Part 5

I know what will here be the Objection _viz._ that these things are design’d only for the Cough, and not expected to Cure the Habit of the Body, and that therefore they may be allow’d to be a good sort of Composition for that Palliative Service they are directed to; but this will not suffice, for there is not one in ten that makes use of these Medicines, but relies on ’em for the Cure of the whole Distemper; and therefore this is the broken Reed that has deceiv’d so many; especially of the Poorer Sort, and which leads ’em in such numbers into the Hospitals to end their Days there, after they have lost the Opportunities of Recovery by depending on these Trifles. And if any one must needs take offence at some of these Expressions, let him consult _Ludovicus_, an allow’d Judge of these matters, in his _Pharmacia Moderno seculo applicanda_, he will find what is his Opinion of these things in the 19th _Page_ of his _first Dissertation_, speaking of the _Confectiones communes & Candisatæ Conservæ recentiorum siccæ (simplicis sui Pulvere plerumque debiliores) Martis Panes, Pandaleon, & antiquariæ Saponeæ Confecturæq; reliquæ_, he says, _Væ Hecticis tabidisq; quando tandem ad ejuscemodi Refectiva, sesamo atque papavere sparsa, pineis Pistaceis, &c. damnantur: Arentes hinc fauces (quamvis difficulter interdum) lenitas vidimus, curatum neminem, quin potius intensiores inde depascentes febres, dejectum magis appetitum, festinatosque Fluxus colliquativos_. And speaking before, _pag. 9._ of _Decoctions_ and _Infusions_, he says, _Procertis interdum Circumstantiis in Pectoralibus & Vulneraris dilutiora hæc contractioribus dosibus commodiora deprehenduntur_; and, it seems, he thinks this Observation, relating to the Use of _Pectorals_, to be of such Moment, that he makes it one of the Heads of his _Additionary Comment_ or _Appendix_, where, _pag. 582._ he has these Words; _Natura interea nihilominus, præ Essentiis Extractisq; pectoralibus, præq; fauces in internis ibi ardoribus tantisper lenientibus Morsulis, Trochiscis atque mixturis antihecticis, antiphthisics, diffusius quidpiam & ad remotiora perveniens unà ut plurimum velle videtur_.

These Citations plainly shew, that he thought those sugar’d Compositions no apposite Remedy for Persons in such Circumstances, but that whatever Remedy is made use of, it ought to be made to dilute as much as possible; which does agree with the Reason, which I shall shew anon, for the plentiful use of those mild Vegetables. I have made these Citations at large, that what I have said may not be thought to be any Figment of mine, but that I may appear, that I have Precedent as well as Reason on my Side. But to return to the Root I was upon—Besides the mixing of Sugar with Liquorice, to what purpose is the Aqueous part of its Juice exhal’d; what harm would that soft _Lympha_ do to People, who have a continual Thirst upon ’em? To what purpose must the Juice be inspissated, in order to acquire an Acrimony by lying, not to speak of its Adulterations? These are things which I could not forbear animadverting upon, because they put us out of the right use of a Medicine, than which there is not perhaps a greater _Analeptick_ to be found, if it were taken in the same quantity as other Juices are taken. A Medicine that is a kind of a Balsam _in Ficri_, and the most likely to be wrought up to Perfection in the Blood, and of which the Fresh Juice ought undoubtedly be taken to a Spoonful or two several times a day. But thus it is, we give a thing the Name of Physick, and then stand aghast at it, and take it with Guard and Circumspection, as if it were not possible that any thing should prove a Medicine, and yet be taken in an Alimentary way.

There is another Plant, the _Cynogloss_, which seems not unlikely to be of Use in this Case, because it seems to have something of a like Gleamy Substance in it; it has been deliver’d down to us under some mistaken Notions, as if it caused Sleep, which perhaps have been occasion’d by its Cooling and Styptick Quality; but a late Author of unquestion’d Judgment and Experience has us’d it pretty much in Decoctions with _Turnips_, and says, it has no such quality, but recommends it to People in this Distemper; to these may be added some of our Vulneraries, of which there is great Variety of all Rates, of all degrees of heat; and among ’em one of the Temperate sort, never enough to be valu’d, _viz._ the _Comfreys_, and which in Consumptions, upon spitting of Blood, may be expected to do great things; These Roots may be so manag’d by a good hand as to be eat as Food. The Female Retailers of Physick would perhaps take it Ill, if among these things I should forget their Preparations of _Turnips_ and _Snails_, which may all have their time of being serviceable, either as Food or for Variety, and what is more, all these things are Compatible with a Milk Diet too; these things may be taken in small quantities at different times from the taking of the Milk; tho’ if taken with it, they could cause no Coagulation, and so a mild and Medicated Chyle may be continually passing into the Blood to the great Advantage of the Sick.

These Instances are sufficient to shew the Nature of those things, which I take to be the most adequate Remedy in this Case; _viz._ that they ought to be such as are of a Medium, between common _Balsamicks_ and _Acids_, and that they are such, as seem most likely to prove Nutritive to People in so weak a Condition; the reason why I set such a value upon these moderate things, is taken from the state of the Blood of People in such Circumstances, which seems unable to manage stronger Medicines, the least tendency to a _Diaphoresis_ being some disturbance to those Persons; so that what is to be done, must be by things which may suit with the Blood, and as it were grow upon it, that may be transubstantiated into its _Crasis_ after an Alimentary way; there must be a continual Rill of these temperate Juices into the Blood, without the observing of Physical Hours, and then ’tis to be hop’d the Blood may renew by degrees, and the Acrimony may decrease for want of Fuel; and thus we may perhaps better obviate the Periodical Ebullitions of the Hectick, by substracting their Cause, than by stifling the Hectick by keeping in the Cause; I have not Scope here to explain my self, but I think the common Causes assign’d for those Fits, don’t seem sufficient; I can’t think the Ripening of a Tubercle able to do so much, that little quantity of _Pus_ can’t contain a _Putredo_ sufficient for such effects, not to say the same Hectick happens, where no Tubercle has broke; to be short, it seems to me most probable, that when the Blood is so much saturated with disagreeable Particles, as in Consumptive Persons it is, as these Particles encrease and grow upon those Particles which make up, the Proper, Genuine, Inseparable Essence of the Blood in its true, State; I say as the first gain ground, there is so great a Correspondence and Harmony in the Oeconomy, that these latter must contend and resist the other, tho’ in the Contention, Nature gains no great Advantage, but only fights and retires till she is quite overcome; this seems to me no unlikely Idea of the Hectick, and if it be true, the best way must be to substract the quantity of the Morbisick Particles, by using such a Food, as cannot possibly afford Matter for ’em.

Having, then consider’d these Medicines, I will suppose it granted me, that they are proper in this Case; I won’t say that they shall be Sufficient to Cure of themselves, (tho’ I don’t doubt but they may in some Constitutions do the Work themselves) but I will only suppose, that they do greatly dispose towards it, which _Postulatum_ will, I conceive, be readily granted me; I will suppose likewise, that Riding (the Exercise I propose in this Case) does likewise dispose towards a Cure, which _Postulatum_ will be granted too; I will suppose farther, that these two Courses are Compatible, and may be us’d together; as the Medicines help the Fluids, the Exercise helps both the Fluids and Solids; which _Postulatum_ cannot be deny’d me neither; what then naturally Results from this, but that they be both us’d in Conjunction? And is it not more than probable, that these two Methods joyn’d, shall effect that which neither of ’em can singly? Do not we see enough of this every Day in Natural Occurrences, where one, two or three things, indifferent in themselves, shall, when blended together, produce a valuable Effect, which none of ’em could alone? And shall these things be observ’d in lesser Arts, and be slighted when a Man’s Health is at Stake? Seeing we abound so in Compound Medicines, why may we not for once take up with a Compound Method of Cure, (if I may so speak) that is, if we cannot obtain Health by one sort of means alone, why may we not expect it from a Complication?

Thus I have run up these Arguments to a Head; I have shewn that the Medicines appropriated to this Case, ought to be very Mild and Temperate, upon the account of that less prevalent quality, there may be Hazard, lest they should not always prove equally effectual; and therefore to supply any such Defect, I substitute a most easie Natural Gymnastick Course, as a common Aid to the weakness of the Medicines, and an assistance to that part of the Oeconomy, which those Medicines can’t reach. Whether this is not most suitable to, and consistent with the even Tenour of Nature, tho’ it may not relish so much of the Magnificence of Art, I must submit to those who are best Judges; to me it seems to promise enough, and carry more Healing with it, than some things that are dignifi’d with the great Titles of _Gilead_ and _Peru_.

If after all there are any People who will think, I have taken too much upon me, in venturing to attack the _Balsamick_ Method, if they cannot think slightly of Medicines, which will give such present mitigation of a Cough, and which are so Fragrant and Costly, let ’em enjoy their Opinion, and persist in the use of them; and if they find ’em at any time not so effectual as they could desire, let ’em but superadd the Power of Exercise, and they will doubtless find ’em much improv’d; and if they come by that Means to succeed, I shall not envy their good Effects.

Besides these two main Indications, there is something more to be consider’d in the Cure of the Consumption; and that is, how we may obviate the Moisture of the Air; which is a very troublesome Enemy to Consumptive People, of what Constitution soever, who dare not make use of Generous Liquors to fence against it; for that Practice would be prejudicial upon another Account: Now what can be more Natural in this Case, than the raising the Spirits to resist this Moisture, by a gentle Motion of the whole Body, which at the same time, causes a greater Degree of Heat, and that equally diffus’d all over the Body, which must needs rarify in some measure, the moist Air, and besides, make the hot and acrimonious Particles in the Blood, supply the place of warm Internal Medicines, which in another Person would have been proper to have been given, to oppose the Moisture of the Air? Now this is much the same, that the Change of Air can effect in the Body of a Sick Person, for ’tis the equal Influence, the universal moderate Rarefaction of a warm Air, that makes it so beneficial, and if we will cast in the benefit of the Tension, which is caus’d by moderate Riding, together with the Equality of the Heat, it will appear to be very little short of what is usually expected from a Journey into a Foreign Air, and I could here give an Instance of a Gentleman, who, when he was in the South of _France_, found but little Relief, any longer than when he was on Horse-back; and who after his return to _England_, found that Riding supported him as much, as the Change of Air; So that upon the Consideration of the equal promoting of the insensible Perspiration, and the Benefit, which at the same time accrues to the Solid Parts, this Exercise which I have so much insisted on, may be allow’d to be almost, if not altogether, an Equivalent to a Warmer Climate.

_Lastly_, I shall urge but this one more Reason for this Exercise, which is not taken from a Natural, but a Prudential Consideration, from the particular Humour of most People in this Distemper, who are strangely inclin’d to think themselves in no great Danger, even tho’ the Distemper is far advanc’d; they don’t love to be told the Truth, tho’ it is ever so necessary; but an honest Physician is to them, as _Micaiah_ was to _Ahab_, he never has any thing good to say of ’em; they think they are strong enough in the Main; they’ll tell ye, they should be as well as ever, if their Scurvey Cough, or the weight on their Breast was but remov’d: Now the Genius of the Sick must be consider’d, and these People who have so good an Opinion of themselves, may in some Sense be indulg’d and wrought upon, to exert their Imaginary Strength in Gentle Riding, and then they may perhaps come to enjoy that which is real.

I might now proceed farther, to consider in what degree of this Distemper Riding will be beneficial, whether any thing is to be expected from it in the second and last State of it; but this would be to run out beyond my Design of Brevity; only I shall take Notice, that it is no rare thing to meet with Consumptions, without any Putrid Fever, or any Reason to believe an Ulcer in the Lungs, or perhaps so much as Tubercles, but a continual Hectick, and a precipitate Wast of Nature by the Direful Acrimony and ill Quality of the _Serum_, as Doctor _Benet_, in his _Theatrum Tabidorum_ observes, _Pag. 109._ _Tabidorum languor sine pulmonum aut visceris cujuslibet corruptelâ tacitâ vi obrepens Anglis infestissimus est, & nisi primis obediverit remediis (quod rarissimè evenit) funestus._ In this Case I can’t but be of Opinion, that Riding well manag’d would be serviceable, tho’ undertook very late, if there is any tolerable Measure of Strength left to put it in Practice.

I must here again repeat, that when I here speak of Riding, I understand the Habit of Riding, the want of which Distinction, has made it ineffectual to many a Man; He that in this Distemper above all others rides for his Health, must be like a _Tartar_, in a manner always on Horse-back, and then from a weak Condition, he may come to the Strength of a _Tartar_. He that would have his _Life for a Prey_, must hunt after it, and when once he finds his Enemy give way, must not leave off, but follow his Blow, till he subdue him beyond the Possibility of a Return. He that carries this Resolution with him, will I doubt not experience the Happy Effects of the good old Direction, Recipe _Caballum_; he will find that the _English_ Pad is the most noble Medium, to be made use of for a Recovery from a Distemper, which we in this Nation, have but too much reason by way of Eminence to stile _English_.

OF THE _DROPSIE_.

The Second Distemper which I shall consider as subject to these Measures, is one _Species_ of the _Dropsie_; that is, the _Anasarcous_ Kind, from which likewise I except those, which are attended with a hard Liver, or a remarkable Obstruction of some of the _Viscera_.

This kind of _Dropsie_, thus circumstantiated, does at first View, seem not to need the Assistance of any extraordinary means to help towards a Cure, it being the most Curable of all Dropsies; and we have daily Instances of its giving way to Common Medicines, nevertheless there are such exceptions in this most Favourable Case, as give trouble enough to a Physician sometimes, and requires more than usual Application; as for Instance; sometimes a Person happens to be brought so low by an Unseasonable Purge, that afterwards Diureticks and Corroboratives will have no effect upon him, but the Case becomes deplorable, without the Rupture of any _Lympheducts_ or other the like Difficulty.

_Secondly_, when People decline in Years, there are some extraordinary means requisite to make the Remedies exert themselves with like Success, as they do in Younger Persons.

_Thirdly_, in Hysterick Women it is difficult to carry off the load of Water by common means, without some such Method as I shall hereafter mention; because their Spirits are so low, that they can bear no considerable Evacuation.

_Fourthly_, when a Dropsie comes upon an _Asthmatick_ Person, there are particular Difficulties arise, and the singular Advantages of constant and gentle Exercise in this Case are universally known.

These four different Circumstances of this Distemper, may suffice to shew that I have Colour enough for my calling in the Gymnastick Method into this Case, and ’tis the first of the Exceptions, I mean the ill Effects, which sometimes follow upon the Use of Purgatives, which have chiefly occasion’d me to inquire, whether we ought in this plain Case, thus circumstantiated to halt between two Opinions, between Purgatives and Diureticks, without endeavouring to establish a certain Praxis upon Just Foundations.

There are none will deny, but Diureticks are the most proper and natural Remedies in this Case, if they would always succeed, because directed to the proper Emunctory, the Kidneys, and because they can go hand in hand, with the Corroborative Medicines to be given at the same time; I take it for granted therefore, that whenever Purgatives are us’d in this Case, it is because the Diureticks don’t take quick enough, or in order to carry off the load of _Serum_, that the Diureticks may the sooner display their good effects, because it will be alledg’d that the _Serum_ becomes so Ropy and Glutinous in the Passages and Capillary Parts, that the Diuretick cannot always act upon it. But tho’ this is granted, it will not suffice to warrant the Use of the stronger Purgatives, because their manner of Acting cannot agree with this Distemper, and because those difficulties objected, may be overcome by other means.

_First_, the very Nature of strong Purgers, makes against this Case, it seems very preposterous, to have recourse to such Deleterious Drugs, to those _Mortis Catapultæ_ (as _Ludovicus_ calls the _Esula’s_ and such like Purgatives) in Order to the Restoring an impoverish’d Blood; if they acted only by Stimulating the Intestines, something might be said; but since it is indisputable that they pass into the Blood, and act powerfully upon it, there is no doubt to be made, but they fuze and divide it, and break its Globules, and consequently make as much Water as they carry off, which is the very Reason why Sweating is laid aside, and Salivation, tho’ they both seem so proper to carry off Watery Humours; I know it may be alledg’d in Defence of these Medicaments, that the _36th_ and _37th Aphorisms_, of the _Second Section_ seem to imply, that a Sick Person would receive less Harm from ’em, than one that is in Health; but yet this will not excuse their Use in our Case, because tho’ the Viscousness of the _Serum_, may blunt the Particles of those Drugs for a time, and hinder ’em from working so quickly, yet when once they are throughly imbib’d, and begin to exert their Force, they ravage the very Principles of Life, and can by no means be fit for a Person in so low a condition. But admit that the Water is carry’d off by these means, the Blood will be left as poor at least as it was before the Dropsie first appear’d; and then how can we be sure the Waters will not rise again? Suppose an _Anasarca_ follows upon an _Hæmorrhage_, which is very common, and you draw off the Water by Purging; will not the Person be just in _Statu quo_, upon supposition that the Medicines in their working did not impair Nature? but that is not to be granted, because it is impossible to suppose, that such _Drastick_ Medicines, should not prey upon Nature, even while they are assisting her; and can we be assur’d that the Blood will not run into the same Colliquation it did before? Besides, may there not be some reason to suspect that the very quantity of the _Serum_, supposing it is not too Turgid indeed, may sometimes be serviceable, to the promoting the activity of the Diuretick, even as we find in the true _Ascites_, it is of some use in the Cavity of those Persons, because they often can’t spare it, without certain Ruine? We don’t know how much the confidence of the Fluid may conduce to the keeping its homogeneous Particles combin’d, and we ought to be very tender of doing any thing, that might tend to dissolve the _Crassamentum_, the Globules, which are as it were the very _Semen Sanguinis_ (if I may so speak); for how far Nature would endure such measures, before the Sanguification would be totally subverted, would require a Dissertation, longer than my Scope will permit; but that this is sometimes done is not improbable, and I take this to be the Case of a Young Fellow I knew, who falling into a slight Dropsie, goes to an _Empirick_ somewhere about _White-Chappel_, from whom he had a Dose of Pills, which gave him about 30 Stools, which sunk him so much that his Nails turn’d black, and he died in two or three days time; Here ’tis very likely the Signification was entirely extinct, and the Blood chang’d into a Preternatural Fluid, and all by the great Power of these Deleterious Drugs; and tho’ ’tis likely the Quack did not know the proper Dose of his Medicines, yet one would think, this was no more than what might be expected from Ten Grains of _Elaterium_, which yet has been allow’d by an Eminent Writer.

Besides the weak State of the Blood, the Ventricle is always more or less impair’d in this Distemper, and consequently unable to be put to bear the violent _Stimuli_ of the stronger Purgers, without Danger of having its Tone irrecoverably ruin’d.

It may likewise be Prudent to forbear Purging in this Case, left happily there should be some greater Obstruction in the Liver, than we are aware on, for then it might be follow’d with ill Consequences; ’tis true, if that Bowel is really _Schirrous_, it may be discern’d, or a great Tendency toward it, will shew it self sometimes in the Greeness and Virulency of the Bile mixt in the Excrements, together with other Indications; but a slight disorder there, is not always regarded, and Brick-colour’d turbid Urines are so common in all kind of Dropsies, that we may not discern that the Blood does abound too much with Bile, and so a Purge given at such a time may do a great deal of Mischief, for the Bile is of a light Nature in Comparison of the _Phlegm_, and moves easily, and no Man knows what he does when he rouzes it; I knew an ill accident happen once upon a Purge, given by a very Eminent Physician, to a Gentleman in a _Jaundice_, which put him into the most extravagant and fatal _Hypercatharsis_: thus bold Administrations to such weak Subjects, may be attended with Tragical Accidents, but the milder and gradual measures may succeed, without such dangerous Risks, if we consider what have been the Difficulties which have lay in the way, and hindred the Operation of our Diureticks.