Part 10

℞ _Rad. liliorum alb. +℥ ij.+ porrorum, medullæ carnis ficuum ana +℥ j.+ sem. lini +℥ [ss.]+ flor. Sambuci, meliloti ana p. +[ss.]+ micarum panis alb. +lib. [ss.]+ coq. in s. q. lactis, addendo sub finem ol. ros. liliorum alb. vel sambuc ana q. s. ut F. +Cataplasma+._

Or,

℞ _Fol. Scabiosæ, acetosæ ana +M ij.+ chartâ bibulâ involut. & cineribus scintillantibus subditorum, quibus adde fermenti veteris +ʒ ij.+ salis tantillum, agitentur probè in mortario cum s. q. axungiæ suillæ, ad usum præmemoratum._ But that I may not be too tedious in reciting particular Forms of this Kind, any necessary Variations are left to the Discretion of every Physician in his own Practice.

WE do not wait for the Suppuration of a Buboe until it breaks of it self, when the Pain and other Symptoms continue very severe without Remission; besides, there would in doing so be Danger of wasting the Spirits too much, and letting the morbifick Matter retreat, besides the Smalness of the Orifice, which when they open themselves, is seldom large enough to give due Vent; we therefore open them by Incision, or to prevent Mortification, by a potential Cautery; and for the same Purpose it hath also been many Times found reasonable to mix the milder Causticks with Digestives.

YET although common Experience attests to the Advantage of Cataplasms, as they wonderfully cherish the languid and almost extinguished natural Heat, supple the neighbouring Parts, relax the Skin, and contemper and asswage sharp Humours; yet, I say, because their frequent Repetition is sometimes on many Accounts inconvenient and disagreeable, I used to substitute the following _Cerate_ in their Room.

℞ _Emp. Oxycrocci +℥ iij.+ galbani colat gum. curannæ ana +℥ j.+ picis navalis +℥ ij.+ è liquatis simul. cum ol. chamemeli, & liliorum, v. a. e. F. massa pro empl._ And I am bold enough to affirm, that with this I have prevented the Want of a Surgeon in more than a thousand Instances: But when a Buboe is artificially opened, it is the most proper to do it in some depending Part of the Tumour; taking Care not to wound the larger Vessels and Muscles.

BUT whether a Buboe breaks of it self, or is opened by Incision, it is to be washed and cleansed with a _Lixivium_ of _Ashes_, _Scordium_, _Betony_, _Bugloss_, _Sanicle_, &c. in which also is dissolved some _London Treacle_: And the following Mixture I have found very good for this Purpose, consisting of _Birthwort Root_, _Myrrh_, _Aloes_, and _Saffron_, infused in _Spirit of Wine_, and to the strained Tincture, adding a little _Oil of Turpentine_. Furthermore, to promote Digestion, and prevent Putrefaction, the following may be applied:

℞ _Mellis ros. +℥ i.+ terebinth. cum vitello ovi solut. +℥ [ss.]+ theriac. Lond. +ʒ iij.+ farinæ tritici +℥ ij. [ss.]+ cum ol. hyperici & sambuc. ana q. s. coq. in Cataplasmatis consistentiam._

Or,

℞ _Ung. basilic. p. duas, linimenti Arcæi p. Tertiam, ol. terebinth. +ʒ [ss.]+ M. S._ But here it is to be observed, that Detergents are by no Means to be used, unless the Ulcer is foul; as also that to appease the Enormity of Pain and Inflammation, by Opiates and Repellers, is a most pernicious Practice, because it drives back the Venom upon the nobler Parts; and also by their frequent Continuation, is a Sphacelation endangered upon the Extremities.

THESE Ulcers are likewise by no Means to be healed up until they are well cleansed, and all the pestilential Symptoms quite disappear. But here I cannot but remark, that these Ulcers do heal much easier than any other when the Venom is fully conquered: And in the Cure, it chiefly concerns the Surgeon to prevent the Lips growing callous, because sometimes that Error is not easily again remedied; when the Ulcer is well cleansed, the ordinary _Sarcoticks_ used in the common Method will soon fill up the lost Substance: To prevent Repetition, the _Parotides_ are to be treated after the same Manner as Buboes.

AFTER this transient View, our Method now brings us to the Cure of Carbuncles; since therefore these Eruptions have their Rise from a pestilential _Lixivium_, thrown upon several Parts of the Body, and there burning them into an _Eschar_, the Business of a Surgeon herein is directed to three main Intentions.

1. THAT the Carbuncle does not spread too far, like a Gangrene, knowing no Bounds.

2. TO bring it as soon as possible to a Separation; and,

3. TO cure it as carefully as it can be done.

FOR the first Intention, such Remedies are suited which give a Restriction to the Part, so that the venomous Particles cannot spread; and such also as asswage the distempered Heat, and cherish and preserve that which is natural.

BUT the Cure of a Carbuncle is varied by its Nature, Progress, and Situation; and is accordingly to be treated sometimes with more, and at others with less Severity. In this Case Benefit is sometimes received from a Cataplasm with roasted _Garlick_, _Soot_, _London Treacle_, and _Oil of Turpentine_; Or,

℞ _Fermenti veteris +℥ [ss.]+ allii assati +℥ ij.+ stercoris columbini +℥ j.+ confec. Sinapi +ʒ v.+ euphorbii +ʒ ij.+ cum s. q. saponis nigri F. Cataplasma._ But it is to be observed, that in the Application of these Cataplasms, which are very sharp, the utmost Caution must be used, that a Pain is not aggravated thereby beyond the Patient’s Power to bear; that the Humours be not colliquated, and thrown upon weaker Parts; and that an immoveable _Eschar_ be not made thereby.

WHEN the _Eschar_ does not fall off, nor any Signs of Separation appear, Unguents and Oils are not to be blamed; but if the Carbuncle spreads further, it will be necessary to have Recourse to more effectual Means; in which Case neither the Tenderness of Sex or Age is to be regarded. Sometimes the pestilential Venom is to be drawn out by Cupping, or Scarrification, or _Epispasticks_: Sometimes also for the same Purpose is applied the bare Rump of a Fowl, repeated until these Creatures appear not to be hurt by it; for this natural Warmth sooths the vital Heat of the Part it is applied to, and entices away the morbifick Venom through the Pores; Pidgeons used alive, and warm Sheeps Lights, have likewise been observed thus to asswage the Acrimony of this pestilential Virulence.

THE _Eschar_ is sometimes got off by burning, and sometimes by Incision; I never indeed found any thing more effectual than the actual _Cautery_; and in this Practice of ours we differ not from the celebrated _Concoregius_, who tells us, _pag._ 39. that in his Time they were wont to burn the Carbuncle with a red hot Iron. There are very convenient Instruments amongst the Surgeons for this Operation, which they call the _Button_, being so shaped; but they are of little Service, except the Burning extends to the Compass of the Eruption; and the Iron is by no means to be taken away, until the Patient is sensible of it; but to get off the _Eschar_, the middle Part must be burnt deepest.

AMONGST many other Advantages, I shall mention but a few that are received from the actual _Cautery_ in these Cases; for from hence the Parts affected are rendred more firm and strong; hence the Vessels are more astringed; hence the subtil _Miasmata_ are rarified and evaporated; hence the Poison is corrected and dried up; and lastly, hence the languishing Heat is quickned; and, not to use many Words, the pestilential Venom seems to be destroyed by Burning, no otherwise than the Bites of poisonous Creatures are cured after the same Manner.

AS for what is done by the Knife, the Infected are certainly as much benefitted by it, as by the actual _Cautery_; especially if the Incision be made deep, and goes to the Root at the Centre; for by this may be made a very expeditious Elevation and Separation of the _Eschar_; and this Means is more particularly to be used where a Gangreen is threatned; but in doing it, great Care must be taken, as before hinted, that there is not made any Effusion of Blood by cutting the larger Vessels, especially the Arteries.

BUT when this Separation is once finished, whether it be by a Knife, or by Burning, or of its own Accord; the next thing is to peal it off; and this is frequently assisted by moistening it with new Butter, Oil of _Elder_, or Oil of _Lilies_. The _Eschar_ is likewise to be loosened gradually, and not too hastily; that is, a kind of Maturation is to be waited for. After the Carbuncle is fallen off, Care must be taken to cleanse away the _Sordes_ upon it, and promote Digestion by the Use of suitable Applications; and every thing else carefully managed, as before directed in the Cure of Buboes.

LASTLY, Incarning is gradually to be effected, and the Ulcer slowly healed over; for by being too hastily closed, it is not uncommon to find some pestilential _Miasmata_ lurking behind, which afterwards prove mischievous, and often fatal, as may easily be gathered from a preceding History, and many others not here mentioned.

BUT because sometimes the Parts where Carbuncles arise, cannot be cleansed conveniently from the morbid Humours, whence the Cure proves slow, or cannot be effected at all, the circumjacent Parts at first should be guarded by Defensatives, which would astringe the Laxity upon those Parts, keep the Passages clear, and give Room for the due Motions of the Juices and Spirits, while at the same time they prevent the Exhalation of the natural Heat; But if notwithstanding the utmost Care, Sphacelation comes on, immediate Recourse is to be had to Embrocation, with the following.

℞ _Cinerum absynthii, scordii, cardui, centaurii min. ana +℥ iij.+ è quibus paretur lixivium, indendo flor. chamemeli, sambuci, meliloti ana +M j.+ liquoris limpidi +lib. ij.+ adde spir. vini opt. +lib. [ss.]+ dissolve theriac. Lond. +℥ ij.+ M. S. pro fotu p. affectæ bis de die, quàm caladissimè, exin Cataplasma conficiatur è theriac. Lond. cum Elix. proprietatis_.

LASTLY, To put an End to this Section, wherein to prevent prolixity, I have studiously avoided all Points of Controversy; I cannot altogether omit the Mention of those skilful and faithful Surgeons, with due Honour, whose Task in this raging Calamity was very hard and dangerous, how they had the Care of all pestilential Tumours and Ulcers, _&c._ But although some of these fell themselves in the Discharge of their Duty to others, yet the Survivors went on chearfully in their Business; and they who lived through the whole, owed a great deal to a Constancy of Mind, as well as to the conservatory Power of Providence.

SECTION VIII.

_Of Preservation from a Pestilence._

IT is manifestly much more adviseable to keep off the Invasion of a Pestilence, than to stand its violent and fatal Shocks; and Self-Preservation, as well as the Example of all other wise People, admonishes us to use all possible Endeavours to keep it from us, and guard our selves against it while at a Distance. This Part therefore concerning our Preservation from a Pestilence, regards both the Duty of the Magistrate, and the Care of every Individual; that is to say, it is the Magistrate’s Duty, that when the Nature and peculiar Qualities of this Disease are known, and reported by Physicians, such Laws should be provided, as might best conduce to prevent its Spreading, if not to its utter Extirpation.

_FIRST_ of all therefore, they ought to be deemed as a kind of Traitors, who frighten the credulous Populace with the Apprehensions of an approaching Plague, by idle and groundless Reports and Predictions; for the Propagation of the late Sickness was too notoriously assisted by this Means, to want any Arguments to prove it.

THE timely Separation also of the infected from the well, is absolutely necessary to be done; because the most sure Way of spreading it, is letting the sick and well converse together. Publick Funerals ought to be forbid, as also all kinds of Meetings, and frequent Intercourses of several Persons together: An Injunction also of Quarentine from infected Places, according to the Custom of Trading Nations, is by any Means not to be omitted, and carefully to be executed.

ALTHOUGH it is looked upon as almost impossible by the most artful Contrivances, and the most prudent Councils, to avoid the Influence of a common Cause; yet the Call of Nature, and the Laws of Self-preservation, demand our utmost Diligence and Labour, both in publick and private, to prevent the Encroachment of such a subtile and cruel Destroyer. And it was certainly to this purpose a wise Contrivance of the Magistrates, to constitute two in every Parish daily to visit every Family, and be satisfied whether every one belonging thereunto was well, and free from any Infection.

BUT both the Ancients and Moderns have taken the utmost Pains in contriving to purge the Air, on a Supposition that, in a pestilential Contagion, that is _substantially_ infected: But as the Air, as before demonstrated, is only the Lodgment or Vehicle to the pestilential _Miasmata_, which are every Way agitated in it, it does not seem so much to want Depuration on its own Account, as that poisonous Mixture which is joined with it. Indeed the pestilential Particles residing in the Porosities of the Air, may often, without any Change of Figure, for Want of due Agitation, remain and stagnate in it a long Time, so as to be drawn in by the Lungs in Inspiration, and hence from the intimate Mixture and Confusion as it were of both, a Suspicion may be entertained of the Taint coming from a Corruption of Air; but of this we have said enough already; and as howsoever this Matter is, a Purgation of the Air is by common Consent called for on all Sides in these Cases, we shall consider this Matter, chiefly in these two Respects.

_FIRST_, That the pestilential _Seminium_ be dislodged; and to this Purpose contribute brisk Winds, especially from the _North_, and the frequent Explosions of great Guns, in the Morning and Evening chiefly; because such Concussions agitate the poisonous _Miasmata_, and not only help to dissipate them; but to change and alter them in those particular Configurations whereby they become so noxious; and it hath been attested by Experience, that an intimate Combination of _Nitre_ and _Sulphur_ greatly alters the saline Qualities of the pestilential Taint.

_SECONDLY_, The utmost Diligence is to be used to prevent the pestilential Particles from taking Effect; which is succesfully done by proper Fumigations. _Hippocrates_, the Oracle in Physick, hath left it to Posterity, to kindle Fires in the publick Streets; and these sometimes I conceive may do good; but not as some will have it, by absorbing the pestiferous Humidities, but by diffusing on all Sides a great deal of _Nitre_, which gives a considerable Change to the venomous _Miasmata_; I judge it best therefore that such Fires should be made of resinous Woods, which throw out a clear and unctious Smell, such as _Juniper_, _Fir_, _Oak_, _Ash_, _Elm_, _Chesnut_, &c. but by no Means Coals, which exhale an impure, fetid, and suffocating Sulphur.

BY the Care of the Magistrate also the Streets, Sinks, and Canals, should daily be cleared of all Filth; because Stench and Nastiness are justly reckoned the Entertainers of Infection, and we find the Air to be corrupted frequently from noisome Smells; so that the pestilential Venom cannot but receive additional Strength from such Means.

BUT to be yet more particular about these Fumigations, both to mend the Air, and refresh the Houses that have been infected, they must be composed of such Things as raise and comfort the Spirits that were languishing, with their grateful Flavours; for refreshing Smells are a kind of natural _Pabulum_ to the animal Spirits; or they should be of such Substances as by their gummy Viscidity entangle and cover the venomous _Spicula_, so that they cannot act; or, lastly, of such Things as breath out such nitrous Steams, which will either preserve our Bodies from receiving Impurities, or change the Nature of the infectious Particles.

I do not indeed deny, but some ungrateful Smells may be sometimes more convenient than sweet ones, as they fix those Spirits which would otherwise exhale; and a copious Efflux of saline Particles will often keep them from Infection and Injury. But to reduce these into Classes.

The _Simples_ of the first Class are _Musk_, _Civet_, _Amomum_, _Lavender_, _Rosemary_, _Roses_, _Angelica_, _Marjoram_, _Cloves_, _Rhodium Wood_, _Aloes Wood_, &c. Of the second, _Frankincense_, _Benjamin_, _Storax_, _Bdellium_, _Labdanum_, _Pitch_, _Sagapenum_, _Myrrh_, &c. Of the third Class, _Sulphur_ and _Nitre_, more of which hereafter.

BUT further, that all the Means of propagating the Plague may be removed, it is very wisely ordered by the Magistracy, to kill all Dogs, Cats, and other domestick Brutes, lest these Creatures in their Passage from one Place to another should carry along with them the pestilential Infection.

YET although both the Makers and Executors of the Laws were very diligent in their Duty during the late Sickness, the Contagion notwithstanding spread; when therefore all the Care and Skill of the Magistrate could avail nothing in stopping the common Destroyer, the utmost Application was made to preserve the Individuals under its Visitation: For which Purpose, first of all were removed all Means of rendering our Bodies more subject to take the Infection, and the best Care taken to fortifie the Constitution against its Attacks, and to support it under its Tyranny.

I know not indeed a greater Neglect than in not keeping the Body clean, and keeping at a Distance every Thing superfluous or offensive; and during the pestilential Constitution nothing was worse than Evacuations of all Kinds: But if a _Plethora_ required _Phlebotomy_, the Blood should be taken away by a small Orifice, in but little Quantity, and at several Times: A Person loaded with bad Humours, should be discharged of them, if possible, immediately; if they glut the Stomach, and first Passages, they ought to be thrown off by Vomiting, Drinking in the Operation good Quantities of Posset-Drink, in which hath been boiled the Leaves of _Carduus_ and _Scordium_; and also the Bowels should be cleansed, to which Purpose the following is useful:

_Salis Tart. +℈ ij.+ F. Solutio in spir. vini opt. +℥ ij.+ tum adde guttæ gambi +℈ iv.+ peractâ solutione evaporetur spir. tum adde colocynth. cum urinâ præp. +℈ ij.+ scammaii, Sulphurati +℈ j.+ Aloes, rosatæ +ʒ ij.+ trochisc. de rhabarb. rec. +℈ iv.+ gum. ammoniaci in aceto, scil. sobuti +ʒ j.+ salis absynthii, cardui ana +℈ j.+ ol. carui gutt. +vij.+ cum s. q. Syr. de rhamno F. massa, inde pilulæ, min. formentur, Dos. ad +℈ ij.+_ And thus to throw off those Humours which join with and aggravate the pestilential Venom, very much prevents the Want of Antidotes afterwards.

CARE must be taken that there be no Suppression of Urine; the Non-naturals must be used with great Regularity; the Body must be kept transpirable; the Tone of the _Viscera_ strengthened; Fasting avoided; Choice made of a good Diet, such as will yield good Nourishment, make but little Excrement, and be easy of Digestion; to which several Pickles and Sauces are to be recommended; as _Juice of Sorrel_, _Lemons_, _Oranges_, _Pomegranates_, _Barberries_, &c. and at every Meal Sack is to be allowed, whose Vertues we shall hereafter have Occasion to speak of; and Care should be taken not to be Abroad in the Evening.

AND to express all in a few Words, all the animal Fluids must be kept in a natural State, in an Equality of Motion, and an equable Degree of Mixture and Fluxility; they must not be put at any inordinate Hurries, nor be too much rarified or exalted; nor must they be suffered to grow vapid and languid, for Want of Depuration, and a Retention of excrementitious Particles. But a proper Regimen is better to be had from other Writers, we therefore hasten to proper Antidotes.

_An Antipestilential Electuary of +Mayerne+._

℞ _Juglandium virid. +lib. ij.+ ficuum, prunorum ana +lib. j.+ macerentur in aceto, & pulpa trajiciatur, cui adde pulv. subtiliss. rutæ, +lib. [ss.]+ viperinæ Virginianæ +℥ j. [ss.]+ rad. contrayerva +℥ iij.+ petasitid. zedoariæ, ana +℥ ij. [ss.]+ sacchari perlati +lib. j.+ Syr è succo Kermes +℥ j.+ Syr. calendulæ, caryophyll. ana q. s. ut F. Elect. molle, addendo fol. Auri 40. Dos. ad quantitatem nucis Jugland. maj. mane, & vesperi_.

_An Electuary for the Poor._

℞ _Conserv. lujulæ, galegæ ana +lib. [ss.]+ calendulæ +lib. j.+ Theriac. Londin. +℥ iij.+ boli armen. vitriol. +℥ iv.+ cum syr. limonum q. s. conficiatur Elect. Dos. ad +ʒ ij.+ vel +iij.+_

_An Antipestilential Confection._

℞ _Radic. scorzon. Hispan. petasitid. contrayerva ana +℥ ij.+ helenii, tormentillæ ana +℥ [ss.]+ angelicæ, chelidoniæ, mai. ana +℥ j. [ss.]+ bacc. Junip. præp. +lib. [ss.]+ summit. rutæ +p. j.+ sem. cardui, citri ana +ʒ ij.+ quibus præp. affunde p. duas aceti sambuc. & tertiam spir. vini opt. infusione peractâ & expressione, liquor igne lento evaporetur ferè ad mellaginem: extracti +lib. j.+ adde theriac. Londin. +℥ ij. [ss.]+ boli arm. terræ sigillatæ ana +℥ j.+ flor. sulphuris +ʒ v.+ succi Kermes +℥ ij.+ conserv. lujulæ +lib. j.+ cum syr. limon. q. s. F. Elect. molle, Dos. ad quantit. nucis myristicæ mai. ter, vel sæpius de die._

_Antipestilential Pills._

℞ _Extract. rad. helenii, angelicæ, contrayerva ana +℥ j.+ adde extract. alb. glycyrrh. +ʒ iij.+ flor. sulph. ad quatuor altèm vices sublim. +ʒ ij.+ C. C. philosoph. calcin. sem. citri pulveriz. ana +ʒ j. [ss.]+ salis scordii, absynth. ana +℈ ij.+ cum s. q. picis liquidæ F. massa pro pilulis, Dos. ad +ʒ [ss.]+ vel +℈ ij.+ mane, & horâ somni._

_Antipestilential +Elixir Proprietatis+._

℞ _Croci Angl. opt. +℥ [ss.]+ extrah. tincturam cum aq. ulmariæ, scabiosæ, cardui; vel melissæ s. q. additis spir. sulphuris aliquot guttis ad leviusculam aciditatem: liquor per chartam emporeticam agatur, in colaturâ ad lentum B. calorem dissolve Aloës pellucidæ è vesicâ +℥ iv.+ per sataccum linteum haùd ita rarum trajiciatur liquor; deinde F. condensatio ad eundem calorem, acquisitâ pilularum molliuscularum consistentia, adde myrrhæ purissimæ +ʒ vij.+ flor. vel. magisterii præcipit. Benzoin +ʒ iij.+ salis C. C. +ʒ ij.+ cum syr. sambuc. q. s. F. massa unde pilulæ formentur, Dos. ad +℈ ij.+_

_Lozenges against the Plague._

℞ _Extract. rad. angelicæ, & contrayerva +℥ j.+ extr. alb. liquiritiæ +ʒ iij.+ flor. sulphuris myrrhat. h. e. cum myrrhâ sublim. +ʒ v.+ ol. cinnam. gutt. +viij.+ saccharum crystallin. ad duplum omnium pondus, cum mucilag. gum. tragacanth. aq. scordii parat. q. s. F. Tabellæ parvæ subling._

SOME used every Morning to swallow a Clove or two of _Garlick_; and many eat unripe _Walnuts_ pickled. The following Draught was of admirable Service:

℞ _Aq. rosar. rubr. camphoratæ +℥ ij.+ aceti opt. +℥ j.+ in quibus dissolve bol. arm. opt. +℈ ij.+ adde syr. scabiosæ simpl. +ʒ iij.+ M. S. F. haustus._

SOME old Nurses, as themselves have informed me, for an Antidote gave human Excrements; but for the Efficacy of this Secret, I have nothing to say. Some found Benefit by drinking of Urine; but many who have thought themselves by these Means so well fortified, would venture themselves too inadvertently into Danger, without any necessary Occasion, to the great Hazard of their Lives.

BUT in these precautionary Directions, it is to be particularly advertised, that Astringents of any Kind whatsoever, as _Bole_, _sealed Earth_, _Lemnian Earth_, _Coral_, &c. are not to be given to Maidens, and Women in their monthly Courses, for Fear they should occasion Obstructions, and other bad Disorders: Those Remedies also are as much to be blamed which force this Evacuation by thinning the Blood too much, and irritating the Uterine Vessels: And lastly, in the Preservation as well as the Cure, the Seasons of the Year, Sex, Constitution, Age, _&c._ are carefully to be attended to.