SECT. I. Clearing, that the infallible Principles of Law, Equity, and Reason, and the necessary con­sequences thereof, applicable to the Physician ▪ does both oblige and direct him to get light in this subject, and in the other means of his Im­provement.

IF the Profession, that seems most deser­vedly, to be intrusted with the Standard of Iustice, whereby Humane Act­ions are commensurable, Equity and Law, makes the unskilfulness of Phisi­cians, highly culpable. does give out, and determine, that to be a quasi delict, or kind of Crime, when a Judge, through unskil­fulness, gives an unjust Sentence, [Page 2] thô thereby we only suffer in our Goods and that Damnage be also reparable, by a Revise, or the cognizance of an higher Tribunal: And further if that Profession, does calculate the Attrocity of Crimes, ac­cording to the degree of hurt done, toge­ther with the the kind of Negligence occasion­ing it, which if Supine and Affected, and in matters of great moment, and trust, makes then so gross an fault, that being equiva­lent to fraud or dole; and thus giving the essential thereof, it constitutes likewise a a true Crime:

May not truely then, the unskilfulness of Phisicians, arising from incapacity or negli­gence; especially, when supine and pertinaci­cious, and that also under a trust so great, either bringing, or permitting, (while it is in the power of Art to prevent it) the irre­coverable loss of Life, justly carry the taint of a true, and no small Crime: Thô with­all such, as rather for want of competent Iudges, then for want of sufficient and crying Guilt, is re­served wholly to the last Tribunal.

And it being also very sure, that by how much the danger and loss, from the unskilful performance of Medicinal pra­ctice, is greater; and the difficulty of at­taining [Page 3] to skill therein, is also more, then in that of the Judge, or any other offices what­somever; by so much it requires both greater Iudgement, and more Labour, and Industry in the Undertakers; and that as well for their accomplishment therein, as for the particular discharge thereof: And indeed such as are rather suitable to the Im­port and Difficulty of the work, than to the Capacity, or Ability of the Operator. It seems therefore, that the only Innocence capable to pro­tect, from the Imputation, and Impeachment of this Crime, is commensuarable in proportion to the vigour of the understanding, and activity of Industry, in prosecuting the Qualifications requi­site, for the particular, and faithful discharge of this practice.

Whence seem Trespassers here, all those, who not being above the ordinary gifts of Mind,Acuteness re­quisite in Phi­sicians. nor en­dued with a singular Acuteness; althô altogether unapt; yet do ingire themselves into this Study, and Practice. That the saying of Petrar [...]h de Remede Vtr. Fortun. Lib. 1. Dial. 7. Tha [...] nothing is more odious to wisdom, then too grea [...] Acuteness, may have its due use in Morals, and Conversation, where the observation, and stopping at every Punctillio, does rather [Page 4] amusing retard, then enlightning direct: Yet the self same exactness, and penetrating, which thô in Moralls, and perchance also in Common Prudence, is debased into Precise­ness, and Caprice, in Medicne, (as exalted to Medical Prudence) does really adopt the true Sons of Art; For in taking a Survey of the works of Techy Nature, in relation to become a Moderator therein, nothing being so Minute, and Latent, but (as cap­able of, so oft signal for influence,) deserves likewayes expiscation and eventilation: The practise therefore of Medicine requiring, as a large and full, so a distinct and acurate prospect; to comprehend all things, that can instruct the Physician, in relation to the knowledge and cure of Diseases, and ma­ny of these, by their Minuteness as well as Sublimity, escaping the less curious in­quirie. It seems then, its only the most exact dyve­ing, (as lyable to the fewest of such escapes) that can of right entitle, to any degree of eminency, and perhaps sufficiencie in this Imploy; Or at least, nothing can propitiate for the defect of this, but the proportionable increase of Industry and Diligence, sometimes equal­ing this acuteness in search and discovery.

In the next place seem culpable here, these who albeit endued with preg­nancie of Wit,§ 3. And they being seque­strate from other Im­ployes, or Divertise­ments. yet do exercise [Page 5] the practise, by way of parergon, or by-work; and labour there­in, following an other imploy, or study; perhaps also of that per­plexedness, and moment, requir­ing likewise their whole endea­vours: and thus serving two rigide Masters, and parting their labour betwixt them, they do most unworthily, apprehend themselves, to discharge sufficiently the di­ligence agreeable to Medicine, which, consi­dering the Intricacy and Import thereof; can be satisfied with nothing less, than the con­tinual, and vigorous bending, and intension, even of the most acute and perspicacious mind thereupon; & without notable and injurious impairment, can never suffer any such invasion of its right, or to be ri­val'd by considerable wast of time, be­stowed ei [...]her on Occupation, or Diversion, be­side it self: Excepting always, the care and con­cern due to the chief Interest of everlasting hap­piness, Properly, and Significantly, termed the general calling.

In the next degree come here censurable,4. § Dilligence and Industry requisite. any who althô appearing of competent endue­ments of mind; and further, exercise this Practise alone, yet (as the craving importance and intricacy of this [Page 6] Art altogether requires) are so far from the due and closs following, or by serious inquiry, from the careful anticipating, all the expedients of Improvement, that they shift and decline the opportunities; yea al­ready drest improvements, laid to their hand: these indeed giving a semblance to have sloth for their ascendant, and pertinacie for their predominant, come thereby so far short of the necessary and possible progress, that they are still Stationary; And while the Art it self is in advance, they may be said in a manner to be retrograde, in true and solide skill.

Now these being either more knowing persons, and conse­quently, conscious of the fault of their negligence, yet presume­ing the altogether impunity thereof,5. §. The causes of their ne­gligence ei­ther the im­punity thereof here. they easily venture on the perpetration of any crime, escaping the tribunal of Men; or being less knowing, and so less conscious and wick­ed; then labouring under fundamental er­rours and mistakes; no wonder they make only such a superstructure thereon, as is suitable to the Laws of incuriousness and ease.

For they being altogether in the dark, as to the Nature of that Obligation, 6. § Or ignorance of the strict­ness of the Obligation lying on them. they put upon [Page 7] themselves, by undertakeing a Profession, that does certainly obliege them, to such exact discharge, as makes the least errors, both of Commission, & Neglect, especi­ally when (as often they are) of danger­ous, and Fatal Purport; to be placeable to the undertakers acount: If by any qualifi­cation from Capacity, Diligence, & Scrutiny, these might have been evited, no wonder then (since they have no distinct, and clear Impressions of this) they should have like­wayes no Stimulating Impressions from this.

Now the strictness of the O­bligation,7. § The Nature and Extent of it cleared from Law and Equity. lying upon the Phy­sicians, in relation to their dili­gence, is not only deduceable from the nature of trust in ge­neral, which Lawyers (clearly giving out as obliging to the diligence of prudent men,) make accountable for the lightest errours and escapes: But also from the nature of these trusts, that being the subject matter of a profession, seem therefore to imply as a supervenient, so a stricter tye, than simple trusts do; the very setting up to a profession, importing no less, then as the undertakers asserting his Capacity, so a kind of invitation, to be trusted therein: [Page 8] and this certainly putting him under [...]n accountableness for meer neglect, of any sort; seems to put him likewayes under a stricter obligation, to accomplishment, then these trusts do others, which being the sub­ject of no profession, are indifferently com­mitted unto, and administred by any: for the Mandator choicing a person that by no character of profession, gives out himself qualified for the trust, he can expect or ex­act no more from him, but suitable to the Skill and Qualifications he really has: Now Medicine, beside what is common to it, with other both trusts, and professions implyes yet a stricter Tye: for almost in all other im­ployments, the Qualifications being so far discernable, that importing the Imployers acquiescence, from his choice, in that mea­sure of skill, he finds or might find, him he trusts, endued with; he cannot justly charge him with the escapes, especially of Skill, he saw or might easily perceive him lyable to: but in the Profession of Medicine, the Qualifications lying so deep, that it is hard to perceive, whe­ther they be there, or not; this makes it difficult likewayes, to make a solid electi­on, where to place that Trust: Here there­fore being Trust, upon Trust. Viz. Not [Page 9] only the Patients trusting him [...]elf, to the Phisitians Skill; but also the tru [...]ting the sufficiency of that Skill, to the Phisician him­self: This must therefore necessarly, put the Phisitian likewayes, under the double obligation, as well to sufficient capacity in his Employ, as the faithful di [...]charge there­o [...]: For could the Patient clearly descern, where the most eminent qualities, deser­ving such a Trust, were lodged; he would only choice to lodge there likewise, the Trust of the great concern of his Health, and it may be Life also. Now if simple Trust, oblige to such exactness, as makes the least Errors chargeable, what accuracy does this agregation of Trust, (as being the subject both of a Profession, and of one so momentu­ous, and intricat, that it includes a double trust) oblige unto.

The espcapes of meer Neglect thô (rather for want of the Phisicians suffi­cient Sense, §. 8. than through his Innocence) giv­ing no check; yet these being often equal­ly, fatal here, with errors of Commission, should not this undoubtedly therefore, prompt him to such an Indefatigable, Vigo­rous, and Vniversal Search, as may justly give him, the infallible Assurances, that [Page 10] even these escapes, (under the qualification of might, and should have helped,) shall ne­ver rise in judgement against him, it being a very sure, thô sad and frequently incur­red Certification, that in so far, as the Phi­sician fails, in this dilligence, in the pro­portion to the consequence of the Escapes, a­rising from the neglect thereof; he is un­doubtedly rendered guilty, even of a Cri­minal thô secret deceit in his trust.

§. 9.The Phisician in his Practice, be­ing to march in an extraordinary narrow path, environed on the one hand, with the dangers of escape, and neglect; and on the other hand, with the perills of positive and plain hurting: So then he often study­ing too cautiously, or rather ignorantly; to avoid hurting, may be miserably frighted into, the timorous neglect of the eradicating, and only effectual Remedies, and contrary­wayes, by serious Incumbency on these, he may rub on the other extream of hurt­ing: There seems therefore to be nothing, but the sure evidences, and plain instructions, of this assiduous, and serious Application, that can obtain to him a full and positive exoneration, bearing, that he has altoge­ther freed both these, (indeed very close lying together) extrems: Or that any de­clension, [Page 11] [...]o either side; (whose frequency is as certain, as it self is secret) is so much ve­nial, that being unavoidable, and there­fore of the nature of casual, he can no­wayes be made acountable for it, howe­ver, that the difficulty to avoid hurting the Patient, is more than is commonly ap­prehended, will be plain, by considering that these Remedies that to a mean Tin­cture of Skill, appear innocent, (and this thô a silly one, is the best Commendation many can, and do give, their Remedies and Methods) yet these innocent Remedies, may by a greater degree of Knowledge, disco­vering much enveaglement of crossing cir­cumstances in the Disease, be discryed re­ally dangerous; and farther, another Re­medy, that this degree of Knowledge, may in place of these acquiese in, by an higher pitch of Skill, (armed with more perspicaci­ty) may justly be repudiat: And so through all the degrees, unto the farthest attainable pitch of humane Art, (which unto a degree of farther Skill may also yet appear short) the greater may still see more, than the lesser: So it is plain, that as no attainable proportion of knowledge can absolutely se­cure the Artist even from real hurting, so its only the outmost attainable proportion, can atone for the guilt of it.

[Page 12]And on the other hand, if we turn to the consideration of neglect; we will find it may ly in a point not a whit less Nice, In how nice a point ne­glect may ly and the coming under the possibili­ty thereof, a­larms suffi­ciently to in­quiry. and Important: As when a Patient is (notwithstanding of all the Phisitians endeavours) lost; yet if there could have been any Remedie in Nature or Art, which serious application, consideration, or other dili­gence, might have made known to the Phisitian; and by which he might have saved his Patient, then and in this case, of whom, and of what dyes the Pa­tient, I pray you?

Now this bare possibility of Neglect, al­beit overly considered, and under the No­tion of a Peradventure only; it gives small impression on the mind; yet the concern­ment it carries to the saving or loosing the Life of Man, being closely laid home, can­not but raise such an anxiety in any think­ing or tender Phisitian, (especially under the clamorous Rumours, seeming to impeach him of so important and gross negligence) as nothing can calm, but a serious, imparti­al, and thorow Inquiry, at experience. And this the rather he may be prompted to, be­cause such experience lying open to his view, as the result of other Mens Industry, [Page 13] does not oblige him to try by himself what he reckons dangerous and new experiments; and then it is not doubted, but the issue of this will (putting off all ambiguity) re­solve this peradventure into a certainty: Un­less it happen as may reasonably be feared, that such a restiness, as needs to be so hard spurred on to the duty of Inquiry, will also in trifling the Survey of Experience, altogether defeat the hopes of true discovery: But at length as there seems to be nothing that can approve these Remedies, given out by the sure experience of others to be of all yet known the most effectual; but as palpable evidences of their ineffectualness, built on the like exact experience; so it is hoped none will let their logick out go their honesty so far, as to bring any such agrument against them. And withal it would be noticed, (as it fre­quently falls out in other matters) that al­thô such mistakes as (in these that are wil­ling to be informed by evidence) are easily curable; yet the longer they be wilfully and tenaciously maintained against light; (beside the execution and havock they in the mean time do make) they do thereby become the more confirmed and habitual; and make the delivery therefrom, if ever, alwayes with more difficulty, torture, and remorse; than otherwayes it would be.

[Page 14]Now from all these, as it is certain that palpable inconsideration, inconcernedness, and neglegence; may equipe out plain incurious ignorance, and inconvinceable pertinacy under the colours of discreet and warry caution; so the conclusion of the whole terminates in this, that the only directive light the under­standing is capable of, doth arise from the sparkles made by the collision, and smart stroaks of this brisk scrutiny; and also that the alone solide peace the mind is calmed by, flowes from the Reflection and Conscience of this ingenuous labour and inquiry throughly and sincerely performed.

SECT. II. Containing a Model of the Phisicians diligen [...]e by which it will be plain, that Industry alone furnishes the Motives, Opportunities, and Means of Improvement.

FOr further manifesting of all this, it seems necessary to give a scheme & draw a Land-skip of this diligence; which being plain­ly done will serve as a Directive to the Physi­cian in this dangerous & difficult road: for it be­ing thus in whole subjected to his vieu, will manifest the proportion symmetry, and direct tendency of all the parts of this diligence to the great end of his Inprovement, and to the Dis­charge [Page 15] of these strict Tyes lying upon him by his trust and profession. But such a Figure be­ing only obvious and taking to the eye of a perspicacious mind, any other never being able to discern Order or Use herein, (be­cause rather replenished with prejudices a­gainst Industry, than susceptible of any per­swasive Impressions of its conduceableness to true knowledge and skill) will let it pass both in portraiture and in the life altogether unco­pied and unregarded.

In prosecution then of this,The gene­ral diligence of his accom­plishment. it comes to be remarked, that tho the trust of the Physitian, as being alwayes versant in parti­culars, may seem likewayes acquitted by a diligence and discharge also particular; yet this particular in its Qualification and due Exercise, altogether depending upon and being the product of a diligence more general, and of accomplishment; the delineating then of this seems first to be required.

This diligence then of accomplishment equally respecting all the Subjects of Me­dicinal practice seems to consist in acquiring such a stock of Learning and Knowledge, as may serve for particular exercise and discharge; and this Knowledge by the accession of all New Practical discoveries is still to be on the improv­ing hand, for when Advance is possible, (it be­ing [Page 16] alwayes necessary;) this diligence cannot endure any measure of Skill to be stationary: And moreover this knowledge only consists in the Imprinting the mind with such solid and genuine notions of the operations of Nature, in the production, various fa [...]eing, and cure of diseases; as will direct in choicing and fol­lowing the most effectual measures also to their cure by Art; and these directive impres­sions may be most compleately & effectual­ly gotten, (beside what the Physicians own particular and serious contemplation affords him) by the diligent quest of, exact search into, and profound meditation upon (for perfunctorious triffling and scruffing is never more unseasonable then here) the works and writings of such Authors, who having given the truest Histories of Diseases, and therein unraveling Natures Intrigues have proven thereby the best Interpreters of her misteries, and of such as have descended into the farthest and lowest specifications of dis­eases, by bringing most light to the know­ledge thereof, have also brought most fruit of practical and methodical Cure: And fur­ther of such as by the native clearness and succinctness of their method of treating these things, illustrate the mind with a more clear and durable impression thereof: and moreover there being several notable pra­ctical [Page 17] Observations incidently occurring in Authors, who deliver the same in no systematical method of Diseases, and also to be met with in common Medical conversation; Now these to serve their prope [...] expedients, being difficult to be fallen on, and more diffi [...]ult to be exactly remembred; by means of this gen [...]ral diligence deserve (being picked out) to be orderly classed up; beside, the light that the samen so disposed (increasing the stock of Know­ledge) do bring to Theory, that (being thus in order also more easily run over) they may be more expeditely brought forth u­pon their proper and par [...]icular Exigencies of future practice.

And indeed this Concupiscence in the Phisician, §. 2. The benefit of this Dili­gence. thus to appro­priate the Labours of others, to pluck the better Fruits of their Lives, to drain the sweet, and extract the quintessence of their Works; is so far from any injury unto them, that with the grate­ful acknowledgement of their Merite and Praise, it is the most due retribution of Iu­stice; and there seems nothing left us to palliat our ingratitude if we neglect this, but with a Criminal breach of our Trust, Cruelty to Mankind, and Vnkindness to our [Page 18] selves: That inquiry and search being the only apposite mean of our improvement, and including so comprehensive a Benefit, as to be the only proper Expedient, in propor­tion to our Diligence herein to lengthen the short Life, (our compiling together the acquisition of many Lifes, at least compensing the disadvantage of the shortness thereof) and also after this man­ner overcoming the length and difficulties of this long Art, to shorten the length there­of by our speedy disciplinating therein. And further the Nourishment and Vigour of the Mind, being thus also promov'd, this Labour and Exercise stands in the same relation of Vtility and Necessity thereunto, as the natural Appetite, Assumption, and Digestion of Aliement does to the Body; for without this Food of the Mind taken in and digested; thô under the visard of a polite Personal, pru­dence, some personating Skill and Learn­ing, are by undiscerning Persons esteemed for well furnished, robust, and quadrate Cham­pions in Medicine, and so do easily fa [...]cinat the Mobile, in most of things (but most of all in this abstruse Art) grasping at shad­dows for substances; yet to the discerning how squalide, languishing, and truely enervate a Figure do these make.

[Page 19]The other kind of Diligence re­quired in the Phisician, The parti­cular Dili­gence be­gets experi­ence. because versant about particular & indi­vidual cases called particular (and also in its due Qualificati­on, depending upon the former accurately discharged: and farther by its exact exercise reciprocally advancing the general stock of knowledge by experience for fabricando fabri fimus) does consist first in that outward care & attendance due by the Physician; but the neglect of this reflecting too sure, sensible, & pungent inconveniencies on the Physician himself, makes for the most part, upon that account, the sensible Diligence to be suffici­ently intent and bended; unless sometimes when Age and Prudence, pretending Value, & thereby Right, have procured a patent of Reputation from Opinion, (which rarely con­sults Merit) to raise the price thereof, then with Advantage and Safety it may, and for keeping of its Honour it must, be­come more remiss, and be made a rarity of: Thô Medicine gives no Monopolising Pre­hemenencies by vulgar Opinion; and this Diligence gives neither Dispensation nor Priviledge, but suitable to the necessity of the present exigency. And next, but withal, more especially this particular Di­ligence does consist, in the secret, inward, [Page 20] and conscientious Industry, making an exact Expiscation of all concurring outward and visible causes, and other circumstances, with the accurate observation of all the Phoenomena and narrow consideration like­wise, of the disposition of the Body; by which Light may be brought to, or a genuin idea given of, the continent cause, or essence of the Disease in hand; This Cause alwayes lying invisible and secretly couched, in the dispo­sition of the Body, betwixt these two visibles of outward causes and Phoenomena. And this Diligence here also requires the consigning of these to Writing; that with more leisure and effect (all being duely pondered) there may be farther discovered, what effects the given causes are apt to produce in the Bo­dy; for by the Contemplation of their Nature, may be known what will be the consequence of such seditious Disturbers their invading the oeconomie; where comes like­wise to be considered the disposition of the Body, and its susceptibility either of impres­sions altogether different from, or of more grave effects, then these ordinary resulting from such causes use to be; this common­ly resolving in an Idiosyncrasia or Propriety of temperament: and thus also the Physician, may consider fully the Phoenomena, what [Page 21] News and Report they do bring from the inward troubled state of the Oeconomie; where it is also observable, thô these Phoe­nomena being often in disguise, impose upon, and deceive the Unexpert; yet be­ing soon unvisarded by the sagacious Artist, they may be made to tell, (without dissi­mulation) the truth: So by making a ju­dicious calcule of the given causes, disposition of the Body, and appearances; there may be in most cases more then a probable computation also be made, and a true Idea thereby had, wherein the discomposure of the Oeconomy doth immediatly consist: and for restoring of it, solid and sure Mea­sures adjusted and taken, and that either by means of the Phisicians proper, but so­lidly founded experience, or that of the more eminent Practitioners likewise being con­sulted. And this method of consigning the Patients case to write, and for the same use and end, was the custom and practice of that famous Practitioner Theodor: D. May­nerne of whom Harres in his Pharmocologia an­ti Empyrica, relates, That in Chronical cases, e­specially such as would permit deliberation, he used not to shake his Consultation out of his Sleive, but comitted all the circumstances and Phoenomena of the disease to his Diaries, about which he [Page 22] consulted his dumb Doctors, & by summing up all their Councils, having gotten a true Idea of the Disease, he did thence take his indications.

Moreover this exact consignation of the Patients case to writing, §. 4. being equally conduceable to the Physician, seems to be of far more necessity to him (by rea­son of the far greater import and difficulty of his Practice) than that usual exactness in Lawyers, their taking up the state of their Clients causes likewise in writing, is unto them: For the damnages of their negligence thô more perceiveable, are yet more tolle­rable and reparable then the same in Me­dicine; where it is scarce permitted to fault twice, and over the Brink the dearest Life is irrecoverably precipitated.

This particular industry doth farther require the inserting al­so into a journal as a proper con­servatory thereof,§. 5. An journal of the Physi­cians pra­ctice requi­site. the whole history of the Physicians daily practice [...] therein being parti­cularly comprehended the Medicines given to each Patient, with the effects thereof: For by such an exact History; he will be surely directed, how to take his measures, and make more safe and ready hitts, in their cases, who having been formerly his [Page 23] Patients, stand there recorded as the subjects of any remarkable circumstances, or scene of medical Practice: There being truely few but something various and singular in their Temper, doth discover it self; which con­cerning their security and safety, concern also the Physicians diligence and fidelity, to be carefully put in record, and without this record as a compass to steer by, he will be in hazard either to commit some error of precipitancy, or to lose time (which the quick current of some cases may render extraor­dinary value able & precious) in reiterating those irksome & Nauseous (thô hovering Trials) to familiarize their nature, temper, & con­stitution, that at first his caution did neces­sarly put him upon. And such Physicians who neglecting this, (especially under the throng of many Patients, or considerable interven­tion of time) do not more carefully take up & preserve such Lineaments, of their Patients Constitutions, as their occasions of medicating them does afford; save what alone their Me­mory can give them thereof; since thereby they seem altogether to transgress & violate the only condition inferring the benefit of their being the ordinary, deserve they not like­wise to forfeit that endearing relation and the priviledges thereof; which like Love [Page 24] thô it should cover many of the Physicians Infirmities; yet scarce any of such impor­tant and gross Negligence, where for so small and easie coast, they forego so great a Be­nefit to their Patients.

And moreover, this Iournal serving the Physician for a Map of the various unifor­mity of the operations of Nature, and these even by his own Survey drawn from the Life; the serious and frequent view thereof, (by giving him more solid, full, and bright Ideas of Diseases and their [...]ures only be­gets that so much talked of (but rarely found) experimental Knowledge, which in pro­portion to its solidity will surely direct the steady stirring of his Course in after pra­ctice: And that the solid experience in Medicine (thô after never so much practice) can no­wayes so fully and exactly be produced as by such an exact Historiography, is altogether clear from the multiplicite complexity, invei­glement, and variety medical Caises are al­wayes circumstantiat with, which undoubt­edly therefore require to be most exactly and fully collected, represented, and specified, to imprint and conserve in the Mind all these genuine Ideas, that are necessary to bottom all these reflexive, comparative, and discursive Acts of the Judgement, requisite [Page 25] to compute, conclude, and enter in, true and consequential experience. Moreover, this diligence of compiling an exact History of his Practice, (wherein that of others faith­fully communicate to him, may also be comprehended) is clearly resembled in its method, and also in its utility confirmed by that diligent care of Lawyers, when they do collect and digest into certain clas­ses and heads, all Decisions and Practices of particular Cases: These indeed being se­riously considered and pondered; by im­brightning, unravilling & specifying their notions of Law, does give them the truest Impres­sions of Right, which (denoting also expe­rience in Law) must undoubtedly enable them by more certain Hitts, to make the most solid application of these legittimate Notions to particular occasions.

But it may perhaps,§ 6. Whence is the vanity of the many Observati­ons in Me­dicine, dis­eases not being suffi­ciently un­masked. and not unreasonably, be objected, that the palpable multitude and va­nity of such Observations in Me­dicine, wherewith the World is pestered, would therefore seem to discharge any farther pro­gress in that road: But if it be narrowly canvassed, whence it is that so few of those Observations being [Page 26] brought again to be reacted on the Stage, of Practice, does either answer the Authors Brages, or our expectation founded there­on: Not to call in question the Authors Ingenuity, the true reason of this will be rather found to be their want of sufficient Skill, to have set down the Diseases in these Observations, both sufficiently un­masqued, and specified: This surely has in the re-experimenting these Observations, of­ten evacuate the Cure: For first, commu­nity of Symptomes and Phoenomena in Diseases in these Observations, alwayes has been found to class them under one common Type; while many times the Diseases of one Type, really disguise themselves under the Phoenomena of another Type, so, thus the diagnostick and Disease being mistaken, the Cure falls to be so in consequence; and this as it is mentioned and observed, so it is exemplified by our eminent Author, who has indeed been the first that suitable to the true genious thereof, has shewed the Proteus like nature and fashion of Histerique affects, that disguise themselves under the appearances and symptomes of many other Diseases, as under these of these of the Col­lick, Gravel, &c. and abundance of others and which being plyed with the Remedies [Page 27] appropriate for these Diseases are indeed more exasperat than lenified, but soon yeild to an Antihisterick method.

And next many Diseases which in these observations go under one general type as a species, §. 7. Next Dis­eases not being suffici­ently speci­fied. & they made only numerically di­stinct, are really rather distinct species under that Type as a Genus; and may differ as much among themselves, as one Type does from another: No wonder then that Diseases and their Remedies being set down in Observations, with little regard to this particular specification, if the proper Remedie of one species (often being mista­ken) prove ineffectual to cure another spe­cies: And this important and farther spe­cification is first also observed and instanc­ed by the same Author, in the Small Pox, which all antiquity had without distinction of the two species of distinct and confluent con­fusedly treated: For beside the different Therapeia evincing this distinction and spe­cification, that notable Symptome of a di­arhaea so noxious in the distinct, & nothing so, but rather beneficial, in the confluent, with sundry other differences betwixt them, does more fully make this appear.

So that to do any thing effectually in [Page 28] way of observation, Diseases require both to be most curiously and carefully unmas­ked, and more particularly and farther specified, and the cures which before were in gross bulk and confusion, ought specially to be sorted by detail: viz. To every real Disease and proper Species, its own true genuine and particular Cure.

The serious exercise of this double Diligence, The benefit and necessi­ty of this di­ligence. does not on­ly comprehended the Improve­ment of younger Phisicians, but more eminently, pointing there­at, doth recommend the charge of the El­der, yea Eldest Ones: These being altoge­ther capable by larger and firmer steps, to make both surer and farther advance in this road, the only way leading to any pitch of Skill, in this inexhaustable Art.

And Moreover while Natures fecundity (especially impregnat by Mens Exorbitan­ces and accidental Contingencies) does a­larm us with continual Inundations of com­plicat, disguised, and obstinat Effects; should not then Humane Wit and Sagacity, im­pregnat also by Labour, Search, and Indu­stry, prove as broody to discover and ob­viat both their violent and subtile As­saults.

[Page 29]And surely herein as in all the forgoing means of our Improve­ment, the recent Writers seem to have most succesfully labou­red,Why re­cent Writ­ters afford the best means of Improve­ment. it being those that alone having had the great advantage to be set on their Predecessors Shoulders, must undoubtedly therefore have a larger and better prospect of things; althô withal some of them by reason of that prospect, found it altogether necessary for making true survey and more happy discoveries in some Diseases, to take up alto­gether better ground, and new stations, and have in consequence laid down more solid and sure measures of practise; and the ad­vantage of others of them being in that they themselves have been Contemporary with the discovery and Specification of the true Cure of some Diseases: while some others qualifie their advantages and fortunes yet higher, by having had the sagacity to be the Discoverers of these them­selves:The great merit of D Sydenham. Now every one of these circumstances singlely, being ground sufficient to recom­mend recent Writters, (each whereof from these Advantages has made some peculiar improvement) how much then must the [Page 30] Combination of them all, in the person of the Noble and Famous D. Sydenham, (who seems indeed to have made the same proportion of Improvement with these his Advantages, as the suffrage of several lear­ned Physicians hereafter to be mentioned bears witness) recommend and endear these his Labours to all that are mainly either concerned for the benefit of Mankind, or curious of the Improvement of Medicine: But these indeed are too vast capacious and laborious designs, to be hampered within (and perhapes also interferring with) the narrow, petty, and homeward Proj [...]cts, the far greatest part are only capable of.

From all which it will be plain,§. 9. The evil consequences of Sloat [...]. that as on the one hand these that travel in the way of Diligence, (catching the Opportuni­ties, spurred on by the Motives, and guided by the Means, and thus being in the straight road) will certain­ly both land in Accomplishment, and like­wise necessarly take in their way thereto all profitable Discoveries: So on the other hand, these that slight Diligence, (baulking the Opportunities, sitting the Motives, evacuating the Means, and being therefore clearly out of the way to accomplishment,) No won­der, [Page 31] that (never meeting therewith) they be neither capable nor sensible of excellent Improvements.

And farther, as these that earnestly con­tend in this way of Diligence, by tracing sure and clear steps, can only get these true and genuine Impressions of things, that will enable them to make the solidest Decretory Iudgement concerning the validity of any Improvement, and whereupon they may found true Experience: So these that linger & deviat, are thereby prone to have their judge­ment (which restles must still be forming some Ideas, thô Chimerieal ones) so depraved & wrested, by the alay of vain Hypotheses, and Prejudices of empty Theory; that they neces­sarly do carress and substitute a partial, un­exact, and suppositious, in place of true Ex­perience: Not much unlike a Garden, that without diligent Culture, becoming natu­rally all overspread with useless and noxi­ous Weeds, yeilds neither Pleasure nor Profit. And thus it seems may be unridl'd that Paradox, why some Physicians notwith­standing of all the Light, Certainty, and Profit therein, may yet remain unprosaly­ted to excellent Methods: And also, that they may (at a blind Adventure, levell [...]ng at Innovations) be really found to hitt and beat down excellent Improvements.

SECT. III. Shewing that too great throng of Practice, hin­ders both Improvement, and faithful Discharge of the Physicians Imployment; And that Re­putation the occasion of that hindrance is ra­ther the effect of Artifice; and popular Errors then of true Industry.

AS a necessary consequence of all has been said comes the Censure of such Ph [...]si­cians, who (because thereby also straying from the true method and means of Im­provement) althô endued with under­standing, and nowayes [...]loathful; yet un­dertake at once, the Cure and Care of more Patients then their Ability; yea, that of the most compleat Artist, accord­ing to the due steps and measures can tho­rowly expedite: And thus that bottom that would otherwayes carry through, and land safely a convenient number may (being impestered and thronged) be so o­verloaded, as to loss or hazard all. Every Pasture may be overlaid with too many Cattle; and every Field may be exhausted by two much Corn growing thereon; eve­ry Cart or Ship may be overburdened: Yea, every particular Artificer whose work when it is incompleat all perceive to be so; [Page 33] may also undertake more then he can dis­patch; and no hurt comes thereby to any but delay: But only the Physician and Lawyer (and sometimes by a plurality or largeness of the Benifice, also the Clergy-men) setting down no bounds of their capacity and un­dertaking; but conform to the limits of their Trust; profess such a kind of trans­cendent ability as is like a little Omnipo­tency: Because forsooth for the most part no evidence can be had, but their Faith; that the Trust is honestly discharged. And thô it be hard to set down positive bounds in this matter, their capacity being the true measure of every Ones undertaking; and althô the Sagacity of some be improveable to that hight of dexterity, that they can make surer hitts on the wing, then others do poring from their rests; yet this seems to be far from warranding by too much undertaking, to lay a necessity on them­selves to be alwayes extemporaneous in their Resolutions, and to marr the evident and possible advantage of such Sagacity, that rather pointing thereat, it does en­courage, yea oblige, to the fulfilling the great expectation, that the uttermost Im­provement of that Acuteness by sufficient deliberation does really promise.

[Page 34]Whosoever then is involved in more Business and Practice, then will permit him to discharge the Diligence due to every Case and Patient, and that both in the ge­neral and particular course, as he thus baulks the means of his accomplish­ment, and never meets with occasions of Improvement, so he necessarly bungles and scruits his work, and deceives his Trust: and seems to have reputation rather the conquest of his Artifice then merit: And such (thô hurried unto precipitancy by a pretended necessity, and straitness of time, but really by avarice) shall undoubtedly be charged with the consequences of their Errors (tho covered with the earth) no less then the rest of the unqualified Labourers in Medicine.

So then in the last and most eminent degree seem Criminal all such, who from Incapacity or Negligence, wanting Skill, do yet (as a succedaneum thereof) succesfully bestow all their Wit, Industry, and Care, in the Im­provement and Artifice of Personal Prudence, The suc­cess of Ar­tifice and personal Prudence hinders Improvement. rather than Medical Prudence; in laying down measures to acquire Fame and Re­putation, rather then by true Knowledge [Page 35] or Merit to deserve them: all that such com­monly find proper to aspire unto in Medicine, is first, a great Busle of external care, & a most obsequious, and delectable Compliance (for if their Skill be not very sufficient, they give it both cheerfully and also in good measure) unless when the adult Grandour of meer Reputation is improven to that de­gree by Artifice also, to enfranchise from such truckling; and then any thing look­ing that way, becomes so Meritorious, that it goes on the borders of Supererogation and Munificence: And the next Artifice such follow, is to be Masters and accurate Displayers of some plausible and common thô false Scheme of Theorie; exactly calculate for the Meridian of vulgar Capacity and Curiosity: Now this is enough to shew it quite Antipods to Truth and Nature it self, common Capacity being never able to reach the Mysteries of Nature, nor depths of the Medical Art: To which The­orie by a dexterity sufficient to subdue po­pular Rudity, they make all the Phoenomena in Diseases and the Method of Cure exact­ly to stoup; and thus gratifying vulgar Cu­riosity, they amuse easie credulity into a profound veneration of their Learning and Skill; and that indeed by a learned and [Page 36] flourishing discourse, which unto common people clinks as good articulate and clear sense, as the Bell does to the Fool.

Now these being only garnished with the outside, and wanting the Soul and Life of a Physician, seem much to resemble the like in Religion going under the Name of Hypocrites, for as they under the masque thereof, simulating true Piety, and escap­ing all Humane eyes, are only unvailed to the Searcher of Hearts; even so does Me­dicine nourish the like spurious brood, close wrapt up in the glistering Vail of empty appearance, dazling the eyes of such as see no more than Skin deep, and only disco­verable by the Sons of Apollo: Neither is Piety it self, or at least the profession there­of, esteemed so sacred by some as to be exeemed from being a proper expedient of this Artifice, the vulgar having so great an esteem of a Physician with probity; under the Banner therefore of Religion, the short­est and easiest cut to esteem & Reputation in this profession seems to ly: But Religion can indeed give no more Improvement in this then any other Art, where it may hap­pily for Conscience sake quicken Industry, and better the Heart; but little the Head: Yea, the only spurr that stimulats to bear [Page 37] out against the tedium of laborious Scruti­ny, seems to ly in the perspicacious glances of the mind clearly discerning the utility, yea and necessity of labour and diligence; for indeed grosser Heads, thô with honest Hearts; easily closing with every thing, find neither the pungency of need nor profit, to subject their received sentiments to the Touch stone of accurate examination.

And moreover, all these Artifices and many more most commonly and succes­fully being exercised by the weaker sort of Physicians, who are also themselves weak Men, and even over the weaker sort of People, such as Women, and even the weakest of these also, do owe their success to this, that the Physicians Judgement and Capacity, being much of a size with theirs, breeds first Simpathy and Concord, next brings forth Affection, and at last, trains them up to a firm adherence to the Physi­cian: And this thô a less glorious, is no ungainful Conquest: For these being thus gained to his side, by reason of their mul­titude and noise, together with their ordi­nary priviledges of Importunity and Op­portunity, with their frequent usurpations of Impertinency, prove no unsuccesful nor contemptible Trumpets of his Reputation.

[Page 38]But on the other hand, this unskilfulness in ingenious or good Men, when under the Vail of any Arti [...]ice, doth also catch the wary and prudent in a more latent, and consequently more dangerous hazard in their choose of a Physician, because judici­ous Persons by a short and easie reasoning are able to establish sound Conclusions a­gainst weaker Men exercising this Practice, but to draw just consequences against these of more parts, the Bowels of Art must ne­cessarly be searched into, which by way of By work to do, is above the most pro­found Judgements, especially under the di­version of other Occupations.

And as in most other Crimes beside the principal Actors,The p [...]e­cipitant Judgment of the vul­gar and their pre­concei [...]ed opinion hinder improv­ment and is fatal to peo­ple, thô it be the basis of Reputation. there are oftentimes also Complices, who according to the degree of their accession, are likewise cul­pable, and make the Principal in some maner excusable; how much then think you does contribute to foment & cherish, and conse­quently to extenuate this unskil­fulness in Physicians, the precipi­tant headless and ignorant Judg­ment of People frequently Interposed con­cerning Physicians and their Practise, with [Page 39] the fruits of whose Unskilfulness upon this account they themselves not unde­servedly seeme to be chastised: For Opinion being the Monarch, bearing greatest sway in the minds of Men, has his Dominion up­held for most part by appearances, mistakes and errors, these being the most Plausible wares and Passable Coyne in that state; con­forme therefore to the same measures, the Honors and Dignities of that Court fame, and Popular applause, and the apanages thereof, are entailed on shadows rather then the substances of true merit: And this Empire likewise extending it self over the Province of Medicine, thorow the misrepresen­tations brought therefrom to that court, in depressing true merit to exalt the umbrage thereof, exercises most of its Tyrrany and arbitrary Government there: For vulgar capacity the only Inteligencer come­ing with news from Medicine, never be­ing able to descend into the depthes and un­fold the misteries of Medical prudence, is in stead thereof taken and deceived with the Prudence of the Physician only com­mensurable to that capacity, and for Iuno Imbracing the Cloud brings very false re­ports of desert from the Medical state: thus the way to Skill and Reputation being far [Page 40] laid asunder, layes also on the Physici­an an invincible necessity, suteable to the Laws of another great Monarch of this world interest, to improve personal Prudence glistering Ware in the Court of Opinion, and thereby also is loosed, or slackned his Allegiance to Medicine, by his being put under the constraint to neglect the study and exercise of Medical prudence, because it is circumstantiate with tedious uselesness here, and perhaps noxious by its frequent interfeiring with the profitable Art and use of Personal Prudence.

Mankind also being for the most part rather delighted with the Freedom and Liberty of ease, (especially it without loss and not Impeaching on Interest) then with the Yoak of honest labour, and bending of serious Industry, and there being in all human affaires no case so much favoring, yea Inviteing, yea Tempting to sloath, as Medicinal Practice is, (the fruits and ef­fects of all other Arts and Labours carrying a more obvious impress of Industry and Skill then this Practice does, where it is truely difficult to marke the subtile, and fine Steps, by which Art sets the cause a go­ing to produce the effect; or to observe the secret and hidden Concurse it has to Faci­litate [Page 41] it, this for the most part both makes Spectators ignorant, whither Art, Nature, or chance produces the effect, & cools the Physici­ans industry. And further, such being the Apish humor of popular ignorance, that inimitation of its direct contrary knowledge, it must still be judging, sentencing, & drawing conclusi­ons, by a reasoning, so ill counterfeit that it bears rather the Character of Mad­ness; The vulgar (being apt to mistake every consequent in Medicine, for the effect of Skill) often confound by their sentences, the chances or sequels of the Ig­norant, with the effects of the Skilled, and so becomeing Prodigal wasters of the re­ward due to Skill, by misplaceing that re­compense upon its contrary Ignorance, they take off the allurement, to Industry the Parent of Skill, thus adding to its dif­ficulty, they deprive Mankind for the most part of the benefit thereof. And more­over the favourable Judgment of the vul­gar concerning the Physician turning al­wayes to the byass of a forestalled O­pinion, that is to be Imposed on them either by his Prudence, or some other by-respect (it being very hard to have true knowledge of his skil) makes it altogether ne­cessary for the Physician to endeavor by Ar­tifice, [Page 42] and Culture to become one of the most modish and plausible Gallants in the Court of opinion.

And so People madly choosing rather to be artificially Imposed on, than honest­ly and Skilfully dealt with all, and being willing to purchase the gratification of their humors, curiosity, & capric [...], tho at the cost of their better concerns, health and life, comes to be the great tentation of Physicians to wast their Spirits and time, in studying and exer­ciseing Practise on the humors of the mind rather then these of the Body, to obtain favour, and esteem to themselves, rather then health to there Patients, in the mean time neglecting as nothing contributive to these Purposes, all study and care of ac­quireing true and solide Skill or Medical Prudence, pre-conceived and pre-acquired opinion serving as a refuge & sanctuary from all effects of Unskilfulness, and scarce any real Skill or Innocence being able to wea­ther out the blasts of an evil and ground, less opinion, without the help of Artifice.

And further years in the Phy­sician seldom fail to contribute a good Equipage for a preconceived O­pinion, and that under the notion of Experienced;The vul­gar Errors of the pre­conceived opinion of experienc­ed, disco­vered. these indeed serv­ing with little other assistance to set up the Aged on some pinacle, [Page 43] of fame: Such being the fond Opinion of the populace, because Nature brings all things to maturity and ripeness through time, therefore they think this Relation and Ally of Nature the Physician however insipide, vapide and crabbed stuff he be compact'd of, that he must be mellowed and brought to the Ripeness of Experienced also thorow time: But a quite other thing is Experience, then is commonly conceived, and not being al­wayes the product of time in a Physician it seems rather to be the Product of sagacious Industry (after a long contemplating) making such an exact Observation of all the concurring Causes and Circum­stances going to make up any Phoenomena or Effects, as may begett in the Physician an habitual Promptitude (so far as human Power can reach) to produce or ward off these ef­fects or Phoenomena, Pro re nata; And this Ex­perience is only gotten (as was before Inti­mated) by the Considering and Pondering the most exact, clear, and full Histories of Natures Operations, and Phoenomena, where­by the best Notions of her Lawes, Customes, and Constitutions being Imprinted in the mind; The surest Directive Ideas likewayes will arise therefrom, how to moderate Supplie and Regulat her as the case requires.

[Page 44]For in the conduct of Nature, as the on­ward concurring and visible causes do empty and wast themselves in the producti­on of the nearest Continent Cause of the Phoe­nomena, and with concurrence of, and allow­ance to the Susceptibility of the subject they do further stamp their Effigies thereon, so does that Continent Cause (with the same Concurrence and allowance) manifest and characterise it self by these Phoenomena: And Nature having (thô exceedingly various and multiplicite) yet a Certain Vniformity herein, and the Comprehension thereof only rendering her in proportion thereto tractable by the Artist, this most surely be the alone thing that denominats Experience in Medicine: And further as the study of these Histories is the road only leading to experience, whosoever then takes any other way, with how much so ever Assiduity & Application he contend to make progress toward Experience, shall be found walking at random and widening his di­stance always to stray the more therefrom.

That a long and constant Practice is not a­lone sufficient to acquire this dexterity & ex­perience, will be farther plain by considering the difficile delicate & untractable Genius of Nature, not improperly comparable to [Page 45] that of a Captious tetchie and easily irritate master, which makes his service as the ex­ercise of a very Circumspect Prudence, so an exceeding hard task: Yet this Master have­ing a servant, who by his diligence and Caution observes Curiously what things, and by what order & concurse of circum­stances, either in his Master or the things themselves, these makeing their impressi­on him, use (by grating or cherishing him) to excite or lenifie his evil Humour or Canker: And who likewayes faithfully treasures up in his mind or otherwayes, these his observations to be imployed as di­rectives for the advantage of his future ser­vice, this servant is not only capable to per­form to his Master pleasant and profitable Service, but calming his severities, mode­rating and governing him, may exercise a kind of dominion over him: (as it has been observed that some wyllie Servants in the like circumstances have done) When ano­ther Servant void of this warrieness and pru­dence, thô growing old in his service, thorow inadvertancy or carelesness, misguiding his Affairs, does still exasperate him, and shall never render him placable, nor any thing mitigate the nature of his despotical dominion: The same very way the prudent [Page 46] and cautious Physician, Natures Minister, carefully observing her genius, and by his circumspection diligently catching and us­ing all the opportunities to serve her (there­by sopiting all her severities) will undoubt­edly become a Moderator and Arbiter there­of, and in consequence have his prudent Service recompensed by Natures subject­ing unto the political dominion of the Physician. Whence, it is clear, that Experience and Skill being almost identified and acquired & exercised by the same conditions and mea­sures, old age therefore in a Physician, is no more capable alone to produce Experience, then in other Men it begets Wisdom and Prudence in the rest of Humane Affairs.

Yea, Years are very far from bringing on apace with them such a deep rooted and solid experience in Medicine as may yeild a fruitful Harvest of effectual Practice, where the Aged (and Age bringing on apace with it sloath) have only grown old in these Hypotheses of Theory, and Methods of Practice founded thereon (now of late per­haps both convict'd of error) in which they were at first instituted, they sticking as closs by these as others to the Religion, in which from their Infancy they have been educat­ed, such indeed being the power of educa­tion, [Page 47] which upon most has a dominion and empire, but upon these exercises a tyranny, in keeping them manacled in the chains of chimerical prejudices, and fetters of theoreti­cal errors so much the more hurtful to Mankind, as being really damages under the pretext and show of profitable helps: Especially where sloth & ease is in the play which freights them to go to School again, or enter into a new Apprentiship; or Vanity and Pride, which layes aside the professing any thing importing the reproach of that vain knowledge that did formerly puff them up: Which indeed would not so much de­press them as the perseverance therein, does both them and the Common good of Man­kind. To err indeed is Humane, but to preserve therein, notwithstanding of the Light, and in a matter of much import, seems Diabolical.

From all which, it is plain, that as Ar­tifice in the Physician and Error in the peo­ple is the best soil and compost in the natural climat of Opinion of the most fragrant and luxuriant Reputation, so real Improvement and Art transplanted into that clime, are likely (as exotick Plants) to give a very flaccid and languishing Figure.

How deplorable then is it, That Medicine [Page 48] which being for the solace of our Miseries should be, and that by our own faults, so depraved as to conspire with them against us, and prove but a miserable and deceitful▪ Comforter, in so far as the Artist is put under the strong land invincible necessity, by its being most easie, advantagious, and honourable, to prosecute his own ends, altho with the neglect of these of his Art: And that he should be put under the pusl­ing difficulty to consult both his own credite and his Patients Health, he being obliged to acquire and exercise at once qualifications wholy satisfieing and advancing his repu­tation, but of no further use. Any other Skill apearing perplexed intricat and super­flous, from the care whereof vulgar Opinion and Error has wholy Emancipated him: Be­cause interfeiring with his esteem at least nothing advanceing it.

The vulgar Error of the vanity of Me­dicine consi­dered & dis­proved.Neither seems Medical indu­stry and Improvement under any better circumstances of thrive­ing or advance, by another O­pinion that being prettie trium­phant in the world is Endemical to those, who think themselves wiser, as being less credulous or apt to be Imposed upon by Artifice and Prudence then the former sort: Such thereof [Page 49] only look on Medicine as an Art big with great Pretensions, which being brought forth without the Mid-wifery of simple Credulity amount to nothing worth the while; and so run to the other Extream (the Badge likewise of professed Ignorance) of doubting and diffidence, and consequent­ly, Contempt of all Medical Endeavours: Now this opinion deems the conduct of our Lives toward their Period, committed either to Rigid and Inexorable Fate, incapable in its Carrier of any Stop, or to Tottering and Wa­vering Chance unmanageable by the discre­test conduct; and therefore it excludes as vain all means of Health and Life: The former Opinion despirits and depraves Indu­stry; this taking aim at Personal Prudence, quite extinguishes and kills Medical Prudence: That tempts to Imposture this Brands the most serious and succesful Endeavours therewith: That incourages hopes from the Physicians Endeavours, (since all Dan­gers under the visage of evitable, confound less then the same allayed with no measure of hopes to escape) and this sterving all hopes is enough alone to kill the Patient, and make the King of Terrors more ter­rible, and fearful, implying the ground he has advanced unto, to be reco­verable [Page 50] only at his discretion, and his earnest assaults to be past remedy: And it is indeed from no small mixture of this base Allay in the Opinion of some, who using the Physi­cians help, & altogether uncapable of Privacy to their Escapes, by putting so smal value on their Pains & Industry, that the aspiring Improvement in this Art is likewayes clog'd.

But indeed this robbing of Art, to en­large and dignifie Natures Empire over and with all effects, may be properly both re­sembled and confuted, by takeing a glance of that grosness which possessed the Indians, when they took Ships for great Animals, here being nothing but the not comprehen­ding the Artificial Intrigue of their structure (the chief cause of their Phoenomena) that gave rise to that Mistake and Error.

So likewise, there being many products that to a shallow and overly view, althô they bear the Resemblance rather of Na­ture than Art; (as a Watch appeared to a certain King of the Indians to be a living Creature, when he asked what kind of Food it lived on) yet such Products, to those hav­ing the Eyes of the Mind capable by a more diving, sagacious, and polished Inquiry, to make exact and full survey, will impress and display their true Nature: This Capa­city [Page 51] being the absolute condition to get true Knowlege without mixture of Im­posture; no wonder then, through want thereof, that the busie, active, and restless part of Man, which is still judging be pre­cipitat unto Mistakes and Errors in the Dark.

And indeed this Turkish fixing of Fate, in spight of all Endeavours, did it ever hin­der any to pull his drowning Friend out of the water, or a Choaking bone out of his Throat? the stop put to Death in his full Carrier and the warding of the most potent and direct Thrusts of Fate being here conspicuous, and Diseases being as certain, thô more private, and hardly stopt Leaks to let in Death at, which never makes passages, but only enters in at these which Nature has left open, when Art fails to observe and close them; & also seing the facultys of the Mind as well as the Organs of the Body, by their natural Strength and Ex­ercise, by Application, or other Artificial Helps, may attain to many degrees of Per­spicacity, Activity, and Perfection, beyond what they will be without these, or in one Man under the Advantages of these, more then in any other without them, that the difference (especially in sensible things) is [Page 52] even Stupenduous: Why may not then such Improvement (upon the ground of Natu­ral Vigour) make the Mind Susceptible of many Impressions giving both Light and Knowledge to espy these private Posterns Death makes use of, and also to find the means to stop & close them, & here also be had as certain evidences of warding off death, as in the other caise, thô as proper only to these having such enduements, as the seeing the danger and relief of a drowning Man is proper only to these that are not blind.

And that Conspiracy frequently entered into against our Lives, by Deaths Agents, second Causes, tho through its depth, and cunning its above the Vulgar sight to discover and capacity to prevent and stop, yet as it may be reached by the eye of the sagatious circumspect Medical Politician, may also be counteracted by his power and Art.

And it being also very probable, that (the Body seeming a curious machine) motion is the main ingredient, if not the very Essence of our Lives, the period where­of consists in a total and permanent stop put thereto, and the Integrity of that mo­tion depending on the soundness of the first mover, the matter moved, and the passa­ges through which motion is made, it seems [Page 53] this Machine is as well as others subject to many disorders, and as other engines have their particular Arts subservient to their Regulation and Redintegration, which by pick­ing out the causes thereof, may by conve­nient instruments and means remove their Stops and help their Disorders, why may not Art likewise take place, in relation to the distempers of the oeconomie of man, were it for no more then to save the Irritancy of a great part of the Creation, which seem pregnant with these advantages to Man­kind, but being rejected for Instruments, or Means here, seem of little or no use at all: And further what great difference both in the Advantage and Pleasure may be perceived betwixt Nature going wild at random and liberty, and the same sub­jected to Artificial Culture and Improvement: As may be seen in the difference betwixt wild Fields and well cultivat Gardens; yet such as neither perceive, nor know Arts Influence here, would certainly give the ho­nor of these improvements only to Nature.

And as Nature furnishes Matter in some cases for Art to work on, thô in others Nature furnishes only occasion by its stopps, & disorders, into which it may be brought rather from other causes, then any thing [Page 54] within it self; And so may not Art be use­full as a Confederate and alley to help and rectify Nature in the Straits and D [...]sorders of the machine of our Bodies: And as in the Regulating and Helping of all other Engynes there may be imployed several de­grees of Art and Skill, as for example in a most Curious and Ingenious clock, the dis­orders especially such as come by misguid­ing, may some o [...] them be restored by the proper Skill of the owner while for others that are more difficult, he must borrow the Advice Help and Instruments of a more Expert Artist, yet these that does not know or belive there are any more expert must conclude that the Masters proper Skill and Instruments alwayes does the Fait: Why may it not be just so about this ma­chine the keeper & master whereof Nature, making considerable Efforts and Essays for redentigration of it's disorders, but when these are frustraneous then the acce [...]sion of the Skill and Tools of the Expert Physician is season­able, unless it fall out here as likewayes in other Machines it often times fals out, that the disorder tending to it's dissolution, be in the order of Reparation incurable, and so requiring the Capacity and Skill of an yet higher Artist, contriver and maker of [Page 55] that Engyne, import rather the Creation of a New then the Reparation of the Old one: Neither does this so much disparage the skil of the lesser Artist as extol the admirable & inimitable Art of the first and cheif Archi­teck, in displaying so much Stupenduous Skill in that curious Contrivance of a piece of work, which being maimed in it's substan­tial and Essential parts and motions is no­wayes Redintigrable by minor Artists.

Now the fruitlesness of Physicians endeav­ours resolves alwayes in some of these; (viz.) Either in the want of dew admini­stration of such promising helps as the Art does really afford, and that either by the fault of the Patients or other assistants: This is by an unjust Ignorance Pinned on the Physician: And nixt it may depend on the Physicians not discovering and curing what through Art and Industry, being per­ceiveable, is also cureable: And this does indeed taint him with a certain, thô most part secret Guilt, which the Criticks in Medicine suspecting, at adventure by an Ignorant Ju­stice may casually Hitt, but scarcely know: Or finally the unsuccesfulness of Physicians Practice depends upon the case, being by Art & Industry, either Indiscoverable or In­cureable or both, especially such as sudden Accidents and Essential Breaches which do no [Page 56] more concern him to repair, then to be a Creator. Now the most conceited Pretenders to the Arbitriment of the Physicians Fame, are altogether in the mist justly to deter­mine them, when such caises do occurr.

And farther, there seems no­thing more perswasive of the va­nity of his Endeavours, then the discreet Physicians unwillingness to be brought on the Rack of Prog­nostick of the event of the Disease,The un­certainty of Prog­nostick, a great pil­ler of that Error [...]on­sidered, & removed this being the question he is first and most importuned with, and a quack Expedient extraordinarly gratifying Curiosity, seems also to be the earnest of a more solid Skill: And if he venture thereon, as he luckily hitts, or unluckily misses, it does not fail accord­ingly either to add to, or pare, both his Authority, and that of the Art: But the wiser being shye therein, it is constructed by most, to spring from a consciousness of such uncertainty in the Art and Practitioner, as puts all Endeavours on the borders of Fru­straneous and Vain, and that the Cure when it falls out must be rather an effect of Nature or [...]hance, then of Art and Skill.

But surely, Prognostick seems to contribute no more to the Cure of Diseases, then Pal­mistry [Page 57] does to the conduct of our Lives and Fortunes, and any Dexterous Hitt therein is improven more to advance the Physicians Personal Value and Ends, then these of his Art, and raises more a tottering Reputation, then is either the Product or Manefesto of any solid Skill: And Prognostick being alwayes most sure on the worst side, let all there­fore beware that put too much stress there­on, lest they get their doubts cured to their greater coast, & put the Physician sometime in the strait (to save the credit of his Reputation built on that of his Prediction) to neglect, not to say worse, the plausible means of Cure: Or at least, that these satisfying marks of his Skill, be rather suitable to the usual events of the vain and empty Methods he makes use of in the like cases.

Now farther, althô Medicine be seated with much more disadvantage for a Pro­spect to make a certain Praediction, then o­ther Professions, in which the claim laid to the wished effect cannot be denied, yet these cannot contend with Medicine in the cer­tainty of Prognostick: As for example, in Law where the Rights or Strength of both Parties is fully laid open; yet there is often as much diffidence & uncertainty to which side the Ballance will cast: And in War [Page 58] where circumstances concurring to bring Light to Prediction, may be yet more in the Dark then in Law, but not so much as in Medicine, for thô the Strength and Cou­rage of both sides, with sundry other con­siderations affording probable Conjectures towards a conclusion concerning the event, may be discerned; yet there may be un­seen Stratagems, and accidental Contingences, which may make promising Victory both to hover and light on the unexpected side: And yet all these difficulties, or uncertain­ties in the determining the event, do not so much disparage and make appear vain the Endeavoures of these useful and noble Professions, as they serve to quicken the Eyes of Circumspection, and raise the value and glory of brave and ingenious Behaviour in disperate and dangerous Cases, whither suc­cesful or not: But indeed in these Arts the wit and direction in the conduct being pal­pable, where the miscarriage of the success may be pinned, is also alike visible. Now Medicine thô as to Prediction it has equal certainty with these Arts, yet it has the mis­fortune to be under far worse circumstan­ces, yea, and even under insuperable difficul­ties as to the certain and axact knowledge of the present posture and state of Affairs [Page 59] about which it is to be an Actor: For being often to act a Scene within the Curtain, when it self stands without, and having none to consult therein, but very subtile and infi­dious Intelligencers the Phoenomen [...] and Symp­toms, (for true and sure Intelligence, being the life of War; Is likewayes the Soul of Medicine) and because there is much diffi [...]ul­ty, there is need of great sagacity to un­ridle and decypher the mysterious appear­ances bringing Light to the present condi­tion of Affairs, and any Light gotten, should rather put the Artist upon just measures how to act then to predict; and make his endeavours [...]un in this, that his hands may not come too short to help such tim­ous discoveries as are made by his Eyes.

But in sum, all this matter being both acted in masquerade, and among such a croude of common Enemies second causes roving up and down, (and having more power and influence then is perceived re­quire also alwayes stricter Guards then is believed) some whereof either by in­advertance or meer accident, may im­pinge one and overturn the fairest ap­pearances of Escape and Recovery; no wonder then that there can be no more cer­tainty either in the Conduct or Predicti­on, [Page 60] then the circumstances & the unalter­able nature of the thing does determine & allow: And the Inference of the vanity and emptiness of Medicine in its conduct from the uncertainty of Prediction of the event of that conduct, equally militating against other known and commendable Arts, seems of no more import in the one then the other case.

It being never considered among all this Busle of Tottur­ing and Wresting Medicine to the Touchstone of very in­competent Judgements,Upon what does the Ar­bitriment concerning the Medici­nal Practise depend. that the only Solid and Prudent knowledge in Medicine turnes upon the Cardanal hinge of the true understanding & uptaking of the genuine and true propaga­tion of effects from their causes; In the due comprehension whereof as the Physicians Skill is eminently denoted, so the same gives only right and title to the Arbitri­ment of the Physicians Fame and Merit: And sometimes matters here are so obscure from their depth or sublimity, that the quickest perspicacity of profoundest Artists will falter and hallucinate, and be modest­ly ambitious of the Epithet due to the happy Inquirer.

[Page 61] Faelix qui potuit rerum cognoscere causas. [...] while blind Ignorance and Percipitant Impru­dence Spurrs on, almost every one to ar­rogat to be an Arbiter therein, but how deservedly will appear, if we consider that Health and Recovery is still the work of Nature primarly, and the subsidary Help of the Physician is designed only to remove Impediments, now how does this Arbiter of Physicians know whither the Direful s [...]mtomes arrising in a Disease, be the effects of ob­stacles put by the preposterous Ignorance of the Physician and Regimen, rather then the Native products of the Disease; Yet after the recovery from this Disease, when perchance, nature attacqued both by the Malady & the method, was almost brought to succumb, and only by the vigor of tempe­rament escapes, notwithstanding by mean [...] of the Physicians Prudence, never calling Na­ture to the plea, this Arbiter precipitantly and ignorantly gives sentence approbative of the Cure, as redeeming from a prodigious Danger, but in the mean time if any Interpreter or Proxy were admitted or sent from Nature to expound and speak, it would clearly evince that the Method made all these terrifying symptomes, which is evi­dent and palpable from this, that in some [Page 62] diseases as for example, the Smal Pox (which is little noticed by the most part) in so farr as you indulge a hot and Cordial Method and Regimen, which indeed is the most us­uall in this Disease, all the horrible dan­gerous symtomes fall on proportionably, which Disease being treated with a contrary Method and Regimen, all these do evanish or lessen; Unless the former error has en­graven them too deep.

Iustice, Law, and Policy con­sist in the consideration of what contributs to the good & integrity of the Society, The dispari­ty betwixt the Arbitriment Concerning Practise and Policy▪ and that of Phy­sicians where­in is comprehended that of every single Person; The due prosecution whereof, by these intrusted therewith is obvious to the prespicacious Judgement of most if not all, and thô some endeavour to Mounte­bank it also in State, and with the stock of pub­lick Authority, favour & influence drive private and by-trade, yet the tendencie of the meas­ures being by the Ballance of sound reason examinable, there can scarce be any con­siderable or lasting deception therein, every Man almost being Master of as much reason as may with a litle education quali­fie him to judge therein, so the honest [Page 63] Practitioners of these Disciplines are rarely destitute of their due merite and applause, or Impostors or Ignorants under any Mask able to rival them.

But it is farr other wayes in Medicine which consisting all in matters of fact and experiment drawen out of the Phaenomena of Nature and Practise bears no other trial of reason then what is Commensurable by them: for as Nature has its proper Lawes and Customes, so Medicine that Moderats Na­ture, has its proper Measures for attain­ing its ends, suted to these, the adequatness whereof are only conspicuous to the Adept and Sons of Art, and these genuine and true Sons of Art are only among themselves (as its talked of the Brethren of the Rosie Cross) mutually conspicuous, escaping the sharpest sighted of all others seeing no more but Skine deep in this Cryptick Art.

Hence it is that these have only usurped Fame and Reputation in this Art, who having strained & violently bended Medi­cine by excogitating or feinging Specious & Rational Theories, by which, altho without reall foundation, the wits of learned Men have been extreamly charm'd, and the In­venters have thereby enhanced greatFame & Reputation to themselves, but whosoever [Page 64] having their heads stuffed with such rati­onal Theories shall attempt to Practise con­form & pylote by them, will find they are nothing but wild fire leading into devious & dangerous pathes: It's therefore only Solid and Sound Practise that must yeild a true Theory, Only from Practise comes Im­provement in Medicine. and such will altogether quadrate with practise, and be farther useful thereto, as is plain in several Mechanick Arts E:G: In dyeing where the variety of coloures, and their Multi­plicit Generation and Conversion furnishes the Philosopher with fine Speculations, but none of these are solid, Profitable, or for the further improvement of the Art, unless such as are taken from the practise, or agree­able thereto, so the Mechanick gives Laws to the Philosopher.

And indeed this method of beginning at experiments to establish Theorie has given both name and solidity to the Philosophy of this Age,As it is in Philosophy called Ex­perimental. and dis­covered the vanity and infirmi­ty of that of the former Ages.

Neither was Philosophy more empty, which from Aristotles dayes, untill of late received small Improvement, then was Me­dicine which from Hippocrates time so much [Page 65] strayed from advancement, that leaving his Methods, to wit, of discribing the true Histories of Diseases, and drawing Indica­tions therefrom; All Writers almost de­liver the Histories of Diseases superficially, without particular branching, or descend­ing into their Specifications, but compre­hend under one Type these that differ much from one another; as also, what they deliver, being according to their Theoretical Hipotheses, is more to confirm these, then to illustrate the Disease in its Natural Fi­gure and Shape, from which can only be drawn Indications that are tottering: and to supply these defects, they heap up so great a Mass of Receipts, that the waver­ing Election, mistaking the Remedy of o [...]e Species for another, rarely hitts the Mark: And farther, the most part following close the footsteps of their Predecessors seem rather to have Copied then Written.

Does not then Medicine wrapt up many Ages with Philosophy, in the same Fate of Obscurity, by the mist of empty Theory? require likewise with it to be experimen­tally inlightned and advanced; for it is not to be judged, that time which has rypned and brought to perfection all other Arts, should leave Medicine altogether Stationary, as incapable of farther Culture, becomes it [Page 66] not therefore all generous and sagacious Physicians, having entered the right path of Diligence leading to true Improvement, with all their might to liberate this noble Art, from the chains of Errors and Fetters of Prejudices, and to make it splendidly tri­umph over all Calumnies and Detractions, to which it has been so long, esp [...]cially throw vain Theories, obnoxious; and that by inquiring, so far as Natures Light whetted with Industry will go, into a solid and experi­mental Improvement, and only by such safe conditions and measures as are adequat and propper for acquiring thereof, and thereupon to found a genuin and solid The­ory: which will not only enlighten the un­derstanding with true Impressions how these experiments are produced, but will also give direction to apply the same true Notions to farther experimental Improve­ments.

SECT. IV. That the great advantage and import of the Im­provement of the Cure of Continual Fevers, making it highly the Physicians concern, to advance it, makes also what is already said, as a Praeliminary; not improper: where also is shown that the common Indications and Diaphoretick Method, Comonly used in Fevers, being considered, ought to be disapro­ved; and that the Authors Method proposed being also considered, ought to be embraced.

AS in all Humane and Wordly concerns, there is nothing more Valuable and Precious to Men, then the Life and Health of them­selves, and their dearest Relations, with­out which all other Wordly Comforts are unrelishing; So among all humane studies and Arts (the effects of Mens endeav­ours to ward off, or alleviat to their Miseries, and Calamities) there is none whose due Prosecution and Improvement is more ac­ceptable then Medicine: In like maner, there seemes to be no subject in that Art, that partaking more of the general advantage, requires more to be Improven, then this Subject of Continual Feavers does: And that [Page 68] by reason of its extent, (for with its Pendicles it takes up the half of all the Diseases that Men are afflicted with) and of its danger and Precipitant invasion; It being the Disease that by a Sudden eruption and Devastation, in a trice overturnes our Hopes and Comforts, doth therefore make the loss of Life more bitter and grievous; This Disease seeming to Envie and Prevent other Languishing Distempers, or Wrinckled Age, in the spoil of Beauty, and ruine of Strength, triumphs in their Sudden and Unexpected downfall; And by the cruell Ravage it makes, out­does a leisurely dissolution in dismal effects both upon the Souls and Estates of many Mortals; Men being thereby in surprize hail'd out off the arms of seemingly perfect Health, & Security, & throw the vale of mise­rable delirium stupidity, or Distraction, precipi­tated into the Shades of the other World: life here being taken by furious storme, has all the dreadful effects of a Pitiful saccage, while a leisurly dissolution gives oportunity for Pre­paration to make Peace with the great Mon­arch whose Messenger Death is, and for a hon­ourable and happy Surrender: And now since all this is done under the Presidence of a Go­vernment, whose trust makes it the concern­ment thereof to inquire narrowly, whither negligence or mistake may give occasio [Page 69] to the Course of so sudden a Devastation, this makes it no less the Credit of Faithful Physicians, then the Common interest of Man­kind, to put the Cure of this disease to ap­pear in the first rank for Tryal, Reformation, and Improvement; And may also shew the reason and necessity of our going so far back and making a Ramble, to rally up the whole force of that obligation lying on the Phy­sician to diligence and Improvement, and to con­jure down negligence, and araigne all vulgar errors and mistakes capable to stiffle or de­prave Improvement in this particular Subject, or any other in that Art; Such indeed seem­ing to stand like Mountains in the way, by serious consideration therefore deserve first to be removed and levelled

In Pursuing then of this Improvement of the Cure of continuall Fevers, it comes to be observed, that althô the remote and An­tecedent cause of this, and most part of other Diseases, seems to be a load of Humours often viscide, yet scarce do we understand the specifical essence of this or that humor, which excites this or that symptome, and pro­duces the variety of diseases, except in so far as the nature of the place it clogs produces the symptoms, (and this being a purely Me­chanical reason gives but little light to the [Page 70] specifique quality thereof) far less can we tame these noxious humours with specifi (que) or appro­priate Remedies, which were indeed the best expe [...]imental improvement, were it known; unless in somuch as the cortex pernvianus seeming to be the specifique of intermittents is known; And altho some essay to ex­plain the essence of Diseases, & lodge it in such modification of the figure, quantity, and motion of the particles of matter, in respect of the pores, fibers, and channels of any Bowel or Organe; which make obstruction, impression of pain irritation, convulsion, and the rest of the s [...]mptoms competent to this or that Organe, which modifications seing they can­not as yet be determined, and pitched on, as by their subtilty escaping the Edge of the sharpest Ingine, neither can these be reached or subdued by way of Indication.

Therefore as yet all our certain cure and curative indications, are directed not against the continent and nearest cause, but only a­gainst the ant [...]edent cause, or fewel of the disease; to wit, to carry off the load of hu­mours, and not to attacque its specifique, and evil quality, that being seldom if ever hit, and if at any time, but by a very faint blow▪ and althô the specifique cure provid­ing it were known, would be both the shor­test [Page 71] and surest, yet this cure might ly o­pen to the like hazard that sometimes falls out in the Cure of intermittents, by the co­pious use of the bark, which as our wor­thy Author observes are sometimes there­by translated into a scrobutique rhumatisme, the morbifique matter, being divested of one specification or modification, puts on another.

Seing there is no specifique cure pretend­ed to, in continual Fevers, their cure must then lean on some in­dication;The com­mon and diaphore­tique me­thod con­sidered. which false Theory and long custome, has made to de­gress and decline to the satisfy­ing the common indication of at­tenuation of the Febril matter, and expulsion thereof throw the pores of the skine; some forceing it by a milder, some by a strong­er, and all urging it by some degree of Diaphoresis but still without any trium­phant or solid, yea rather, with many la­mentable and funest experiences.

This indeed were no unfit Design or Method if the morbifique matter were so thin and little, and sticking in the superfice of the Body; that it might easily yield to the impulse of Diaphoretiques: But on the other hand where the matter or at least the fewel of the Disease is copious, [Page 72] viscide, and besets the first wayes the Ven­tricle, intestines, and mesentery; in so far as you attenuate and force that matter by Dia­phoretiques in proportion ye shal translate and turn the antecedent cause lurcking there, into the continent and nearest cause of the Disease, to wit, by subliming that viscide and obstructing matter into the mass of Blood, and habit of the Body; which shall further exasperate the tumult of the Fever, and overwhelm the natural efflux and reflux of the Blood, and thereafter this matter being carried from the mass of Blood into Head, and region of the nerves; will like­wise excite there symptoms competent to them being so infested, till at length na­ture unable to wrestle under such a load of viscous matter poured in upon the Blood and Nerves, wholly despirited and over­whelmed must succumb.

And that such an viscous, slimy, and copious Matter is at least the antecedent cause and fuell of many Fevers,The Fomes in Fevers considered perchance also of all, can be made evident not from any Ratio­cination, but from Antopsia or Sense it self.

For in several Fevers, especially these accompanied with delirium or raving, there has frequently been seen a great quantity [Page 73] of such touch flegm, sometimes evacuat by stooll, sometimes by Vomit; and that only by putting the Finger into the Throat; after which evacuation almost an total ease of all the Symptomes, but chiefly of the de­lirum or raving did follow; until that after some dayes the matter re [...]ruiting and regur­gitating, and bringing the same Symptoms required a reitera [...]ed evacuation; which was signalised with the former benefit; and so furth, as the plenty of the matter requi­red, until a perfect Evacuation Cured the Disease: What novice in Medicine will judge such plenty of Viscidity and Slime could be with advantage or safety forced into the Mass of Blood, to be ex­pelled throw the Pores of the Skin; or that it can be so attenuate, especially under the languid natural Heat of Persons in Fe­vers, that it be noways hurtful or obstructing, when it comes to the small capillar Vessels.

As to the rest of Medicaments used in Fe­vers, as Refrigerants subser­vient to the indication of Refrige­ration;Refrigerants considered. since it can be shown that heat is nothing of the essence of Fevers, & that their proper effect is to encrease the viscidity & tenaciousness of the humors (per­haps the continent cause of Fevers) they do [Page 74] rather hurt then help: As likewise, these that are called Temperers of Acri­mony, and Sweetners of the Blood seem to be no more profitable,Temper­ers of A­crimony & sweet­ners of the blood in re­gard Acrimony consists in such a modification of the particles of Mat­ter, in their figure or motion, in rela­tion to the texture of the Organs or Bowels, bringing trouble or pain thereto; and we scarce knowing where in that Modification making the discrepancy betwixt the Agent & Patient does consist, we can hardly form thereto an adaequat Indication: And althô this mitigative Indication could be found and satisfied, since it does nought to the Dis­ease or its Cause, by prosecuting thereof, you advantage no more, then if ye should apply Anodyne Balsoms to the [...]kin, sore with whipping; and yet still whipp one.

And farther, since all these Symptoms commonly supposed to arise from Acrimo­ny, are only the result of the efforts of Na­ture strugling to ride it self of the Disease, and are raised various according to the genius of the matter besetting, and the organe besett; altho these could be perfectly subdued, when the Disease and its cause are untouched, what if the Disease restrained in one Symptome, shall break out into a more [Page 75] dangerous one; so little coercible or obsequi­ous proves Nature to any preposterous and undiscret management, that thereby ra­ther are transla [...]ed, then extinguished or directed, its irregular and impetuous motions; not ve [...]y unlike as when a Dam of water is kept up by a Bank, without dry­ing up, or diverting the source that in­creases it, as it is stopt at one breach, it will alwayes make or find another.

As for Aperients and Inciders, Aperients and inciders. they being much about the same Nature, have the same Inconvenience with Diaphoretiques; Especially where there is a Copious fomes, or great Obstructions in the Capillar Veins; For by there grating and grinding off Particles from the mass of gross and viscide Humores, they must exceedingly increase these obstructions; every little par­ticle seeming to be of a like Nature with the whole, and scarce, when in any quantity, subjugable by the motion of the Blood, or capable to be so attenuate as to pass easi­ly the smallest channels of the Vesells; Such then being brought there, cannot but have an obstructing effect. And farther these things being narrowly considered will also make the Truth of that Observation of of our Noble Author past all doubt, that [Page 76] many and most dangerous Symtpomes of Fevers, are the native effects of the method, rather than of the Disease.

Leaving then this Diaphoretique method, The true method proposed that is most probable. until we find out a speci­fique cure of Fevers, since we can­not level directly a [...] the essence of the Disease, we being most part in the dark as to that, what hinders us as is usual & succesful in many other diseases, & which impartial well ballanced experience has found to be also so here, but that we may prosecute the Indication taken from the antecedent cause or fewel of the Malady, by purging; and so by intercepting the suste­nance, to sterve that Enemy we cannot get within handy blows of: Is it because in Fevers the tumult and commotions in the re­gions of the Body, in that tottering state of the Oeconomy would be so hightned by the spurrs off the Purgative, as to brake out into more furious and incompescib [...]e Symptoms? and the Orgasm that was for­merly only in the Mass of Blood, should thereby break over also into the Region of the Nerves and Head, and so beset, pervert, and overwhelm the first springs of Motion and Life.

[Page 77]Now althô this difficulty seems not im­pertinently to be started, yet whosoever shall lay a great weight thereon, will be­tray great inconsideration and inadver­tance to what our Noble Authour has delivered concerning the reasonable­ness of this Cure, for he clearly shews both by reason and experience, that the Inconvenience and tumult arising from the irritation of the purgative, is very effica­ciously restained by the immediately pre­ceeding Phlebotomie, & the subsequent use of the Paregorick; and how happily the Cath­arick is administred under this double check, these that have never tryed it cannot so much as dream; Notwithstanding what ever is said to the contrary by famous Au­thors concerning the use of Purgers and Pa­regoricks in Fevers: which althô it be true in the case (which is that mentioned by them) where these are administred sepa­ratly & without respect to this order and method of our Author, that they may not only be unprofitable but hurtful, but ac­cording to this his Method, these means are in that order Connected and Ranked, that they become wholy beneficial; For the preceeding Phlebotomie, and Cathartick paves the way to, and makes safe the effecacy of [Page 78] the Paregorick, and the Preceding Ph [...]eboto­mie and subsequent Paregorick infallibly Checks and Bridles any noxious Energie of the Cathartick; As more fully shall be be shown afterward. But in the mean time it may be considered that these Practical Phaenomena, beside the rational appear­ances they bear, are by such repeated a­curate and evident experience confirmed, that they can no more by A [...]guments be convelled, or their evidence by reasoning stiffled, then the most sensible and palpable experiments in Nature can be.

SECT. V. Motives to this Method from the Authors Ingen­uity Ability, and the prodigious Hazards he escaped, and also from his Reputation both at Home and Abroad.

SInce then it is obvious to all that the us­ual manner of the cure of continual Fevers is so uncertain and unsuccesful, that it should prompt all good and wise Physicians, at least from commiseration of Mankind, to search and try all ways for a better, yea, and when Men worthy of Trust, whose ability and intergrity may not only deserve, but [Page 79] command Trust, do from their undoubted and certain experience, complement them with laying to their hand a more sure and compleat Method of cure: the Inaptitude or Impropriety whereof none can, save from fictitious & chimerical prejudices affirm or as­sert, but noways from knowledge or expe­rience; in which case as its the part of (even the most rigorous) caution, to sus­pend Judgement, so it gives the most grave and profound marks of Folly and Arrogancy, to pronounce peremptorly any thing concerning a matter of Fact and Experiment, altogether unknown to them. He then that wants Courage or Faith to Ex­periment it himself, necessarly must watch the occasion to behold the Practise of others having this Method for conduct, and so getting a Mature and deliberate know­lege of the thing, he may then with some reason pronounce his Opinion concern­ing it.

Whosoever then shall do otherways, and either chide or Condemn this Method or only contemn or neglect it; Let him have a care, least being suported by prejudi­cate Opinions and Errors, he be found to lay an Ambush for, and assault the truth, and to Sacrifice to his contumacy and sloath the [Page 80] Lifes of the Sick, and the Tears of their Friends: this matter being now so circum­stantiat by such clear Evidences and Proofs, that an Errour or mistake therein cannot be as invincible Ignorance excusable, but as affected, supine, and contumacious negligence, re­presenting a true and attrocious Crime is culpable; In respect this method is as clear­ly (as the Sun at noon) displayed in the last writtings, (emitted at length with the Approbation of the Colledge of Physicians of London; And likewise by the private ex­perience of other eminent Physicians appro­ven) of that incomparible, sagatious, and expert Practitioner, D: D: Sydenham, Who, Alace! to the great loss of Medicine, departed this life the 29 December, 1689▪ Whose former Writings being most acceptable to the learn­ed World, and acknowledged to have brought no more pleasure than profite, most deservedly ought to concilitate Fa­vour, Trust and Authority to this his last Schedule, as to his Letter will and Testament: Neither can it go well away with good Men to think, that this great Man so oft by strange and special Providences pluckt out of the very jawes of Death, has be [...]n pre­served for an Imposture, so dismale to Man­kind: Thò I cannot stay to reckon all the [Page 81] Dangers among the Calamities of the late Civil Warrs, (where he was an Actor) that pas­sed with great difficulty over his head,An unpa­ralleled dan­ger he es­caped. as his being left in the Field among the dead, and many other dangers he met with: yet there is one that representing ra­ther a miracle than a common providence, can­not be passed over, which as I had from his own mouth, is thus, at the same time of these Civil Warrs, where he discharged the office of a Captain, he being in his lodging at London, and going to bed at night, with his Cloaths loosed, a mad drunk fellow, a Soul­dier likewise in the same lodging, entering the Room, with one hand griping him by the breast of his Shirt, with the other dis­charged a loaden Pistol in his bosome, yet, ô strange! without any hurt to him, most won­derfully indeed, by such a narrow sheild as the edge of the Souldiers hand, was his breast defended; for the admirable providence of God placed & fixed the tottering hand that gripped the Shirt into that place & posture, that the edge thereof and all the Bones of the metacarpe that make up the Breadth of the hand, were Situate in a right line be­twixt the mouth of the Pistol and his Breast, and so the Bullet discharged neither declin­ing to the one side nor to the other, but [Page 82] keeping its way thorrow all these Bones, in crushing them lost its force and fell at his Feet, O! Wonderful Situation of the hand, And more Wonderful course of the Bullet! by any Industry or Art never again Imita­ble! And moreover within a few days the Souldier, taken with a fever arising from so Dangerous and Complicat a Wound, died; surely providence does not bring furth so Stupenduous Miracles, but for some great and equivalent end.

And further can it be thought that this great Man,His Sagaci­ty and Ingen­uity marred his Reputati­on. who in all the course of his life, gave so full evidence of an in­genuous generous and perspi­catious Spirit, would or could die an Impostor and Murderer of Mankind (which imputation to deserve, he frequent­ly professed, would be more heavy to him, then any Punishment could be) for he it was, dispising the blandishments of the world, popular applause, Riches and Hon­our, yea his own Health wasted with intense and assiduous Meditations and thoughful­ness, that liberally sacrificed them all for the Publick good; In so far, that after he had long weighed and expended the common and received Methods of curing most Diseases & [Page 83] therrfore had forsaken & relinquished them as vain and improper, and after his inti­mate search into the bowels of Nature he had discovered others more aposite and Power­ful; He thereby only gained the sad and unjust recompence of calumny and ignominy; and that from the emulation of some of his collegiate Brethren, & others, whose indig­nation at length did culminat to that hight, that they endeavored to banish him, as guilty of Medicinal heresie, out of that illust­rious Society: & by the whisperings of others he was baulked the Imployment in the Royal Family, where before that he was called among the first Phy [...]icians. Behold now the World governed not by Opinion, but by perverse Prejudice and mistakes▪ And not only the due Fame and Praise of Vertue and Worth smothered, but Vertue it self opprest: But what wonder that his Noble discoveries should be tossed with the same fate, among many other notable In­ventions, the discoverie of the Circulation of the Blood long was; which althô it did illustrate and embellish; and, besyde the the self evidence it bare, did most extraor­dinarly inlighten the theorie of Medicine, yet was it long kept at the door; and that throw the prejudice of Men, occasioned by their [Page 84] uncuriousness to be at any Pains for dis­coveries themselves; and by Pride, hating to receive light from; or to be beholden therefore, to the labours of others; and thus they choice to part with any improve­ment, before they hazard ever so little of their esteem: after the same manner, and from the very same Principle, but with much more loss and detriment to Men (by the same, proportion that real profit exceeds meer Pleasure, and that Practical and useful inventions do exceed meer Theoretical ones) seemed his useful and Practical Observations and discoveries to have been treated.

And thô it may be thought that the courage of this Magnanimous Man, which being rather whetted then dashed, did still persevere in his begun Methods, soon might have weathered out this Storm, which not being universal but rather endemical, was only within the confines of one City, and perhaps but of one Tribe and class of Men; yea and it may be only of one faction of that Tribe; yet often such is the force of calumny, that the malevolent endeavors of a very few, and these very weak Men may, like one that can faster pull down, then twenty can rear up, so far blast Reputation as to make it very hard for Innocence, yea for [Page 85] the greatest merit it self, to set up the head; and that by reason of the Rude and Ignorant vulgars quick and ready susception of false aspersions, in the production whereof the World is verry broody, which therefore being in plenty, are cheap, and easily come by; Few being willing or able to purchase knowledge or the true representation of things, at the coast of serious inquiry exa­mination and tryal, the neat price thereof. But at length as truth & light after they are smothered in one place, do break out with more brightness in another, so these efforts carried his Fame and Renown throw all the Corners of England, and also into foraigne Nations: and the opposition he got, inspiring with commiseration of suffering me­rit some no small Men, brought several such over to a constant and faithful adhe­rence to him: althô at the coast of some piece of Reputation, (that requiring to be buoyed up with a complacency oftentimes in­terfeiring with honesty) & among the first, that favoured him, as the truely eminent and worthy D. Goodall, had the sagacity to re­ceive the best Characters of him, and of his practice: So had he the ingenuity & courage, to be the chief, that in his behalf Cartelling ignorance and malice, made way for the [Page 86] due propagation of his most deserved fame: And indeed in process of time Sydenham was by Letters from many eminent Physicians thorow England, saluted the worthy Impro­ver and Restorer of Medicine; As (among ma­ny others,) by D. Brady, Professor of Medi [...]ine in the Vniversity of Cambridge: And by D: Paman, Publict Orator of that Vniversity, and Professor of Medicine in Gresham Colledge, and by Dr. Cole, Physi [...]ian in Worchester, as may be seen in there Epistles [...]mitted with his works.

And to show how his Writings were re­ceived abroad, among many other testi­monies can be given, these few may suffice; In Ettmullerus, the famous Professour of the Vniversity of Lipsick his works, he is fre­quently made honourable mention of, by the Character of the Accurate and Elegant Sy­denham.

And Doleus the chief Physician to the Lant­graue of Hess, being to put furth his Ency­clopedeia Medica, by an Epistle directed to D. Sydenham, intreated that he would give him an Encomium to prefix to his Book; To which he answered, that he was ready to give such as he thought the Book after it was perused by him could deserve, which delay Doleus being, it seems, a little impa­tient [Page 87] of, the Book, containing also very ho­nourable mention of Sydenham, was set forth with a fictitious Elogium under his name: Now it being alwayes precious, and not common and mean things that use to be forged or stollen, this seems not an impertinent Argument of the Fame and Authority of Sydenham, both with him, and whereever he might expect his Books would come.

In France likewayes, the worthy D: D: Spon Physician at Lyons, in his Epistle writ­ten in 1681, to the Abbot of Sylvecane does wonderfully extoll his praise; especially, his dexterity of cureing Fevers, which he sayes, are so constantly cured by him at London; that he goes under the name of the Fever cureing Doctor: Yet Spon does wonder that his methods are so little either there, or any other where, followed by others.

At length, even in London it self, time did, as it does in most other things, help to ripen and promote Truth, and settle these tumults that were raised in Mens minds & hindered its appearance, because not only a new but a contrary method in cureing most Diseases, and which appear­ed to charge the most part also with igno­rance, and errour, seemed to be obtruded [Page 88] be obtruded on them: &no wonder that Men puffed up with self-love, did with difficul­ty swallow over such an harsh morsel: but the rancor being somewhat remitted, there wanted not several ingenious & honest Physi­cians, that did acknowledge his merite, a­mong whom was that Famous D: Michel­thwait, who when near death, (the time that the fume of passions being evanished, gives both a more clear perception, and inge­nuous and sincere expression of truth,) did profess that notwithstanding of the at­tempts of severals against the methods of Sydenham, yet these would yet prevail and triumph over all other methods.

Neither wanted there another Class of Physicians, who tho they had no less wit and understanding, yet had much less honesty then the former; these indeed perceiving the efficacy of his practice, did readily imi­tate it themselves, but were so much Plagi­aries, that far from acknowledging the Au­thor, they were the foremost to calumniate him, & it may be his methods too; and least they should be taken in the crime, had al­so the sub [...]erfuge, either of adding some triffling thing to his inventions, or say­ing, they were Masters of these methods be­fore he did write or publish them.

[Page 89]Then at length, Truth by its native force prevailing wholy over Error, as Light doth over Darkness, by the help also of time, brought forth in the year 1688. The second Edition of his Schedula Monitoria, (as the first Edition was, likewise under Pro­tection and Patronage of the worthy D: Goodal, who had been an assistant to him in much of tha [...] Practise) and also sealed with the Colledge of Physicians at London, their Appro­bation annexed to the Book: Where the Author delivers this new Method of the Cure of Fevers, most faithfully and clearly, and even that very same which the first Edition contained, and came forth without their Approbation: But it seems the short space of an year or thereby, betwixt the first and second Edition of that Schedule, did conci­liate so much favour to the Author, and the work, that they declared the second edition and the Method therein contained, to be worthy and useful; and not pernicious; As some ridiculously affirme, preferring their private judgement taken on a Superfi­cial view, and perhaps only by Hearsay; To the mature and deliberate Iudgement of that Honourable and learned Society.

But the Honesty and Iustice of others more Eminently Displaying it self, does elevate his Praise somewhat suitable [Page 90] to his desert, and give him such Panegyricks, as without sufficient merit in the Subject, have never been consigned to Books or Letters, by such Wise Prudent and Learned Men, as these do evidently in their late Writtings manifest themselves to be; And because in the mouth of two or three witnesses every thing is established, so many, whose works are now at hand with us, may there­fore suffice.

The first is then, that Fam­ous D. Morton, D. Morton his Elogium of D. Sy­denham, in his Treatise of Pthisical Diseases or consumptions lately emitted, where like ano­ther Hercules, he does indeed as­sault that Herc [...]lean Disease, with a Method both new and profitable: For according to that common axiome, Qui bene distinguit bene docet; he has most judiciously instituted the several species & degrees of that disease, accor­ding to which he has most reasonably insti­tuted the Indications, and [...]ure to be varied: And when in his preface to the Reader, he is proposing the several means of the Improve­ment of Medicine, he judges and that very rationally, that it consists alone in practical Observations, describing Diseases in their real and true Appearances; and therefore he chides the sloath of some Physicians, that [Page 91] seem to bury with themselves a great trea­sure of practice, which they might have ac­quired: Then he concludes, saying, ‘if I were able to hold forth the renown of so great a Man as our Sydenham, I should extoll his name to the skyes, and set him for a noble Exam­ple for the most experienced Practitioner to walk by? For this Man, being of great Age, and having his natural sagacity, wherewith he is extraordinarly endued, further polished with long use and experience; never ceases to im­prove and illustrate with his Learned Writ­ings, the practical part of Medicine, both to the great comfort of the sick, and the great Credit and Advantage of the Art:’ And that these praises did proceed from nothing, but the very conscience of the merit of the Man; This Book came forth when Syden­ham had almost bidden adieu to the world, and Dr: Morton was scarcely known to him by the face.

The other Testimony is of that notable London practitioner D: Harris, D. Harris his Elogium. in his Book lately emitted, concerning The acute Diseases of Children, which containing seve­ral remarkable Observations, do also contain his Testimony from the page 45. unto the 51. In these words, saying, ‘after I had used for some years the like Method in Cure [Page 92] of Childrens Fevers I durst not ven­ture on the same in adult Persons, until I most happily met with the first edition of the Monitory Schedule of that incomparable Practitioner D. Sydenham, and finding that Method approven of in adult Persons by the experience of that most Sagacious Man, as much overjoyed as I had gotten a great favour from Heaven, I presently set on to try that Method in adult Per­sons also, and found it no less succesful then I had found it before in Children, and a little after he proceeds, saying, For his discovery of the Cure of Fevers, and many other his notable Im­provements, I hope that every Age, so long as Medicine shall flourish, shall pub­lish his Name; for the great Ornament and Light of this Age. Sydenham has with an extraordinary Courage and Ingenui­ty compleated the Cure of Fevers, both by sufficient Reason, and by Experi­ence, and Practice, concerning which, others have given nothing but words.’

SECT VI. Containing the Opinion of some Authors concern­ing the Nature of Continual Fevers, and the same from Reason rejected, which makes it necessary to inquire for a more probable one, in relation to the clearing their nature, and this Method of their Cure.

NOw to make this Method every way compleat, it is convenient as was in­sinuate in the beginning, after the manner that a practical Discipline ought to be treated, to essay, if from this Experiment and Method of Cure of Fevers, we can draw any unstrain­ed and probable Theory: Which inquiry ne­cessarly presuposes the Nature and Essence of Fevers, seeming yet altogether to ly in the dark, to be narrowly searched into and exposed: Having first weighed and eventilate what the Ancients and Neotericks has delive­red concerning the Nature and Essence thereof.

The first then, and which is the Opinion common to most Authors, placing the Essence of a Fever in a Preternatural heat kindled in the heart,The Opini­on that Fe­vers consist in heat. and diffused by the [Page 94] Blood through all the Body? indeed seems a very improper Metaphorical Description: For the Heart is compared unto a Chimney, neither is there a fewel capable of accension determined, there being no fewel in the Body proper to foment a Fire but all as liquid and aqueous contrary thereunto: And although in a Fever there be a great heat, the same can be made clearly to depend upon another Prin­ciple, then any thing of accension, as shall be afterwards shown: and also seing intense Heat is only accidental to a Fever, and may be absent therefrom or present therewith; It can be nothing of its essence, more then the rest of the symptoms are; for in the cold Paroxisme of Intermittents it is ab­sent for a while, with the presence of an Intense cold: And in some algid Fevers it is always absent; yea, in fevers that are esteem­ed malignant, it is very mild, and nothing beyond the degree usual in health; for its reckoned commonly a sign of malignity when the heat does not rise proportionably with the other Symptoms. And farther if Heat were of the Essence of Fevers, in re­spect there is no distinct Species of Heat, but all the difference thereof is gradual by In­tention or Remisson, it must undoubtedly [Page 95] follow that there can be no distinct Species of Fevers, but only that they are gradually different; which is against the commonly received Opinion.

As to that qualification of Heat, that it is preternatural: It may be obvious to any that seriously perpend the matter, that no Heat is pre [...]ernatural. thô its cause may be said to be so: For Heat is nothing else but a natural and genuine Passion, imprinted in the [...]ense by the presence and energy of a calorifique Efficient: Neither can it be any more said to be against Nature, then pain can be: It being most natural for pain to be raised upon the action of a dolorifique Ef­ficient: And so furth, necessarly and natu­rally all the rest of the Passions are made by impressions of the object impressing, in the subject receiving. But that the speculation of Heat must be more subtile, then to be inlightned by the common and dark ex­plications thereof, may appear from that common Phoenomenon of the breath, which being leisurely blown out, imprints upon [...]he hand a sense of Heat when this same breath with force blown out, gives a sense of coldness thereon: this diversification insi­nuates the Impression of Heat to consist in a modification of the motion of the Particles, [Page 96] perhaps in a thwart, transverse, and tottering motion, some thing resembling Refracti­on, or Reflection; And that cold on the other hand is Imprinted by a direct motion: from which a true Idea of Heat subservient to the true explication of Fevers, may be perhaps clearly drawn afterwards.

Nixt follows the opinion of Wil­lis, Willis his Opinion of effervescence in Fevers. who reasonably rejecting that of the Ancients, placed his in a notable [...]ffervescence of the blood & humours: This ingenious Philosophical Physician doth with great fervor bend both his own Brain and the Subject, to establish a certain effervescence in the blood of the Fe­verish persons, proportionable to the Fer­mentation of Liquors: He nowayes taking notice that all the Circumstances and Con­ditions requisite to the fermentation of Li­quors, are not only wanting in the genera­tion of Fevers, but the contrary are present free eventilation, and rest of Liquors to be fermented, being necessary conditions: But in the blood the eventilation stopped, fre­quently is the cause and condition of Fe­vers: And furder, the circuit motion of the blood will hinder its fermentation; as it falls out in Liquors which are to be fermented requiring rest: Neither did any ever [Page 97] see in the Blood of Persons in Fevers, any signes of fermentation, but rather tokens of viscosity and grosness; Signifying coagulati­on: Neither can the Phaenomena in Fevers, be so commodiously explained from that Ef­fervescence, as from the contrary Coaleseence; of which afterward.

There is another Opinion of Cartesius affirming a Fever to be the Perturbate mixture of the Blood,Cartesius his Opinion. which description does rather darken the subject, unless he should teach us in what the Na­tural mixture did consist; And how the Perturbation thereof should excite a Fever, and the manner of the dependence of the Phaenomena upon that Perturbation; And see­ing he seems to insinuat a determinate Order and Position, to be naturally requisite to the Particles of the Blood, and the Dis­turbance of these to make a Fever; It is very difficult to understand, how the Particles of the Blood should be carried from the Heart so rapidly throw the smal branches of the Artry's, and keep that Order; or how they should again make up their ranks in their reflux throw the Veins back again to the Heart.

As for the Opinion of Para­celsus Paracelsus and Helmon [...] their Opi [...]i­ons. making a Fever to be the [Page 98] accension of Sulphur and Niter or an Vniversal Excandescence of the Bal [...]om and Mercury of life; and that of Helmont making it an Imparity of one part of the Archeus that thereby is affected with Wrath and Indignation; Because they seem altogether enigmatical & vain, & bring more obscurity then light to this dark Subject, therefore we leave them both.

Next follows the Opinion of that Hero in Medicine, Sylvius, who has placed the Pa­thognomick signe of a Fever in the Pulse pre­ternaturaly frequent, having conjoyned therewith Trouble, Pain, or the blemish of any function requisite for the felicity and ease of Life: The cause whereof, which makes to him the Essence of Fevers, is either first a too great and Permanent Rarefaction of the Blood made by a violent Heat break­ing out of the Effervescence of the Blood? Or secondly, any Acrimonius, Acide, Lixivial, or Muriatique salt carried thorow the Veins, together with the Blood and gnawing the Parenchyma of the Heart: or thirdly, any flatulent halitous Matter brought with the Blood to the Heart, and augmenting the expansion thereof: Fourthly, any sharp or hard thing in the Pericardium, or other wayes externally grating upon the Heart. [Page 99] This Great-Man to whom Medicine this day is much indebted, as being the first that clearly discovered the Errors and Di­lusions of the Schools, has also found out a more efficatious and sure practice in many Diseases: Yet he (there being none able for all things) has fallen into some Errors of Theory, about his triumvirat Humor, and the effervescence of these Humors in the In­testines and Heart; and about the motion of the Bile towards the Heart: All which subsequent and more acurate anatomical In­spection having found to be otherwayes: his Hypothesis of Fevers being established u­pon these, must necessarly fall: Yet these that reject this his Theory do imbrace his Practice in the Cure of Fevers.

In the last place, follows the Opinion of Barbet, placing a Fever in the circulation of the Blood increased; which Opinion since it seems directly contrary to what we think most probable, with the confirmation then thereof, it will necessarly of it self evanish.

SECT. VII. Containing a New and Mechanical Hypothesis of the Essence of Fevers, with the cause effici­ent and occasional of the frequency of the Pulse, and that matterial or occasional cause also far­ther Mechanically traced.

IT seems very probable, that all the Physicians hold­ing the former Opinions have Erred,The occasi­on of these Errores dis­covered. and the Fountain of all their mistakes appears to be that fundamental error, as the acurate Bontikoe observes, that they took the imme­diate efficient cause of the motion of the heart to be the blood, and that the frequent mo­tion thereof and the Arteries, did alwayes depend upon some alteration of that blood; but that this must be otherwayes seems plain, because the Heart of some Animals being cut out when they are alive, and holden in the hand, will beat a long time without a drop of Blood: So the mo­tion of the Heart seems not to depend on the Blood, but on some other cause, per­haps on the influx of the animal Spirits, pro­ceeding from the Brain, by the remainder [Page 101] whereof inviscate in the Heart, the motion seems to be continued after the separation thereof from the Body.

The next fundamental Error, and obser­ved likewayes by the same Author, seems to be, that they esteemed the intension of Heat alwayes to depend on the rapide ef­flux or circulation of the Blood; and that it was both a sign and effect thereof: The con­tracy of which appears by an Inflamation or Tumour, where the Member affected is vexed with a great Heat, and kind of Fever ▪ which is oft times communicate to the whole Body, and here it is clear, that the Blood is rather stagnant then swiftly moved, and the Fever that is communicate from the Inflamation, certainly shewing a near resemblance betwixt them, perswades that a certain degree of Incrassation from this Foun­tain of Co-agulation: And accompanied also with a frequent Pulse, does affect the Blood, as the Ignorance then of the concur­ring occasional cause of that frequency of the Pulse, gave rise to all the Errors about this subject, so the bringing to Light the true cause thereof, will make all these Er­rors evanish.

For clearing then of this,The Scheme of the New hypolsices of Fevers laid down. it is to be considered, that the Body [Page 102] of Man being a curious Ma­chine the motion wherewith it is en [...]ue [...], like other Machines as it has an efficient cause, so it has a final cause thereof; And in respect the final cause is alwayes the reason of placing the efficient cause, and that the Idea thereof is still in the mind of the Architeck before the Idea of the efficient; This makes the Idea of the efficient to be alwayes shaped subser­vient to the Idea of the final Cause; And must also make the structure of the efficient in the Fabrick of the machine to be moulded to that final Cause likewise, & instructed & qualified Suitable to attain the end of the motion, that is to say, that it may have a faculty of Intension and Remission to be regulate and moderate according to the exigence and necessity of the final, to be productive of the end of its being put there; At least in so far as the Contrivance of a Mechanism will go: As in a Watch whose Spring is so contrived that it may be Bended or Slack­ned for attaining the end of its motion. And it seems also probable that in every motion in Nature, its only the end that both puts the Efficient, and sets it a going; and therefore it must be still by that end, that the motion must be regulate, Hightned or diminished: [Page 103] As it is seen when Mariners do exercise the Pump of the Ship, its alwayes with respect to the breaking in of Water at the Leaks; Which being in great quantity does excite to frequent and vigorous Pumping to save the Ship.

Much after the same manner it seemes probable that this motion of the Heart which is nothing but a Pump designed to lay in the alimentitious Juice, and so has for its end a proportionable proportional reparation of the functions and parts suitable to their Consumptsion and Waste; And that by the sending to them throw the Chan­nels of the Arteries the arterial Blood, which is to be dispersed in such quantity and time, as may answer to the reparation of their Consumptsion and Waste; The Body consist­ing, which seemes to deny it all consist­ance, in a continual Flux, and succession of new parts coming in place of the old that are wasted, like a River which has nothing Identitious but the Channel: And so this final cause would seem to require an efficient whither that be the first Impellent, the Archeus or Spirits indued with a capacity and apti­tude not only to continue, but also to in­cite and quicken this motion according to the exigence of the final, as when the In­tervention [Page 104] of any stops or Impediments of the motions of the Blood does Interveen, to o­vercome which its necessarie that the efficient of the motion be bended to Superate these stops and gain tis end, then it must necessarly double its Force and Stroaks? Otherwayes every light Impediment or Obstacle which were equivalent to, and of equal moment, and Force with, the moderate and odinare career of the motion of the Blood would put a stop thereto: And indeed there is in a River something of a resemblance of this faculty, thô from an other kind of efficient, yet for the same or the like end; For any Impediments put to barr or dam up a River are soon overpoised by the swelling Force of the Water above them, till in proportion it overcome the strength of the stop: Now if it were otherwise, every Impediment equiva­lent only to the present current of the River, either put by Accident, or Designe would interrupt their course, to the great hurt of Mankind, and the blemish of the Worlds fabrick.

Seing then the returnes of Reparation to the parts and functions ought to be made, both in time and quantity in proportion to the waste, by the efflux of the Arterial Blood from the Heart as the vehicle, and [Page 105] thorow the arterys, as the conduites of these recruites; When this is done vegetlie, in­tegrally, without any stop or delay, then redounds felicity, ease, and integrity, of the functions and life: But when that efflux is retarded or stopt, either by reason of the Blood it self, or some stopage in the ex­tremities and small channels of the vessels; or by reason of immoderate and unusual waste beyond the proportion of the ordina­ry supply, (as falls out in immoderate ex­ercise and motion;) And, so I say, when by reason of any these causes, the heart cannot convey and lay in the desired sup­pliment in due proportion and timeously, by stroaks repeated at the usual intervals, then it does, by precipitating the stroaks, and straiting the intervals of the pulsations, endeavour, what in it lyes, to overcome the slowness of the motion of the Blood, & to come so near as it can to the due and proportional distribution of nutriment ▪ in respect of the wa [...]te: But if, notwithstan­ding of these sedulous endeavours of the heart by the redoubling of the pulsations, that slowness of the Blood, shall by a gra­dual encrease of the thickness, and of ob­structions in the capillary vessels, prove yet so obstinare as still to be augmented, then [Page 106] this leads straight to the porch and gate of Death; Death being nothing else but a to­tal and permanent cessa [...]ion, and defect of this distribution.

If there remain yet any dif­ficulty to comprehend this Scheme, An obje­ction against this Hypothe­sis answered. because this incitation of the pulse, being only a natu­ral action, and proper to the Animal part, thus circumstantiate, is made too like an effect of Reason, and savours too much the acting for an end, or of a vo­luntary motion, to be applicable here: To answer this reasonable doubt, since it is very plain that Nature in the structure of the outward parts of Animals has acted so much Reason and Design, as importing clearly that the Idea of their end has regulate their fabrick; has also made the structure of all their parts terminate into such a perfecti­on of the Animal, that the most rigide sur­vey can find nothing wanting: As is most ingeniously displayed by the Honourable and Learned Boyle, in his Treatise of the Final Causes of natural things: Why should not the same Architect also have instructed the Function and inward parts with faculties to be exerted less or more, according to the particular exigence of the Animal: But [Page 107] especially that radical and fundamental one of supplying all the rest with sufficient provi­sion and nou [...]ishment; that it should be endued with a faculty to accelerate, when the n [...]urishment either by its fault or im­moderate waste, is more then it ought, in its Returns, delayed: Otherwayes every light cause that did retard the accession of reparation or did waste it much beyond the ordinary recruite; would soon precipitate the Animal into inevitable ruine.

And also, seing most Animals are endued with swifness beyond their ordinary pace, whereby they flee dangers; why should they not be endued with the like inward faculty, to escape dangers internal that frequently threaten them. And indeed all these efforts which we call from Irritation giving a Re­semblance of such a faculty as this, argue as much reason and acting for an end as this, that's here laid down does; For the Impression made in the place, being resent­ed in the Brain the Fountain of Sense and motion; the Irritation or endeavour to be rid of the offending cause has its effects in the place first invaded or beset: and why should not the starving of the parts as much querelous as the surcharge of them is, be as well heard, and have also its releif; so far at their least, as motion can help them.

[Page 108]And there is yet a clearer resemblance of such a natural Action as this to be seen in the Pupil of the Eye, which without consent of the will Contracts and delates it self so much as is needful for the comodity of see­ing, viz. Dilating where there is too little Light to let in more, and convey the Species into the Eye; and Contracting when there is too much Light, and letting in only so much Light, as is necessary to Paint the Species in the Eye.

And althô there is a Phaenomenon and case in Fevers which seems to oppugne this Hipo­thesis, yet it is hoped that the same being duely considered,Another de­ficulty solved will rather confirm and clear it and the Cas [...] is this, in some Fevers the Pulse is not altered as to the frequency or Vigour yet these portend great & imminent danger: which Phaenomenon or slowness of the Pulse comes from this, that althô the final Cause of its motion be here craving enough of the acceleration of the Pulse for reparation in proportion to the waste, yet it seems the efficient or Impellent of this motion or the first spring thereof that should answer ex­actly the exegencies of the final; Is either stupified, attacqued, or befettered; and so there is no strugle or essay to overcome [Page 109] the Impediments, and Supply proportion­ably the waste: And as this case is of all Fe­vers the most dangerous, commonly giv­ing the name of malignant, so it brings the oeconomie, for the most part, soon to disso­lution.

To unfold yet further this paradoxical Hypothesis, if any desire to know upon what nearest and immediate cause this slowness of the motion of the arterial blood, or delay of Reparation which excites the pulse to ac­celeration does depend; unto this not imper­tinent inquiry that an apposite answer may be made; it is to be adverted, that the blood is made up of innumerable little glo­bules swiming in a limpide watery serum: As, being observed by Loewenhoek, with help of the microscop, is also delivered and describ­ed by him: and as its very probable that these Globules do naturally require to be of such a bulk, figure and number, and the sero­sity wherein these swim, doth also require to be of such tenuity and quantity, as may best facilitate the motion and course of the Blood throw the small channels and con­duites betwixt the Arteries & veins: In which passage for the most part it depositates its nutritious parts, or particles: So it is very probable that slowness of the bloods mo­tion, [Page 110] to overcome which the heart excites frequent pulses, doth for the most part pro­ceed either from the number or magnitude of these Globules augmented, or some vi [...]iation of their spherical figure, as their scabricity, and the like; Or further, thorow the visci­dity of the serum into which as a vehicle they swim, and are carried: And thô from any of these alone this slowness of the blood may clearly proceed, yet it is certain that the ingemination and complication of these causes, rendring the groseness of the Blood more intense; may also render the slowness of its motion more contumacious.

To conclude then, as by this scheme here laid down, seemes indeed may be given pretty clearly, both a rational discovery, & a Mechanical solution of the nature & phenomena of Fevers; so it appears that former explications thereof, having raised so many fumy effer­veseences, and turbid fermentations concerning them, could never yet bring the matter to a digested, pellucide, and defecat conclusion but having clouded the eyes with the mist of [...]iry phantasmes, still left the mind boiling and working in the tumult of commotion, doubt and difficulty.

SECT. VIII. Shewing that the Heat in Fevers is the [...]ffect of the slow Motion of the Blood: And how Heat is made, & may be consistent with that slowness.

SInce by what is said the rapid Circulation of the Blood in Fevers seems to be over­turned; And that the rapid motion there­of was the only adequate Reason commonly given, to solve the Phaenomenon of Heat in Fevers; Because swift and violent motions used often times to produce Heat in Bodies: althô we perceive motion to produce Heat in no bodys; but where it is acompanied with grating and grinding of hard & solid parts on upon another; but never in fluids; and so we find the violent motion of the Body produces Heat therein by the at [...]rition which the Museules make on themselves, and the adjacent parts: Which also produces a thickness of the Blood, and in consequence slackens its motion: It remains to inquire to what parent this off spring of Intenss and Feverish Heat can be most properly legiti­mate: The inquiry into this Phaenomenon may not only discover how Heat is made, but will perhaps also further establish the [Page 112] Hipothesis of Fevers already laid down: For if we take a view, and find that all these things which as external causes bring Imoderate Heat, that the same do bring on a pace with them thickness and crassness of the Blood; Which is necessarly followed with the slowness of its motion; And so to sup­ply the parts with proportionable reparati­on suitable to the waste that is made, the Ac­celeration is stimulated, and frequent pulses are excited, in proportion to that thickness and slowness of the Blood: as it falls out in vehement motions of Body and Minde; Great and long heat of the Sun, and fire; the ex­cessive abuse of strong Liquors, and in per­spiration impeded, &c.

In the vehement motion of the Body, beside the above mentioned grateing of the muscles upon one another, and upon the parts ad­jacent exciting heat, there is also such a waste of spirits and particles of the Blood and humours which in motion do exhale, that, to make proportionable supply and refo­cillation with the arterial blood, the heart is made to mend its pace; As also that copious eruption of exhalations, which sometimes comes to the degree of sweat, leaving the Blood, and Humors more gross and thick­ned, must necessarily also increase the slow­ness [Page 113] of its motion, which therefore crave grea­ter and repeated force to squeeze it forward into these narrow Channels: And so from all these circumstances, in violent motion there is raised a paroxisme as to Heat and Pulse altogether resembling a Fever: Which is mu [...]h after the same manner also produced by all the rest of external causes exciting Heat; but with this difference, that the Heat coming from the abuse of spirituous Liquors (as apears by the Spirit of Wine, which being poured upon Blood doth immediately co-agulate the same) comes from their immediate incrassating and co­agulating effect upon the Blood: Which In­crassation has likewayes and for the same cause, that stimulating effect upon the Heart. And how stopt perspiration produces Heat shall be in its due place shown.

Whence we may conclude, that all In­tense Heat grivous to the Body, is the ge­nuin effect of the grosness of the Blood; as it is clear by the contemplation of the Com­munity of the Causes, and the Communi­ty of the Phoenomena Natural and Pra­ctical belonging to both, and shall after­ward more fully be shown.

Having thus far premised, It remains to clear how this Thickness and Grossness of the [Page 114] Blood produces also intense Heat: And that the same Heat does not establish, but rather evert both the Effervessence of the Blood and the swiftness of that motion thereof, by some called the circulation, and by others the circuit of the Blood.

In prosecution whereof, it is to be noti­ced, that in the natural state of Health, the Heat is more strong and veget, then in the valetudinary state, where it is fretting and with trouble felt: For in the state of Health the Rayes of Heat (now whither or not these be thickly compacted together troops of Spirits it seems not worth the while to contend) these Rayes (I say) do chearfully and pleasantly glide with the arterial Blood throw the Channels of the Arteries, in a fluid, sequacious and yeilding enough; and by passages open sufficiently, toward all the Bowels, Organs, and Habit of the Body; for their refoccilation, in which for the most part they are consumed: And so from the con­tinual efflux of these Rayes chearfully ac­complshed, does result the faelicity and ease of Life, and integrity of the functions of the Oeconomy.

But in the state of sickness, and cheifly in the heat of Fevers, these rayes or Com­panies of Spirits flowing throw a viseuous & [Page 115] crass-medium, such as the arterial Blood then is, and also approaching the narrow Channels of the arteries partly obstructed and partly beset with scabricity by means of this viscous Blood; these rayes (I say) must undoubtedly, in there passage throw that viscid and unequal Medium, suffer refracti­on; And in their approach to the extremities of the arteries thus obstructed or vitiated they must suffer Reflection or Collision: Such modifications then of the rayes of heat seeme likely to produce the same effect on the sense, that the like modifications of the rayes of Light and of Sight do: It being known that the diversity or inequality of the medi­um throw which these pass, and by which they are refracted; Or the variety of the superficial textures on which these inciding; are therefrom also reflected; doth occasion Impressions on the organe of Sight, whereby the object is represented either some way depraved or greater, or more multiplied, then it would be represented without such refractions or reflections: So it seems not very Improbable, that the rayes of Heat passing throw the medium of crass unequal and not sufficiently Diaphanous Blood, that they should be several wayes refracted, and so coming to the Organe of feeling, that is, the nerves [Page 116] dispersed every where throw the Body, that therefore they should imprint therein a greater sense of Heat then usual: Or other­wayes by reflection, which comes to the same purpose, as when these rayes are darted throw the trunes of the Arteries, & incid up­on the small Channels obstructed either in whole or in part by this crass Blood, they must necessarly, being reflected several ways impinge on the Nervs the sensorie of Heat; and affect them with more brisk twitches then if they did glide smoothly along the trunks, and by open passages were dispersed, and exhausted in there designed ends.

And that the sense of intense heat is made much after the same manner, seems clear by the Instance mentioned before, to witt when the breath is with a wide mouth slow­ly exhaled, it gives the sense of heat upon the hand; Because the Particles of the breath are not caried streight and directly forward, but being dispersed by an Oblique transvorse and rec [...]illing motion, they under­go a Modification much resembling refraction; And coming so modified to the nerves of the hand, imprint thereon the sense of heat when these very same Particles flowing out forcibly, give no sense of Heat, but of Cold: The Particles being straight and direct in their motion undergo no such mo­difications.

SECT. IX. Shewing that Fevers being treaced up to their Fountain. viz. The outward causes, in that quest this grossness of the Blood and Humors presents it self. Where insensible Perspira­tion is touched, and how much the same lesed contributes the generation of Fevers. And how indigestion of the Stomach is also accessory thereto, with a new Hypothesis of digestion proposed.

TO comprehend more fully and clearly this dark subject of Fevers, its neces­sary to trace the same up to the very foun­tain and spring, according to the Concaten­ation of causes and effects, which termmate in that production called a Fever; And whose presence is testified by all the various Phaenomena, that as Irradiations & beames are darted therefrom: Now if in this Inquisition we find all such causes concur [...]ing and con­cateuat as produce that thickness and gros­ness of the Blood, and that these Phaenomena can be nowayes so comodiously resolved; As by there being made likwise depending on that grosness and the product thereof: and also that the Practical Phaenomena of Hurt­ers [Page 118] and Helpers have their immediate effect, in respect of this grosness or what depends alwayes thereon, the slowness of the Blood; then with a certainty litle below a demonstra­tion, we may conclude according to the al­leadged Hipothesis.

Here then the Procatartick and external causes, as first in operation deserve the first consideration; Such are errours about the six things commonly called not Natural, viz. Air, Aliment, Motion and Rest, Sleeping and Watching, Excretion and Retention, and Passions of the mind: For the errours about some of these using to generate, and about others of them to retain and accumulate, crudities Peice meal which serve for the antecedent or potential cause of a disease; and this ante [...]edent cause gradually by its own tendency, and sometimes more quickly by some great error superveining favoring this or that disease; Is acuate and formed into the conti­nent cause or very essence of the disease it self.

And even as the life of Man thorow Infirmitie and Misfor­tune is incumbred and invol­ved in manifold straits difficul­ties,Insensible Perspirati­on. and sometimes necessities, whereby he must transgress the measure and bounds [Page 119] and run into the excess or defects, of the use of these things; Which would surely make his life both very miserable, and without any comfort; but that it would likewise be very short: Were it not that the bounti­ful architect, giveing as well an evidence of Providence and Art as of Commiseration, and tenderness has contrived these bodies exceed­ingly commodious in the multiplicity and convenient situation of excretory passages, by which the noxious matter accumulate be­ing expelled, the errours hapening about these none natural things might be amended; and that not only throw the Gutts and Bladder, these sensible and patent wayes, (serving also sometimes for extraordinary turns as well as for their ordinary and na­tural Excretions;) but by another indeed most ocult, and obscure; yet no less cer­tain and obvious to the mind and reason, and more adequat and oftner serving, to these extraordinary, thô necessary Excre­tions: And that is insensible Perspiration, which sends forth continually throw the Pores of the whole Skin such a quantity of excrementitious Rayes, as does twise exceed all other sensible Evacuations; and is the Ex­crements of the third and last Conco [...]tion.

And indeed such a wonderful work of Na­ture [Page 120] should by lurking always not have had as much certainty & evidence as it demonstrats sagacity and providence; and so the Ignorance of Men should have intercepted, & smother­ed their admiration and gratitude; if the most ingenius Sanctorious a Sanctorio Physician & Pro­fessor of Padua, by divine Influence had not a­bove all exception demonstrat to the world the reality, necessity, and measure, together with Rules for the regulation, of this Per­spiration insensible: After whom for Fourty Years almost now since elapsed, Mortals have so much forgot themselves, that they have not only neglected (in so far as I know) to improve this Doctrine delivered by him (perhaps tending more to the con­servation and also to the recove [...]y of Health, then all other means whatsomever preser­vative or curative) but also to receive or make any Benefit or Fruit of his Industry and Discovery: Except what the most a­cure Bellinus Physician and Professor of Pisa, and Ettmullerus Professor in Lypsick have ob­served of it. And indeed that most acurate and piercing wit Sanctorious, delivers all his Observations approven to the eve by the Ballance; for having weighed the Body and all the aliment taken, in 24 Hours time, the next Morning, he again weighes the [Page 121] Body before the Excretiones sensible of Bel­ly and Bladder, and after the evacuations does the same again, and the difference betwixt these two last weights goes to make the weight of the Excrements, which is much within the weight of the aliement taken in, the weight of the Body remaining the same it was the former day: As for example, Suppose the weight of the whole aliment be 8 pound, the next morn­ing the Body being weighed before and af­ter evacuation of the Belly and Urine, the difference making the weight of the Excre­ments may be about 3 pound: The rest of the 8, being 5, evaportating by insen­sible Perspiration: But in this computation some consideration is to be had to the Urine excerned the former day, which in so­ber People is little, & for the most part the recre [...]ment of the Liquors taken in the third day before, & as that most exact observer by thirty years Experience found the bu­siness so or so to hold in the state and con­tinuation of health; it was likewise very ob­vious unto him, & may be so too unto any considering person seriously pondering the mater that this subtile, insensible, & because lit­tle noticed often times vitiated evacuation, [...] [Page 122] altho but in part, any long time lesed, that it must, heaping up copious morbifique matter, sow the seeds and become the fewel of manifold Diseases; which any slender and dispositive cause may soon precipitate into the continent and immediate cause of a Disease: Therefore that sagacious Man ob­serves from statical Experience, that the fore­seeing of the approach of Diseases is more certain and timeous, by the observation of the perspiration, then from the Lesions, of the Actions.

The due expulsion of this perspirable matter depends upon the integrity of all the concurring causes thereof, whither efficient, matterial, or instrumental: And as an efficient here (beside the first impellent the common efficient of all the motions of the Body) the Air by its elasticity and expansive power seems to have no small influence thereupon, for the Air being in the act of inspiration drawen into the lungs, and the vesicles thereof filled thereby, by the Heat of the lungs it is also rarefied, and thereby re­quiring a greater room, does also by its force distend these vesicles; whose stru­cture being with a narrow entry and large cavity, the Air therein contained and in expiration compressed, is not all in [Page 123] proportion to that compression expelled at the orifice of the vesicle; but some thereof must be forced also into the smal branches of the pulmonick vessels; & be mixed with the Blood in the pulmonick vein returning to the heart; and this air being once gotten into the ca­pillar Veins of these pulmonick Vessels by the continual expansion and contraction of the Lungs throw which these Vessels are inter­spersed; that air is pressed and driven on with the Blood towards the greater trunks of that Vein: For the motion therein be­ing made from a lesser cavity unto a great­er; is by that structure of the Organ more easie; and the Bloods advance facilitated and its regress hindered: So that by the motion of the Lungs alone, and without any Pulses; it is not only thus carried to the left ventricle of the Heart; but receives its whole complement and perfection in the progress, by the continual agitation of the Lungs, which do attenuat and grind and most intimately commix it with the air, as appears by the Blood in that Pulmonick Vein, which has its colour more florid and is it self more spumose, and rarified then before its ingress in the Lungs, and that alone by the Airs congress and agitation therewith. And further, the mixture of the Air with the [Page 124] arterial Blood is clear, by that Experiment of Mayow, Page 144. who putting venal Blood into the pneumatick engine, and pump­ing of the Air therefrom found it made on­ly a small ebulition: But having used ar­terial blood so, it made a wonderful expansion and boiled up into a great deal of spumosity, and that by reason of the great Quantity of Air contained therein, which expanding upon the weakning the pressure of the ambient Air, does dilate it self, and the Blood in which it is inviscate in proportion to the pressure of the Air that remained after the Pumping. And further the ingress of the Air into, and mixture thereof with the blood, is clear by this phaenomenon, that the superfice and extremities of the body, be­come tumified when the body is heated by motion; for then there are ordinarly more frequent and greater inspirations of Air into the Lungs, which the violent motion of the Body disperses thorow the several Mem­bers. As also, the same is made further e­vident, because the Hypothesis gives only the clear solution how the skine rises upon the application of cuping glasses, for the Air within the Body finding the Air within the Glass, not of equal resistance, doth by its elasticity expand it self and raise the flesh [Page 125] therewith. And moreover the Airs influ­ence and activity for promoving of perspi­ration as an efficient, is plain, by the above­mentioned experiment of Mayow, for the ar­terial blood appears turgid with such arerious particles, because these by their volatility serve to sweep off the perspirable matter: And further, that same blood exhausted and stripp't off these aerious particles, is by the Veins carried back to the Lungs, to be of new impregnate therewith. And likewise, the Necessity and Utility of the Aires sweeping and sifting thorow the Body, by its entry at the Lungs and going throw the Arteries, and out again at the pores disperse devery where throw the super­fice of the Body; appears from this as Hel­mont observes tractat de blas hum ▪ that heat a­lone is not sufficient to expel all these re [...] ­rements that are in the Blood and Body; For Heat in its operation, as in destellation leaves alwayes a great remander or caput mor­tuum: Yea, as Boil observes in the origin of formes the most limpide rain water being a hundred times redistilled leaves alwayes some Earthy and fixed recrements, that can be altered by no vehemency of fire, so that to eliminate and expell this perspirable matter, without recrements; beside the action of [Page 126] heat, there is further required some other proper volatilising efficient, which the Air may be clearly judged to be: For as Helmont and Tachenius observes, timber putriefying in the free Air gives by calcining little or no fixed Salt: And dry Herbs give far less quantity thereof, then green Herbes do; For this reason, that the Air being the pro­per menstruum of that Salt; Yea even of the same Salt within our Body does dissolve & extract it. And likewise the influence that pure Air has upon our Bodies, and which is observed by Helmont, must be also from this reason; For in serene and cold Air we eat and digest better Because that Air not being Saturat with fuliginous and noxious Particles; In running its course throw the Body, sweeps out powerfully the perspirable matter, and for the like reason these that Sail long on the Sea, eat very much and have fewer sensible excrements then other­wayes: Because the continual and swift motion of the Body not only promoves di­gestion and distribution of the aliement (as will be shown afterward) but also pro­moves perspiration, by the continual agitati­on and shaking of the Body; Which looses any of the Particles of the perspirable matter that incline to stick in the passages and pores, and so the Air more easily sweeps off that [Page 127] perspirable matter. And also, (as our worthy Au­thor Sydenham observes) long riding has the same effect and it may be thought for the same reason, and the effects of both these motions, are likewise observed by Sancto­rius, in his Aphorismes, Sect 7. where he shews that ryding respects most the expulsi­on of the perspirable matter above the Loynes: And that ambling is most wholsome, but trotting unwholsome: and that the being long carried in a Boat or in a Litter is also most wholsome as disposing to perspiration.

It follows next to be shown that the due expulsion of this perspirable matter seems fur­ther to depend upon the integrity of the instrumental, matterial and nearest causes there­of, such as, The strength and firmness of the Fibers and Glands of the skine, The con­venient aperture of these passages and pores thorow which it must go. And lastly, the sufficient tenuity and sequacity of that perspi­rable matter. But what things help or hurt here, will be too great a Digression to mention, seeing the Author Sanctorius may be consulted concerning it himself; and be­cause that very useful Treatise is scarce to be had; we have therefore placed down af­ter all, a select parcel of his Statical Aphorisms: It remains then only now to shew, that [Page 128] one or more of these requisites to perspira­tion being vitiated; that perspirable Matter may be retained and accumulate about the borders of the capillary vessels; until by its burden and bulk it provok the Fibers to its expulsion by sweat, all sweat especially giv­ing ease coming from a great and undue collection of perspirable Matter, seems there­fore never to be a Natural Excretion, or to have place or use in perfect Health, and is only profitable in so far as it shuns a great­er evil, and carries the same respect to the Excrements of the third concoction, that a Flux of the Belly does to these of the first or second; and those that sweat most, per­spire least in the Natural order & manner, as Sanctorius shews Aphoris. Sect. 1. That Sweating is not good, because it abates the strength of the Fibers, yet seing it di­verts a worse evil, it may be called respe­ctively good.

But if Nature, either out of Sluggish­ness or Weakness, do not provide against the retention of this perspirable Matter by Sweat or some otherwayes, it being still farther accumulate threatens a Disease, and very often a Fever, after this manner; for this perspirable Matter retained, being wholly excrementitious and unapt to be indued with [Page 129] Spirits degenerates into viscosity, and it may be into Purulency: and lying into the confines of the Veines, among the fibres of the Flesh, which being irritated by its bulk and use­lessness, do wring it out into the Channells of these Veines: And so being easily absor­bed by the refluent Blood, it infects by its viscidity and Purulency the Particles and glo­buls of the Blood; Increassing there bigness and vitiatng there Spherical figure: Which Blood thus vitiat, being carried back to the Heart by the Veines, and from it into the Arteries to be dispersed throw the whole Body, is with much difficulty admitted in­to the small capillary vessels, by reason of the disproportion of these globuls unto the conduites, or their scabricity; making their passage difficult: so that the heart is forced to double its pulses to drive on the Blood, to supply the craving parts with their due nourishment. And albeit often­times the heart doth by this assiduous la­bour overcome these obstructions, (for the vigorous agitation of the Blood, and of these globuls upon an another, doth so atten­uate and polish them, that they are made to pass without sticking, and so many thereof as are not redintegrable, as per­spirable matter are expelled:) Yet some­times these obstructions by their obstinacy [Page 130] from the copious Retention and the conti­nual Accession of perspi [...]able Matter, may not only elude these strenuous endeavours of the Heart, but also be so encreased, that, sterving all the Functions, they may over­whelm the Oeconomie, and put a total and permanent stop to the motion of the Blood; which really and formally makes extincti­on of Life.

Now that the Progress and Pedigree of a Fever may be after this manner, is much more probable, because it is very consonant to the Sentiment of Sanctorius, who in the first Section of his Aphorisms, declares, That, the perspirable Matter retained, neither being dis­cussed by Nature nor by a Fever superveening, presently disposes the Body to a Malignant Fe­ver: By the which may be understood a Fever of the highest degree; that depends upon contumacious Obstructions, and is extraordinary dangerous: And in the next Aphorisme, he sayes, Such as are in Fe­vers grow worse and worse if their perspiration be diverted by excessive applications of Medicines from an unskilful Physician.

And so seems to be acted the first seene of a fever, which seldom proves tragical, unless by a preposterous officiousness: For by the strength of Nature alone, or by some little Art, [Page 131] viz. By Sweating, Bleeding, and other easie means, it is for the most part brought to an happy conclusion.

Unless, which very oft falls out, a Mass of crude Matter generated from the Errors in the other Non-natural things, and lod­ged in the first wayes, as the Ventricle, Inte­stines, Meseraick Veins, becoming (as it is very apt to do) a fewel to this Disease make it both long and dangerous: Now this Crude Matter seems to be nothing else but the Recrements of the imperfect & perfunc­torious Digestion of the Stomack and o­ther Bowels: the search therefore into the cause of such Recrements amassed up, di­rectly lead us in relation to the discovery, first to make inquiry how perfect and na­tural Digestion is made.

Then passing over the com­monly received Fermentation the Aliments in the Stomack,A mechani­cal Hypothe­sis of Digest­ion. which seems justly to be rejected here for the same Reason that Effervescence is repu­diat in Fevers, this operation not only suc­ceeding always without Eventilation or Rest, the requisites to Fermentation, but altoge­ther refusing them: And so this action of the Stomack seeming much more intelli­gible to be made Mechanical, does rather [Page 132] consist in a grinding or attenuation of the Ali­ments, by which they are made chyle, for the requisites to compleatly expede Dige­stion are first the contraction of the Ventricle, and closs embracing of the contained Ali­ment: and next the gentle and continual compressive rowling of the Aliment alrea­dy closs embraced by the Stomack; and that by the continual motion of the Dia­phragma depressing it, and the motion of the abdomen again repressing it: Which motions reciprocally coming and going u­pon the Aliment close Imbraced in the Stomach, may be thought to have upon it the like mellowing effect that the rowling of the hand upon an Aple or other fruit al­wayes has; and that by the continual at­trition the Particles of the Aliment have up­on one another, they are mellowed into Chyle. And further what may be the Joint effect of the Stomacks Imbracing and Con­tracting it self closs upon the Aliment to pro­move this atrition of the Particles, will further appear, by the consideration of the effect of Monsieure Papines digester, by which bones are softned, with no other artifice but by the vessel so contrived, that it Imbraces the con­tained matter with compression upon all sides; by which these Stems & Vapors, which [Page 133] in ordinary boiling breake out, being Im­prisoned, do make their Rambles throw the whole contained matter, and give such twitches thereon, that they do so far atten­uate the Bones as to make Iellie of them.

Now beside this compression and rowling of the Aliment contained in the Stomack by the Diaphragma and abdomen the chief Instruments to make the Chyle, the powr­ing in of certain Liquors from the Glands, to macerate the Aliment, seems likewise to cooperate to the same purpose: As also the continual influx of Spirits by the great Nerves that comes to the Stomack, seems as well the promovers of that intestine mo­tion bringing first Attrition, next Concocti­on, as they are Authors of other admira­ble actions in the Body done by their stu­penduous Elasticity, such as the motion of the Muscles. And beside all these, there seems to contribute likewise to the Concoction of the Aliments, there being impregnat with Aereous Particles, while they are chew­ed in the mouth, these also serving to sub­tilize and rarifie them: And for this use the Wind-bladder in Fishes which is alwayes filled with air, has a Conduite to their ven­tricle, as is observed by Needham: And for this reason also it may be, that serene [Page 134] and clear air does contribute exceedingly both to Appetite and Digestion: And the Meat thus impregnat with the air coming to the Stomack is the fitter to be acted u­pon, and volatized by the Spirits, which also are of an aereal nature, and the Spi­rits influence to Concoction is plain by this, that these that are affected with Intense Grief and Sadness, or indulge anxiety and thought fulness, by which the Spirits are diverted from the Office of Chylification, do not digest, but find a weight about their Stomack, and have likewise the other to­kens of bad Digestion upon their Body, and also Appoplectick Persons do eat and digest double the quantity of Aliment that they do when they are whole; which seems to be only for this reason because the influx of the animal Spirits, being denyed throw the rest of the Nerves, takes the course more liberally throw the wandring pair and intercostal Nerves going to the Stomack & Bowels (whose safety Nature studies long­est to maintain) so these places being most copiously imbued with Spirits, do perform their Actions more vegetly. All which is learnedly treated, with the reasons for rejecting of Fermentation in Digestion, by Con­radus Brunuerus in his Diatriba de Lympha & usu Pancreatis.

[Page 135]Now from this it would seem to follow that these belchings that happen in bad digestion, are as well the cause as the sign thereof: for the stomack sending up throw the oesopha­ge these Steemes that with their Careers throw the Mass of the contained Aliment should attenuate & comminute it into Chyle, is a clear Argument of the laxity and infirm­ness of its Tone; And that it is not able to Imprison them, and by straite Imbracing the Aliment and them-to keep them there, in Inviscate at there work: and this con­traction of the Stomack to Imbrace the Ali­ment upon all sides is so necessary, that any vacuity how ever little betwixt the Ali­ment and the Stomack, is frequently the cause and occasion both of indigestion and of the sending up of these eructations: that vacuity being a receptacle for these steemes which finding themselves at liberty from the Im­braces of the Aliment, by their volatility & ex­pansiveness distend the Ventricle, thus proving troublesome to it, they force their passage at the mouth thereof, and are voided by way of belching and ructation: And this is also observed by Sanctorius in his Staticks where he finds that less quantity of Aliment then the usual being taken in, does neither di­gest nor perspire, because the Stomack [Page 136] scarce contracting more then its ordinray is not so far constricted as to touch the Ali­ment on all sides.

Moreover to confirm this Hypothesis of the Stomacks Digestion by gentle rowling of the contained Aliment, the benefit that in most chronick Diseases comes by long rid­ing seems to be no small adminicle: For these Diseases for most part coming from crudity and the recrements of the Indigestion, which beget obstruction, by this continual motion & jogging of the Body in riding, are not only removed, but actual Digesti­on is thereby extraordinarly promoved; and that by agitation of the contained A­liment making Atrition of the parts there­of upon one another: And what alterati­ons motion and agitation alone is able to pro­duce in liquids is seen in the churning of Milk, whereby Butter is made; and that with­out any Fermentation or Effervescence.

Having thus far digressed to essay how Digestion is made; it plainly follows that Indigestion leaving the Particles of the Ali­ment less comminuted, attenuat, and mellowed, resolves in the Congestion of a Mass of crude Humors lodged into the first wayes, and ready to be a Fewel to begin or increase any Disease, especially a Fever, [Page 137] For althô any part of this crude Matter be­ing carried into the Blood, while it is un­der a Brisk & Vigorous circuit, Efflux and Reflux, for the most part is soon attenuat­ed and subjugated, and by that sprightful motion eliminated by insensible Perspirati­on; Yet in the case when the Blood is act­ing the former scene, these gross Particles and Viscous matter, being carried into the Mass of Blood, do both augment the Num­ber and grossness, and vitiat the figures of the globuls of the Blood, and so putting more obstructions in the small vessels, puts also more Contumacious barrs to the mo­tion: and thus the Lungs, the Forge, and the Heart the Pump of the motion of the Blood making life, being beset on both sides, viz. By the crudities ascending by the lacteal Vessels on the on side, and by the per­spirable matter retained on the other Hand both hindering by obstruction the effect­ual making and distribution of the arterial Blood; Comes all these Phaenomena arguing the presence of a Fever; and for the most part one of the highest degree or first rate.

SECT. X. The Natural Phaenomena in Fevers made to confirm this Hipothesis, such as Thrist, Pains, Inquietudes, Anxieties, Deliri­um, and Spots.

ANd that a Fever proceeds from Obstruct­ion, especially in the Capillary Vessels, may be easily conceived by any who were ever taken with a Fever themselves, if it did not ascend to that height to bring along with it Stupidity, for they cannot forget the continual and frequent Pulsations, wherewith they were then afflicted in the Head, Back, and all the Extremities; which certainly denoteth Obstructions, and difficult passage of the Blood throw the small Vessels of these parts, upon which the Blood, endeavouring to open these closs doors, did continually batter and beat; when in the state of Health no such thing is felt; because the Blood enjoyes a free passage thorow these Channels clear and open.

But to confirm this Hypothesis farther, it remains to shew how the most ordinary Natural Phaenomena in Fevers may be made to agree therewith.

[Page 139]And first as to Thrist in Fevers, it seems not to be an effect of Heat, as is common­ly believed; but is another Branch which springs from the same Root of grossness of the Blood, and of Obstruction depending thereon, that Heat it self does likewayes come from: It is not therefore the Heat that dries the Tongue, Iaws, Throat, Oeso­phage, and Ventricle; but it is the defect of the watering these places with the Lymph and Spittle; because the Lymphal and Sali­val Glandes, being in like manner affected with the same Obstruction from the crasness of the Humors, either do not secerne their proper liquor from the Blood, or do not excerne and squeeze it out on these parts.

The Phaenomena of Paines of all sorts in­quietudes, and anxieties, may also be re­solved in that same fountain of obstructi­ons; For the rayes of Heat, or Spirits not being able to run their course, and carreer; by reason of the gross Medium and obstructi­ons; do therefore resile and recoile on all hands, and by their brisk twitches on the membranous parts endued with exquisite sense, they raise paines, and uneasiness: and acting their scenes in every organ they do excite S [...]mptomes Competent thereunto.

[Page 140]And in the Brain Delirium or Raving seems to be raised much after the same manner,How de­lirium is made for it appears only to be the Direct and Regular motion of the Spirits by Refraction and Collision perverted, imprnting a Troubl­ed Chattered and False Imagination; Much after the same manner as there is a decepti­on Imprinted in the Fancie, when an Oare appears broken, the one half thereof [...]eing only in the Water; And that because of the Refraction or Distortion of the visible rayes coming to the Eye: So then it is very pro­bable the Spirits within the Brain, at the least the nervous juice their vehicle or medium, being generate of that crass and unequal Blood the parent of these Refractions and Perversions acted in the Mass of Blood, that thereof also may be generated such nervous juice as will make the Spirits obnoxious likewayes, by Refractions and Depravations of their motion, to produce all these Phaeno­mena competent to the region of the Brain & Nerves: And that by reason of the Obscuri­ties or Inequalities of their medium, that is the nervous juice, throw which these Spi­rits do pass.

And that these Delusions are raised much after this manner is farther clear, by pon­dering [Page 141] that familiar deception of the Touch, which is made and exercised by crossing the Formost finger with the Mid-finger of the same Hand above it; and with the points of the two fingers thus placed, if ye shall touch any little Ball, you will not only think, but swear it to be two, nei­ther will you any wayes be delivered from this error but by the Eyes: The true rea­son of this delusion seems to be from the distortion of the nerves, which necessarly in­duce a depravation of the Impressions made and conveighed by the nerves unto the Brain: And as this distortion in its manner & effect resembles very much the refracti­on of the visive rayes misrepresenting the object in the Organe, so it bespeaks a delirium or depraved Imagination to come from some refraction of the spirits within the Brain As concerning the eruption of spots in Fevers, How spots are made there seems no­thing more perswasive to con­firm the Hypothesis: For these altogether resemble the markes made by stroaks on the Skine; And these markes are also made by the stagnation & coagulation of the Blood in the small Channells bruised and distorted; which remain until new Blood superveen­ing, both cleanse and repair these [Page 142] Channels, and restore to the skine its usual colour; which is soon done when the Mass of Blood is intire and not infected with an obstructing Grossness: After the same man­ner these Spots in Fevers happen; but with this difference, that they come not from the bruising of the Channels; but from the thick and gross Blood stoping and coagula­ting in these Channels; and tinging the Skine with blewness or redness: And in Fevers the difference betwixt red and purple Spots as to the cause is the same, that is betwixt these from an external cause: Blew Spots being from a greater stroak and contusion, beget a more intense Coagulation of the Blood; and the red from a less, produce a lesser effect; for every Light external cause is apt to make the Skin red; as the bits of the Fleas often do: And so a lesser coagulation in Fevers begets red spots, and a greater makes purple Spots.

SECT. XI. That the Phaenomena of Helpers and Hurt­ers, in Fevers confirm this Hypothesis: And first how Bleeding a Helper confirmes the same: And several other Phaenomena concerning Bleeding, [...]leared according to this Hypothesis.

THE nixt point both bringing light to the Theorie and fruit to the Practise of the Cure of Fevers, is the exact consider­ation of the Practical Phaenomena, the Helpers and Hurters in Fevers; And how they do the same.

And the first is Bleeding, which by the consent of almost all is granted to be very beneficial; but if by this Theory is be clear­ed how it is so, it may perhaps have its effect further improven also thereby; Now its certain that for the most part Bleeding Cooles the Body, Calmes and slackens the Pulse, and allays almost all violent Symp­tomes? In so much that being celebrate to one in the Fury and Fever of a Drunkenness it allays that also; But how it does this is to be inquired: Its certain that the immedi­at effect of Blooding is the Emptying or de­pletion [Page 144] of the vein that's cut, and the nixt effect to this must be that the Blood that's poured forth of the Vein that's cut, not going back to the Vena Cava or great Vein, must be in consequence a proportionable Depletion of that Vein also; Because the usual accession of Blood from that Vein cut is intercepted; Now this Ebb made in that great Vein must certainly make the rest of the Veins that feed it flow with greater Force and Quantity thereunto likewayes; Because the moment of Resistance in the great Vein thereby being less then it was, is also less then the Pressure of the Veins feeding it, which must make them empty themselves there­in with greater freedom and force then they did before. And this in consequence, diminishing the pressure of the Blood in the whole Veins which lay against the Ar­terial Blood, must make the arterial Blood from all the Arteries go into all the Veines with more freedom also: When before the whole Veins being choak full, by the resistance & contranitence of the venal against the arterial Blood, the arteries emptyed themselves with di­ficulty into the veins & any obstructions betwixt the Arteries & Veines could not easily yield to the Pressure of the Arterial Blood; Because the Venal Blood being throng, and Regurgitating [Page 145] its Resistance was equivalent to the Pressure of the Arterial Blood: And so little or no advance being made in the motion of the Arterial Blood toward the Veins, it could not sweep and clear these passages betwixt them & the Veins: Not very unlike, as when a Mill-Wheell stands still and has its motion stoped by back Water, there being an equivalent weight with that which should force it a­bout hinging on the other side of it; But when the back Water is removed off, or falls low, then the motion goes on as before: even so it is here that any sudden Depletion of the Veins, as taking away the Resistance, gives the Arteries freedom to squirt the Ar­terial Blood more freely into the Veines; And consequently to sweep away all stopes and rubbish in the way.

But it is to be observed here, that upon the opening of any Vein, this scouring of the Passages is most effectually performed in these conduits that are betwixt the Arteries and that Vein: These Arteries being first, and most sensible of the removeal of the counter Ballance that lay against them, catch the opportunity, by emptying themselves precipitantly into that Vein, to sweep pow­erfully the interjacent Passages.

From this may be offered a proposal for [Page 146] improvement of Phlebotomy, A Proposal for improv­ment of Phlebotomy. to wit, if it may not be thought the most effectual and most univer­sal way to clear the Obstructi­ons throw the whole Body, that in place of Bleeding in one Member the same were used at the four Extremities: And also in the same quantity which is used in one Bleeding; and that by opening the Vein in each Arm & in each Foot: For thus there being at once made a depletion of so many Veins containing a counter Ballance against the Arteries answering to them, the Arterial Blood would, by its quick springing into these Veins, powerfully scoure all these Passages betwixt them and these Veins: from which would follow a sudden, chearful, and uni­versal efflux of the Blood from, and Re­flux thereof back again to, the Heart; which motion was before slowly, par­tially, and superficially performed; for the Arteries not emptying themselves cleaverly enough into the Veins, there is little room made in them to receive the return­ing Venal Blood, so there follows almost a stagnation in both: Notwithstanding of the frequent and assiduous attempts of pulsation of the Heart.

[Page 147]If we consider further the other Phoenomena of Phlebotomy, we will also find that they concur both to the establishment of this Solution, and of the principal Hypothesis: As the be­nefit thereof in Hemorhagies, How Blooding helps in hemorha­gies. which has been violently strained by the patrons of E­ffervescence, and of the rapide motion of the Blood to favour their Theories, but being narrowly pondered, will appear both to e­vert theirs, and establish this: For Hemor­hagies, especially these in Fevers, come most part from the Arteries, not because the Blood then circulates more rapidly, for in that case meeting with no obstruction▪ it would have no occasion to burst the Vessels: But rather because it is not received a pace into the Veins as it is sent from the Arteries, breaking its bounds and brusting its Vessels, its poured out another way: And the pro­per Remedy of this being Phlebotomy doth clear this; because it diminishes the pressure of the venal Blood lying on the Borders of the Arteries, whereby they overcome and work off any obstructions betwixt them & the Veins; and emptying themselves easily therein, the Blood does no more deviat into those Ruptures. But that this Remedy may be more speedily effectual, it would [Page 148] seem to require the opening of the Vein that directly answers to the Artery that is bro­ken, as more immediately taking of the contranitency lying on it: At least this would be done after the opening of one at more distance, which althô oftentimes at first is to be done, yet sometimes it falls out to be done without effect, and then this imme­diate Vein ought to be opened.

And farther, an Hemorhagy from the ve­nal Blood turgent, & brusting the Vessels, or from Acrimony contracted by its Stagnancy, corroding them, yielding likeways to this Remedy gives also the same Confirmation: For the Stagnation of Blood in great quan­tity in the Veins, does not only swell their Coats and weaken their Tone, (by which they contract to thrust the Blood back to the Heart;) but may also so far streach them, as to make a Rupture: And this is most effectually cured by Phlebotomy, for the Veins being emptied, the Coats shrink in, and the Rupture is closed: And farther the Blood upon that emptying, making its Circuit more quick to and from the Heart, is no­wayes apt to devia [...] or secede again into these Ruptures. And here by the way may be observed, why an Hemorhagy from the Veins, is not so usual as from the Arteries, & [Page 149] if it fall out it is more easily stop [...]d in them then the Arteries: the reason of which is both from the different Nature of the Blood contained in these Vessels and the differ­ent structure also of the Vessels themselves, in respect of the motion of the blood therein: For the Arterial Blood being more spiritu­ous and volatile is easily evacuate at any chink:Other Phoeno­mena of the mo­tion of the Blood cleared. As also the Blood in the Arteries, making its progress from a wide place of the Channel unto a narrower, any obstructing matter it meets with, is by its mo­tion more impacted and rivetted into the narrower part of the Channel: Which occa­sions the Arterial Blood to burst its passage another way: Whereas the motion of the Blood in the Veins is from a narrower place of the Channel into a wider; so any ob­struction is easily carried before the Blood. As also it occurrs here to be observed, that for the self same reason the Arterial Blood, thô it make no faster advance from the Heart, then the Venal makes its return to it; and also althô it be more spirituous and volatile then the Venal; Yet it needs the help of Pulsation to carry it on which the Venal needs not: The reason of this seems to be the same different structure of these [Page 150] Vessels in respect of the Bloods motion in them: For the Arterial Blood making its progress; as is said, always from a wider place of the Arterie unto a narrower, needs the force of the Pulse to drive it foreward: But the Venal contrarywayes moving from a narrower place of the Vein into a broader, is served with less force; the contraction of the Coats of the Vessels, with the help of Respiration at every turn pressing on the great Veins within the Trunk of the Body, and the Valves hindering its return, is sufficient alone to carry it back to the heart.

There is moreover another Bene­fite to be remarked in Phlebotomy, beside the simple depletion of the Veins and the former beneficial consequence thereof,The reason why the worst Blood is first evacuated. & that is this, if the Vessels or the Arteries situated beyond the Orifice made in the Vein, do contain any Labefacted, Rheumatick, or Purulent Blood, such is most part voided; the more opime and pure being retained: The reason of this Phoeno­menon appears to be thus, when the circuit of the Blood is not throwly perfected, many of the Globuls or Particles thereof, stagnat­ing become torpid and purulent, and such for the most part are accumulat toward the [Page 151] inner Superfice of the Trunk's of the Vessels, the more Opime Part being carried in the middle of the Channel toward the Heart: As is observed in a River or Torrent which al­wayes drives Heterogeneous & grosser Bodies toward the Brink: This seems the true state and disposition of the Blood in the Veins, when Phlebotomie being used, exhibites such Blood, for the Vein being opened, such Blood as is nearest the Superfice of the Vessell comes first out, which diminishing the Pressure of the venal Blood on the borders of the Arteries adjacent, the Arteriall Blood rushing into the veins, Imbraces and caries along with it the opime Particles of the Blood unto the heart, leav­ing these behind that are unapt or incongrous to the genius motion & Imbraces of the Spirits: Whence it happens that more of these, vitiat Particles are heaped up together to­ward the side of the Channel; For such by their congruity and similitude involved in mu­tual Imbraces sticke closs by others; And so this stream of labefacted Particles coming first out at the orifice of the Vein does not only close it to the opimer Blood; but they fol­lowing close stick to one another & make like a Thread Spun out at the Orifice.

And it is known with how much the greater Stream the Blood springs forth of the Vein cut, [Page 152] by so much the more it appears Labefacted, and the Patient has also more ease thereby: Because the Blood stagnating & turgent in the Veines, the Labefacted part thereof no wayes obeying the motion of the Spirits, & of the Opime Blood but deviating into corners is easily thrust out at Chinks and Holes.

In so far as Concerns the first and last coming out of this viti­ated Blood, Why the ill Blood comes first or last. and the appearing thereof also thus different in the measures receiving it; It would seem when it comes first out that these Par­ticles either lay most in the Veins, or that the Contranitencie of the venal Blood, against the Arteries being lesser, such Particles are also soon casten off from the Arterial Blood coming into the Veines: But on the other hand when these Particles ly deeper in the Arteries or Capillary vessells? Or where the Stagnation or Cantranitence of the venal Blood being more, yields only to a greater effusi­on of Blood, the segregation and expulsion of these Particles is slower, & the labefaction a­pears most in the last measures. For which reason, and also in the case where the Pa­tient can more easily bear the same quanti­ty of Blood to be evacuat by degrees, rather then all at once; it would not be impertinent [Page 153] alwayes to make some stops of the Orifice, till the Blood being cooled give the marks of its temper; whence may be made a computation of the due measure and quan­tity of the present Evacuation.

From all these things thus transacted, it is evident that the integrity of the Functions, and the serenity of Health does depend on this motion and circuit of the Blood duly per­formed; except it be in the affects of the Brain and Nerves, the Foundation w [...]ereof is also laid by some latent vice of this mo­tion of the Blood: And farther that this course may throwly proceed, and that the reflux of the Venal Blood may not only fur­nish matter to the efflux of the Arterial Blood, but also that the Venal by its stagnating may not overballance it, or with its weight hinder the arterial Blood to squeeze out any obstacles of its motion sticking into the Channels of the Veins;Why Peo­ple ly down u­pon a fitt of sick­ness. such is the wonderful providence of nature (I say to dispatc [...] the incumbrance of this Motion, epecially from the weight of the venal Blood pressing against the Arteries) that sick People with­out considering so much, are put at once under the Remedies and effects of their e­vils, by their lying down upon the ap­proach [...] [Page 154] of any fitt of Sickness: For, as the Famous D. Lower has observed in Tractatu de Corde, the native Gravity of the venal Blood below the Heart augments its pressure against the arteries more when the Body is upright, than when that situation is changed into a plain level posture, by lying down; for then the venal Blood flowing like a River in a l [...]vel Chan­nel; and so being more easily carried back to the Heart, both takes off the contranitencie from the Arterial Blood, & does at the same time supply the Heart with Matter for new Arterial Blood; and also hands about the mo­tion of the Arterial Blood into the veins, and thus the Symptoms impendent are warded off.

And much for the same rea­son it is,Why Blood letting i [...] easiest when ly­ing a bed. as is observed to good purpose by several Practitioners, that sick People can with more safety & ease endure Phlebotomy lying on a Bed, then sitting upright, be­cause in that situation the Pressure of the venal Blood against the Arterial being less, is not only with less quantity of Blood let out taken off; but also the intercepted course of the venal Blood to the Heart in that po­sture is sooner redintegrated.

If there shall yet remain any doubt of the Verity or Probability of the Hypothesis of [Page 155] the slowness of the Blood in Fevers from the viscosity & crassness and the obstru­ction of the Channels thereby,An Objection of the Bloods not coagulat­ing when drawn in Fevers an­swered. be­cause the blood drawn off feverish persons oftimes remains with­out any solid coagulation: from which many Authours have deduced the tenuity of the Blood.

But the more closs consideration of this Phaenomenon will shew it far otherwayes, for it is certain, that Blood drawn does coagulate, the crass and heavie Particles subsiding, and the thinn and watry Parts sweeming above, upon this very reason that the serosity is en­dued with suteable Levity and Tenuity, and the clotty parts have their due ponderosity and crasness, with such dimension in respect of the tenuity of the serosity, as may make the se­paration: So that by the Levity and Tenuity of the Serum, the grumous parts fall to the bot­tom; and on the other hand by the gravi­ty and proportionable dimension of grumosity the serosity sweems on the top: But if after re­frigeration the Blood remain without distinct serosity and grumosity, it truely denotes either the tenuity of the serum to be vitiated, and its viscosity augmented; Or the gr [...]vity, at least the dimensions, of the solid Particles in respect of the serosity to be altered! And so the [Page 156] Solid Parts and Globuls of the Blood are kept in the Embraces of the serosity; Each balanc­ing another so equally that no Percipitation or Secretion of the Crass from the thinner parts is made.

SECT. XII. Purging in Fevers considered from Reason and Authority.

THE next practical Phaenomenon to be con­sidered with its use and utility in Fe­vers, and how it clears the supposed Hypo­thesis is Purging, as coming in the Method of our Author immediatly after Phlebotomy: And is only required when there is plenty of Fewel to nourish the Disease lodged in the first wayes, the Stomack, Intestines, Me­sentere: Which by its emitting of Crudities into the Region of the Blood introduces new Obstructions, the former being scarce well subjugat and subdued; and causes the con­tinuance of the former Scenes in a Theater very much disposed thereto: And that by joyning forces with the Perspirable matter retained, scarce yet eliminated: whose choke Nature severally and separate would be able to sustain; but being altogether une­qual [Page 157] to their joint assault, without fresh supplies she must thereto yeild and suc­cumb: Then is most welcome the aproach of the Cathartick with its force & power, as only sufficient to intercept and divert the Enemies Provision and Forrage from this Coast.

But farther, to evince the security, uti­lity, yea necessity of this Auxiliarie of Nature in this Intestine War; it's to be considered that this Method of our Author is not on­ly exactly adapted to the Concatenation and Complication of causes making and [...]oment­ing this War; but thereby all the Auxili­aries are drawn up and planted in that Or­der and Battalion Form, that each of them does both back and make good each others assault; And bridle and restrain their De­pradation, Ravageries and Exorbitancies: For the Cathartick and Paregorick Forces charg­ing the Enemie severally and alone, instead of Auxiliaries often prove Depredatory: So then in the first place comes Phlebo­tomy, whereof the proper & direct effect is not more to be considered, then the Respe­ctive & preparative relation it has to the cathar­tick, (often times to be given on the back of it;) comes to be remarked: Which in that order administred as it operats; gently and with­out [Page 158] tumult; So does it more efficaciously then being administrat otherwayes. And this as it is observed by the most famous Silvius is comunicat as a remarke very use­ful in Practise. And thô there can be no such p [...]rswasive Arguments for this as ex­perience; Yet for satisfaction of the curious inquirer of the reason thereof, & that they may have an adequat idea of the Phenomenon (perhaps also bringing light as well in o­ther cases as this,) I shal make this essay to give a reason therefore.

It seemes probable that all tumult and commotion in the Body, with anxieties and trouble accompanying it, has its rise from the complication of thir causes, and ac­cording to their Intension or remission is more or less, viz. From the energie of the Impel­lent faculty or explosion of the Spirits, exciting frustraneous Essayes to pass themselves throw their Medium ▪ or to carry matter throw proper passages destinate for that end: and these Essayes are frustraneous either because of indisposition and inaptitude of the matter throw viscosity or grosness; Or because of the closness or Scabricity of the passages: And so these explosive motions of the Spirits termi­nate in collisions, repercussions, & irksome touches of themselves; Or of that moveable matter [Page 159] upon the Walls, and Fibres of the Vessels and Bowels inducing therein Irritations, spasms, anxieties, and troublesome sense: some being affected principally & some by consent: in which tumultuating state the Functions de­prived of their due Incomes and Recruites, do also languish; and consequently become lank in their office: So then on the approach of the Adventitious irritating and stimulating force of the Cathartick, either under a pre­sent Orgasme thorow the foresaid cause, or under a Disposition or Proclivity thereunto; there must necessarly a Tu­mult arise; or one already begun be height­ned; there being so much of an additional cause put, as the Commotion of the remainder of the crude humors stirred up by the Purga­tive; which being thereby somewhat atenuate, are easily carried into the Blood; and do by their viscosity and gros [...]ness, which makes their unaptitude to go throw the small Channels and Vessels, stop and close these Channels.

But by Venesection, the Obstructions as was shown, being much resolved, and the course of the Blood in a manner restored, these Spirits incitat and irritate by the Purgative enjoying a free course throw a pure medium, [...] [Page 160] do excite no tumults, & also these particles of commoved matter meeting with a brisk motion of the Blood & patent channels, are soon dissipate, scattered and expelled by perspiration insensible.

And the Benefit of Connecting immediatly toge [...]her Phleboto­mie and Catharticks in Fevers has been the succesful Practise of many famous antient Authors (yet none there­of adverted the beneficial use of the Pare­gorick after the Cathartick) as Riverius in his Practise of medicine, Authorities purging for in Fevers. Lib: xvi. Of the pestilent Fever, chap 1. In that most cruel Fever that raged at Montpelier which took away the half of these that were infected therewith, althô the sick People had the eruption of paroti­des, & were brought to extreme weakness, yet he, induced with the unsuccesfulne [...]s of all other Methods Cured them with Bleed­ing and Purging: So that none that were so treated by him died. And Sylvius Delaboe that, deservedly to this day famous, pro­fessor & Practitioner of Medicine at Leyden, does in the first Book of his practise, Chap: 29. In­stitute his Cure, yea of Burning Fevers with Blooding and purging; the purge to be given even▪ within an hour after the Blooding: And he appoints both to be reiterated till the [Page 161] Fever become much thereby subdued. And Donckers that Famous Practitioner in Cologne in his treatise of the Petechial Fever, which is the same with a Malignant Fever, does follow much the same Method, begining with Purging & Bleeding in that Fever: and gives with all this Practical Caution in the use of Purgati­ves, that, especialy to these whose Constitutions and Strength are not known;Some Practi­cal Cautions Concernig Purging in Fevers. they be admini­stred, not in one whole Dose; but in partited Doses: For a larger quantity that way given, will have a more mild and a far more effectu­al operation, then a less quantity by the third given at one Dose will have. But above all which I have yet ob­served to contribute to the secure & effectual present operation of Catharticks in Fevers, Other Cautions. there is nothing to be compared to volatile Salts, with which the Doses given to Febricitants being well imbued; The an­xieties, tumults, and faintings; Using to a­rise during the time of the operation are extraordinatly checked and supressed: But yet if by the present disposition of the Body, there be such a proclivity to Orga­smes and Anxieties, in the time of the operation; That these volatiles given in [Page 162] this manner are not sufficient to Bridle them: It may be surely as I have frequent­ly observed, and to great surprize, as it were like an Inchantment done, by the reiterated administration of these volatiles at that time in a convenient vehicle: Which has seldome or never been observed to faill of the de­signed effect; And makes the purgative absolve its operation without any trouble­some or hurtful symptome; And the rea­son of thir effects seemes to be by the inti­mately commixing the Volatile Salt with the Cathartiek, or the Superadding it, so that wherever the Cathartick coming exerts its stimulating force and operation with unea­sieness, it is attended also with the opening and atenuating efficacie of the volatile mak­ing its operation easie.

SECT. XIII. The benefit and season of using Paregoricques in Fevers: and there Diaphoretique vertue comended, and the danger of other Dia­phoretiques: with a doubt from the Author Sydenham's Constitutions of years answe­red, and this Method shown to be common to all Constitutions.

BUT at length when the Fewel or matter being the antecedent cause of the disease is so plentifull and Contumacious, that be­ing [Page 163] only raked up & troubled by the Pur­gative, it therefore does send into the Blood more crudities and viscosities then the Motion and Crasis of the Blood only newly restored can fully subdue, and which appears al­wayes most sensibly and palpably by an In­gruescence of anxieties uneasiness, and sickness after the Purgative: Then does most o­portunely come the third and last auxilliary, (the sole invention of our Noble Author Sy­denham) to be at this season used: and this occasion does not only securely bear, but Invites and Implores for the use of the Pa­regorick; By which not only are stroaked and repressed these stimulating Impressions stamped on the Spirits, by the commotion of the crudities diffused throw all the Regions of the Body, which are thereby contaminated with viscosity and obstruction; But also a sequa­city, attenuation and yeilding in that viscide and obstruent matter, is obtained by the Paregor­ick; Which, bringing on sleep and rest does refocillate and recruit all the functions, whose Integrity and Vigour cannot miss to perform peice meal the attenuation of the re­licts of that viscide matter. And thus the Tu­mult apt to arise upon the Purgative being intercepted by the Paregorick; an other Ca­thartick may be administred under the pa­cification [Page 164] obtained by the former Paregorick which having also brought off some of the Fewel of the disease, its Tumultuary effect may be likewayes preveened by a subseqent Paregorick: And so comodiously and safely we may Purge and Quiet by turns, as the quanti [...]y and tenacity of the matter re­quires, and make the Purgative exert its desired effect without any Noxious one; Until the evacuation of the whole fomes, and in consequence the Famishing of the continent cause of the disease: And for any small relicts of the matter, that escaping the Purge having got in, do fluctuat in the Mass of Blood and yet do molest and trouble it; These will be easily and safely elimi­nated by the diaphoretick force of the parego­rick still to be continued: with which dia­phoretick vertue it is clearly testified to be endued, by several famous Authors, from their sure experience, As Wedelius in his Opiologia, and Ettmullerus in his Treatise de vi Diaphoretica opii, both (avouching many other Authorities for it) clearly ma­nifest the same.

And how acceptable must the use of the paregorick be unto Nature, in respect of its quieting vertue, under this confusion and im­minent consternation of the oeconomie? For it [Page 165] may be easily supposed that Nature, weari­ed by wresling with the diseas, would very gladly embrace and cherish a truce; as if she would hold a Counsel to deliberate; (which now may be securely done, the strength of the Enemy being in some mea­sure broken and intercepted by the Cathar­tick) and to put to execution her resolutions, unto which sleep and rest is eminently sub­servient, especially coming in this order.

But that which more evi­dently contributes to this pur­pose,The hurt of meer Diapho­retiques in Fevers. and commends the use of the Paregorick, is its having the joint vertue to be both Quieting and Diaphoretick; in which it ex­cels all other Diaphoretick, which by their Impetuous & Precipitant Stimulating crude Matter toward obstructed Channels, do both raise a great confusion there, and rivet and fix that matter more therein: Much after the like manner, as when a House suppose a Church is filled with People▪ and this Peo­ple being struct with some sudden terror, should all strive to go out together; this sudden and universal press of going out, will certainly both beget such a Confusion, that each will hinder▪ other attempts to get out, and make the essay of all to be in vain, [Page 166] every one proving like a wedge to keep in one another: While after the usual and or­dinary way, Patience, Order, and Quietness, will afford to all an easie egress; by mak­ing these at more distance from the Doors, to wait untill a way be open to them, by the removal of these that are nearest there­unto. So much after the same manner it may be apprehended, that a great and p [...]r­rilous Confusion will arise in the Body fil­led with crude and viscuous Humors, where­by the impulse of Diaphoreticks, they are all carried in Choak toward the superfice of the Body: In which journey the more crude and viscuous Matter lurking in the first wa [...]es, as obnoxious to the first and most valide impulse of the Diaphoreticks is propel­led into the Blood; by which is motion al­ready vitiat or vaccillant comes to be more obstructed: And beside there is also there­by more Matter driven toward the Pores already stoped and distorted, then can be expelled by them; which must be sent back again in the Blood, and from that to the Head and Nerves, where it will act dangerous Tragedies. But to make this Evacuation happily by Diapho [...]eticks, Na­ture and Reason seems to dictat that it ought to be gone about the just contrary [Page 167] way; first by opening the Pores and robo­rating the Fibres, to invite the nearest and perspirable Matter sticking in the supersice of the Body to exhale; then that which is next and mixed with the Blood, by a patent way may be solicited to perspire; and at length if ever happily, the Crudities in the first wayes may be inticed forth by this path with Diaphoreticks.

And it is not to be questio­ned,The hurt of a method directed to a Crisis. but many of the Symp­tomes; and these most dange­rous ones in Fevers, has their rise from the Method and Regimen directed toward the course of a crisis: which will be evident both by pondering what is alrea­dy said, and also if it be observed, how many dangers attend on all hands, in the course of a Crisis, made either by Nature or Art, because for the most part Nature stands hovering with an equal Ballance, whither to determine the Crisis to Life or Death: For often the plenty or tenacity of the Matter, makes Natures endeavours termi­nate either in no Concoction, or in one with­out excretion: But if by hard toyl it ela­borate an Excretion, it is often intercepted by a Funest, or at the least by an Irksome Translation into an other Disease; as by [Page 168] the morbi [...]ick Matters being poured out upon some Noble and Internal part: Whereas the Method of our Noble Author, being free of all th [...]e Dangers and Labyrinths, never tarries on the Crisis; but smothering the Disease in the Egg, suffers it not to run its usual Tragedies.

Moreover, it is here seasona­bly and seriously to be noticed,A difficul­ty answered shewing that this Method agrees with all constitutions of years. by all that will consider the bene [...]it of this Method, that it must not be supposed bounded within the narrow limites of the Fever of one Constitution; and that it doth not enlarge its Jurisdiction and Empyre over all Continual Fevers: For when our Expert Author did at the first draw his sagacious Observations, concerning acute Diseases, from the prototype Nature, he did most properly then impress the variety of Symptomes, and Cures of Diseases befalling several Setts of Years, with the name of distinct Constitutions: Thô the variety and differences of the Diseases of these Constitu­tions seem to import no more but what might depend on the more or less plenty or contumacy of the morbisick Matter, which made its easie or difficult Concoction or Eli­mination: Therefore according to the Me­thod [Page 169] of a Crisis, he levelled in these Constitu­tions, as the genius of that Intention would permit: So it was only the difference of the Cures by way of a Crisis that did with him intitle different Constitutions of these Years.

But in the last Constitution of which he treats in his Schedula, most happily falling on a method that did sure with that constitu­on; and expending it further, he did find it a method that did quite alter all the for­mer measures, and conduct of the cure of Fevers, and consequently his constitutions: and that it was a method which made the practice of the cure to run in an other chan­nel, and which did take up different indi­cations, & passed over the needless & dan­gerous conduct of Nature throw the maze of a crise; As that this method did save the strength of Nature, from a laborious prodigal and uncertain profusion: and was a me­thod that profitably and securely anticipa­ted the crise, he did therefore most rea­sonably judge it, as I received it from his own mouth, that it would agree with all manner of continual Fevers: neither can there be yet any solide experience brought into the field, that will weaken this Conclusi­on, while the daily practice of sundry Physicians offers it self to all that will notice it, clearly establishing the efficacie of this method.

SECT. XIV. The further Helpers in Fevers considered, and how they work and confirm the Hypothesis; such as fixed and volatile Salts, Alcaline and Testaceous Concrets; and also Cup­pings, Leeches, and Frictions. Where­also some Phoenomena of Hurters are consi­dered; as the continual Sweats in Fevers: And the continual lying in bed: And lying with the head much Depressed: For all which, Reasons are given confirming the Hypothesis.

IT remains in the next place to enquire into other Helpers and Hurters in Fe­vers, how they Operate, and if the expli­cation of such Phoenomena can bring any light to the foresaid Hypothesis: And first, as for helpers volatile, and fixed salts, are by the consent of all granted to be very effectual, which altho in the case of a copious fomes they seem not to be [...]afe, yet the clearing how they work, may shew as that they are [Page 171] effectual, so when they are fit: then to answer this it would be noticed, that as the state or crasis of the blood may be vitiate two wayes, so there may be so many wayes stops and bolts put so the motion thereof in­ducing its slowness and making it need more frequent or greater pulses to drive it on to distribution; And first, when the se­rosity of the Blood, endued with due te­nuity serves for a fit vehicle for the globuls, but these globuls are vitiated either by their bulk, number, or in their figure; that is by scabricity, all which vi [...]es severally, much more when they are complicate, makes these globuls stick and stop in the small pas­sages and channels of the vessels; and so bari­cade up the course of the Blood, that there are raised frequent and violent pulses of the heart and arteries to remove them, and carry on the blood. The next fault in the crase of the Blood is, when the due proporti­on in the number, bulk and figure of these glo­buls is kept; yet the tenuity of the serum is vitiated by viscidity; and this fault also makes the Blood slow in its passage throw the small vessels; to overcome which the heart does excite great and frequent pulses likewise; In the first case, where the glo­buls are only vitiated, and the serum intire; [Page 172] the sick are infested and weakened with sweats; Because the frequent pulses drive away the serosity of the Blood out at the pores, (which is called the dissolution of the crase of the blood) leaving the globuls cru­ded up together in the small vessels.

And in this case fixed and Alcaline salts, testaceous and marine concrets, made in sub­tile powder seem much to help, because all these concrets consisting (as is known) of particles very rough, scabrous and rigide, the minutest particles whereof, where ever they go carrying that Figure with them: so then such being mixed with the blood and carryed along with it must necessarly, impinging on the obstructions and scabricities in the small channels, not only scoure and clear them, but likewise by their contin­ual Attrition of the Globuls of the Blood, they must polish and grind these globuls, and make them fit for passage thorow these chan­nels.

As to the other state and crase of the Blood where the Serosity being viscide makes the slowness of the Bloods motion, here as there are no sweats, so it's difficult to raise, & dan­gerous to attempt them.

Before any remedie can be justly level­led for the removal of this fault of the Blood, [Page 173] it must be first inquired in what this viscosi­ty does consist: it seemes then that viscosity being a degree of Solidity and Firmness, and the first step from Fluidity thereunto, and that Fluidity consisting in the actual and due Motion of minutest parts of the Liquors, viscidity then must Import some abatement and diminution, as of their due Fluidity, so of their Motion; And that either from the weakness of the Principle of that Motion or the unaptitude of the matter to receive and obey Impressions of that Principle; As having some glewy viscous matter mixed therewith: But whatever it proceids from, it is certain that the outward or sensible Rest in Liquores that naturally ought to be moved, is a concurring Cause to there vis­cosity, so the agitation of Liquors does alto­gether take off there viscosity; As may be seen in the example of Ale, which being ropie and viscuous is by tossing and agitating th [...]reof in a Bottle closs stoped, soon brought to leave its viscosity: So then the viscosity of the serum of the Blood seemes to be the effect of its want of due motion; And is further a cause to hinder that due motion of the efflux and reflux; And as this visco [...]ity seems originaly to depend upon the serum not be­ing duely Impregnat and Irradiat by the Spi­rits, [Page 174] which do make it diaphanous and subtile; so the want of this irradiation, may depend upon its viscosity, hindering that irradiation, and so as these causes may hinder its due motion; that want of due motion also does exceedingly contribute to its viscosity, and check the influx of the Spirits: And thus e­very one of these are mutually causes and effects to one another. Yet unto these Ef­ [...]ects from whatsomever of these causes they be produced, seem much conducible all such things which give copious Matter to the generation of Spirits; and also which give them being generated also Spurrs; such as are all volatile Salts, which for this rea­son are known to break and attenuate all viscosity: But these are indeed to be used with moderation and warriness in Fevers, least we should spurr faster than we open and clear the way; and so these Spirits too much incited should waken up or exasperat all these Scenes of Confusions and Tumults to which the Blood is very prone under this state.

It is certain, that long experience has found the use of Cuppings, Leitches, and Fri­ctions to be very beneficial in these Fevers: The cause wherereof being enquired into, will also confirm this Hypothesis: For these [Page 175] being used in several places of the Body, as they alwayes are when beneficial, by their raising the Flesh and Skin, they do shake and loose throw all the circumambient parts, that congealed and clotted Blood ob­structing the capillary Veins; which does fa­c [...]litate the arterial Blood to run more easily throw them, and that by clearing these Passages of Obstruction. And for Frication and Rubbing of the Skin, that makes such Im­pressions on the capillary Vessels, by pressing them hither and thither, that it must ne­cessarly force the obstructing Matter into mo­tion again: And moreover the benefit, that even in Fevers, has redounded to some by riding, yea when the Patient was necessitate to be held on Horse-back for a while, can be no other wayes accountable, but by the Impressions that the jogging of the Body makes on the fixed and coagulated Humores, to set them again a going.

Now as to these Phaenomena which are hurtful in Fevers, it is no less certain that these being duely pondered, will also con­firm this Hypothesis, for it is clear that in many Fevers the sick are poured forth all in Sweats; And that without any ease there­by, but rather with great hurt and weak­ening: Therefore as our experimented [Page 176] Author observes these ought not to be in­dulged, but rather checked.

Now this Phaenomenon may be easily sol­ved, by considering that the serosity of the Blood is in this case, by the frequent Pulses squeezed out from the Globuls, whereby the Blood being much thickned, the obstructi­ons are increassed: while Sweats called criti­call and giving ease (which rarely fall out in long and great Fevers: Because these are nourished of a copious and viscide fewel in the first wayes:) fall out in diseases only caus­ed by perspirable matter first attenuat and comminuted and nixt expelled by Sweat, and as this evacuation, is altogether the effect of Nature, so it rarely succeeds happily by stimulating Medicines: Which after its wisely argued, is most reason­bly concluded by Sydenham in his Schedula Monitoria.

And further as our Author observes and dayly experience also confirmes,Continual lying in the naked Bed why hurtful in Fevers it is very much Hurtful to Persons in Fevers to ly continually in the naked Bed: For the continual Heat of the Bed doth exceedingly lash, enervat, and relax the tone and firmness of the pores and fibers; Whereby they shrinke and creep [Page 177] in; And so retain the perspirable matter which ought to be evacuate throw them, and this matter retained recoiling on the Blood does much increase all the tumult and dis­orders there: But by exposing of the Body to a moderat refrigeration by putting on the Cloathes some Hours in the day, the Natural Heat is both Concentrate to expel that perspirable Matter; and the Tone and Firm­ness of the Pores and Fibres are restored to give a free passage to it. And this is very suitable to the Experimental doctrine of Sancto­rius, who finds and Declares reasonably that, the inward heat being by the external heat too much diffused, is not sufficiently Con­centrate, & bended to expel the perspirable matter; as it happens in Aestival heat that is very trouble­some to the Body, not so much because of any vehe­ment Impressions it makes thereon, For every part of the Body is hotter of it self then the external heat affecting it; But because of the detension of the Perspirable matter through the defect of sufficient Concentration of the Internal heat to expell it. And indeed this state of the inter­nal heat does also render i [...] subject to seve­ral indirect and refractive Motions, instead of the direct motion by which the perspirable matter should be sweeped [...]orward, and ex­pelled: so the lesion of perspiration upon these [Page 178] reasons seemes in this case to be amended by the Patients keeping out of the naked Bed several hours of the day, and lying on the top of the Bed with their Cloaths on: And in that Situation rather than the up­right posture of the Body, the vacillant re­flux of the Blood unto the heart is also pro­moved as was shown.

And also as our Author observes,Why hurtful to lye with the head too low. it is hurtful in Fevers and several other Diseases to ly with the Head much depres­sed; it being more conducible to ly with it raised somewhat; because in that posture the lighter & finner Particles of the Blood,De pass. anim part. 1. cap. 10.as Des Cartes thinks are sublimed up to the brain for the generation of nervous Liquor and Spirits; and the grosser and heavier parts are carried by a descent downward: And so in that posture only there is an ascent of the Blood throw the Arteries unto the Head, in so much that the subtilest Particles thereof, prove alone obsequious to the Impulse: And if it chance that any grosser parts mixed therewith, do endeavour likewayes to ascend; they se­cede and turn off at the axillarie Branches: So that nothing but the most sublime parts of the Blood in this posture does ascend, [Page 179] like the subtile Spirits of Wine which are only carried so high, as is fit to separate them from the Phlegm: But when the head lyes level with the Body, and that especi­ally in Sickness, and when the Blood is vitiated in its Particles and Motion; be­cause then and in that posture there is no ascent to the Head, nor descent to the rest of the Body; the grosser parts of the Blood being carried indifferently to the Head do there generate Obstructions: Which must certainly produce all such Phoenomena as are competent to the Brain and Nerves being affected.

SECT. XV. Some Difficulties concerning the Hypothesis Answered.

IF perhaps there remain any difficulty in the mind concerning this Scheme, be­cause it may be thought that the Blood be­ing alwayes first strained throw the narrow Vessels of the Lungs, before it come to have difficult passage in the small Vessels be­twixt the Arteries and the Veins, that it should leave or Imprint some marks of [Page 180] its grosness in the Lungs: To Answer this dif­ficulty it is fit to premise something concer­ning the progress and pedigree of Sanguification: And therefore it may be reasonably thought very likely that the Lungs are not only the Colatory for, and Test of, the Bloods sufficient Attrition and Comminution; but al­so they by their Braying and Levigating there­of, give the same the outmost Perfection and Complement:The manner of Sanguification. which they do by their continual mo­tion and agitation: For their con­traction and dilatation meeting with the Pulse of the Blood coming from the Heart into the Lungs, must necessarly make such impressions on the Particles of the Blood going throw the Arteries of the Lungs, as will attenuate, smooth, and polish them, and thereafter the Lungs sends them thus levi­gated and intimately mixed with the Air back again, and that under the notion and name of Arterial Blood unto the Heart, to be dispersed by it as a Pump throw the whole Body.

And indeed that the Blood receives its outmost perfection in the Lungs, and not in the Heart; As is commonly accounted, is clear from this, that the Blood which is sent from the right Ventricle of the Heart by [Page 181] pulsation unto the Lungs, is nothing diffe­rent from the rest of the Venal Blood; While the same Blood being immediatly sent back to the left ventricle of the Heart from the Lungs, has before it enter the heart, both the colour, consistence, and rarefaction proper to the Arterial Blood; And differs nothing from the Arterial Blood in the Aorta or great artery.

Now in the case of a Fever althô the gros­ser Particles or Globuls of the clotted Blood returning from the Veins into the Lungs, are grinded and levigate over again, and then the Blood gives small token of its fault; Because being so near, it is also under the brisk impressions of the Hearts motion, and also being crumbled by its passage throw innumerable ramifications, and small capillary vessels in the Lungs, while they are like­wayes under a perpetual Systole and Diastole; it is so attenua [...] and grinded that any tend­ency to coagulation or obstruction is soon put off; But yet when such Blood comes to the extremities of great Arteries, where the force and strength of pulsation cannot be propagated in proportion to the Bloods slow­ness, there then it must loyter and stop.

And moreover in some Fevers, which are indeed very dangerous ones, the slowness of the Blood's passage even throw the vessels of [Page 182] the lungs is conspicuous; that always mak­ing high, difficult, & frequent breathing.

And moreover the Blood is also depurate and defecate from its crudities and viscosities by its passage through the Lungs; And so by their taking care of the whole, and en­deavoring to repair the faults of the other functions they smart for them, and be­come the Seat of many Diseas [...]s themselves: for that same viscosity and grosness of the Humores does frequently make blemish­ing Impressions on them, by obstructing & tumefying their glands, many of which obstructions are shaken off by the force of respiration, but not always. For althô the Mo­tion of the Systole and Diastole of Lungs, con­trarying alwayes the direct Motion of the Blood in the vessels of the Lungs must subti­lize & attenuat the Blood; So that it stickes not easily in the Channels of the Lungs: yet often the fault of the former functions is so deep ingrained, that the Blood sent here can­not be sufficiently attenuated, and the crudi­ties and viscosities expelled by the glands of the Lungs; But does obstruct and tumefie them; And breeds that disease called P [...]hisis, or Comsumption of the Lungs: Now this Disease being of as universal extent among Chronick Diseases, as a Fever is among [Page 183] acute ones; is most Learnedly treated by Dr: Morton in his Pthifilogia: But alas! as he wisely observes, the Practise in this Dis­ease is rarely attended with success; For this reason that the Disease steals on the Patient unawares; And before he pe [...]ceives he is irrecoverably taken with the Distem­per; It is then hoped, it will be thought no impertinent or useless digression, if to instruct every one against the surprize of such a remediless attack, there be trans­ferred here from his work, which is in La­tine, such apposite signs, as may admonish every one of the aproach of that Disease; and put them upon their guard in case of imminent danger, to pr [...]vide the timeous help of a faithful and skilful Phy­sician. The first sign he gives is, The signs of an ī [...] ­minent Consumption given by D Morton. The Descent from Parents that have been Pthisical: For this Disease seems most hereditary of all Distempers. (2) An evil frame of the Breast, whether na­tural, or a [...]cidental; and that is either narrow or strait. (3) A small Voice and H [...]low. (4) White and soft Skin, with a thin habit of Body. (5) A soft and Phlegmatic [...] habit of the Muscules.) (6) Oppression or Weight in the Breast. (7) Thoughtfulness, anxiety, sad­ness, and anger without a manifest cause. (8.) [Page 184] The Suppression of usual evacuation by Issues, old Ulcers or any other usual. (9) Spitting of Blood. (10) A continual haughing of Viscide and black plegm in the [...]orning. (11) Salt or sharp phlegm haughted up. (12) A pronness to copious evacuation of spittle, either with or with­out an evident cause. (13) An continued and increasing prostration of appetite without any other Disease accompanying it, and with oppression of the Stomach, and Spontaneous La [...]itude in time of digestion. (14) A Troublesom and continual Heat especially in the Soles of the Feet, and Palms of the Hands, chei [...]ly after meat with a Pulse something too frequent. (15) A shortness of Breath with difficulty of respiration. (16) A great disposition to the Cough, which is brought on frequently, either by a slender or no evident Cause at all, which is the most evident signe of an imminent Pthisis. And the more of these signes there be, the more still is the danger.

Now this Disease having alwayes a Fever accompaning it,The Phaenome­non of the Fe­ver in a con­sumption con­firmes the Hy­pothesis. and that with an exacerba­tion some houres after Meat answering exactly to the time when the Chyle comes to the Blood, doth also confirm the foresaid Hypo­thesis of Fevers: For the chyle coming with the Venal Blood unto the Lungs to receive [Page 185] there its attrition and perfection; While they are affected with obstructions and tumors in [...]heir glands, that must be superfic [...]ally done; And many of the Particles of the Blood do therefore return back to the Heart without sufficient elaboration, which coming to the small Channels o [...] the Arteries betwixt them and the veins, pass there also with difficulty: So that to distribut the nourishment a f [...]e­quent Pulse is raised, until the Particles, by often passing that way, be yet farther polish­ed & attenuated: And so passing with grea­ter ease the Fever and Pulse is remitted.

If any shall yet judge that this grosness of the Blood should be rather productive of tumors and inflamations, Another diffi­culty about the supposed Hypo [...]hesis an­swered. then of Fe­vers: It is to be considered that Fevers and Inflamations have that common to them both, that they use to be generate together: And also Fevers do depend on tumors & inflamations, which shews they are near of Kin to one another: but yet they seem to differ in this, that Fe­vers depend on an universal, altho lesser grosness of the Blood, which makes it with difficulty pass the small vessels; and tremors depend as upon greater grosness, so upon to­tal obstruction of the Blood or other Liquores [Page 186] in some particular vessel; And oftentimes they are generate and propagate by com­pression: And perhaps it is the perverse fi­guration of some particles of the Blod, or humours in respect of the Pores and Chan­nels of a vessel, which wholy stoping makes a total stagnation therein: and this stagnation making a compression on the neighbouring vessels, and these again upon the next ad­jacent, affects them all with stagnation like­wayes. And thus that obstruction that be­gins in a point, may have the sphere of its activity so extended as to infect all the neig [...]ouring parts with that tumour, as is seen in a Thorn which pricking the Flesh do [...]s compress the next adjacent vess [...]ls, and makes the Blood to stagnate therein; And they again compressing these nixt to them, produce therein the like effect; And so forth until the compression spend its Im­pression & force. Now in this case these Tu­mors being made of the Blood and Humors. That should slip throw the Channels when they do stop & coagulate there the humors are again set a going by the use of these things that add Spurrs to the Spirits and attenuate viscosity, such as volatile Salts, and also by such things as grate and grind gross Humors [Page 187] such as fixed salts, &c. which internally used are all dissolvers of tumours. And farther▪ as we find that the impurities which do cleave to garments worn, called sweatiness, and which being bred of the perspirable matter sticking there, do yield to nothing but smegmatique mixtures, so the coagulations therefrom within the body may yeild to such internally used.

And indeed it seems that there is as much forcein the grosness & viscosity of the humors, & obstruction depending thereupon as will produce not only Fevers; but the most of all chronick Diseases also: But that the va­rious faces with which Diseases appear, pro­ceeds as from the Deg [...]ee of grosness and ob­struction, and from the nature of the place or organe aff [...]cted therewith; so from the im­pression that is thereby made on the impel­lent or the disposition of the Body, exciting either resentment and irritation; or only grief and languishing; And altho in Fevers from the present disposition, the impellent is for the most part irritated, and strives to shake off the cause of the malady; yet in chronick Distempers, from another disposition, it is less commoved, and rather groans under, then resents the invasion and oppression; And these d [...]fferent effects from the like occasio­nal [Page 188] cause in the natural body, are paralelled by the like different consequences springing from the same occasional causes in the body politick; For Tyrrany and Arbitrary Govern­ment exercised upon a Heroick and Generous spirited People; uses to beget War; but all the impression it makes on a servile and de­spirited Nation, resolves only in languishing and depopulation: And the parallel may be yet carried farther, for as tyrrany & oppression of a People is often shaken off by civil Wars; and they thereby brought into a vegete and flourishing state; so Chronick distempers in the natural body, are often loosed by a superveen­ing Fever, and the body thereby is brought into a sound and healthy condition.