A DEFENCE OF Dr. Oliphant's SHORT DISCOƲRSE Of the USEFULNESS of VOMITING in FEVERS, In ANSWER to The Melius inquirendum, &c.

[...]n a LETTER to a Friend.

Maledicus a Malefico non distat, nisi occasione.

Quintil.

EDINBURGH, [...]rinted by J. W. for Thomas Carruthers, and sold at his Shop in the Parliament [...]loss, Anno Dom. M.DC.XC.IX.

Sir,

YOur Surprise was but equal to my own, when you saw the Answer to Dr. O's Discourse about Vomiting in [...]evers; the passing over his Reasoning with seeming Negligence, and the Wresting [...]nd Suppressing his Quotations, were but [...]ch Replyes as the Dr. expected, seing [...]here could be no other: But the Represen­ [...]tion of the Matter of Fact is so grosly false, [...]nd doth so consist with my own Know­ [...]dge, that I thought my self, in Justice and [...]riendship, obliged to make you and the [...]orld acquainted with it. And here I shall [...]ot insist on the Dr's own Assertion, which [...] you and me who know him, will go fur­ [...]er than that of the Answerer. But a [...]entleman of Undoubted Credit, who was [...]y when the Dr. was first called, told me, [...]hat when he proposed Vomiting to the Pa­ [...]ent, he so far disowned the getting of se­ [...]eral Vomits before, that he told the Dr. he [...]as sure it was the only thing would do him [...]ood, and that he was sorry he had not cal­ [...]ed him sooner. And for the Answerer's Ap­ [...]ealing to the Apothecary's File, by which, [...]e says, it is manifest he had been Vomited se­eral times, tho I had heard Mr Montelth, [Page 4]whom the Patient employed as such, open­ly affirm the contrary, yet I could not ima­gine any Man would be so Bare-fac'd, with­out some Ground, so that to be fully satis­fy'd, I went with the Dr. to the Shop, and not only saw the Ordinary's Bills, but got a Copy of them written by the Apothecary's own Servant, and Attested by him and his Master who was present, to be the only had been ordered before the Dr. was called▪ They are as follows.

July 12. R. Decoct. Com. pro Clyst. Lib. 1. In Colat. dissolv. Elect. lenit. unc. 1. semis. Mel. Merc. unc. 1. Sal. Prunel. dr. 1. F. Clyster.

R. Amygd. d. exc. no. x. sem. 4. frig. maj. a dr. 1. pap. alb. dr. 11. cum s. q. Aq. Font. F. Emulsio, ad lib. 1. In Colat. dis­solv. sach. cand. Aq. Cinam. a. unc. semis.

July 13. R. Decoct. amar. cum dupl. senna. unc. 4. in Colat. dissolv. sal. absinth. dr. semis. F. potio. And each of these was once repeated.

And except the Answerer call Vomits an [...] Emollient Clyster, an Emulsion and the bit­ter Decoction with two Drachms of Senna, which is more proper for allaying of Vomi­ting than provoking it, there was not so much as the Vestige of any other.

The Dr. did not think these worth mentio­ning in the Account he gave, because they were no way proportioned to the Greatness [Page 5]of the Disease, and what he had mentioned were the Remedies mostly insisted upon, and he said very justly, a Man might as reaso­nably expect to take a Fort with no better Artillery than Pen-guns, as to think to make such Evacuations as were evidently necessa­ry by such Ineffectual Medicines. These Frightful Symptoms as want of Pulse, Spasms, &c. which we are told in the Answer, fol­ [...]owed the taking the Vomit ordered by the Dr, are as false as that the Answerer had given one himself. And the Dr. was so far from being in any great Apprehension of Danger, that it was not his own Motion to call any other Physician, it was done to comply with the Desire of the Gentleman's own Lady, who had too near a Concern to be a proper Judge in the Affair, and who, without any Wonder, might be allarum'd, when the Life of so kind and deserving a Hus­band seem'd any way in Danger; When that other Physician and the Dr. came toge­ther, they found him in so Soft and Sound a Sleep, that they stayed a considerable time, before they would disturb him, so far was he from that low Pass the Answerer brings him to. And to vindicat what these two Gentlemen thought proper to be done after­wards, against any Reflections made by the Answerer, I think it is at least sufficient to [Page 6]oppone their joynt Opinion against [...] single one. As for the Dr's leaving the P [...] tient before he saw the Effect of the Vom it is of the same Piece with the rest, sei [...] he was actually by him most part of all th [...] Day. That this is the true Matter of Fa [...] any Man who will give himself the Troub [...] to enquire may be satisfied, either from t [...] Apothecary, or the Gentleman himself, these who were Assistants. But it is no wo [...] der the Answerer had nothing but false C [...] lumnies to stuff his Paper with, or you kno [...] Stultorum Thesaurus Maledicentia.

Amongst the other Slanders he asperse the Dr. with, there can be none more M [...] licious than that of calling him a Banterer Scripture, and saying it was a Syrophenici [...] Story; which you and my self, and othe [...] who ever discoursed him on that head, kno [...] to be so false, that we have all the Reason the World to think the Dr. does more firml [...] and upon more solid Grounds believe tho [...] Sacred Truths contained in Scripture th [...] any of his Accusers do: But it is easie to d [...] cover the base Motives of some People [...] dispersing such Calumnies not only of him but of others who, I believe, are equally Innocent. But I shall wave all this, and ma [...] hast to the Answers given to the Dr's Re [...] sons and Authorities.

And First, He passeth over the Dr's own [...]easonings, by tellling he grants all; and [...]hat the Dr. Discourseth concerning Blood­ [...]ng before Evacuations; he says concerns [...]vacuations in general, and so leaves them [...]s he found them. I have nothing to reply [...]o that, but refer you to them again; only [...] cannot understand what he means by Eva­ [...]uations in general, seeing the Dr. is speak­ [...]ng plainly of Evacuations in continued Fe­ [...]ers, when the Stomach and Primae viae are [...]vercharged with Choler and other Hu­mours. I come next to the Authorities.

The Dr. had made an evident Conse­quence from two Aphorisms of Hippocrates, which may be reduced to a plain Sylogism, [...]hus, When Humours are to be Evacuated, let [...]t be done the way that Nature affects most, (i. e. [...]f there be an Inclination to Vomiting by Vo­miting) but in very acute Diseases, let the Hu­mors be Evacuated that same day, if the Matter is turgid (which is any day so long as the Matter is turgid.) Ergo. Now, To overturn this, the Answerer brings another Apho­ [...]ism, which proves that Hippocrates was a­gainst Vomiting in Fevers, which the Dr. [...]ad obviated by acquainting us that Hippo­crates knew no Effectual Vomit could be safely given in any case. This is answered by calling it Stuff, though it be the very [Page 8]same thing Fernel says. The Dr. had also taken notice, that the Fevers in those Climat [...] and Times were far from what we now have which has made several of these Aphorism in acute Diseases, which either were not understood, or not to be followed in Fevers which did not agree with these Hippocrate [...] had observed in any thing but the Name do so much harm in the Cure of Fevers. cannot pass over what Dr. Tournefort says o [...] this head in his Learned Preface to the History of Plants about Paris. Deux ou trois lignes, says he, mal expliquées d' Hippocrate out coûté la vie a des millions de personnes Depuis le renouvellement des lettres les Mede­cins qui ont eu le plus d'erudition & qui se son [...] piquez de bien entendre la Doctrine de ce gran [...] homme, se sout retranchez a ses maximes le [...] moins assurées, & ont tout a fait negligé la ma­tiere medicinale dont il se servoit. Two or three Lines of Hipprocrates ill Explained, have cost a Million of People their Lives. Since the restoring of Letters, Physicians who have had the most Learning, and who have valued themselves on the right Un­derstanding, the Doctrine of that great Man▪ have laid aside such of his Maxims as were the least certain, and have quite neglected those Medicins he used, by reason as he adds afterwards, they were too violent.

Next, he comes to Celsus, and tells us [...]hat the Authority the Dr. brings from him [...]s, concerning intermitting Fevers; to prove [...]he contrary of which, I shall only insert the Quotation again with the Answerer's Additi­on. Vomiting, says Celsus, as in perfect Health it is often necessary for such as are Cho­ [...]erick, so it is also in these Diseases which are [...]ccasioned by Choler, what the Answerer [...]dds from the Author, is, Ergo omnibus qui [...]nte febres horrore & tremore vexatur. &c. [...]ecessarius est, in English, therefore it is ne­ [...]essary to all who are troubled with Chilness and shivering before Fevers, whereby it is evi­dent he is speaking of putrid continued Fe­vers, which do most commonly Invade that way, and which by no means can be said of Agues which have that trembling and Chil­ness through their whole Course. However, [...]hat you may not be in a doubt about Celsus's Opinion, the Dr. quotes Cap. 7. lib. 3. De Cu­ [...]atione febris ardentis, of the cure of a burn­ [...]ng Fever, where he orders positively Vo­miting in the height, and cautions it not to be done before the Fourth day, si pituita, [...]ayes he, in Stomacho coiit, inclinata jam ac­ [...]essione, vomere cogendus est, and afterwards, Cum vero in summo incremento morbus est, u­ [...]lique non ante diem quartum, magna siti ante­cedente, [Page 10]frigida aqua copiose prestanda est, u [...] bibat etiam ultra satietatem; & cum jam ven­ter & precordia ultra modum repleta, satisqu [...] refrigerata sunt, vomere debet. Take notice here that Celsus useth the word Accessio in a [...] continued Fever, which solves the Objecti­on the Answerer has to Fernel's Authori­ty. The Dr. had told in his Discourse, that Celsus used such Vomits as the Answerer sets down, and gives the Reasons of it, which [...] need not repeat.

What he objects against the Quotations of Fernel and Plater, I shall briefly discuss. He says Fernel speaks in that first Citation the Dr. adduceth, only of intermitting Fe­vers; on the contnaty he is treating of all these which are attended with redundancy of Choler and other Humours, which all of 'em have sensible remissions and Exacerbations, which is what he means by the Accessiones, and such are almost all the Fevers we com­monly have among us. He hath nothing to say to the other Quotation, but that Fernel speaks there only of Purgatives, which the Dr. brought as an Argument a Majori; for he had told before, That the Ancients used these, because they knew no effectual Vomits which were safe, but used Purgatives, not­withstanding of the vast Commotion they make in the whole Juices of the Body beyond Vomi­tive [Page 11]and Laxative Medicines, such was the force of the Indication. That Plater used on­ly these Vomits, the Answere speaks of, is no wonder, seeing he knew no other; but to be obstinatly addicted to such now after the discovery of the many Excellent and safe Preparations of Antimony, is truely to be such a one as the Answerer speaks of, whom Experience is never to make Wiser.

Etmuller by his own Confession approves of Antimonial Vomits in all Fevers, and ad­heres to Sydenham. Now, to let you see it was not from him he had it, but from his Master Johannes Nichael, whose Practice he strictly followed, Preceptoris sui scripta (speaking of Etmuller) in adornanda praxi pro norma fere atque Cynosura habuit, successu certe felicisimo, says the Prefacer to Michael's Works. In which Cap. 3. De febribus Patridis in genere. He says, Vomitoria optima sunt ex Antimonio: Nam Antimoniatis radicitus hoe febres extingui Pos­sunt, and quots Hartman, whose practice hath been very much esteemed, and who Cap. CCXXXV. speaking of two Prepara­tions of Antimony, whereof the one is for Vo­miting, and the other for Purging, adds Utervis autem pulvis, justa dosi exhibitus, me­detur febribus tam intermittentibus quam con­tinuis.

Willis he ownes gave Vomits in Fever but not after the fourth Day, I know n [...] what way he can prove this, seing Willis far from saying any such thing. It's true, that Observation the Dr. mentions, the V [...] mit is given the fourth Day, but that do not say, but he might have given it later the Indication had continued. But here ta [...] notice, that the Answerer speaks not o [...] Word of that Vomit Quoted by the Dr, whi [...] Willis gives to a Slender Weakly Woma [...] which is the precise Quantity of Emeti [...] Wine the Dr. gave, because it was to ma [...] both Willis and Sydenham guilty of giving Quadruple Dose. And here it is lucky for th [...] Answerer his Patients are not much acquainted with the Doses of Medicines, otherwi [...] they might easily understand what good the [...] were to expect from one who is not ashame [...] to owne that two Drachms of Emetick Wi [...] is a sufficient Dose for any thing above fiv [...] Years of Age. The Dr. indeed added to h [...] a very small Quantity of a Gentle Purgativ [...] by which he designed chiefly to make th [...] Operation of the Vomit both Easie and Saf [...] and that this is not only his, but the Practic [...] of the best Physicians, he gives the Authority of Dr. Tournefort in the forementione Preface, where speaking of what the Brea [...] and Organs of Respiration suffer in the tit [Page 13]Vomiting, goes on, C'est pour cela que les [...]s habiles Medicins se sont avisez sagement [...]mesler en plusieurs rencontres les Emetiques [...]ec les Purgatifs, pour eviter une partie de vio­ [...]tes Secousses que donnent les Emetiques, et pour terminer les matieres a sortir par les deux [...]uts. It is for that Reason, says he, that [...]e most Skilful Physicians, have wisely jud­ [...]d it convenient in many Cases, to mix [...]omitive and Purgative Medicines together, [...]t so they might prevent a part of the vi­ [...]ent Concussions which Vomits occasion, [...]d to make the Humors come forth as well [...]wnward as upward.

The Authority of Sylvius is too particular be well Answered, therefore he passeth over, by telling that Sylvius speaks only Fevers in general. Whereas he says pat­to the Matter in Hand, In Fevers, when [...]e Gall works up, and is too plentiful, Vomi­ [...]g and Purging by Stool are chiefly conducible, [...]d afterwards positively prefers Antimonial [...]mits to all other.

I am now safely come to Dr. Sydenham, [...]d if he don't make the Charge good, I shall content both the Dr. and I quite the Field. [...]e Answerer pretends, That these conti­ [...]ed Fevers Dr. Sydenham treats of, which [...]ged four Years together, viz. 61.62.64. and were accompanyed with an In­clination [Page 14]to Vomit, were successfully Cure by Vomiting, but in the Fevers which fo [...] lowed in the 65, tho attended with the sam [...] Symptoms, that Vomits had the contrar [...] Effect. Now to confute this, I shall onl [...] adduce Sydenham's own Words, whereby [...] shall plainly appear, that what he had said [...] Vomiting in that Quotation, he design'd fo [...] a General Method in most of their Fevers which, as the Dr. had taken notice of, wer [...] the same precisely we usually have amongst u [...] That Fever which broke out in the 65 an [...] 66 the Answerer speaks of, was truly th [...] Plague, and is by Sydenham called Febr [...] Pestilentialis & Pestis, and was quite different from these ordinary continued Fever he had observed before, and because Vomiting had not the same Success in that, as i [...] the preceeding Fevers, he concluded it to be of an extraordinary kind. I shall ad [...] his own Words. After he tells he ha [...] given a Vomit to a Lady seized with one [...] these Pestilential Fevers, he adds, Pag. n [...] 95. Postero mane, cum aegram iterum adirem ei alvum profluere intelligo, quae res, ab alquot annorum usu insolentior visa, mihi non l [...] vem sollicitudinem injecit. Exinde autem Febre [...] non vulgaris generis esse judicavi (quemadm [...] dum etiam eventus docuit) Proindeque aliam a [...] ­ea, quae superius tradita est, quaeque constanti sucessus [Page 15]serie hactenus a me usurpata fuisset, meden­ [...]li rationem sibi vindicare. Next Day, says he, when I Visited my Patient, I understood she [...]d a Looseness, which, by the Experience of [...]eral Years, seemed somewhat Unusual, and [...]de me not a little Anxious. But from [...]t I concluded, it was not a Fever of an [...]dinary kind (which I was also taught by [...]e Event) And therefore, that it required [...]other Method of Cure different from what have given before, and which, by a con­ [...]ant Tract of Experience, I had found suc­ [...]ssful. From which it is plain to a Demon­ [...]ation, That he had laid down that Method Vomiting, as a General Rule in the Cure the most usual Fevers. And for his using [...]gatives afterwards, that he also did on [...]he Account of a New Fever, he had never before observed, as the Title of that Schedule [...]hows, which he calls Schedula Monitoria de Novae Febris Ingressu, and in the very begin­ning tells the Occasion of his Writing that Schedule. Populare scilicet meos admonens, says he, de subingressu Novae cujusdam Consti­tutionis, a qua pendet Febris Nova Species a [...]uper grassantibus multum abludens. It was to advertise his Countreymen, of the coming [...]n of a certain New Constitution, from which [...]d depend a New Sort of Fever, very far [...]ifferent from these which raged formerly. [Page 16]And in Effect, that Fever was a Sort of Peripneumonia Notha, as is evident from the Schedule.

But last of all, the Answerer enters into a Confederacy with his sworn enemies, the Mathematicks to defeat the Dr. and fo [...] that makes use of Dr. P's Dissertation of the Cure of Fevers by evacuation, wherein tha [...] Gentleman, after comparing the Cutaneou [...] Perspiration or sweating with the other E­vacuations, concludes, That if the Morbi­sick matter to be evacuated be actually mix­ed with the Blood, and circulating in the Blood-Vessels, it will be Ten times soone [...] done by Sweating than Purging: Whereas Dr. O. is supposing a great deal of the Few­el of the Fever stagnating in the Cavity o [...] the Stomach and Intestines, and of the Use­fulness of Evacuating that timeously by Vo­miting, which otherwise would mix with the Blood, and put us to the necessity o [...] Diaphoreticks to do our best to save the Pa­tient's life: But that Dissertation it seems h [...] understands as well as the other of Dr. P [...] Writings.

He Answers nothing to that Quotation the Dr. brings from Dr. Tournfort to prov [...] that the French Physicians had changed thei [...] old way of treating Fevers, for that of g [...] ing Antimony, and other the most violen [...] [Page 17]vacuating Medicines we know. I shall on­ly add, That to my certain Knowledge, it is so far the Practice in England of their best Physicians, that they are not contented to give Antimony Infusion, such as is the E­metick Wine, but give the Emetick Tartar, which is Antimony in [...]ubstance, and which operats a great deal more violently, and that on any day of the Fever, if the Indication continues. And I have frequently heard the Dr. tell, That when he was at Oxford, he knew some of the most famous Physicians there give strong Vomits towards the very last period of the Fever, to wit, when the Lethargick, and Comatous Symptoms were look't on as the Immediat Fore-runners of Death, and that sometimes with surprising Success.

I shall conclude with this, That I'm sorry the Dr. should have been so unluckily engag­ed to enter the Lists with one wrho had no­thing to oppone to his plain Reasons, and irrefragable Authorities, but malicious Ca­lumnies, and Ungentlemanny Scolding, sa­vouring altogether of the Lee of the People and mean Education; which he thought as far beneath him to Answer, as to retort. I [...]m.

Sir, Yours, &c.

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