutical Spots are Symptoms of weak Fibres.
Leanness is no Sign of weak Fibres, for though the bundle of Fibres which constitute the Muscle may be small, the Fibres themselves may be strong and springy.
Such as have weak Fibres ought to avoid all great Evacuations, especially Letting of Blood, Substances viscous, and hard of Digestion, a sedentary Life, and moist Air.
They ought to take Aliment frequently, in small Quantities, nourishing, and of easy Digestion, such as Milk, Broths and Jellies of Flesh Meat, Panadas,
&c.
Their Drinks ought to be austere Wines mix'd with Water, or any Wine mix'd with chalybeat Water; and to use in their Aliment styptick austere Vegetables, such as are enumerated No 1, as far as their Stomachs can bear them.
Too strong and springy Fibres.
A Body hard, dry, scraggy, hairy, warm, with firm and rigid Muscles, a strong Pulse, Activity and Promptness in Animal Actions, are Signs of strong, rigid, and elastick Fibres.
Such Constitutions are subject to inflammatory Distempers.
They ought to avoid the Diet proper in the contrary State.
Their Nourishment ought to be emollient and cooling, the Pulps, Juices, Jellies, Mucilages, and Decoctions of Vegetables mentioned No 2. animal Oils, and all things which relax and increase Fat, avoiding all things seasoned with Spice and Salt: Their Drink, Water, Barley-Water, Whey; and especially to avoid fermented Spirits, which to such are extremely hurtful.
Bathing in tepid Water is beneficial to such Constitutions, and immoderate Labour or Excercise hurtful.
Plethorick Constitutions.
The Signs of a Plethorick Constitution, or of such as abound with laudable animal Fluids, are evident.
The Causes of it are a good Stomach, nourishing Diet, a good Digestion, little Exercise, much Sleep, and Suppression of usual Evacuations, especially Perspiration; therefore the avoiding these, and inducing their Contraries, are the proper Cure.
A plethorick Constitution is subject to a Stoppage of the Circulation, and consequently to Suffocation, Ruptures of the Vessels, and sudden Death; therefore it ought to be speedily broke by proper artificial Evacuations, and restoring the usual natural ones.
Long Abstinence is not proper for plethorick Constitutions, for it thickens the Fluids; frequent Blood-letting, in small Quantities, often increaseth the Force of the Organs of Digestion, fattens, and increaseth the Distemper.
They ought to avoid oily and nourishing Substances; watery Vegetables, as being less nourishing than animal Diet, are proper; and Fish rather than Flesh: In a
Lent
Diet People commonly fall away.
Sanguineous Constitutions.
Such are known by their Complexion, or Colour of their Countenance and Skin: They are subject to Haemorrages, Inflammations, especially of the Lungs, Impostumations, and often to scrophulous Distempers.
All things which accelerate the Motion of the Blood are hurtful to sanguineous Constitutions, as violent Exercise and Watching.
Acid Substances, No 5, especially Vinegar, are useful; the copious Use of Vinegar brings Paleness.
The sanguineous ought to avoid the copious Use of all things that abound with an acrimonious Salt and high exalted Oil, as Mustard, Onions, Garlick, Leeks, the Herbs us'd in Seasoning, mention'd No 6, and in general, all Spices.
Constitutions subject to Acidity.
Sour Belchings, a craving Appetite sometimes of unusual things, as in the Case of the Green-Sickness, Colical Pains, dry Gripes, change of the colour of the Bile from Yellow towards Green, a sour Smell in the Excrements and Sweat, paleness of the Skin, lowness of the Pulse, and some sort of Eruptions of the Skin, are the common Signs of such a Constitution.
The chief Seat of Acidity is in the Stomach and Intestines, from whence it will sometimes pass into the Blood, and other Juices.
Such ought to abstain from the copious use of acid alimentary Substances, mention'd No 5, they ought not to eat much Bread, nor take grea
Quantities of mealy Substances, no
drink much of fermented Liquor especially sour and thin Wines.
Their Diet ought to be rather of animal Substances than vegetable: The Flesh of those Animals which live upon other Animals is most anti-acid, as several Birds, and Water-Fowl; tho' those are offensive to the Stomach sometimes, by reason of their Oiliness. Vegetable and animal Oils are often agreeable to such Stomachs, as Almonds, Pistachos, Cream, Butter, Marrow.
Their Diet ought to consist, in general, of Substances mentioned No 4.
Water or Wine not sour or thin, is their proper Drink.
They ought to use much Labour or Exercise, for labouring People have commonly a good Digestion, and subdue the Acidity of their Aliment.
Acidity in the sucking Infant is to be cured by an alkaline Diet in the Nurse.
To know whether Eruptions of the Skin come from an acid or alkaline Cause, one must attend to the previous Diet and the concomitant Symptoms; (Children, by eating unripe Fruit often, have Eruptions upon their Skin) the Lentor, itching Colour, and State of such Eruptions, not inflammatory, nor tending to Suppuration, point rather to an acid Cause, and the Success of the Cure often demonstrates the same, such being often heal'd by animal alkaline Salts.
Constitutions abounding with a spontaneous Alkali.
This Constitution is more natural to Human Bodies, because all animal Substances are alkalescent.
Heat, Thirst, hot nidorose Belchings, Foulness of the Tongue and Palate, a bitter and hot Taste in the Mouth, Sickness, Loathing, bilious Vomitings, Stools with a cadaverous Smell, Pains in the Belly, with Heat, are Symptoms of an alkaline State of the Humours in the Stomach and Bowels.
Such a State disposeth the Humours of the whole Body to Heat, Inflammations, and Putrefaction, hinders Nutrition, and often causeth Eruptions on the Skin, dark, livid, lead-colour'd and gangrenous, and what is commonly called the hot Scurvy.
Such Constitutions ought to avoid alkaline Substances, mentioned No 4,
viz.
an animal Diet, especially Fat, Spices, and all Vegetables which abound with an acrimonious Salt and high exalted Oil, and the copious use of Salts in general; all animal Salts are alkaline; Sea-Salt and Rock-Salt, tho' they are of a mix'd Nature, rather increase the Disease; Salt-Petre is the most cooling and proper.
They ought to use plentifully the acid Substances mentioned No 15, to live much upon Aliments made of Grains or mealy Substances, to eat much Bread, and season much with Vinegar; thin Wines, Wine mix'd with Water, Water with Juice of Limon, and especially Milk and Water, are proper Drinks.
Those who feel no Inconvenience in taking Acids, ought to take them plentifully.
People of such Constitutions ought not to use violent Exercise, nor long Abstinence, which disposeth to such a State, and after long Abstinence they ought not to eat plentifully; they ought to use liquid rather than solid Aliment.
Plethorick Constitutions are subject to fall into this alkaline State of the Fluids, which is more dangerous than that which proceeds from Acidity, for the Bile (which is here redundant) is the strongest Anti-acid, and when it is highly exalted, and acrimonious, is capable of producing all the dreadful Symptoms of malignant and pestilential Fevers, as is evident from the Experiments that were made in the Plague of
Marseilles.
There is nothing corrects the Acrimony of the Bile so much as the acid Diet above-mentioned; therefore one cannot be too early and quick in discerning a Tendency to such a State, and observing if the Person be plethorick, hot, or dry; if the Air be hot; if bilious Fevers reign; if there be any Acrimony in the Faeces, Urine, Sweat; or a yellow; Cast in the Skin; with the Signs above-mentioned, by an early Application of proper Remedies, many dangerous and fatal Diseases might be prevented.
Phlegmatick Constitutions.
Sickness of the Stomach, a Sense of Fulness without eating; Crudities or Meat remaining in the Stomach undigested, Dejection of Appetite, Wind coming upwards, but especially tough Phlegm frequently rejected by Vomiting, Inflations and Tumors of the Belly (sometimes short Breath) and Paleness, are Signs of a phlegmatick Constitution; when a Child grows pale, and his Belly swells, as happens to those that are rickety, there is certainly tough Phlegm in the Intestines, which commonly shuts up the Mouths of the Lacteals, and hinders the Nourishment from passing: Persons of such Constitutions ought to avoid mealy Substances unfermented, unripe Fruits, and all viscous Nourishment; they ought not to let Blood, except upon urgent Occasions, nor provoke Sweat, which thickens the Humours.
Their Diet ought to be alkalescent, of Substances mentioned No 4, because whatever brings them into an alkaline State, is a proper Cure for the Disease; therefore soapy Substances, which consist of a pungent Salt and volatile Oil, Spices, Salt, Garlick, Onions, Leeks, and the warm Vegetables us'd in Seasoning, Thyme, Rosemary, Savory, Basil, Marjoram, and in general, every thing which exalts the Bile; for bilious and phlegmatick Constitutions are opposite; and even Children so diseas'd ought to use a warmer Diet, than what seems proper to their Age without it.
Phlegmatick Persons ought to drink fermented Liquors and generous Wines, such as put the Blood in a vigorous Motion. Warm Water dissolves Phlegm, but it relaxeth too much.
Thickness of Blood.
Thirst, Leanness, Excess of animal Secretions, as of Urine, Sweat, liquid Dejections, too strong a Perspiration, are Signs and Effects of too great Thinness of Blood.
For such, the Diet prescrib'd in Debility or Weakness of Fibres, is useful; Milk boil'd with Grains, especially Rice, rather solid than liquid Aliment, and austere Wines for Drink.
Oily or fat Constitutions.
Fat People ought to eat and sleep little, and use much Exercise, in which the Cure chiefly consists.
Whatever heats moderately, stimulating Substances abounding with a pungent acrid Salt, as Mustard, Horse-Radishes, Garlicks, Onions, Leeks, Spices, and the aromatick Plants us'd in Seasoning, Saffron, carminative Seeds, Meats high season'd with Salt, Pepper and Vinegar, are all proper, and dissolve Fat; they have only one Inconvenience, that they create Thirst, and great Quantities of Liquids increase the Disease, by diluting and relaxing the Solids; Salt is a great Dissolver of Fat.
Fat People ought to avoid oily Nourishment; but Soaps, which consist of Oil and Salt, are proper, because they are resolvent; therefore Honey, Sugar, and ripe Garden-Fruits are useful.
Some of the astringent Substances, mentioned No 1, are useful, because their Fibres are commonly too lax.
Whatever promotes Perspiration, and therefore Frictions of the Skin, are useful.
Their Drink ought to be thin Wines; Coffee and Tea, as they dilute and stimulate moderately, are useful; great Quantities of oily fermented Liquors increase Fat; mere Water relaxeth too much; moist Air is hurtful to fat People, by relaxing the Fibres, and stopping Perspiration.
Melancholy or atrabilarian Constitutions.
A Tendency to this is known by Darkness or Lividity of Countenance, Dryness of the Skin, Leanness, a quick penetrating Genius, a slow Pulse, and Respiration, Obstruction of the Belly, and too great Application to one Object.
To such, all things which heat and promote too great a Perspiration, as all Substances that abound with an acrimonious Salt and volatile Oil, are hurtful, which the Reader may see in the First Chapter. Nourishment viscous and hard of Digestion, and nothing more than salted and smok'd Flesh or Fish; in general, every thing that thickens the Fluids, or reduceth them to a pitchy Condition.
Astringent austere Aliment, mention'd No 1, and austere Wines, are hurtful.
Too cold and too hot Air are both hurtful, for in such States of Air, melancholy Persons are always worst.
Diluting is beneficial, especially with Water impregnated with some penetrating Salt, Substances which cool, relax the Belly, and resolve the Bile; Barley-Water, Whey, ripe Garden Fruits, emollient Pot-Herbs, especially Lettuce, Cichory, Dandelion, and Honey most of all.
There is one Caution to be observ'd, That the Diet ought to be opposite to the particular Acrimony which occasions the Disease; for if it proceeds from too great Acidity, in such a Case an animal Diet, Broths made of Flesh-Meat, and even Eggs, are proper; if the Cause be alkaline, the contrary Method is useful.
Faulty Motion of the Fluids.
The Blood and other Fluids of a Human Body, are often not only peccant in their Qualities, but Motion, which may be either too flow, too quick, or in some of the Vessels totally obstructed.
Those who have too slow a Circulation, are to be consider'd, as in the Case of phlegmatick and fat People; and those who have too quick a Circulation are to be consider'd, as in the Case of such as are bilious, hot, and alkaline; and the respective Diets are proper.
In Obstructions of the Vessels inflammatory, the Aliment ought to be cool, slender, thin, diluting, avoiding the copious use of Substances of a saline Quality, which stimulate, and consequently may increase the Inflammations, unless in some Cases where there is hopes by volatile Salts to attenuate the Fluid, and remove the Obstruction, or where the Intention is to produce a Suppuration; but it is certain that any stimulating Substance, when it does not remove the Obstruction, increaseth the Inflammation.
In cold Tumors, where the Intention is to dissipate and attenuate, the Diet ought to be diluting and stimulating, consisting of such Substances as are of a soapy Nature, that is, of Salt and Oil.
Wounds.
The Aliment of such as have fresh Wounds ought to be mild, that is, without stimulating or saline Substances, of easy Digestion, of such sort as keeps the Humours from Putrefaction, and renders them oily and balsamick.
When a Suppuration is to be promoted, the Aliment ought to be more copious and warm, because such induceth a Putrefaction.
When a Sore is healing, the Patient is in some measure in the Case of an Infant that is growing, whose Aliment ought to be such as lengthens the Fibres without Rupture, for it is by such an Elongation of the Fibres that Sores heal; and indeed the Chirurgeon ought to vary the Diet of his Patient as he finds the Fibres lengthen too much, are too flaccid and produce Fungus's, or as they harden and produce Callosities; in the first Case Wine and spirituous Liquors are useful, in the last hurtful.
Women in Childbed are in the Case of Persons wounded.
CHAP. III.
Of Acute Diseases.
Fevers, with their various Symptoms.
RIGOR, Coldness.
A right Regimen during the Rigor or cold Fit in the beginning of a Fever, is of great Importance, and Mistakes of dangerous Consequence: A long continued Rigor is a Sign of a strong Disease, and is in it self an. Approach towards Death; during the Rigor, the Circulation is less quick, and the Blood actually stagnates in the Extremities, and pressing upon the Heart creates great Anxieties, and may produce Concretions about the Heart, and in other Parts of the Body; therefore a Rigor increaseth an Inflammation. Those who die of Quartan Fevers, die in the cold Fit; and indeed there is no Mischief but what may proceed from a Rigor of long Duration.
In such Rigors, all warm Cordials and stimulating Substances are improper, for the first acting with force upon the right Ventricle of the Heart, may drive the Blood with too much Force through the Lungs; and stimulating Substances, by constringing the Vessels, often increase the Symptom.
In such a Rigor, nothing is more proper than Water, which dilutes and relaxes at the same time, and will sooner terminate the cold Fit, and throw the Patient into a Sweat, than the warmest Cordial; if a very small Quantity of Rhenish Wine be mix'd with the Water, it will be still more effectual: In this Case strong Frictions of the Extremities relieve.
Anxieties.
In Anxieties which attend Fevers, when the cold Fit is over, a warmer Regimen may be allow'd; and because Anxieties often happen by Spasms from Wind, Spices are useful.
In those Anxieties, Soapy Substances which dissolve the Blood, are indicated; ripe Fruits; some of the lactescent Plants, as Lettuce, Endive,
&c.
and especially Honey, have this Quality.
Thirst.
In Thirst attending Fevers, Liquors should not be drank quite cold; for cold Liquors, by constringing the Glands of the Palate and Throat, do not quench Thirst so well as Liquors moderately warm: In this Case subacid Liquors should be drank plentifully; all Salts increase Thirst, except Nitre, and dulcify'd Spirit of Nitre mix'd with Water, is very proper in this Case; so are BarleyWater and Emulsions, except in great Weakness and Flatulencies of the Stomach, in which Case Water mix'd with a small Quantity of Rhenish Wine, is best of all.
Sickness, Vomiting.
This is one of the most troublesome Symptoms attending a Fever, because it renders the Patient incapable of taking any thing.
This Symptom is often prevented by giving a Vomit; or cur'd by promoting the Vomiting for a while by tepid Water.
During the Symptom, acid Liquors, and ev'n such as are austere and astringent, are indicated, because such strengthen the Fibres of the Stomach; and indeed Nature directs Patients to such a Diet, for they covet subacid Liquors, and abhor fat and oily things.
Diluting, and sometimes relaxing the Belly, and carrying the bilious Salts downwards, often cures this Symptom.
Attention is to be given to the Appetites of Patients, in this and many other Cases, who have sometimes coveted odd things which have reliev'd them, as Salt, Vinegar,
&c.
Vomiting, from a bilious Cause, is cur'd by subacid Liquors; Vomiting, from some putrid Cause, by Salts of all Kinds; in such a Case, Water-Gruel with Cream of Tartar, Rhenish Wine and Water, Jelly of Currants, Marmalade of Quinces, Sorrel boil'd in Broths well skimm'd from Fat, are beneficial.
If the Vomiting comes from a phlegmatick Cause, Spices, and bitter things will relieve. The Counterpoison must be adapted to the Cause; for Example, in Poison from Sublimated Corrosive, and Arsenick.
In the First, alkaline Substances; in the Second, oily Substances are proper; in both, diluent.
It is easy to judge of the Cause by the Substances which the Patient throws up.
Whether Vomit may be safely or properly given, must be judg'd by the Circumstances; if there be any Symptoms of an Inflammation of the Stomach, a Vomit is extremely dangerous.
Wind
and
Spasms
are occasion'd by the feverish Heat expanding the aerial Particles in the Fluids.
Whatever is anodyne and quiets Convulsions, and what abates the Heat, relieves this Symptom.
Weakness,
or the Impotence of exercising animal Motion which attends Fevers, proceeds from too great Fulness in the beginning, and too great Inanition in the latter end of the Disease; for whatever stops or retards the Circulation in the smallest Vessels, especially those of the Brain (which either of these Causes will do) produceth this Symptom. Those two Causes demand different Methods, in the first emptying and diluting; in the latter, a more plentiful Nourishment, the use of Wine diluted with Water, and Spices in small Quantities, Jellies, Broths, the alkalescent Quality of which may be corrected with some acid, unless there be Signs of Acidity, and in that Case the Diet ought to be contrary to the Cause of the Symptom; Viper-Broth is both anti-acid and nourishing.
In Debility, from great Loss of Blood, Wine, and all Aliment that is easily assimulated, or turn'd into Blood, is proper; Blood is required to make Blood; a small Quantity of Blood brings the Patient into danger of a Dropsy.
Frictions of the extreme Parts relieve Weaknesses, as they promote the Flux of the Juices and Spirits in the Joints and Limbs.
Fat People are most subject to this Symptom of Weakness in Fevers, because the Fat, melted by the feverish Heat, obstructs the small Canals, and consequently produceth this Symptom. This is evident by the great Loss of Fat such People sustain in Fevers. In the latter end of Fevers, such are weak by the Laxity of the Fibres, and the Emptiness of the smaller Vessels; such therefore must be treated with particular Care,
viz,
after due Evacuations, diluting strongly both by Drink and Clysters, avoiding all things oily, and using Sugar, Honey, and ripe Fruits.
Cordials made of spirituous Liquors are not the best Remedies for this Debility, tho' they increase the Force of the Heart, and are necessary sometimes to keep up the vital Functions, they rather coagulate the Fluid; they add Strength to the Mill, but congeal the Stream. Whatever makes the Circulation more free through the small Vessels, is a Cordial.
Heat;
the Degree of which may be known by the Thermoscope, the Sensation of the Patient, the Intenseness of the red Colour of the Urine, the Sizeness of the Blood, the Dissipation of the fluid Parts, which renders it thicker; the Hardness, Strength, and Frequency of the Pulse, which makes the Friction the stronger, to which the Heat is proportional, the bad Disposition of the Humour, and the dry Temperament of the Body.
Feverish Heat is moderated by Blood-letting, by muscular Rest, by moderate Ligatures which compress the Veins only, and often removed from Joint to Joint, by a mechanical Reason, retard the Circulation; of such sort is dry Cupping, bathing the lower Parts, watery Liquors for Drink, not cold, but tepid; subacid, as Jelly of Currants dissolved in tepid watery Liquors; Decoctions of mealy Substances acidulated, Substances anodyne, Substances which dissolve Concretions, as Sugar, Honey, and the simple Oxymel, often used by
Hippocrates,
plentiful diluting, and restoring as much Water to the Blood as is dissipated by the Heat; all demulcent and relaxing Substances, cooling the Air in the Room, opening the Curtains, and removing too thick Bed-clothes; all stimulating and slyptick Substances to be avoided, because they increase the Force of the solid Parts.
Delirium.
Too great Alacrity and Promptness in Answering, especially in Persons naturally of another Temper, is a Sign of an approaching Delirium: In a feverish Delirium there is a small Inflammation of the Brain; therefore any thing which increaseth the Circulation in the lower Parts, and diminisheth the Pressure on the Brain, is beneficial, as immerging the Feet in warm Water; nothing relieves the Head more than the Piles, therefore Suppositories of Honey, Aloes, and Rock-Salt, ought to be try'd, relaxing by emollient and watery Substances, both in Drink and Clysters, especially Barley-Cream and Barley-Gruel.
Coma Sleepiness.
A Coma will proceed either from a Pressure upon the Originals of the Nerves, by too great Repletion; or from a Penury of Spirits by too great Inanition.
Old Men are subject to Comas by the Tenacity of the Fluids circulating in the Brain, which being resolved by the Fever, obstruct the small Canals of the Brain: In young People it commonly proceeds from Fulness, and is best cur'd by letting Blood, and relaxing the Belly. The Sign of such a Fulness is, a red Countenance, and Eyes inflamed; if it proceeds from a glutinous Oil, it ought to be attempted to be resolv'd by Water, nitrous Salts, Soaps, and subacid Liquors.
People recovering from Comas, must take at first soft Nourishment, and in small Quantities.
Watchfulness.
This Symptom, which is sometimes call'd a Coma Vigil, often precedes too great Sleepiness, and is perhaps the most ill-boding Symptom of a Fever.
The Expedients in such a Case are extreme Care to keep the Patient from Noise, and what makes any strong Impression upon his Senses, some of those Helps us'd in a Delirium, because this is an Approach towards it; a moist softening Diet; all Preparations of Barley, Emulsions of Poppy Seeds, and Almonds, Aliment of some lactescent Plants, especially Lettuces, Decoctions of Scorzonera Roots, Almond Cream, and what is call'd Winter Flummery, us'd as Aliment; Tea, made of Cowslip Flowers, relaxing gently the Belly.
Boerhaave
proposes some mechanical Expedients which may perhaps have a good Effect, as a soft Noise of Water distilling by Drops into a Bason, and the Patient trying to reckon them.
The Air perfum'd with the Smell of soporiferous Plants, as Poppies, Mandrakes, Nightshade, Bean Flowers.
Application of Cloths dipp'd in Vinegar to the Temples.
Opiats must never be given but after great Evacuations.
Convulsions.
It is of the utmost Importance to know the Cause and the Seat of this Disease, which is often obscure.
In Infants they commonly proceed from Acidity in the Stomach, and are cured by terrestrial Absorbents; in such indeed Convulsions attending Fevers are not quite so dangerous.
Convulsions arising from some Acrimony in the Stomach, or from something vellicating a Nerve in its Extremity, and not in its Original where it ariseth from the Brain, are not very dangerous.
Convulsions which arise from great Evacuations, as great Haemorrages attending Fevers, are dangerous.
Convulsions arising from Inflammations of the Membranes of the Brain are commonly fatal: The Symptoms attending them are a great Heat, a hard Pulse, and a Delirium: The Remedies, and even those from Diet, are to be us'd according to the Seat of the Disease.
If from the Stomach, such Aliments as are contrary to the particular Acrimony, Acid Alkaline, or Oily, residing there, as in the Case of Vomiting.
If from something impacted in the Brain, warm volatile and spicy Substances will increase the Disease; in that Case, Substances which relax and dilute are proper, especially such as open the Belly; which,
See in the First Chapter;
and in general, the Regimen prescrib'd in a Coma, or Delirium.
Violent Sweats
proceed from a Laxity of the Vessels, and too vehement a Circulation of the Blood.
Profuse Sweats deprive the Blood of its most fluid Parts, thicken, and often cause Obstructions; it is not good Practice to push Sweating too much in Fevers, except in such as are pestilential.
In profuse Sweats, Care at least should be taken, by diluting, to restore the Liquid which the Blood loseth, and to use the Methods advised in too great Heat, by taking away some of the Coverings of the Bed, and admitting of cool Air, and using a Diet moderately astringent; Wine, Spices, and spirituous Liquors, in this Case, have often a good Effect; spirituous Liquors thicken the Fluids; Sage is a good Remedy in the Case of profuse Sweats.
A Diarrhoea Looseness
proves often a dangerous and fatal Symptom in Fevers, it weakens, excoriates and inflames the Bowels, occasions Bloody-Fluxes, thickens the circulating Juices, and exhausts the Strength of the Patient; notwithstanding, a critical Diarrhoea is not to be stopt, for fear of incurring these Dangers.
Attention is to be given to the Cause of Acidity; it is to be cur'd by Anti-acids; but, as in Fevers, the Cause is more frequently alkaline and bilious, Acid or four things resolve, and it happens that oily Substances by blasting the Acrimony will do good in Diarrhoeas. Oily Substances of themselves do not irritate or provoke Diarrhoeas, they only lubricate or make the Bowels slippery. Diarhoeas arising from Quantities of Fruit are often cur'd by Emulsions.
Vomiting, by evacuating the irritating Cause, often cures such Diarrhoeas.
Anodyne Substances are proper, and generally speaking, solid and dry Aliment, rather than liquid.
Inflammatory Eruptions.
In all these of any kind whatsoever, as Small-Pox, Meazles, Scarlet Fever, Purples, the Intention in Diet ought to be, to avoid strong Sudorificks, which push out too great a Quantity of the Matter upon the Skin; to use cooling and temperate Diluents, which keep the Matter fluid and moveable, so that it may be secern'd from the Blood; to keep warm during the Eruption; and that then Diet be cool; for which Reason the moderate Use of Acids, as Juice of Limon, is indicated.
A due Attention to the few Rules above-mention'd, in the several Symptoms, will prove very successful in the Cure of most Fevers. I shall only add a few more according to the various Kinds of Fevers and Inflammatory Distempers.
An Ephemera, or a Fever of one Day, is cur'd by Abstinence, Rest, and Diluting; and the same Method will prove effectual if the Fever lasts several Days, and is not putrid, or attended with a greater Inflammation and Acrimony, and Obstruction of the Vessels in some Parts of the Body, amongst which is what is commonly call'd, a Causus, or burning Fever.
The Causes of such a Fever are various; Errors in the Non-Naturals, Air, Meat and Drink, Rest and Motion. Such a Fever will be rais'd by Vehement Exercise or Labour, Heat of the Sun, by long Thirst, by the immoderate Use of fermented and spirituous Liquors; and hot things, as Spices; and by great Lassitude endured any way, especially in hot Weather.
Its Symptoms are a burning Heat in the Skin, a Sensation of extreme Heat inwardly; sometimes Coldness in the extreme Parts; Dryness of the Skin, Mouth, and Nostrils; a Dryness and Roughness of the Tongue; laborious and short breathing; great Thirst; Loathing, Sickness of the Stomach, and Vomiting; Anxiety, Restlesness, Weariness; sometimes a Cough and Hoarseness; Watchfulness and Delirium, and Exacerbation every other Day.
Such a Fever is often resolv'd by a bleeding at the Nose, which ought not to be stop'd unless it endangers Life. It is likewise often in the critical Day resolv'd by Sweating, Vomiting, Looseness, and Spitting of thick Phlegm. The fatal Signs are commonly bloody Urine, Difficulty of Swallowing, watery Sweats about the Head and Face, without Relief; Coldness of the Extremities, Trembling, too great a Looseness; and sometimes an Inflammation of the Lungs.
The Regimen, in such a Fever, is keeping the Air of the Room pure and cool, untainted with Fire, Smoke, or the Breaths of many People; they ought to have no more Bed-clothes than barely protects them from Cold; their Curtains ought to be kept open so as to renew the Air; and their Posture in lying, as erect as they can bear; the Sick, in this Condition, covet all these things, and their Contraries offend them.
Their Drink ought to be cool, mild, subacid, tepid, given in moderate Quantities, and often, as Water with Juice of Limon or Tamarinds.
Their Aliment ought to be light, of farinaceous Vegetables, as Water-Gruel, Preparations of Barley, with some Juice of Limon; Rice boil'd in Whey, and strain'd. Roasted Apples in the Progress of the Disease; a little toasted Bread with Rhenish Wine and Water, Jelly of Currants; Broths and Jellies made of animal Substances are rather too alkalescent, at least they ought to be qualify'd with Juices of Limon, or some acid.
Sometimes such alimentary Substances as gently stimulate the Belly, are useful, as some ripe Fruits, Strawberries, Currants, Mulberries.
The Symptoms increase by the Use of hot things given either as Aliment or Medicine.
Intermitting Fevers.
They are (at least in this Country) very obstinate, often return in spite of all Remedies, and by long Continuance they degenerate into Hepatical Fevers, and many chronical Distempers, as Jaundice, Dropsy, Schirrus's, and Scurvies; therefore in this Disease a right Method, both of Medicines and Diet, is of great Importance. There is a great Variety in these Diseases, as to the Intervals of Times between the Paroxysms; Tertians sometimes redouble their Paroxysms, so as to appear like Quotidians. I think it may be taken as a general Rule, That the greater Distance of Time there is between the Paroxysms, the Fever is less dangerous, but more obstinate.
There is a different Regimen to be us'd during the Continuance and Absence of the Paroxysm; and in the Paroxysm itself, during the Rigor or cold Fit, the Heat and the Sweat.
During the Rigor, the Regimen prescrib'd in the foregoing Part of this Chapter, in the Article of Feverish Rigors, is proper in all Fevers, and Care is to be taken by all proper Methods to shorten that Period as much as possible, and by tepid Diluents to bring on the Sweat soon, but not to push it beyond its due Measure, because an intermitting Fever relaxeth and weakens the Body extremely.
Between the Paroxysms, too great Abstinence is hurtful as much as too great Repletion; as intermitting Fevers are often of long Continuance, extreme Abstinence is impracticable, and would reduce the Patient to a Condition not to be able to sustain the Shock of the next Attack.
Between the Paroxysms, such Substances as temper, correct, and subdue the bilious Alkali, as acid Substances, nitrous Salts, small thin Wines with Water, Chicken Broth with Juice of Limons; Wine with Bitters infused, are proper; Cichory and Dandelion are useful, because the express'd Juices of them cure intermitting Fevers in warm Countries; the Physicians of these Countries likewise use astringent Vegetables,
See
Chap. I. No 1.
Exercise, to as great a degree as the Patient can bear, is extremely beneficial between the Paroxysms.
But the chief Remedy of all is to endeavour to prevent the cold Fit, by getting to Bed, by Frictions, and some sudorifick and warm Liquor; for by putting off the cold Fit some Agues have been cur'd.
Letting of Blood seldom does good, and often a great deal of Hurt in intermitting Fevers; but the Condition of the Patient is to be consider'd in this Case.
Intermitting Fevers have been observed to free from some Chronical Distempers, as the Gout and Convulsions, but they often induce great ones themselves.
INFLAMMATORY DISEASES.
A Phrensy, or Inflammation of the Brain.
This Disease, of all others, requires the speediest Applications, profuse Haemorrages from the Nose commonly resolve it, and copious Bleeding, by opening the temporal Arteries, are the most effectual Remedies: But to stick to my Subject, which is the Diet.
Substances which cool, and at the same time relax the Belly, are highly beneficial, as Tamarinds boil'd in Water, which taken plentifully may at last bring a Looseness which is a great Relief to the Head.
Soliciting the Blood to other Parts of the Body; therefore tepid Bathings of the lower Parts, and procuring the Piles, relaxing Fomentations apply'd to the Veins, which carry the Blood from the Head, relieve in this Disease. Cool Air, and Sitting up, if possible; for the warm Air of the Bed exagitates the Blood.
The Aliment ought to be slender, of farinaceous Substances, as Water-Gruel acidulated, or subacid ripe Fruits, with their Jellies; the Drink small, diluting, and cooling, Barley-Water, Small-Beer, or the Decoction of Tamarinds above-mentioned. All such gentle Anodynes as are to be found amongst the Alimentary Kind, are safe.
See
the Articles of Delirium and Watchfulness in this Chapter.
Quincy.
The Tumour of the Throat, which occasions the Difficulty of Swallowing and Breathing, attending this Distemper, may be of various sorts: Sometimes it proceeds from a Serosity obstructing the Glands, which may be watery, aedematose, schirrous, according to the several degrees of the Viscosity of the Humour; sometime inflammatory, which Inflammation will sometimes end in a Suppuration, or Gangrene.
The Difficulties of Breathing and Swallowing, which happen without any Tumour outward or inward, after long Diseases, proceed commonly from a Resolution or paralytical Disposition of the Parts, and is the immediate Forerunner of Death.
The Regimen in those Quincies which proceed merely from the Obstruction of the Glands, must be to use such warm Liquors as gently relax, soften, and moisten those Glands, such as carry off the redundant Serum by Stool, Sweat, and Urine; or by stimulating, open the Emunctories of these Glands to secern the Humour
See
Chap. I.
.
In a more watery Tumour, the Diet may be more warm than in the inflammatory, and the moderate use of Wine often relieves the Patient.
The Difficulty of Swallowing and Breathing, occasion'd by Schirrosities of the Glands, is not to be cur'd any otherwise than by Extirpation.
Those who are subject to Inflammations of the Throat, ought to live temperately to prevent a Plethora; or to break such a Fulness speedily by proper Evacuations, to beware of cold Air, too astringent or stimulating Aliment or Medicine, and violent Exercise, which, by increasing the projectile Motion of the Blood, heat; but especially the swallowing of cold Liquors when they are hot.
In these Inflammations a slight Diarrhoea relieves; therefore Aliments which promote it are useful, as Tamarinds infus'd in Whey. Decoctions and Emulsions of farinaceous Vegetables moderately acidulated, and such as abound with a cooling nitrous Salt, are proper; it is commonly thought that Punpenella, Saxifraga, or Burnet, is a Specifick in this Case: Every body knows the Benefit of Mulberries, taken all manner of ways. All Acids, as Sorrel, Juice of Limon,
&c.
abate Inflammations.
The Mouth and Throat must be kept moist, and the Nose clear, that the Air may have a free Passage through it; for Air drawn by the Mouth, dries.
When the Deglutition is totally abolish'd, the Patient may be nourish'd by Clysters, which I have known to have been done for a whole Week, after which the Tumour suppurated.
When the Inflammation ends in a Gangrene, the Case generally proves mortal, except it be only in the
Tonsils, Uvula,
and Palate, and go no further, which Parts may be separated, and the Patient live.
Inflammation of the Lungs.
Such may happen either in the bronchial or pulmonary Vessels, and may soon be communicated from one to the other; when the Inflammation affects both the Lobes and the whole Body of the Lungs, the Case is desperate, because the Circulation must be stopt, and no Blood can flow back into the Heart. Besides the general Causes of Inflammations, those which affect the Lungs particularly, are a bad Conformation of the Lungs and Thorax commonly attended with an Asthma, Air too hot, cold and moist, abounding perhaps with caustick, astringent, and coagulating Particles; the Lungs, properly speaking, are an outward Part of the Body, expos'd to the Air, which, by its immediate Contact may easily coagulate the Blood which flows along the Surfaces of the Air-Bladders, and I believe the Qualities of the Air are the general Cause of the Inflammation of the Lungs which happen in the Winter time.
As the Lungs are the chief Organ of Sanguification, crude and viscous Chyle, viscous Aliment, Spices, but especially spirituous Liquors, may occasion this Inflammation; too great an Exercise of the Lungs, so as to occasion a short and laborious Breathing, or keeping them too long upon the Stretch by Vociferation, or loud Singing, may produce the same Effect: There are coagulating Poisons which affect the Lungs very suddenly; extreme violent Passions, by affecting the Motion of the Heart, may do the same; it is a common thing to see People in sudden Transports of Anger breathe short. Inflammations are sometimes translated from other Parts to the Lungs; a Pleurisy easily passeth into Peripneumony. The avoiding those Causes is the best Rule of Diet to prevent the Disease; besides, speedy and plentiful letting of Blood before it has quite taken place.
This Disease is often cur'd by the critical Resolution, Concoction, and Evacuation of the morbifick Matter, which is either attenuated so as to be return'd into the Channels, and to go on in the common. Thread of Circulation, or expectorated by Coughing, which may be easily known by the Abatement of Symptoms,
viz.
the Fever, Difficulty of Breathing, Thirst, Anxiety, Restlesness, and the Patient's falling into gentle breathing Sweats. One of the best Resolvents is the Blood of the wild Goat.
Copious Bleeding is the most effectual Remedy in the beginning of the Disease; but when the Expectoration goes on successfully, not so proper, because it sometimes suppresseth it, and in that Case Sudorificks thicken the Matter that is expectorated. The Motions of Nature ought to be followed. This by the way.
From the Symptoms in this Stage of the Disease, and the use of the Lungs, it is evident the Aliment ought to be more slender and thin than in any other inflammatory Disease whatsoever, common Whey being sufficient to preserve the Strength of the Patient; watery Liquors, and even the Steam of warm Water taken in by the Breath, attenuates the impacted Matter. Relaxing Aliment, of which Barley and all its Preparations are the best.
In this State, Diureticks, which have not much Acrimony in them, are proper, for Fluxes of Urine relieve the Lungs; for this Intention, an Infusion of Fenel Roots in warm Water, with Milk, is good, both as Nourishment and Drinks.
If Nature relieves by a Diarrhoea, without sinking the Strength of the Patient, it is not to be stopt, but promoted gently by emollient Clysters.
Decoction of Cichory, Lettuce, as being anodyne and resolvent, are proper.
If the Patient is not reliev'd nor dies in eight Days, the Inflammation ends in a Suppuration and an Abscess in the Lungs, and sometimes in some other Part of the Body; the Symptoms of which are, an obstinate dry Cough, increas'd by Motion and taking of Food; theeasiest Posture in Lying being upon the affected Side; a continual Lent-Fever, with Rigors invading with uncertain Periods; Exacerbations after Motion and Repast, Thirst, Night-Sweats, a frothy Urine, Paleness, Leanness, Weakness.
In such a Case one must forbear letting of Blood. The Diet must be mild, soft, incrassating, and more plentiful; tepid Vapours admitted into the Lungs, of Decoctions of proper Ingredients; and when by the Symptoms and Time the Imposthume may be judg'd to be ripe, the Vapour of Vinegar it self, and any thing which creates a Cough, as Oxymel, or Vinegar and Honey, Exercise and Concussion are proper, the sooner it is broke, the less Danger to the Lungs.
Tho' such a State is extremely dangerous, it is not quite desperate; the Aliment ought to be Milk; the Drink, Milk, and Barley-Water, and such alimentary Substances as are expectorating and cleansing, with gentle Anodynes, that the Patient may have some Rest.
See
Chap I.
The principal Intention in every State of Inflammation of the Lungs is to promote Expectoration, and to restore it when it is lost.
If the Inflammation ends in a Gangrene, the Case is desperate; if in a Schirrus, incurable.
There is a spurious sort of a Peripneumony, not inflammatory; when the Vessels are obstructed with a viscous Pituite that mixeth with the Blood, and invades in cold Weather, it is dangerous, and often suffocates; it is incident to weak and old People. In this, some of the Methods used in the Inflammatory are proper, but not so copious Bleeding, Clysters frequently injected; Aliment more generous, Broths, and Jellies with Juice of Limon, Hydromel, or Honey and Water; for Drink, soft Oils, and Aliments which abound with a soft, not volatile Oil, are beneficial.
A Peripneumony is the last fatal Symptom of every Disease, for no Body dies without a Stagnation of the Blood in the Lungs; as long as it circulates through the Lungs, it will circulate through the rest of the Body. The total Extinction of Breath is caus'd by the Stagnation of Blood in the Lungs.
Pleurisy.
There is none of the Membranes which invest the Inside of the Breast, but may be the Seat of this Disease, the Mediastine as well as the Pleura.
The Causes of this Disease, besides those common to all Inflammations, are often a particular Disposition to inflammatory Distempers, a Straitness of the Arteries of the Pleura, a Callosity of that Membrane, an Adhesion of the Lungs, the sudden Admission of cold Air by too thin clothing, too hot a Regimen, and especially the copious use of spirituous Liquors, cold Liquors drank when the Body is very hot, a Translation of some inflammatory Matter from some other Part, but most of all cold Air from a Northerly or North-easterly Wind; from which Causes proper Cautions may be taken in the Regimen by way of Prevention.
This Disease is sometimes dry, without any Spitting, and sometimes attended with Expectoration from the Lungs, and that is taken off by a Coction and Resolution of the feverish Matter, or terminates in Suppurations, or a Gangrene.
The Regimen ought to be much the same as in a Peripneumony, a cool, relaxing, slender, diluting Diet, and avoiding all things which increase Heat, even too hot Air.
The Symptoms of Suppuration are the same as in Inflammations of the Lungs; when the Matter is made, the Side must be opened to let it out.
When the Disease is obstinate against all Remedies, a sudden Abatement of the Pain, a quick weak Pulse, sometimes intermitting, short Breath and cold Sweats are Symptoms of a Gangrene, and approaching Death.
Paraphrenitis, or Inflammation of the Diaphragm.
The Symptoms of this Disease (which is often mistaken) are a violent Fever, a most exquisite Pain increas'd upon Inspiration; by which it is distinguish'd from a Pleurisy, in which the greatest Pain is in Expiration.
This Pain is increas'd by Sickness, Vomiting, Repletion of the Stomach, or any Compression of the Muscles of the Abdomen, by rendering the Faeces or Urine. The Breathing is extremely quick, suffocating, and seems to be perform'd only by the Motion of the Breast: It is likewise attended with a Delirium, Fury, and an involuntary Laughter, the Convulsion emulating this Motion.
This Disease terminates as Pleurisies and Peripneumonies, but is generally fatal if it suppurates the Pus, is evacuated into the lower Belly, where it produceth Putrefaction, and a most miserable and painful Death.
The Regimen, if any can be successful, ought to be the some as in Pleurisies.
Inflammation of the Liver.
The hepatical Artery, and the Vena Porta, carry the Blood into the Liver; the first being very small, and the Motion of the Blood in the last being slow, is the reason that Inflammations in the Liver are not so frequent as in some other Parts of the Body; but when they obtain, extremely dangerous, unless they take up but a small Part of the Liver, and such happen more frequently than is commonly imagined.
Some of the best Cautions in Diet may be taken from the Causes and Symptoms of this Disease.
Which, besides the general Causes of Inflammations, are extreme Fatness. Fat dissolv'd by Heat and Inflammations obstructs the Vessels of the Liver very suddenly. Cattle fatted by good Pasturage, after violent Motion, sometimes die suddenly; in such the Liver is found to be inflamed and corrupted. An atrabilarian adust Temper of the Blood and Gall, an acrimonious or purulent Matter, stagnating in some other Organ, is more easily deposited upon the Liver than any other Part, especially if attended with the use of hot and spicy Aliments, spirituous Liquors, great Heat, and a Fever▪ Erosions, by the Acrimony of the Gall, or Obstructions by Viscosity; any Callosity, Schirrus, or Stone in the Liver; Thirst, long endur'd, being suddenly chill'd by cold Air, cold Water, or drinking cold Liquors after great Heat; Vomits given injudiciously, when the Liver is already unsound, which if they do not remove the Obstruction, exagitate the Liver too much; inveterate hypocondriacal Distempers. All these Causes may produce Inflammations of the Liver.
In such a Case, the Liver being swell'd compresseth the Stomach, Diaphragm, and the neighbouring viscera of the lower Belly, stops the Circulation of the Juices, the Generation and Excretion of the Gall, and all Digestion; produceth an Infinity of bad Symptoms, the Jaundice, with all the Diseases depending upon it; for the Liver receives the refluent Blood almost from all the Parts of the Abdomen, and is the chief Instrument of all the Digestions which are made there. A Fever, an Inflammation and pungent Pain on the Region of the Liver and Diaphragm, a Tension of the Hypochondres, Yellowness of the Skin and Eyes, and a Saffron-colour'd Urine, are Signs of an inflammatory Disposition of the Liver.
This Disease ends as other Inflammations, being cur'd either by Resolution, Concoction, and Excretion of the morbid Matter, terminates in an Abscess, Schirrus, or Gangrene.
During the first State, a warm Regimen and Saffron, which is reckon'd a Specifick, is improper.
Cooling resolving Liquors taken inwardly, as Whey, with Sorrel boil'd in it; outward Fomentations, and frequent Injection of Clysters, Bathing and Frictions, relax, and render the Matter fluid; Honey, with a little Rhenish Wine, or Vinegar; the Juices and Jellies of some ripe Garden Fruits; and those of some lactescent papescent Plants, as Endive, Dandelion, Lettuce, are resolvent.
Violent Purging hurts, gently relaxing the Belly relieves, Diluents with nitrous Salts are beneficial, or Tamarinds boil'd in warm Water or Whey; bloody Stools, not in an extreme degree, or streak'd with Blood, ought not to be stop'd, because they help to resolve the Distemper, and Haemorrages by the Nose often do the same.
The feverish Matter is often carried off by Urine, and therefore Diureticks not highly stimulating, are proper.
Sweating ought not to be promoted by warm Cordials, but encourag'd by warm diluting Liquors.
It is a deplorable Case when the Inflammation terminates in a Suppuration, unless the Abscess points outwardly, so as it may be opened; for if the Pus be evacuated into the Abdomen, it produceth dismal Symptoms, Putrefaction, or an incurable hepatical Dysentery, or Bloody-Flux.
The Pus, from an Ulcer of the Lungs, growing thin and ichorose corrodes the Vessels (for the Liver of all the Viscera, is the most friable, and easily crumbled or dissolv'd) it is often carried into the Blood, and rejected by Vomiting, with a cadaverous Smell, attended with great Thirst; if it is carried downward, it occasions a purulent colliquative Diarrhoea; acid Substances relieve most in this Case.
This Disease may happen to produce a Cancer, or Schirrus; one cannot say that the last is absolutely incurable, because it has been known by Experience that Grass and fresh Pasture has cur'd it in Cattle; and perhaps the express'd Juices of Grass, and some opening Plants, may do the same thing in Mankind, as of the lactescent Plants above-mention'd.
The Diet prescrib'd here is necessary in a Jaundice, and all Diseases of the Liver; and Abstinence from such Substances as induce Putrefaction, especially salted Fish and Flesh, and above all, strong Liquors.
Inflammation of the Stomach.
The Symptoms of this Disease are a vehement, burning, fix'd, pungent Pain in the Stomach, attended with a Fever; a great Exacerbation of this Pain the Moment after swallowing any thing, succeeded with Vomiting; a painful Hickup, and great Anxiety. The Causes of these Symptoms are those common to all Inflammations, a natural Weakness, and perhaps Erosion of the Coats of the Stomach, and acrid Substances taken as Aliment and Medicines.
If this Disease is not speedily cur'd, it proves fatal.
It terminates in a Cure by a Resolution of the morbifick Matter, a Suppuration, Schirrus, Cancer, but most commonly in a Gangrene.
Of all Diseases this demands most a total Abstinence from every thing that has Acrimony in it, even the nitrous cooling Salts, which are beneficial in other Inflammations, irritate too much; Vomits, all Cordials of volatile or spicy Substances; spirituous Liquors are no better than Poison, and Milk generally curdles; Aliments must be given frequently, and by Spoonfuls at a time, for any Distension increaseth the Inflammation; a thin Gruel of Barley, Oatmeal, Whey, with very little Sugar, or Honey, or Chicken-Broth, are proper Aliments; Whey, emollient Decoctions, Barley-Water, Emulsions, are proper Drinks; and it has been found by Experience, that chalybeat Waters have been agreeable to the Stomach even in this inflammatory State. If there happens an Imposthume, Honey, and even Honey of Roses, taken inwardly, is a good Cleanser, and Decoctions of Comfrey Roots, healing; speedy and plentiful Bleeding, Fomentations, and Clysters, have the same good Effect as in other inflammatory Distempers.
The same Regimen is necessary in a Schirrus, or Cancer of the Stomach; though nothing will be quite effectual.
The same Regimen is to be observed in the Inflammation of the Spleen, Caul, Pancreas.
Inflammation of the Guts.
The Intestines or Guts, most frequently the small ones, may be inflam'd by any acrid or poisonous Substance taken inwardly; from any purulent Matter translated upon them from some other Part of the Body; from Bile, extremely acrimonious, by a violent Tension; from a Convulsion filling them with Wind.
The Symptoms are a total Stoppage of the Passage; a vehement fix'd burning Pain, irritated by things taken inwardly, when any thing toucheth the affected Part, it excites Vomiting, sharp griping Pains, with Wind in other Parts of the Bowels; the Consequences of such an Inflammation are an Ileus, what is commonly called the Twisting of the Guts, but is really either a Circumvolution or Insertion of one part of the Gut within the other. All these Symptoms are attended with a Fever.
It is of the utmost Importance to know what the Causes of Colicks are; for as they are various, the Remedies in one Case are quite opposite and destructive in the other; for the spicy warm carminative things which are given in a Colick, from a phlegmatick or cold Cause, are Poison in an inflammatory one; they may be distinguish'd by the Fever, high Pulse, Thirst, and flame-colour'd Urine attending the Inflammation, as to the Heat, tho' it is great likewise by the Violence of the Pain, the Extremities grow cold; besides, there is a sudden Prostration of the Strength or Weakness attending this Colick, more than any other.
This Disease admits of a speedy Remedy, or none, for it ends in an Ileus, and Mortification of the Bowels very soon.
Besides a copious Bleeding, there is hardly any other Method but fomenting and relaxing the Bowels by emollient tepid Liquids, both taken by the Mouth and by Clysters, injected hourly; yet it has been known by Experience, that Acids have relieved in very desperate Cases, as Juice of Limons taken by the Mouth, and Vinegar and warm Water given in Clysters, have sav'd the Patient, because of the incessant Vomiting; Opiats to quiet the Convulsions are sometimes necessary.
Warm Fomentations even of warm Animals to the Belly, are extremely beneficial.
If the Inflammation happens to be in the lower Guts, it is not so dangerous; and even when it suppurates, it admits of a Cure, then it can be reach'd by proper Medicines in the Form of Clysters; in the latter end of such a Case Chalybeat Waters are beneficial.
If the Patient survives three Days, the Acuteness of the Pain abates, and a Chilliness or Gruing affects the Body, it betokens a Suppuration, and in a few Days the Matter flows either into the Cavity of the Abdomen, producing all the Symptoms which happen in the Imposthumation of the Liver, or into the Cavity of the Intestines, and causing a purulent Bloody-Flux, and often a Consumption,
Sinus's, Fistulas.
Whey and Chalybeat Waters are often beneficial in such a Case, as Drinks.
The Aliment ought to be of such things as generate little or no Excrements, as Broths of Flesh-Meat, with Scorzonera, Parsley, or Fennel boil'd in them; Goats Whey is likewise excellent; fat and oily Substances generally hurt.
The Continuance of the Fever, clammy Sweats, Paleness, an ichorose Diarrhoea, foetid, black, or like the Washings of Flesh, a small intermitting Pulse, and at last a total Cessation of Pain, are Signs of a Gangrene and approaching Death.
If none of the foremention'd things happen, if the Fever abates, and the Patient complains of a Weight, dull Pain, Stoppage of the Excrements, a Schirrus is forming, which increaseth daily, and may terminate in a Cancer, which Purging, and indeed all Medicines irritate; the Patient in such a Case may protract a miserable Life with an exact thin Diet of Whey, Broths, and such things as produce no Foeces, or by alimentary Clysters.
A Thrush.
By this Name are call'd small, round, superficial, Ulcerations, which appear first in the Mouth, but as they proceed from the Obstruction of the Emissaries of the Saliva, by the Lentor and Viscosity of the Humour, they may affect every Part of the alimentary Duct, except the thick Guts; they often succeed Fevers, especially those that inflame the Intestines, or are attended with a Looseness; and they are just the same in the inward Parts as Scabs in the Skin, and fall off from the Inside of the Bowels like a Crust: The nearer they approach to a white Colour, the less dangerous.
The viscous Matter is to be push'd out, therefore Bleeding in the beginning is not proper, nor Sudorificks, because they thicken; but Sweating is beneficial, when the Matter is quite push'd out; tepid, diluent and small Liquors are good in the first State, and Bathing, if the Patient can bear it, with Gargarisms, Clysters; afterwards the Food ought to be nourishing, detergent, Panadas with Bread and Water, Bread and Milk, Honey mix'd with the Aliment, when they fall, Aliment demulcent, soft, anodyne, and the moderate use of Rhenish Wine; when they are separated, lenitive, purging Substances.
Inflammations of the Kidneys.
The Kidneys are subject to Inflammations as much as other Parts of the Body.
A pungent Pain in the Region of the Kidneys, a Stupor, or dull Pain in the Thigh, Colick, Wind, Vomiting, a Fever, Urine sometimes totally suppress'd, in small Quantity, high colour'd; and which is worse, sometimes quite pale, without any Sediment, are Symptoms of an Inflammation of the Kidneys; as to the Sensation of outward Heat, the Extremity of Pain often creates a Coldness in the Extremities, but such a Sensation is very consistent with an inflammatory Distemper.
Whatever obstructs the Blood in the Extremities of the Arteries of the Kidneys, will produce this Disease; a Wound, Abscess, Bruise, Swelling, Lying much on the Back, too violent Motion, especially walking in hot Weather; whatever obstructs the Passage of the Urine, as a viscous Matter, Gravel or Stone; every thing which drives the Blood into the Urinary Canals, Heat, hard Riding, too great Fulness of Blood, but especially sharp and forcing Diureticks: Lastly, Spasms and involuntary Contractions of the Vessels of the Kidneys.
Coffee-colour'd Urine is not a dangerous Symptom; it proceeds indeed from a Mixture of a small Quantity of Blood with the Urine, but often prognosticates a Resolution of the obstructing Matter, and the Expulsion of Gravel or a Stone after great Pain; pale Urine is a Symptom of a more lasting and dangerous Disease.
After plentiful Bleeding, and a careful avoiding of all stimulating Diureticks, which in this State of the Disease will increase it, the Expulsion of the obstructing Cause must be promoted by emollient and soft Liquors drank plentifully, by Clysters of the same frequently injected, by Bathing and outward Fomentations, by opiat and anodyne Substances, which stupify and relax the Fibres; those Liquors must be swallow'd down notwithstanding the continual Vomiting; for Vomiting is the Instrument of Nature to promote the Expulsion of the Stone Gravel, or other obstructing Cause.
Whey, and in a great feverish Heat, Butter-Milk, Emulsions of Barley and Poppy Seeds, Honey in Whey and Water, are proper Liquors for this Intention.
When the Gravel, Stone, or other obstructing Cause is separated from the Kidney, soft express'd Oils, and oily Substances relax the Passages; if the Pain proceeds only from Gravel, or a Stone, oily Substances may be join'd safely with stimulating Substances, as with Juice of Limon, Juniper-Water, and some diuretick Syrrup; this by the way, for it is out of my present Subject.
Violent Motion, as jolting in a Coach, may be us'd in this Case.
The Pain protracted beyond seven Days, a Pulsation, Chillness, often and irregularly returning, a Heaviness and Stupor in the Part, are Signs of making of Matter, which when made will appear in the Urine.
In which Case soft and balsamick Substances are beneficial, for if the Matter stays long, the Case is incurable.
It happens sometimes to end in a Fistula, with which the Patient may live many Years in no great Uneasifiness. Butter-Milk, not very sour, has been reckon'd a great Secret in Ulcers of the Kidneys, and Chalybeat Waters have been beneficial to some; Spruce Beer is a good Balsamick in such a Case: I should advise soft Malt Liquors rather than Wine.
Inflammations of the Kidneys sometimes end in a Schirrus, or great Stone in the Kidneys.
A sudden Remission of the Pain, with cold Sweats, weak and intermitting Pulse, Hickup; no Urine, or in small Quantity, black and foetid, are Signs of a Mortification and approaching Death.
The Regimen of such as are subject to nephritick Symptoms may be in some measure taken from what is above-mentioned.
Such ought to be extremely careful of the choice of their Liquors; sharp Wines which abound with Tartar, are hurtful; Malt Liquors, not hard, nor stale, are certainly better to make use of; some of the softest Diureticks mentioned
Chap.
I. No 15. to avoid acrimonious Substances in their Aliment, use moderate Exercise, and not to lie hot, soft, nor much upon the Back.
Apoplexy.
This Disease is a sudden Abolition of all the Senses, external and internal, and of all voluntary Motion, by the Stoppage of the Flux or Reflux of the Animal Spirits through the Nerves destin'd for those Motions, commonly attended with a strong Pulse, laborious Breathing, a deep Sleep with Snorting.
There is no difference between a Person asleep, and in an Apoplexy, but that the one can be awak'd, and the other cannot.
The Causes of this Disease are a particular Confirmation of the Body, as a short Neck; for there be some who have fewer Vertebrae in their Necks than others; long-necked People are subject to Consumptions, and short-neck'd to Apoplexies, tho' this Rule is not generally true; a gross, plethorick, fat, phlegmatick Constitution; whatever hinders the Motion of the Blood through the Arteries of the Brain, as polypose Concretions, especially about the Heart, attended, commonly with an unequal Pulse, a Vertigo, and sometimes a momentary Loss of the Eye-sight; an inflammatory and coreaceous Thickness of the Blood, preceded by a Fever, attended with the Head-ach, Redness of the Face and Eyes; Old Age, attended with a glutinous, cold, catarrhous, leucophlegmatick Constitution; in such, the Forerunners of an Apoplexy are Dulness, Inactivity, Drowsiness, Sleepiness, Slowness of Speech and giving Answers, Vertigoes, Tremblings, Oppressions in Sleep, Night-Mares; Weakness, Wateryness, and Turgidity of the Eyes; pituitous Vomiting, laborious Breathing upon the smallest Motion; whatever compresseth the Vessels of the Brain so as to stop the Flux of the animal Spirits and Blood; a great Fulness of Blood with its Velocity, increas'd by Heat, violent Motion, a high Diet, spirituous Liquors, Tumours of any kind; within the Skull a partial and imperfect Circulation of the Blood towards the lower Parts. The Effusion and Pressure of any Serosity or Blood upon the Ventricles of the Brain (which is the most common and immediate Cause of Apoplexies) violent Passions and Affections of the Mind. The immediate Forerunners of an Apoplexy are commonly a Vertigo, Staggering, Loss of Memory, Stupor, Sleepiness, a Noise in the Ears, and a more deep and laborious Breathing; those last Symptoms commonly precede an Apoplexy, but they are likewise common to it with other nervous and hysterical Distempers.
Attention to the foremention'd Symptoms affords the best Cautions and Rules of Diet by way of Prevention; for when it has taken place
Hippocrates
's Prognostick is generally true, That it is very hard to resolve a small Apoplexy, and quite impossible to resolve a great one, the gentlest Kind of this Disease is often taken off by Sweating.
The Applications in the Fit are of the Medicinal Kind, it being too acute a Disease to admit of any Helps from Diet, but that may be of great use for Prevention; a thin, slender, cool, regular Diet, opposite to the particular Symptoms above-mention'd; frequent and copious Bleeding; keeping the Belly always open; stimulating Substances, which have been thought beneficial, in this Case very often hurt, by forcing the Blood too much up to the Head; Vomiting may prove extremely pernicious, but the Regimen is to be varied according to the Cause of the Disease, which may be collected from the Constitution of the Patient in these Apoplexies, which depend upon a sanguineous Cause: The Regimen prescrib'd in sanguineous Constitutions is proper; fat and phlegmatick People, who are very subject to this Disease, ought to attend to the Rules prescribed in their Case; and as there are Apoplexies from inveterate Gouts, the Regimen of such must be different from both, the Intention being to translate the morbifick Matter upon the Extremities of the Body.
Those who have a Disposition to this Disease ought never to go to Bed with a full Stomach, nor to lie with their Head low.
An Apoplexy is resolv'd by a Fever, and when not fatal terminates in a Palsy.
There is a Disease of the same Kind, but not so frequent, call'd a Catalepsis, wherein the Patient is suddenly seiz'd without Sense or Motion, and remains in the same Posture in which the Disease seizeth him, the Muscles remaining in the same Tension: Violent Fevers in strong atrabilarious dry Constitutions has produc'd this Distemper; the Diet after the Fit is off ought to be moistening and relaxing. A Lethargy is a lighter sort of Apoplexy, and demands the same Cure and Diet as an Apoplexy from a phlegmatick Case, such being the Constitution of the Lethargick.
CHAP. IV.
Rules of Diet in CHRONICAL DISEASES.
Palsy.
A PALSY is an Immobility of a Muscle from Relaxation, insuperable by the Will or any Endeavour of the Patient; sometimes the Sensation or Feeling is either totally abolish'd, or dull, with a Sense of Tingling: A Palsy is opposite to a Convulsion in the first; there is an Ineptitude to Motion from the too great Laxity in the Second; an Ineptitude to Motion from too great Tension, and a Relaxation of a Muscle, must produce a Spasm in its Antagonist, because the AEquilibrium is destroy'd. The best Rules of Diet in this Disease are taken from the Knowledge of its Causes. Whatever stops either the Flux of the Spirits, or the Flux of the Blood to any Part, induceth a Palsy, for both are necessary for Sense and Motion; such are all the Causes of an Apoplexy, an Epilepsy, extreme and lasting Pains, the Suppression of usual Evacuations either natural or morbid, Translations of morbific Matter in acute Distempers; whatever distends, distorts, compresses, or contracts the Nerves; strong and strait Ligatures, Luxations, Fractures, any Inflammation in the Integument, or membranaceous Sheath of a Nerve, especially in the Ganglia, where they are tied together; Serous Defluxions, Excess in astringent Aliment, especially unripe Fruits; drinking too much warm Water, which is weakning and relaxing; Excess in Coffee, or Tea; extreme Heat; extreme Cold; poisonous Vapours of Arsenick or Mercury.
A Palsy is more or less dangerous according to the Cause, the Extent, and Seat of the Disease; when the Original of the Disease is in the Brain, it is most dangerous; when it seizeth the Heart, or Organs of Breathing, fatal; because Life cannot be continued a Moment without the Use of those Parts.
The Regimen in this Disease ought to be warm, attenuating, consisting of spicy and cephalick Vegetables, such as create a feverish Heat, because such is necessary to dispel the Viscosity. Of Vegetables, soapy; of such as consist of an acrid, volatile Salt and Oil, Mustard, Horse-Radish,
&c.
stimulating by Vomits, Sneezing, relaxing the Belly, purging and diluting strongly at the same time, promoting Sweat by such Motions as can be us'd, or other Means, by strong Frictions,
&c.
Bleeding is to be us'd or omitted according to the Symptoms which affect the Brain; it relieves in any inflammatory Disposition of the Coat of the Nerve.
Epilepsy, Convulsions.
The Causes of which are sometimes an hereditary or family Disposition from Parents; a sudden Fright of the Mother when with Child of the Patient; an Affection of the Brain by a Contusion; Abscess, acrimonious Serum, Splinter of a Bone or sharp Instrument; Inflammation, Corruption, Erosion of the Meninges or Membranes of the Brain; Fulness, Heat, Drunkenness, intense Study, strong Passions, especially sudden. Terror; all violent Affections and Irritations of the Nerves in any Part of the Body; especially by something acrimonious in the Stomach or Bowels, by Worms, by Teething, and Acidity in the Stomach in Infants; by some Contagion or purulent Matter after acute Diseases; Suppression of usual Evacuations, the Menses, Haemorroids; hysterical Affections contracted by Accidents in Lying-in; and often by too great Inanition; the smallest irritating Cause will induce a Fit in such as are subject to it, and such ought to be prevented with great Care.
There is no Disease which insests Mankind more terrible in its Symptoms and Effects, the worst of which are a weakening and perhaps an Abolition of the Faculties of the Mind; whether the Cause of the Disease be in the Brain, is easily known from the concomitant Symptoms.
The Intentions in the Cure of the Disease must be different, according to the Cause; Bleeding, and plentiful Evacuations, when there is a Plethora or inflammatory Disposition in the Brain; Aliments without Acrimony, demulcent, avoiding every thing which stimulates, taking such things as are opposite to the particular Acrimony which causeth the Disease, relaxing the Belly without irritating; in acute and periodical Pains, anodyne Substances; if the Disease is the Consequence of an hysterical Disposition, a warmer Regimen is necessary; if the Cause is in the Stomach, generally anti-acid Substances relieve; if they are not flatulent, several have been cur'd by a Milk-Diet, but it will do hurt when there is Acidity in the Stomach; when the irritating Cause is in some outward Part of the Body, it is proper to eradicate it by Suppuration.
The common Custom of applying stimulating things, as volatile Salts and Spirits to the Nose, during the Fit, is generally speaking pernicious.
Epilepticks ought to breathe a pure Air, unaffected with any Steams, even such as are very fragrant. Their Diet ought to be nourishing, of easy Digestion, avoiding Hogs Flesh, Water-Fowl, and all Vegetables that are pungent, windy, and generally speaking all Fruits, especially Nuts; with little Wine, and none, if they have not been accustom'd to it; they ought not to turn round, nor stand on Precipices, to keep regular Hours for Repast and Sleep, for every unusual thing is a Stimulus; but of all things the most necessary is the avoiding the Occasions of violent Passions, and keeping themselves chearful.
Melancholy, Madness.
The Constitution which disposeth to such a State, the Causes, Symptoms and proper Regimen in it is describ'd
Chap.
II.
This being a Disease more terrible than Death, extremely obstinate, invading sometimes by insensible degrees, and hard to be cur'd when it has taken place, the Approaches towards it ought to be carefully observ'd.
These are commonly obstinate Watchfulness, or short Sleeps, troublesome and terrible Dreams, great Solicitude and Anxiety of Mind, with Sighing, sudden Fits of Anger without any Occasion given, Love of Solitude, Obstinacy in defending trifling Opinions, and Contempt of such as are about them, Suppression of usual Evacuations, as of the Menses in Women, and Haemorroids in Men; great Heat, Eyes hollow and fix'd, immoderate Laughter or Crying without occasion; too great Loquacity, and too great Taciturnity; by Fits; great Attention to one Object, all these Symptoms without a Fever.
When this Disease is hereditary it is seldom cur'd.
The atrabilarian Constitution, or a black viscous pitchy Consistence of the Fluids which most frequently occasions this Disease, makes all Secretions difficult and sparing; the Intention therefore ought to be to render the Humours fluid, moveable, and carry them out of the Body, especially the Bile, which is viscous; Sudorificks indeed are
so proper, because they thicken.
To use the Aliment prescrib
d
Chap.
II, in atrabilarian Constitutions
Boerhaave
gives an Instance of a Patient who by a long use of Whey, Water, and Garden-Fruits, evacuated a great Quantity of black Matter, and recovered his Senses. Cold Bath, and especially a sudden Immersion in the Sea, has done good by acting upon the Nerves and Spirits; whereever there is any Uneasiness or Sensation of Pain, one ought to solicit the Humours towards that Part, or to make the proper Evacuations from them, especially (if it be possible) to procure the Piles, which seldom miss to relieve the Head.
The Madness which proceeds from a Plethora, or too great Fulness, is cur'd by plentiful Bleeding and Purging.
The Weakness which succeeds the Madness requires a more refreshing and warm Diet, especially the use of Chalybeat Waters.
Scurvy.
This is a Disease impossible to be defin'd by Words containing any simple or distinct Idea; it is rather a Name us'd to denote a Multitude of Symptoms, different, and sometimes opposite in their Causes and Cures.
It is a Distemper of the Inhabitants of cold Countries, and amongst those, such as inhabit marshy, fat, low, moist Soils, near stagnating Water, fresh or Salt; invading chiefly in the Winter such as are Sedentary, or live upon salted and smoaked Flesh and Fish, or Quantities of unfermented farinaceous Vegetables, and drink bad Water; such as are Hypochondriacal and Hysterick; and sometimes such as have taken the Peruvian Bark, either in great Quantities, or without proper Evacuations. From these Causes the best Rules are taken for Prevention.
Its Symptoms are a spontaneous Lassitude or Sensation of Weariness, being unrefresh'd by Sleep, laborious Breathing upon small Motion, cold Tumours in the Legs going off and returning; sometime Paleness, or a livid Colour of the Countenance; Spots on the Skin of various Colours, red, violet-colour'd, yellow, livid; sometimes an ill Smell in the Mouth, painful and bleeding Erosions of the Gums, and by these the Teeth growing bare and loose; Haemorrages of all kinds, Ulcers; untractable, especially in the Legs, with a gangrenous Appearance in the Skin; the Itch; a dry crusty Eruption, and sometimes a small degree of Leprosy in the Skin; the Blood, when let, black, grumous, the red part without a due Consistence; the Serum saline, and of a yellowish Green; wandering Pains in the Limbs, increasing by the Warmth of the Bed, sometimes a feverish Heat.
These Symptoms proceed from an ill Temperature of the Blood, too thick or too thin, being of a saline Constitution, either from an acid, alkaline, or muriatick Cause, and according to the Cause, demands very different and oftentimes opposite Remedies.
See
Part First, of acid and alkaline Constitutions.
The Scurvy of Mariners is generally cured by Acids, as all sorts of ripe Fruits, Limons, Oranges, Butter-Milk; alkaline Spirits hurt them; and acid Spirits, as that of Salt, does them good; when the Symptoms are attended with a Foetor of any kind, either in the Urine, Mouth, Breath, with Drought, Heat, Haemorrage of the Gums, or of any kind, such a Disease will be cur'd by acescent Substances, and none better than Whey: In this Scurvy Chalybeat Waters are generally effectual.
If the Scurvy be entirely muriatick, proceeding from a Diet of salt Flesh or Fish, the Vegetables commonly called Antiscorbutick, as Water-cresses, Scurvy-Grass, and Brook-Lime may be given with Success, but tempered with Acids, as the Juice of Oranges and Limons; and the Pot-Herbs which are antiacid in this Case are a proper Diet; but if there be a high degree of Heat and Inflammation, the hot Antiscorbuticks will do hurt.
If the Patient be pale, cool, without Thirst, with pale or natural colour'd Urine, with a previous Diet of acescent Substances, the Eruptions not of a high inflammatory or livid Colour, the warm Antiscorbuticks, animal Diet, and animal Salts, are proper.
There is great Attention to be given to the Condition of the Mouth, Gums, and Teeth, in the Scurvy, from which the Nature and Degree of the Disease may be guess'd at.
Violent Purging always hurts scorbutick Constitutions; lenitive Substances relieve.
Bleeding is not proper, unless where the Symptoms are urgent, and the Case is inflammatory.
A Scurvy, from an alkaline Cause is more dangerous than from an Acid.
Cachexy, or ill Habit of Body.
This is likewise a general Word to express a great Variety of Symptoms; most commonly it denotes such a Distemperature of the Humours as hinders Nutrition, and weakens the vital and animal Functions, proceeding from Weakness of the Fibres, and an Abuse of the Nonnaturals, and often from severe acute Distempers: It sometimes disposeth to Consumptions, sometimes to Leucophlegmacy, Bloatedness, and Dropsies; it is attended often with Palpitations of the Heart. The Rules for Diet must be drawn from the Symptoms.
See
Chap. I. of this Part.
Consumption pulmonary.
This Disease is a Decay of the whole Body, from an Ulcer of the Lungs, the Matter of which is mix'd, circulates with, and infects the Blood, and by its Acrimony infects the whole Mass of the Fluids.
This Disease makes up above a tenth part of all the
Bills of Mortality
about
London,
is often the Product of a scrophulous Constitution, or King's-Evil, seldom invades after Thirty Years of Age, may be prevented, but seldom admits of any other than a palliative Cure, and is generally incurable when hereditary, but easily so when it proceeds from an accidental Cause.
It is often preceded by a Spitting of Blood, occasion'd by its Acrimony, and too great a projectile Motion, with Slenderness and Weakness of the Vessels; to which Persons of a fair rosy Complexion, long Neck, and narrow Chest, are often subject; Aliment too viscous, obstructing the Glands, and by its Acrimony corroding the small Vessels of the Lungs (an Organ of a slender Texture, through which the Half of the whole Blood passeth, and which is never at rest) after a Rupture and Extravasation of Blood, easily producing an Ulcer, then a small Fever, dry Cough, Heat, Flushing after Repast; when the new Chyle enters the Lungs, short Breath, a Disposition to Sweat after Sleep; all these Symptoms, when the Blood is most copious and hot, between the Ages of 16 and 30; such a Disease may be indue'd by the Suppression of Evacuations natural and artificial, by any great Force upon the Lungs, from some accidental Cause; by too hot, full, and acrimonious Meat or Drink, by some acute Disease, the Meazles or Small-Pox.
The Blood is ejected from the Lungs with some small Pain, Heat, Oppression on the Breast, florid, and frothing, with short Breathing, and a small soft quick Pulse.
If after such Haemorrage from the Lungs, the Symptoms increase, Shortness of Breath, Flushing in the Face, a Cough, hectick Fever, but especially Rigours and Chilliness invading irregularly, with Weakness, one may be sure that there is a Suppuration.
In a Haemorrage from the Lungs, no Remedy so proper as Bleeding, often repeated; Stypticks are often insignificant, and if it were possible that they could operate immediately upon the affected Part, so far as to make a Scar, when that fell off the Disease would return. Both incrassating and styptick Substances work universally, but they would hurt the Lungs if given before the Vessels are empty'd. Balsamick Substances often hurt by their too great Heat.
The Intention here is by Diet to abate the Acrimony and projectile Motion of the Blood, after repeated Bleeding; to keep strictly to a Milk Diet, with farinaceous Substances, as Rice and Barley, Milk with roasted Apples, Jelly of Currants, or the Jelly of any ripe subacid Fruit, which is cooling, and very agreeable to the Stomach; Milk and common Water, or Barley-Water, for Drink, taking the Aliment frequently, and in very small Quantities, for fear of charging the Lungs with too great a Quantity of Chyle at a time. (
See Part
I.
Chap.
II.) Avoiding all violent Motion, or any thing that puts the Lungs upon a Stretch. Acrimony is likewise corrected by oily Vegetables, not such as contain a volatile or high exalted Oil, but those whose Oil is mild, as Almonds, Pistachos, Dates,
&c.
The
English
Consumptions, generally speaking, proceed from a scrophulous Disposition; in the first Access of such a Disease any Substance which is deobstruent, without much Acrimony, is beneficial, but what heats disposeth to Suppuration.
There is likewise a Consumption from an Empyema, after an Inflammation of the Lungs, which may be known from a Weight upon the Diaphragm, Oppression of the Lungs, a Difficulty of Breathing, and Inability to lie on one Side (which is that which is found) a perpetual Cough and Fever, with Thirst, Flushing of the Cheeks, Weakness, and Decay of Appetite.
The Cure of such a Case is chirurgical, by opening the Side; if the Ulcer is not broke, it is commonly call'd a Vomica, attended with almost the same Symptoms as an Empyema, because the Vomica communicating with the Vessels of the Lungs must necessarily void some of the putrid Matter into these Vessels, and taint the Blood.
The Ulcer may break suddenly into the Larynx, with the danger of Suffocation; or inwardly, and the Matter may by degrees be expectorated. The Event of the Disease depends upon the Symptoms, especially the Nature of the Pus; that which swims in Water, without any ill Smell, is better than what sinks, is livid, and smells of putrify'd Flesh.
There may be a Consumption with a purulent Spitting, when the Vomica is contain'd in a Cyst or Bag, upon the breaking of which the Patient is commonly suffocated.
In this Case the same Intentions must be pursued in the Diet, as in a Wound or any other Ulcer. The Aliment cool, demulcent, vulnerary, and not drying or hot, but consisting of Quantities of liquid things, even though they provoke Sweat. It is a common Mistake that acid things hurt the Lungs. The Gas Sulphuris may be given with Success in any Disease of the Lungs, but at some distance of Time from Milk, Vinegar, and Honey, is proper and detergent; anodyne Substances relieve the Cough; gentle Exercise by Riding, is beneficial; by an extremely exact Regimen a consumptive Person may hold out for Years, if the Symptoms are not violent.
The Sweats and Diarrhoea attending Consumptions are generally fatal Symptoms, but must be reliev'd by a Diet proper in these Cases, not interfering with what is formerly advis'd.
Consumptions are induc'd by Purulency in any of the other Viscera; the Regimen must be very near the same as in the Pulmonary.
Dropsy.
This Disease is commonly an Extravasation of Serum receiv'd in some Cavity of the Body; I say commonly, for there may be a Dropsy by a Dilatation of the serous Vessels, as that in the Ovarium, wherein the very Membrane of the Ovum is extended with the Water, and at the same time thickened so as to keep it from Rupture.
Therefore this Disease may happen wherever there are serous Vessels; a Hydrocephalous, or Dropsy of the Head, which is only incurable when the Serum is extravasated into the Ventricles of the Brain, and generally fatal in Infants, when the Sutures are clos'd, and the Skull will yield no more.
A Dropsy of the Breast is attended with almost the same Symptoms as an Empyema, and cur'd by the same Chirurgery.
A Dropsy of the Lungs, either by Hydatides, or by Lymph, extravasated in the Body of the Lungs.
A Dropsy in the Forepart of the Windpipe, emulating a Bronchocele.
A Dropsy in the Ovarium,
Testes, Scrotum,
or
Uterus.
An Ascites, or Collection of Water in the Abdomen. 1. In the Duplicature of the Peritonaeum. 2. Between the Peritonaeum and the Bowels. 3. When the Water is contained in the membranaceous Coat of the Glands.
Sometimes the Air is so rarify'd in the Tumour as makes it hard and tight like a Drum, and from thence it is call'd a Tympany; when the Tension is from Air, it is easily distinguish'd by the Specifick Gravity of the Patient, and so is Water.
When the Lymph stagnates, or is extravasated under the Skin, it is called an Anasarka.
Whatever hinders the Return of the Lymph into the Veins, or breaks the lymphatick Vessels, or obstructs the absorbent Vessels, so as the Lymph cannot be absorb'd or exhal'd, produceth a Dropsy: Any Stoppage of the Circulation will produce a Dropsy, as by strong Ligature, or Compression.
The most common of these Causes are an hereditary Disposition; swilling down great Quantities of cold watery Liquors, which are not voided; violent acute Distempers; stubborn Obstructions of the Viscera; the Jaundice, obstinate intermitting Fevers, Bloody-Fluxes; great Evacuations, especially of Blood; Aliment viscous and of hard Digestion; inveterate Scurvies; but the most common of all is the habitual and copious Use of fermented and spirituous Liquors.
The Effects are a Swelling of the Legs at Night by degrees, still ascending higher; a Swelling of the Belly increasing; and in a Tympany founding and tense like a Drum; sometimes the Sensation and Noise of fluctuating Water, Shortness of Breath, Thirst, Urine in too small Quantity, no Sweat; The stagnating Serum at last turning acrimonious, exulcerates and putrifies the Bowels, producing most dismal Symptoms.
The best Cautions and Rules of Diet may be taken from the Enumeration of these Causes and Effects.
The Intentions to be pursued are, removing the Causes, as Obstructions, dissolving the Viscosity or Tenacity of the Lymph, and evacuating it out of the Body.
The Viscosity of the Lymph is best corrected by such Substances as contain abundance of alkaline and volatile Salts, Spices, acrimonious pungent Vegetables, saponaceous Substances; what they are the Reader may see Chap, I. of this Part.
The only Contradiction to this is too great Heat and Thirst, to which Regard is to be had, and do indicate the Use of Acids, Juice of Limons, Oranges, Sorrel,
&c.
I think it may be taken for a general Rule, when the Urine is high-colour'd, that Acids are proper, for they are opposite to that alkalescent State of the Humours, and resist the Putrefaction, which is the Effect of acrimonious Serum.
The Drink should be sparing; but forasmuch as the Thirst is sometimes intolerable, the Patient may be indulg'd the free Use of Spaw-Water and Rhenish Wine.
The Aliment should be dry, diuretick.
See Chap.
I. Diureticks of the acid Kind are the safest.
The Chirurgical Operations for drawing off the Waters are to be left to the Judgment of the Physician.
Nothing is more beneficial than strong Frictions of the Skin, which attenuate and promote the Circulation of the stagnating Serum.
Vomiting, in strong Constitutions, has prov'd often very effectual, for the Concussion of the solid Parts dissolves and dispels the stagnating Humours; and even Clysters of proper Ingredients are very beneficial.
Violent Purgers, by dissolving the Blood, have prov'd often pernicious.
Many have been cur'd by Abstinence from Drink, eating dry Biscuit, which creates no Thirst, and strong Frictions four or five times a Day.
When the extravasated Serum is evacuated, the Diet ought to be such as strengthens the solid Parts, allowing Spices and generous Wine, and especially the Use of Chalybeat Waters, Abstinence from other Sorts of Liquids, dry Food and Vegetables, astringent, Exercise, especially Riding; and in general, such a Diet as generates good Blood.
If the Serum stagnates long, it turns acrimonious, and commonly renders the Patient feverish and thirsty. Acid or sour things are the properest both to prevent and cure these Symptoms, as they are opposite to that alkaline Putrefaction.
Gout.
This is a Disease which may affect any membranous Part, but commonly those which are at the greatest Distance from the Heart or the Brain, where the Motion of the Fluids is the slowest, the Resistance, Friction, and Stricture of the solid Parts the greatest, and the Sensation of Pain by the Obstruction of the small Vessels and Dilaceration of the nervous Fibres extreme.
The most common Seat of it is in the Foot, its Tendons, Nerves, Membranes, Ligaments, and Periostea, or Membranes investing the Bones.
The most common Causes of it are an hereditary Disposition (which operates more strongly in this Disease than in any other) a too rich and high Diet, and too copious Use of Wine and other spirituous Liquors, especially at Supper; Excess in some other Pleasures; a full gross Habit of Body; the too copious use of acid or sour things, the Gout being the only Disease in which they are very hurtful to Human Bodies; a sudden chilling of the Feet after Sweat, or drying them at the Fire after being wet and cold; a sedentary Life, with a plentiful Diet, and intense Study, and Application of the Mind; most commonly a Gouty Constitution is attended with great Acuteness of Parts, the nervous Fibres both in the Brain and the other Extremities being delicate; and there are Instances where Wives have got it from their Husbands by Infection, so
Boerhaave
says; Females and young People are not subject to this Disease, unless where it is hereditary.
A proper Regimen of Diet is necessary in this Distemper, because it does not admit of very many Helps from Medicines, and there are no better Rules than Abstinence from those things which occasion it.
It seems to be a Disease of the nervous Parts, which makes it so hard to cure; Diseases are so as they are more remote in the Thread of the Motion of the Fluids, by the constant and regular Returns of it in some People, and their Freedom from it after the Morbid Matter is exhausted; it looks as there were regular Accumulations and Gatherings of it, as of other Humours in the Body, growing perhaps in some People as Corns.
As one of the Causes of the Gout is the Suppression of Sweat and Perspiration, the procuring a due degree of these seems to be the best Preventive of it; if the Feet could be made to sweat, in due time it would prevent the Gout, which invades in such Constitutions of the Air as suppress Perspiration.
Violent Purging, in Absence of the Paroxysm, by agitating the Humours often hurts, and during the Paroxysm, may draw the Gout inwardly.
The best Diet is Abstinence from acid Substances; the moderate use of such as promote Perspiration, as Substances aromatical, and volatile Salts, which relieve the Gouty, as they make the Body perspirable; diluent Liquors, taken in such a degree as not to hurt the Stomach; Moderation in the Quantity of Food and spirituous Liquors; Exercise without Fatigue; but especially Frictions of the extreme Parts, daily, and often repeated; all possible Methods of making the Feet sweat, and much Sleep.
In the Paroxysm, as temperate and cool, and diluent a Diet as the Patient can bear; Abstinence from Opiats, except when the morbid Matter is separating (by Opiats any Irruption goes on better) the constant Use of them will hurt; keeping the affected Part warm, without the Application of Cataplasms, ev'n such as are emollient, weaken and relax too much, and have been sometimes found to distort the Parts.
It is of the utmost Importance to know if any Disease proceeds from a Translation of the Gouty Matter; for the Methods, especially Evacuations, us'd in an original Disease, would be very improper in a Gouty Case, where the Intention must be to draw the Gout down to the Feet, by Blisters apply'd to the Thighs or Legs, and acrid inflammatory Cataplasms and Plaisters; therefore when any Gouty Person is disappointed of a Paroxysm which he expected by the Season, or the previous Symptoms, and instead of it is seiz'd with another Disease, let him speedily consult his Physician.
If a Gouty Person can bring himself intirely to a Milk Diet, he may so change the whole Juices of his Body as to eradicate the Distemper.
The Approach of a Fit of the Gout is easily known by the inward Disorders, as Wind, Sickness, Crudities in the Stomach, a Drowsiness, these join'd with the Season or Weather, if such a one by a statical Engine could regulate his insensible Perspiration, he might often by restoring of that, foresee, prevent, or shorten his Fit.
Greensickness, Obstructions.
The Symptoms of this Disease are evident, a due Age of the Patient, with an Obstruction of the Menses, a Fulness, sometimes Pains about the Loins, a Laziness, Inactivity, which is both the Cause and Symptom of the Disease; a quick Pulse, often emulating that of a hectick Fever, Palpitation of the Heart, Difficulty of Breathing upon the least Motion, a livid Circle about the Eyes, Diziness of the Head, sometimes an Appetite of odd things, as Chalk, TobaccoPipes, proceeding from an Acidity in the Stomach, a Paleness of the Face and Skin, unnatural Haemorrages from the Mouth, Nose, and other Parts, hysterical Symptoms.
Young Persons under a womanly Age are often troubled with some of the same Symptoms, but not from that Cause; and Women obstructed have not always the foremention'd Symptoms; in those, the Signs of Gravidity and Obstructions are hard to be distinguish'd in the beginning.
This Disease is the Parent of many other dangerous Diseases, and after six Months hardly to be cur'd.
What is to be consider'd in this Case, is chiefly, if there be a sufficient Fulness or Deficiency of Blood, different Methods are to be taken, in those two Cases, Bleeding, which may relieve in the first Case, will do hurt in the Second Motion; Exercise, Frictions, Bathings, Clysters, Fumigations often repeated are very beneficial.
Substances abounding with volatile oily Salts, Substances saponaceous, aromatical, as those Vegetables which abound with a volatile Oil.
When there is not a sufficient Plethora, a Diet wholesome, plentiful, and nourishing, at the same time strengthening the Organs of Digestion, is often effectual.
After Relaxing, such Substances as strengthen the solid Parts in general, are beneficial; it is by this Quality that Steel operates so strongly in this Distemper, and likewise as being an Antiacid.
See
Chap. I. No 18.
A Woman who by some unusual Haemorrage has that natural Defect supply'd, is only to be cur'd by topical Remedies.
Diseases of Infants.
Infants new-born, before they have taken any Aliment, often have the whole alimentary Duct filled with a glutinous cheesy Matter, and all of them have a Meconium, or sort of dark-colour'd Excrement in the Bowels, which ought to be purg'd off.
Most of the Diseases of suckling Infants proceed from Milk growing sour and curdling in the Stomach; the Cure of which is to be effected
First,
By attenuating this curdy Matter; and
Secondly,
by expelling it out of the Body; it may be digested by the Infant by Abstinence from Sucking for several Hours; Honey and Water, with a little Wine, attenuate and dissolve; and some gentle purging Syrup, as Syrup of Cichory with Rhubarb, expels the peccant Matter; oily Substances are apt to turn rancid on the Stomachs of Infants; Clysters and warm Fomentations, and other Applications of aromatical Substances to the Stomach and Belly, are useful in this Case.
Antiacids, especially the Absorbents, are more effectual in the Diseases of Infants than in any other.
Opiats and anodyne Substances are dangerous.
Volatile Salts are hurtful to Infants, being too active, and operate sometimes as Opiats.
Gall is the greatest Resolvent of curdled Milk:
Boerhaave
has given at a time one Drop of the Gall of an Eel with Success.
Gentle Carminatives, as Fennel-Water, Mint-Water, relieve.
The Colick, green Stools, Vomiting, Wind, and Convulsions, all depend upon this Acidity, and when that is rectify'd the Symptoms cease.
Diseases of Infants, and the Cure of them, depend very much upon the Diet of the Nurse.
See
Part. I. Page 93.
When Children begin to feed upon Substances on which Infects deposite their Eggs, especially Fruits, they are often troubled with Worms, for want of a sufficient Force of Digestion to destroy these Eggs.
The most common Sort in Children are the round or Earth-Worms.
The Symptoms occasion'd by the Motion and Biting of these Worms are Loathing as it were from a Feather in the Throat, a Vomiting, Looseness, Fainting, a feverish Disposition, with a small quick pulse, Itching of the Nose, Grinding of the Teeth, Fits, Paleness, a craving Appetite, Weakness, and when the Worms are large they consume the Moisture, and instead of Looseness will occasion Astriction of the Belly, with a Swelling; Worms will perforate the Guts.
Children subject to Worms ought not to live much upon Milk, Cheese, or ripe Fruits, nor take much Sugar; some Insects lay their Eggs in Sugar.
The Gall of Animals, and Mercury, kill Worms, and destroy their Nests; it is found by Experience that the Water in which Mercury is boil'd has this Effect; all Bitters among alimentary Substances; Honey and Oil given by the Mouth, or Clysters, have a good Effect; they may be taken together fasting; any Substance which by its Pungency can wound the Worms, will kill them, as Steel, Hartshorn, Coraline, Coral powdered, Fish Bones.
See
Chap. I.
Above a tenth Part of Infants die in Teething, by Symptoms proceeding from the Irritation of the tender nervous Parts of the Jaws, occasioning Inflammations, Fevers, Convulsions, Looseness, with green Stools (not the worst Symptom) and in some, Gangrenes: It is plain that such a Case ought to be treated as any other inflammatory Distemper.
When the Symptoms of Teething appear, the Gums ought to be relax'd by softening Ointment, the Jaws fomented with emollient Decoctions, and the whole Head to be kept warm; when the Teeth is ready to cut, the upper Part rubb'd with hard Substances, which Infants by a natural Instinct affect, and when there is a manifest Tension of the Gum by the Tooth, then it ought to be cut; but this Operation ought not to be perform'd too soon.
In the Convulsions it is necessary to give volatile Spirits, which they can bear better than when they are new-born.
The Rickets is another Disease to which Children are subject: It has been reckoned a Disease unknown to the Ancients, uncommon in hot Countries, and more common in
England
than any other Northern Country.
Children have this Disease from sickly Parents, and especially from Mothers of a weak lax Constitution, living on a various, high, and plentiful Diet, without Exercise; and Children born healthy, often contract the Disease from an unwholsome Nurse.
A Diet of farinaceous Substances infermented, as of Pudding, much Butter, wet or ill-air'd Linen, cutaneous Eruptions repell'd, or ill cur'd, exposing their lower Parts too long to cold Air, may bring, or at least increase this Disease.
The Disease may be foreseen by the Child's being long in taking to his Feet; when it takes place the Child grows lean, the muscular Flesh decays, and grows flabby, the Skin loose and flaccid, the Epiphyses of the Bones about the Joints of the Arms grow big, the Belly swells, the Blood-Vessels about the Neck enlarge, and so does the Head it self, the Bones grow crooked; these are the outward Appearances, the Constitution of the inward Parts is often much worse.
It is highly probable that this Disease proceeds from a redundant Acidity, because Vinegar will soften and crook tender Bones; and this Symptom must happen in Children when there is no Strength in the Muscles to support them, or they must be inflected to that Side where the Muscle pulls strongest. Contrary to the common Rules for the Aliment of Children, the Diet of those that are Rickety ought to be moderately warm, even making use of Spices or carminative Seeds. They ought to forbear unfermented farinaceous Substances, new Bread; and rather use Biscuit. Their Diet should be pretty much of flesh Meat, such as are commonly call'd White Meats, and rather roasted than boil'd, such Diet being anti-acid. They may be allow'd a moderate Quantity of Wine.
I knew a rickety Child cur'd by a very great Indulgence of fermented Liquors, but it is not an Experiment that I would advise.
Frictions of the Back-bone and Joints with Flannel, smoak'd with penetrating aromatical Substances, and fomenting the Joints with old Malaga Wine, have prov'd often very effectual.
They ought to use as much Exercise as they are capable of, but especially by Voiture or Carriage. Care must be taken to open the Obstructions in the lower Belly by Vomits and proper Purgations, where the Seat of the Disease chiefly lies, and after that the Cold Bath is a very proper and effectual Remedy.
I have lanch'd out of my Subject under this Head, mentioning some medicinal Helps, because the Nurses in such Cases are often the Physicians, which nevertheless they ought not to be when they can get better Advice.
Small-Pox.
Though I took notice of this Disease in the Article of Feverish Irruptions, yet it being one of the most dangerous and universal that infests Mankind, I shall add a few more Rules which may be of use to such as have not the Advice of an able Physician.
The greatest and most important Strokes for the Recovery of the Patient, must be made at the time of the Invasion, or first State of this Disease; therefore it is necessary to know the first Symptoms of it; many have suffer'd by mistaking it for another Disease.
In general, young Persons who have not had the Disease ought to be extremely careful to avoid great Irregularities in their Diet, because the Small-pox which are occasion'd by such often prove dangerous. This Disease is likewise more dangerous as the Fluids are more exalted and dissipated, and the Solids more strict and compacted, and consequently more so as People are advanc'd in Age.
This Disease may be easily communicated by the Contagion or Steams of an infected Person swimming in the Air, and drawn in by the Breath, or perhaps by the Pores of the Skin; and it is evident by Inoculation that the smallest Quantity of the Matter mix'd with the Blood produceth the Disease, tho' not so quickly as those volatile Steams.
The first Symptoms are a Chilness, Rigor, succeeded by a Fever and constant Heat, a certain Splendor or Shining in the Eyes, with a little moisture; this is very observable in Children; a great Pain in the Head, with Dulness, Drowsiness, Sleepiness, a pain in the Back in some, but Pains in the Limbs in all, Anxiety, Inquietude, notwithstanding their Drowsiness, Loathing, Sickness of the Stomach, Vomiting, and in Infants Convulsions shortly before the Eruption. The Blood let the first time, florid; after a second time sizy.
It is evident that in this State the Disease ought to be treated as any other inflammatory Distemper, by such Methods as if it were possible to hinder any Suppuration at all, and to resolve and digest as much of the feverish Matter as we can; for the longer the Eruption is a coming, and the smaller when it comes, the Disease is less dangerous; therefore all the Methods prractis'd in the beginning of inflammatory Diseases are here necessery, with a particular Care of cleansing the alimentary Duct by Vomiting and Clysters, the Impurities of which will be carried into the Blood.
There is not yet found any particular Antidote to the poisonous Stimulus of this Distemper; the learned
Boerhaave
is of opinion, that if any such could be found, it must be in Antimony, or Mercury intirely destitute of all Acrimony: The Effects of Mercury on all Ulcerations are very manifest.
Bleeding, which is extremely useful in the beginning of the Disease, is not so proper and useful when it is advanc'd.
In the first Stage the whole Habit of the Body ought to be relax'd, a free Perspiration thro' the Skin, without violent Sweating, promoted; the Viscosity or Toughness of the Fluids taken off by diluents; the alkalescent State of the Salts corrected; all these things are effected by emollient Fomentations apply'd inwardly in Clysters, and why not outwardly to the Skin? Such are us'd successfully in other Eruptions, as Erysipelas, Shingles, by a slender Diet of Decoctions of farinaceous Vegetables, and copious drinking of cooling Liquors, with nitrous and acid Salts, and other acid Substances, mix'd with them; no Flesh, unless it be small Chicken-Broth; no Spice; the Air ought not to be spoil'd by Heat, nor the Coverings of the Bed so thick as to promote Sweat.
The Greatness and Danger of this Disease is estimated by the Quantity of Eruptions on the Face and other Parts of the Head; therefore the Matter ought to be solicited by all possible Methods to the lower Parts, especially the Legs, by Fomentations, Bathing, Epispasticks, Blistering, and through the whole Disease keeping the Feet and Legs warm; the Breast and Head not any more cover'd than to keep them from the Impression of cold Air.
During the Filling and Ripening of the Pustles, the Diet may be more plentiful, but still not hot or inflammatory, with the due Use of anodyne Substances: In this State Demulcents, or what abates Acrimony; and where the Circumstances of the Patient require it, a Spoonful or two of Canary Wine, twice or thrice a Day, are proper: The Diet in this State ought likewise to be adapted to the particular Symptoms of the Disease, as cleansing, attenuating, expectorating; to promote the Spitting, diuretick; when that is suppress'd, and Clysters diluent, without any Stimulus, frequently injected, are beneficial in every Stage of the Disease.
When the Age, Temperament, high Pulse, and especially a Watchfulness and Delirium, all would seem to demand it in any other Case, why not Bleeding in this State? which I know to have been us'd with great Success; a great many Vessels are in this State almost impervious by the Fluids; those who die of this Disease have inward Inflammations, especially in the Lungs; those Reasons seem to justify Bleeding.
Indeed the gangrenous Disposition which appears in the malignant Kind, is a Reason against it, but hardly any thing will do good in these extremely malignant Cases.
In such malignant Kinds, all that is left is at last to try evacuating the morbifick Matter by other ways, as Epispasticks and Stools procur'd by lenitive Substances, not irritating, which would only agitate the Humours and increase the Fever.
Gravel, Stone.
A Stone or stony Matter may grow in any Part of a Human Body; for when any thing insoluble sticks in any Part of the Body, it gathers a Crust about it; a small Drop of concreted Blood may grow to be a Stone, for by the Evaporation of the most fluid Parts it grows hard, and by the Attraction of new Matter increaseth Blood, and a Human Calculus, or Stone, yield the same Contents by Chymical Trial, tho' in an inverse Order.
These stony Concretions happen most commonly in the Kidneys and Bladder; and indeed if the Tartar and other Contents of the Urine were not constantly voided, such Concretions would happen to every Human Creature; for the Urine of the most sound Person being inspected with a Microscope, after it has stood a while, will discover a black Speck, which is Sand, and wherever this Sand sticks it grows still bigger, by the apposition of new Matter: When such Concretions happen in the Kidneys, and are expell'd or drop into the Ureters, it makes what we call Gravel; when they lodge and stick in the Body of the Kidneys, and grow to such a Bulk as not to drop into the Pelvis, or pass by the Ureters, they make the Stone in the Kidneys: The Symptoms of which are a dull Pain in the Kidney, most commonly bloody Water; upon a sudden Jolt, violent Motion, Pain in Stooping; Pain in the Thigh, Sickness in the Stomach, Colical Pains, various Changes in the Colour of the Urine, black, bloody, pale, occasion'd by something sharp or scabrous wounding the small Blood-Vessels; if the Stone is smooth and well bedded, perhaps this may not happen. Fleshy Filaments, or Matter voided by Urine, are suspicious Symptoms of a Stone in the Kidney, especially if the Patient has been subject to Voiding of Gravel.
When a small Stone is lodg'd in the Body of the Kidney, it does not create Pain, nor much when it falls into the Pelvis; but when it falls into the Ureter, and sticks, the Pain is most acute; it often stops at the Flexure and Valve of the Ureter, and sometimes in the Urethra, or Passage of the Urine from the Bladder; while it stays in the Bladder it creates no Pain, but remaining there long it grows a confirm'd Stone, too big to be pass'd by the Urethra: The manner of its Concretion is by concentrical Rings, like an Onion, about the first Kernel, which shews the Cause to be Attraction. This is not only true of a small Stone, but any solid Body lodg'd in the Bladder will make the Kernel of a Stone; the Experiment of a Bullet's producing this Effect has been try'd upon a Dog; and such an Accident has happen'd to a Man by a Wound, in which a Bullet has dropt into the Bladder.
The Symptoms of a Stone in the Bladder are a Titillation about the Neck of the Bladder, and the Parts thereabout; a frequent Needing to make Water; a Sensation of Weight in the lower Belly, under the Shear-Bone, with a great Pain, especially upon any sudden Motion, which causeth a Concussion of the Bladder, a Dribling, Difficulty, and a momentary Suppression of Urine by the Stone, shutting up the Orifice of the Bladder, attended with a Tenesmus, or needing to go to Stool, and a burning Pain in the Urethra; sometimes a white Mucus in the Urine; tho' this last Symptom will happen without a Stone in the Bladder.
The Regimen in the Stone in the Kidneys is by diluent and soft Diureticks to try to expel it, if it is small enough to pass; if the Stone is brittle, it will often crumble and pass in the Form of Gravel; if the Stone is too big to pass, the best Method is to come to a sort of a Composition or Truce with it; the Diet ought to be cool and diluent, as far as possible to hinder its Growth; to use Diureticks that gently resolve, as Parsley, Fennel, Scorzonera, Sassafras, Mallows, and Tea, Dandelion, Cichory, Oats, Barley, Honey, Honey and Vinegar; Nitrous Salts, as Spirit of dulcify'd Nitre; the most soft cooling Diluent of all, is Whey; the best Emollients are Decoctions of Marshmallows, Linseed-Tea.
Bathing in tepid Water, Clysters, seasoning the Aliment moderately with Sea-Salt, for the immoderate Use of it is resolving and diuretick; the Belly, in all Cases of the Stone, ought to be kept lax and open.
In a confirm'd Stone of the Kidneys too violent Exercise is dangerous.
During the passing of a Stone, one should avoid at first all strong Stimulating; relaxing and lubricating the Passages, and quieting the Spasms by Opiats is certainly the best Method; and where Bathing cannot be conveniently had, OxBladders, half full of warm Water, apply'd constantly to the affected Part may be usefully substituted. Letting of Blood taketh off a Tension better than any thing, and is very necessary where the Symptoms are violent; when the Parts are sufficiently relax'd, stimulating Diureticks may be us'd more safely, especially if associated with Opiats.
As to Dissolvents of the Stone, all that have hitherto been propos'd are chimerical;
Helmont
talks of Bulls Blood; Goats Blood is rather a better Dissolvent.
The surest way to hinder the Generation of a Stone, is to procure a Diarrhoea by Whey, Broth, and a liquid Diet; and indeed what would not one do to prevent so painful a Disease?
When the Stone is fallen to the Bladder, Care should be taken to make it pass as soon as possible, for the Reasons above-mention'd; if all the Symptoms abate without the passing of the Stone, it is not certain that the Stone remains in the Bladder, because a very small Stone may pass insensibly by Urine; if the Stone has pass'd, it is not certain that the Fit is over, for there are often more, and the usual Remedies ought not to be left off.
The Irritations of the Membranes of the Bladder by a Stone, may be much mitigated by the Injection of the Oil of Linseed or Almonds, into the Bladder.
Such as are subject to the Gravel or Stone ought to be careful of their Diet, to use such Aliments as generate a small Quantity of Foeces, or relax the Belly; Aliment demulcent, as Pease; a Decoction of Chick-Pease is a Remedy in a Fit of the Stone; they ought to drink Whey in the Spring, and take Honey in several Forms, if it agrees with them; Rice, Barley, Millet, are all good in this Case; nothing makes Stones or Gravel pass more easily than Opiats.
If the Stone sticks in the Urethra, emollient Fomentation of the Parts, Oil injected, or in case of great Extremity, an Instrument with a Cavity like a small Spoon, dipt in Oil, may fetch out the Stone.
The Stone in the Bladder is not only a painful, but a mortal Disease, if not extracted. The Diet of a Patient in such a Case is such as of a wounded Person, nourishing, without Acrimony.
Let the Reader look into the Article of Inflammations of the Kidneys, where there are some Directions proper for all who are subject to the Stone or Gravel.
Rheumatism.
The Disease seems to be an inflammatory Disposition in the serous Part of the Blood, affecting the lymphatick Arteries, and therefore affecting those Parts where the Vessels are the narrowest. The Blood, as in other inflammatory Cases, is sizy, the alkalescent Salts in the Serum producing coreaceous Concre
ons.
The common Methods us'd in this Case are certainly proper; these are, repeated Bleedings and Purges, interposing Anodynes, and gentle Sudorisicks; and Blisters when the Pain is obstinate in one Part.
As for the Diet, it ought to be cool, diluting, and chiefly Vegetable.
If there be a specifick in Aliment is certainly Whey; I knew a Person subject to this Disease who could never be cur'd by any other Method but a Diet of Whey and Bread. A Milk Diet is likewise effectual for changing that saline Constitution of the Serum of the Blood.
Cream of Tartar in Water-Gruel, taken for several Days, will abate the Pains and Swellings considerably, by its Acidity correcting the alkalescent Salts in the Blood.
In obstinate Sciatical Pains, Blistering and Cauteries have been found effectual, and the most penetrating Medicines, especially the ethereal Oil of Turpentine mix'd with Honey.
I have lanch'd out of my Subject in this Article, because of many common People who cannot always have good Advice.
FINIS.
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