Chapter VII: Section VII: Concerning the Cure of the late Pestilence

ALTHOUGH a pestilential Infection is extreamly dangerous, and doubtful as to its Consequences, very few being spared by it, when in its greatest Height, yet we are by no Means to despair in so great a Difficulty, and give up the whole Race of Mankind to Destruction as soon as it comes, but be rather stimulated to greater Endeavours; and, like faithful Ministers of Nature, study all Helps against such common and grievous Calamities.

BUT before we enter upon that Part which seeks Assistance from Medicine, it may be necessary to exhort the infected, that they have due Regard to the Almighty Power, not only in confessing, and seeking Forgiveness for Sin, but in imploring his Blessing upon those Remedies and Means for Recovery which even the most skilful Physician can prescribe.

THE Infected also ought to be admonished that they make their _Wills_, and settle their worldly Affairs, so as to prevent Contention and Law-Suits, least by the Severity of such a Distemper they should chance to be carried off. But this is to be done before they are affected at all in their Understandings by the Disease.

LASTLY, It is likewise to be enjoined the Sick, that they quietly, submissively, and with a chearful Confidence, commit themselves to the Care and Management of their Physicians; And hence appears the Difficulty of that Task to watch over those who are in such imminent Danger; and what variety of Cares lie upon him who undertakes it, and who often falls himself by that Tyrant he is endeavouring to defend others from?

BUT to do Justice to the _Sacred_ Art, in its relieving Mankind in such cruel Diseases, this must eternize the Sons of _Esculapius_, that they seem to be born for the Publick Good, by their Usefulness even in a Pestilence, as well as other more common Calamities of Life; but on this Head I shall forbear saying more, knowing how unworthy I am to give due Honour to so much Worth.

BUT in the Prosecution hereof, as some heretofore have taken a great deal of Pains to no Purpose in finding an _universal specifick_ against the Pestilence, and have imposed many palpable Falsities upon the World under such Pretences; so our modern _Coal-Blowers_ have in like Manner cried up their pernicious Secrets, and wickedly imposed them upon the credulous Populace. Certainly these publick Cheats ought themselves to be deemed pestilential, as their Notions and Practice is abhorrent to all sound Reason: For if the Arguments on both Sides the Question be fairly stated, and one will be convinced, that there never as yet hath been discovered in Nature, the full and absolute Essence of a Pestilence, but that it still remains a Mystery to Mankind; wherefore in this Distemper a Person must proceed, as in all others, by a serious Attention to the manifest Symptoms, and a rational Conformity of the Means of Cure thereunto; and while we hold to this only Rule of Procedure, although the Severity of the Distemper may conquer several, yet many also may be saved.

IT now comes to us to declare what a Physician has to do in this Calamity; as therefore the Disease admits of no Delays, Help must be immediately procured, and the Physician ought to fly to the Patient’s Succour, least, by any Omission, the Case should be got beyond Recovery, and a Person be lost for Want of timely Assistance.

WHEN the Physician is come, he ought to address the Patient with Chearfulness, and blame those Fears and melancholy Apprehensions which give many over too much into the Power of the Distemper, by cutting off all Hopes of Recovery.

LASTLY, according to the general Directory of our College beforementioned, the most generous and efficacious Medicines must be contrived with the utmost Care and Deliberation.

IN the first Place then, whether Phlebotomy is to be practiced or not is justly to be questioned; and indeed I should pass it by here as fatal, but that I know many unskilful and rash Persons, who not only let Blood largely at one Time, but order it likewise to be repeated until the Patient faints.

BUT if the Authority of the Ancients as well as the Experience of the Moderns hath any Weight, and indeed if our own Practice may be regarded, it is highly to be feared, from many Instances, that Bleeding in a genuine Pestilence is not only to be suspected, but charged as pernicious; for we have many times seen the Blood and Life drawn away together; which makes it astonishing to see the Practisers in such Mischief dare to justifie the fatal Error; what is it that indicates this Evacuation, is it intense Heat; or any Turgescency of the Vessels? Or is it to give Vent to the pestilential Poison to make its escape? Certainly nothing to me seems more absurd; for if the other Symptoms do not remit with the Fever, the Patient will be plunged into the utmost Hazard; for how can the Blood and other Juices be depurated, if the febrile Heat is extinguished? not to say any thing of a Suppression of salutary Breathings hereby, a Perversion of the natural Secretions, and Sinking the Spirits.

THEY also are under as great an Error, who fetch their Reasons for this Practice from the Turgescency of the Vessels; for while inordinate Hurries are excited in the Blood, from disagreeing and heterogeneous Particles striving to extricate themselves from one another, there is made thereby only a seeming Plenitude; what Madness then must it be, in order to remove an imaginary Fulness, to sink the necessary Strength by a rash Effusion of Blood?

AND lastly, the morbifick Poison is not of that kind, as to seek an Escape at the Orifice of a Vein, and run out with the flowing Blood; and which (as before proved) affecting chiefly the Spirits, and residing in other Vessels, makes this Method of Cure in a Pestilence impracticable. I will not however deny but that there may possibly be Circumstances in malignant and pestilential Fevers, which may justifie Phlebotomy, as when it is done for Revulsion sake, in too great a Flux of the _Menses_: But in a genuine Pestilence, it is not to be meddled with. There is but one, as I can remember, who survived it in the late Sickness; but it is needless to say any more upon a Subject so plain, and therefore I shall pass to what is of more Consequence.

AS for what concerns the next Means of Remedy, an _Emetick_ may be given in the Infancy of the Disease, where the Stomach is loaded either by over-eating, or by a Crowd of bad Humours, or when there is a Loathing, or a Bitterness in the Mouth; so that any particular Conformation of the Breast and Neck doth not contra-indicate; and amongst these Remedies they are preferrable which plentifully excite Vomiting, without working also downwards.

OF this kind are the _Syr. Diasari Fernelij_, _Syr. Scabios. compos. Oxymel. Scillit._ and chiefly the _Sal Vitrioli_; but the Antimonial Preparations are not so advisable. The Dose of the _Emetick_ ought to be large enough to Empty the Stomach soon; and the Posset-drink used in the Operation, in order to rince off its Coats all Filthiness, is to be impregnated with _Carduus_, _Scordium_, _Meadow-sweet_, _Butterbur_, &c. boiled in it. In my own Practice, I have always found good Service from large Draughts of the Posset-drink above-mentioned, sweetned with _simple Oxymel_, without any other previous _Emetick_ given.

AFTER Vomiting is over, in order to enable the Stomach the better to keep any Alexipharmick Medicines, its Force may be greatly strengthned by adding Stomachicks to the Alexipharmicks: But if a Reaching to vomit prove Symptomatical, _Emeticks_ are by all Means to be avoided; least the Physician (like old Nurses, who are altogether ignorant of the Rules of Practice) should promote that Symptom, which by fruitless Strains waste the Spirits, and sollicit the pestilential Venom into the Stomach from distant Parts; which when fixed there, still irritates into more violent Reachings, that cannot be asswaged by any Remedies.

ALTHOUGH in other Cases a Vomiting may be removed by _Emeticks_, yet in a Pestilence it is dangerous to follow such Practice; because the Malignity, or rather Nitro-saline _Effluvia_, vellicate the Mouth of the Stomach, and so invert its nervous Coats, although empty, as to bring on Convulsions: And some Persons seem to have their Stomachs full, as overloaded with Food, who crave to be freed by Vomiting, which it is by no Means safe to indulge them in, because such a Sensation of Fulness proceeds only from the pestilential Poyson vellicating the Membranes, while the Stomach is it self free from Food, or bad Humours; but what further concerns this Matter, will come to be further considered under the Cure of Symptoms.

MOREOVER, Purges are justly reckoned amongst Medicines of great Efficacy; but whether or no they are to be used in the Case before us, is a Difficulty, and full of Controversy amongst Physicians; and indeed the Varieties in pestilential Diseases, the Differences of Constitutions, the various Complication of Circumstances, the Uncertainty of Seasons, _&c._ do make it impossible to give any general Rules hereupon; wherefore I shall go no further than what my own Practice hath enabled me to judge concerning it.

A Turgescency or Distemperature of Humours do certainly call for an Evacuation this Way; that is, when the Humours are troublesome more by their Quantity than any stimulating Quality; when therefore the Constitution is not able to conquer such a Burthen, neither by Digestion nor Expulsion, Catharticks are certainly necessary to help away the Load, and especially if a Person hath been before eating to Excess.

BUT if this Evacuation be delayed till the Juices have received the pestilential Taint, the Humours are then rather to be depurated, then purged away by Catharticks; and it is certainly better to trust to the Strength of Nature, when Things are gone so far, to do the Work her own Way: And whether or no the Blood is too much fused, or (according to some) coagulated, purging Medicines are certainly to be avoided; for in the first Case they further agitate and fuse the Blood, besides the Hazard of breaking open such Vessels as may not without great Difficulty be again closed; the same Medicines are also hurtful in the Blood’s Coagulation, because they evacuate only the serous Parts, and leave the Remainder more viscid and tenacious, whereby Obstructions are rendred more perverse and unconquerable, and the stagnant Matter without a Possibility of Dilution, and Restitution to its pristine State of Fluidity, as also more strongly inclosing the pestilential Poison at the same Time; it is also greatly to be feared, that in so great an Agitation the morbifick Venom may be drawn to the Bowels, and Sphacelation follow thereupon.

THAT Purging may be also practised with Success, the Strength of the Patient is carefully to be consulted, for where the Spirits are low, or deficient, it may not only prove unsafe, but fatal; and where the Bowels are extreamly stimulated by the Cathartick, and the Humours greatly put into Fusion by its rarifying Qualities, they will be apt to pass off in too large a Profusion.

WHAT can a Person likewise expect to do with a Cathartick, in Disorders of the Spirits? It certainly appears to me more likely to purge away all the Humours of the Body, than re-kindle the Spirits that are oppressed, cloudy, and almost extinct, by such Means; and further, as the Subtilty of the pestilential Poison inclines it rather to escape by the superficial Pores, than the larger Emunctories, this Method is contrary to that natural Tendency, calling it back again from the Circumference to the Center; I cannot imagine what they propose, who even repeat in these Cases their purging Medicines, until they bring both intolerable Pains, and Gripings into the Bowels, and Sphacelations, as beforementioned.

BUT if after all Considerations any Person thinks it proper to purge, it ought to be certainly done in the Beginning of the Infection, and with somewhat that operates speedily; and to which Purpose those in Liquid Forms answer best, as for Example:

℞ _Aq. Angelicæ simpl. Tartarizatæ +℥ ij.+ Syr. de spinâ Cervinâ +℥ j.+ Elix. proprietatis Crollii vel Antipestilentialis +℈ j.+ & interdum +ʒ [ss.]+ +dissolve+ salis absynthii gr. +viij.+ M. S. Fiat haustus horâ commodâ, & typo remittendo dandus._

A Solution also of _Pil. Ruffi_ from ʒ [ss.] to ʒ j. may be made in _Marigold Water_, by those who like that better. They who please likewise may use the following:

℞ _Extract. Pilularum Ruffi +ʒ ij.+ resin zalapii +℈ j.+ trochisc. de rhabarb. +ʒ j.+ gum. ammoniaci in aceto scillit. soluti +ʒ j.+ salis Tartari, absynthii +ana+ gr. +viij.+ cum tinct. Theriacali q. s. fiat massa, è cujus +ʒ j.+ conglobentur pilulæ +vij.+, vel +viij.+ Dos. in constitutione athleticâ ad +℈ ij.+ prout medico visum fuerit varianda._

IN a Disease that will admit of no Delay, it is best to evacuate but little, yet that not slowly; so that the morbid Humours may be expelled at the first Seizure, before they have received the pestilential Taint, and before its Virulence hath reached to the whole Mass of Fluids: For it is certain that no Digestion is to be expected in this Case, and therefore can there be no Room for _Alterants_ or _Digestives_: But when the Body is very costive, I judge it most convenient and safe to do this with Suppositories.

BUT all Authors and practical Physicians agree in this, to throw out the pestilential Malignity as soon as possible; which is expeditiously and surprizingly done by _Alexipharmicks_; and to these, as soon as the Belly is loosned, Recourse must speedily be had, as to a sacred Refuge: And there is such Plenty of Remedies of this kind, that Nature seems to have had more than an ordinary Indulgence and Forecast, in providing against this destructive Enemy of Mankind; nor hath the medicinal Art been likewise wanting in supplying us with many Preparations of _Simples_, that are powerful against so grievous a Destroyer. But in this great Choice it behoves us to select those which are most efficacious; for this Distemper, which is certainly the most tyrannical of any that besets a humane Body, may be sometimes conquered in its Infancy, which when got to a Head, is not to be managed by the greatest Efforts of humane Skill.

AMONGST the Simples of the three Kingdoms, to begin with the Vegetable, _Virginian Snake Root_, when fresh and fragrant, is the most efficacious; insomuch indeed that I have often admired, that such great Vertue should reside in such minute Fibres, having a Tast very pungent, and a quick aromatick Scent, and discovering somewhat wonderful and almost supernatural; so that it deservedly is accounted the most efficacious and generous _Diaphoretick_ and _Alexipharmick_ for expelling the pestilential Poison. Its Dose, finely powdered, is from _gr._ iv. or vi. to ℈ ij. in any proper Vehicle, due Regard being had to the Strength and Age of the Patient.

THE next Place is justly given to the _Contrayerva-Root_, from which also a compound Medicine, which I shall hereafter describe, is admirably contrived: The Dose of this in fine Powder is from ℈ i. to ʒ i. in _Angelica_, or _Scordium_ Water, or in Wine, _&c._

THERE are other Roots likewise which daily Experience hath taught us to be very good for the same Purposes; and with which, as Occasion requires, many valuable Compounds are formed, in order to effect that with a united Force which they could not do singly; in this Class are the Roots of _Angelica_, _Scorzonera_, _Butterbur_, _Masterwort_, _Tormentil_, _Zedoary_, _Garlick_, _Elicampane_, _Valerian_, _Birthwort_, _Gentian_, _Bittany_, and many others, which any Person that loves Variety may find in proper Authors.

BUT even Gratitude obliges me not to omit saying somewhat of _Ginger_, which I have prescribed both in the Root powdered, and candied, many Times with great Success, for it is very powerful both to raise a breathing Sweat, and defend the Spirits against the Pestilential Impression.

FROM these Roots may be made Extracts, either with Spirit of Wine or Vinegar; for it is agreed by all, that the more subtil Particles collected together, and divested of their grosser and unprofitable Parts, become more efficacious in Medicinal Cases.

THE Leaves of Vegetables most used in Practice, are _Scordium_, _Rue_, _Sage_, _Veronica_, _Dragon_, the _lesser Centaury_, _Scabious_, _Pimpinel_, _Marygolds_ and _Baum_, and from which, on Occasion, are several _Formulæ_ contrived.

GOOD Vehicles to wash down and facilitate the taking more efficacious Medicines, are made of the Waters distilled from those Herbs while they are fresh and fragrant (having not yet lost their volatile Salt;) for those which are commonly kept for Ornament in the Shops are insipid, and of little or no Worth.

A _Clyssus_ also of the same Herbs is preferrable to the Waters, made after this Manner, let a Quantity of Water be drawn from the green and succulent Plant, and the Juice be expressed from another Parcel of the same Herb, and depurated by standing; let then both be evaporated to the Consistence of _Honey_, and from it a Tincture drawn with some more distilled Water and a little Spirit of Wine, which is again by Evaporation to be reduced into an Extract; also from the dryed Plant draw its essential Oil, and from the _Residium_ after Distillation the Salt. Of the Extract take ʒ iv. of the _Salt_ ℥ [ss.], and of the _Oil_ 50 drops, and mix them together, where let them lie to incorporate more intimately with one another. The inspissated Juices likewise of these Ingredients are of good Effect, and in the Winter, Decoctions may conveniently be made of them for the same medical Purposes; and further, that the Remedies in this Case may be yet the more efficacious, they may be joined with _Alkaline-Salts_ dissolved in a proper _Menstruum_: For by this Means the Tone of the Stomach will be strengthened, Putrefaction will be prevented, the nitro-saline _Effluvia_ will be resisted, or at least precipitated, and a _Diaphoresis_ promoted.

SOME Berries are also of great Use in Practice; as the Powder of _Ivy-Berries_ given to the Quantity of one Dram in two Parts of _Elder Vinegar_, and One Part of _White-Wine_; the Spirit likewise drawn from _Elder-Berries_ would do the same in a Dose of ℥ iij. or ℥ iv. the Spirit of _Juniper Berries_ given to ℥ i. a Spirit drawn from green _Walnuts_, with _Treacle-Water_, as also from the Seeds of _Carduus_, _Citrons_, &c. had likewise their due Recommendations in powerfully promoting Sweat.

BUT I know nothing amongst the _Simples_ that hath so obtained, for Ages together, as the _Oriental Bezoar_, and which still hath so great a Name; yet without having any Inclination to contradict a received Opinion, I have been so confirmed by a Multitude of Trials, that the Truth will speak for it self, which manifestly denies its Virtues to be at all equivalent to its Value: And I have really given it in Powder many times to 40 or 50 Grains, without any manner of Effect; and I dare affirm that the _Bezoar_ with which I made these Trials was genuine.

THE Powder also of an _Unicorn_’s Horn, so much cried up for an Antidote, never answered any good Expectations, although I had several Dozes of it given me by a Merchant, on purpose to try its Virtues: But that which would cure Pidgeons, Fowls, Cats and Dogs, from Arsenical Poisons, as the worthy Gentleman assured me that did, had yet no Efficacy against the pestilential Virulence: Yet if it was not controverted to this very Day, whether or no there is such an Animal in Being as an _Unicorn_; and it should moreover be granted that the Horn hath these stupendious Virtues; the Price of it would make it purchaseable only by the Rich; whereas in this dreadful Calamity the Populace were chiefly infected; and therefore cheap and common Medicines should be contrived for them by the Physicians; in the Number of which, first occur the _Troches_ of _Vipers_, given to the Quantity of ℈ iv. in compound _Scordium Water_, or the volatile _Salt_ of _Vipers_ given to ʒ [ss.] in the same Vehicle. A very worthy Person sent us from _New-England_ some Troches made of the Flesh of a _Rattle-Snake_, from which I found more Success amongst the Sick, than those we commonly have here.

THE _Powder of Toads_ was likewise prodigiously extolled by every Body; but I found more Success in _Spirits of Hartshorn_, given from ℈ ij. to ʒ i. in _Plague-water_.

A Youth was seized with a great Difficulty of Breathing, and the Arteries hardly beat, and, in short, all Things seem’d to bespeak him in his last Moments; I prescribed him ʒ i. of the forementioned Spirits in ℥ iij. of _compound Scordium Water_; but the Symptoms continuing obstinate, I again repeated the same in three Hours Time with Addition of ℈ i. more; and five Blisters were also forthwith applied, after which in about half an Hour, he began to move his Limbs, and recollect himself, as if risen from the Dead: but at last when all Things were hopeful, there appeared a Discolouration upon one of his Legs, where a Blister had been raised, with a Loss of Sense very near to a Sphacelation; upon this the affected Part was deeply scarified and then fomented, which, with a Repetition of the same Draught twice in a Day, by the Blessing of Heaven, again restored every Thing into a hopeful Way. For this Spirit is of such a fiery Nature, that it immediately disperses through the whole Body; and on Account of its great Volatility, helps to encounter with, and correct the saline, malignant Quality of the Pestilence: But I need say no more than that it is the most powerful _Diaphoretick_ that can be given in any Disease whatsoever.

WHENSOEVER Things are brought to Extremity, some have Recourse to Mineral Preparations, in Order to drive out the Pestilence by mere Force; amongst which the chief are _Mineral Bezoar_, _Sulphur Auratum_, and _Aurum Vitæ_, &c. the Preparations of which are to be met with in chymical Writers.

I am fearful indeed of being too prolix in the Enumeration of Remedies under this Class; although I am very sensible that some _Simples_ prudently chosen may singly encounter a Pestilence with Success, as well as some other Diseases: But because this Evil is usually attended with so many Complications, the Contrivances to oppose it should also, in the Opinion of some, be equally and proportionably complicated; and all Forces drawn up in Battle against it with full Front, in Order to be equal to the Encounter. To this Purpose some of the Sons of _Esculapius_ have invented manifold Compositions; and some of them so prolix, as if they intended a Sacrifice of an _Hecatomb_ to appease the Severity of this tyrannical Destroyer.

IT would be entirely foreign to our Business here, to extract all the Medicines which some Writers abound with for this End; and it is our Business here only to take Notice of those which were made Use of with Success in the late Sickness; and in this Performance both Gratitude and Duty oblige me to begin with such as were ordered by the _College_, amongst which first occurs their _Plague-water_.

℞ _Radic, tormentillæ, angelicæ, pœoniæ, zedoariæ, glycirrhizæ, helenii ana +℥ [ss.]+ sol. Salviæ, Chelidoniæ, rutæ, summitat: rorismarini, absynthii, roris solis, artemisiæ, pimpinellæ, dracunculi, scabiosæ, agrimoniæ, melissæ, cardui, betonicæ, centaurii min. fol. & flor. calendulæ ana M +i.+ (alii addunt flor. papaveris errat: paralys. ana p. +iij.+) incisa, & contusa infundantur per triduum in lib. +viij.+ vin. alb. opt. dein F. cauta distillatio & liquor usui reservetur_: But here it is by the Way to be taken Notice, that in the Cure of a Pestilence the medicinal Forms are not to be pompously contrived with a long Catalogue of Ingredients, but carefully adapted in every Respect to the Circumstances and Exigencies of the Infected. It is also to be observed, that this Water is by no Means indifferently to be given to all; or to every one in the same Manner; as for Instance, not at all to Women under their menstrual Purgations, least it should provoke them to flow too immoderately; nor is it to be allowed to Women with Child, for Fear of Miscarriage.

MOREOVER the _College_ hath appropriated other Medicines for the same Ends, from which we may extract the following:

℞ _Diascordii, vel Mithridatii +ʒ j.+ vel +℥ [ss.]+ fiat dissolutio in +lib. [ss.]+ possetalæ alteratæ cum partibus æq. vini albi, & aceti opt. Misce detur hæc potio servefacta, ægro stragulis benè cooperto._ Or,

℞ _Radic. Angelicæ +℥ ij.+ tormentillæ +℥ j.+ infusis, & decoctis in aq. font. q. s. ad tertiæ p. consumptionem, adde succi limonum +℥ iij.+ vel aceti +℥ j. [ss.]+ bibat correptus +℥ vij+, vel +viij.+ hujus apozematis calefacti_: Or,

℞ _Sem. pætasitidis +℈ j.+ sem. citri gr. +xxvj.+ cuchianellæ +℈ [ss.]+ caphuræ gr. +xij.+ misce, fiat pulvis, ex haustu aq. cardui, calendulæ, vel scordii sumendus._ Or,

℞ _Expressionem stercoris vaccini recentis in aceto acerrimo infusi ad cochl. +vij.+ vel +viij.+_ Or,

℞ _Theriacæ Androm. +℈ ij.+ Elect. de ovo vulg. +℥ [ss.]+ factâ dissolutione in haustu possetalæ carduatæ, fiat potio, bibatur calefacta expectando sudoris exundationem._

WE shall hereafter come to take Notice of those Medicines which by the _College_ were contrived for the Poor, now therefore take those which by daily Experience were found of most Efficacy, and deserve to stand first on that Account.

_A Compound Antipestilential Decoction._

℞ _Radic. Scorzoneræ, petasitidis ana +℥ v.+ angelicæ, tormentillæ C.C.C. ana +℥ j.+ fol. Scordii, ulmariæ, melissæ ana M +j.+ flor. calendulæ, borrag. ana M +fs.+ bacc. juniperi, hederæ ana +℥ j.+ sem. citri +ʒ ij.+ coriandri præp +ʒ+. +j. fs.+ caricas numero +iij.+ incisa, & præp. in duabus p. aqu. font. & tertia p. aceti opt. infundantur, & decoquantur, sub finem addendo glycyr. taleolatìm sectæ +℥ j.+ in expressionis +lib. iij.+ dissolve theriacæ Androm. +℥ iij.+ nitri purissimi +ʒ iij.+ & adms. interdum Spir. Vitrioli, vel Sulph. guttas aliquot ad leviusculam aciditatem._ Sometimes also we add hereunto Syrup of the Juice of _Citrons_, or _Baum_; but when Matters are in the utmost Hazard, the Patient’s Life is more to be consulted than his Palate; and all _Sugars_ we often omit, as they are both a Load upon the Medicin’s Operation, and in no wise fit for a Stomach affected with a Contagion. The Dose of this Decoction is from 8 to 10 Spoonfuls every 4 Hours.

_An Alexiterial Water._

℞ _Radic. Contrayerva +℥ j.+ scorzoneræ hispan. angelicæ ana +℥ j. [ss.]+ fol. Scordii galegæ ana M +iij.+ fl. ros. rubr. calendulæ ana p. +iij.+ ras. C. C. eboris ana +℥ j.+ bacc. juniperi, hederæ ana +℥ ij.+ in aceto sambucino per triduum macerat: dictamni cretici, cortic. limonum ana +℥ j.+ succ. melissæ, cardui, angelicæ ana lib. +[ss.]+ aceti opt. lib. +ij.+ distilla in organis humilioribus post. deb. infusionem._ Or,

℞ _Succ. Scordii, acetosæ ana lib. +j.+ galegæ lib. +[ss.]+ succ. limonum, aceti opt. ana lib. +j.+ theriac. Androm. +℥ iij.+ digere & distilla Dos. ad cochl. +vj.+ vel +viij.+_

Or,

℞ _Aquæ Alexiteriæ lib. +ij.+ theriac. Androm. +℥ iij.+ Elect. de ovo +℥ j.+ digere, filtra, & usui serva, Dos. ad cochl. +vj.+ vel +viij.+ phiælam agitando._

Or,

℞ _Summit absynthij, rutæ ana +M j.+ Scordii, dracunculi ana +M iij.+ aceti sambuc. +lib. iij.+ distilla in vesicâ, tum in liquore dissolve salis fraxini, carduii, vel Scordii Vitriolat. +ʒ iij.+ Dos. ad cochl. +iv.+ vel +v.+ efficacitèr elicit sudorem hæc Aqua._

_A Treacle-Water._

℞ _Radic. Asari Virgin. +℥ [ss.]+ contrayerva +℥ j.+ tormentilla, scorzon. petasitidis ana +℥ j.+ p. sem. cardui, calendulæ, angelicæ, citri ana +ʒ iij.+ quibus præp. affunde spir. vini, aceti opt. ana +lib. [ss.]+ dissolve theriac. Ven. +lib. [ss.]+ adde croci Ang. +ʒ ij.+ misce indantur organis vitreis, & post octiduanam super cineres digestionem, distillæ, in rostro Alembici suspendendo caphuræ +ʒ iij.+ Dos. ad cochl. +v.+ vel +vj.+_

_A Diaphoretick Oil._

℞ _Salis Absynthii, vel Scordii, sive Rutæ +℥ ij.+ flor. Sulphuris ter, quaterve sublimat. +℥ j.+ ol. Juniperi +lib. j.+ invicèm misc., per biduum calore mediocri benè occlusa relinque, dein per Retortam distilla, etiam alterâ vice distilla, dìgerendo per biduum, addendo salis absynthij +℥ j.+ Dos. ad cochl. unum, vel duo, ex aq. angelicæ, vel scordii, saccharatâ, ad olci +v.+ a. e. Commixtionem._

_An Alexipharmick Vinegar._

℞ _Radic. Scorzon. Hispan. Chelidoniæ mai. ana +℥ ij.+ contrayerva +℥ i.+ angelicæ, tormentillæ ana +℥ i.+ p. fol. scordii, melissæ, scabiosæ ana +M ij.+ summit. Rutæ p. +ij.+ dictamni cret. +M [ss.]+ flor. sambuci, calendulæ ana p. +iij.+ gr. Junip. +℥ ij.+ ras. C. C. eboris ana +℥ j.+ sem. rutæ, cardui, citri ana +ʒ ij.+ portulacæ +ʒ v.+ cinam. opt. +℥ [ss.]+ caryophyll. +ʒ iij.+ Theriac. Androm. +lib. [ss.]+ quibus s. a. præp. affunde Aceti ex vin. albo acerrimi +lib. v.+ vitro opt. obaurato digere per triduum, bis, terve de die conquassando, tum cautè distilla, suspensis camphoræ, & croci ana +ʒ ij.+ in rostro Alemb. Dos. ad cochl. +v.+ vel +vj.+_

BUT sufficiently of these; from whence it is easie for any one to gather, why liquid Medicines, and especially when warmed, are preferrable to others in the Form of _Boles_ or _Electuaries_; that is, because of their more expeditious and more effectual Operations.

BUT because many of the Infected have a Loathing at Stomach, and an Inclination to vomit, in the same Manner as an Overload of Eating and Drinking occasions, Medicines in solid Forms suit best with such, as they are not so easily thrown up, and adhere better to the Sides of the Stomach: Of this Kind we have the following Composition, which at taking may be made into Boles of ʒ ij. each adding thereunto _Salt of Carduus_, or _Wormwood_ ℈ j. or more or less according to the Exigency of Symptoms.

℞ _Elect. de ovo mineralis +℥ j.+ theriac. Androm. +℥ [ss.]+ pulu: serpentariæ virgin. +ʒ v.+ cuchianellæ +ʒ iij.+ croci pulveriz. +ʒ [ss.]+ cum Syr. è succo melissophyll. vel citri, coagmentetur massa._

_The famous Sir +Theodore Mayerne+’s
Electuarium de Ovo_.

℞ _Ovum vulgariter ut in Pharmacopœia +Londinensi+ præp. de quo sume, & sem. sinapios, vel eruca ana +℥ j.+ Antidoti Saxonicæ +℥ [ss.]+ lapidis prunellæ +ʒ v.+ Antimonii diaphoret. fixissimi, & croci metallorum simul ustorum +ʒ iij.+ pulv. scordii, rutæ, zedoariæ ana +ʒ ij.+ +[ss.]+ Theriacæ ven. veteris +℥ iv.+ Philonii Turneri +℈ vij.+ gr. +ij.+ misce & cum spir. Theriac. +ʒ iij.+ & mellis de spumati q. s. Piat Elect. molle, Dos. ad +℈ iv.+ vel +ʒ ij.+ corroborand. adjiciendo corda, & jecinora +vj.+ viperarum v. a. e. præp._ But it is to be observed in this likewise, as in other Antidotes, that a long Fermentation of the Ingredients together in a Mass is very necessary, because by that Means they more intimately mix with one another.

BUT if the Body be too open, the _Lapis Contrayerva_ is very suitable, and ’tis thus made:

℞ _Pulv. radic. contrayerva res. +℥ j.+ serpentariæ virgin. +ʒ ij.+ +[ss.]+ extract. radic. Angelicæ, tormentillæ ana +ʒ ij.+ pulv. C. C. philosophicè calcin. chelarum Cancrorum præp. pulv. Corall. rubr. ana +ʒ j.+ +[ss.]+ Antimonii Diaphoret. vel potius Diaphor. Jovis +ʒ iij.+ cuchianellæ +ʒ [ss.]+ croci +℈ j.+ (aliqui addurat lapid. bezoar. orien. +℈ ij.+) ambræ grys. +℈ [ss.]+ cum gelatinâ spoliorum serpentum, vel C. C. fingantur globuli s. a. exiccandi, Dos. ad +℈ ij.+ vel +ʒ j.+ è vehiculo idoneo, +&c.+_

FOR the same Purpose also is the celebrated _Orvietan_ thus compounded, and given ʒ ij. at a Dose.

℞ _Cardui bened. totius eupatorii mai. & min. ana +℥ [ss.]+ scordii, aristolochiæ utriusque ana +ʒ v.+ viperinæ, h. e. echii, gentianæ, bacc. Junip. bistortæ ana +℥ j.+ bacc. lauri, tormentillæ, dictamni albi ana +℥ [ss.]+ carlinæ, angelicæ ana +℥ j.+ +[ss.]+ rhabarb. imperatoriæ, scorzon. hispan. valerianæ ana +℥ [ss.]+ morsus diaboli, calami aromat. ana +℥ iv.+ Theriac. Androm. opt. +℥ iij.+ corda, & jecinora 12 viperarum, terantur terenda subtilissimè, & cum s. q. mellis despumati fiat Elect. per tres menses fermentand._

IT is to be observed, that these and the like Medicines, whether _Galenical_ or _Spagyrical_, which cannot be prepared as soon as _Asparagus_ can be boiled, ought to be always in Readiness.

THE general Remedies being thus provided, the exact Way of Living and Diet comes to be considered: And first of all whensoever the Patient is taken, he must immediately be put to Bed; wherein we have found it much more serviceable to be covered with Blankets, than Linen Sheets, because the Woollen much better encourages Sweating, and also absorps it, and keeps the Body cleaner all the while; for Linen being not suited to drink up the Sweat, the Pores of the Body, at such Times as open as possible, will be choaked up and obstructed by the Moisture hanging upon the Skin, and giving also a Chilliness to the Flesh: To all therefore who sweat thus, Change of Cloaths is to be denied, for the Patient takes Harm by clean Coverings, not so much from any prejudicial Quality of the Soap abounding in them, (according to the Opinion of _Diemebrooeck_) as from a Dampness which is inseparable from them, and the Approach of Air which is unavoidable in the Shifting; both which will check the Sweating.

UNLESS the Patient hath Occasion for a Vomit, or Purge, or a Clyster, immediately upon his going to Bed, _Alexipharmicks_ ought to be given, and if thrown up by Vomiting, repeated until the Stomach if strengthned, and can retain them; and I have always observed, that such Nauseousness goes off as soon as Sweat breaks out.

SOME indeed of a very dry Temperament, or from a Consumption of their Humidities by the febrile Heat, do not easily get into a Sweat; such therefore I ordered liberally to drink of a medicated Posset-Drink; in order by this Means both to render the viscid Humours more fluid, and contemper and asswage the feverish Heat.

THE Milk with which this Posset-Drink was made, was turned with two Parts of Ale, and one Part of Vinegar, in which had been boiled the Roots of _Scorzonera_ and _Butterbur_; the Leaves of _Baum_, _Scabius_, and _Wood-sorrel_; the Flowers of _Borage_ and _Marygolds_; the Raspings of _Ivory_ and _Hartshorn_, and _Carduus_ and _Coriander_ Seeds.

THESE Sweats we used to keep up for two or three Hours at a Time, as the Strength would bear them; and until the morbifick Venom was rarified and subtilized, so as to be exhaled quite away along with the viscid Humours: Sleep also was industriously kept off, although sometimes, through meer Weariness, the Patient would drop into a Doze.

AS much Care, besides that of Sweating them, was taken to support the Strength and Spirits of the Infected, by such Aliments as the Stomach was able to receive; for which End I ordered them Bread soaked in Wine, poached Eggs with _Juice of Citrons_, _Pomegranates_, or _Elder Vinegar_, as also cordial Waters, Broths, Gellies, and sometimes also generous Wines.

THE Broths then used were made by boiling in Chicken-Broth the Roots of _Scorzonera_; the Leaves of _Pimpinel_, _Meadow-sweet_, _Wood-Sorrel_, _Borage_, Raspings of _Hartshorn_, and _Dactyls_, with a Piece of White Bread, and a little _Saffron_ tied in a Nodule; and the Fat was not taken off unless in a Loosness or Loathing at Stomach: Of the Usefulness of Gold boiled in these Things I have nothing to say: Of this Broth was also sometimes Emulsions made with the _Seeds of Citrons_, _Plantain_, _blanched Almonds_, and _Pearl-Sugar_.

_+Mayerne+’s celebrated Cordial-water._

℞ _Radic. carlinæ +℥ vj.+ zedoariæ, scorzoneræ, imperatoriæ, gentianæ, vincetox. valerianæ, tormentillæ, bistortæ, petasitid. dictamni, bardanæ, pimpinella totius ana +℥ iv.+ fol. cardui, oxytriphyll. scordii, ana M +v.+ ulmariæ, scabiosæ, morsus diaboli, melissæ, pentaphyll. menthæ, rutæ, buglossæ, flor. calendulæ, hyperici ana M +iv.+ limones, & Aurant. cum corticibus ana numero +xx.+ flor. salviæ, rorism. ana M +ij.+ corda vervecina numero +vj.+ corda viper. numero +xx.+ vini generosi +Hispan.+ lib. +xx.+ infusione deb. peractâ, fiat Distillatio cauta in B. M. hujus Aq. Dos. ad cochl. +iv.+ vel +v.+ dulcor. (si ita visum) cum sacchari perl. q. s._

BUT the Patients were kept from Aliments of this Kind until some Relief was found by _Alexipharmicks_; and then only so much was allowed of as their Strength would admit of, for that was to be helped, and not loaded; but as they grew better, more was allowed: Yet an Hour or two after such Refreshment, notwithstanding the Distemper seemed to be extinguished, _Alexipharmicks_ were repeated, until all Suspicion of its Remainder was removed; because sometimes it would on a sudden recruit after it had seemed to be quite gone.

THE Infected were kept close in their Beds the whole Time of the Disease; and those who would not be thus governed, bitterly repented of their Obstinacy; for upon Checking a _Diaphoresis_, and Confining the pestilential Venom, most grievous Pains and Disorders ensued: And they who were delirious, were tied in their Beds, to prevent their doing either Injury to themselves, or those who attended upon them.

IF a Drowsiness came on at the first Attack of the Distemper, or in the Beginning to Sweat, the Patient was forcibly kept awake; although, when some Appearance came of Recovery, a little Sleep was indulged to recruit the Spirits, but not beyond four Hours together; for if they slept longer, they were waked to take their Medicines.

IF the Belly was costive, and the Distemper on its Declension, Clysters were used with Benefit; made of a Decoction with the Roots of _Scorzonera_, _Tormentil_, and _Marsh-Mallows_; the Leaves of _Scordium_, _Meadow-sweet_, and _Violets_; Flowers of _Chamomil_ and _Elder_; _sweet Fennil-Seeds_, and _Anniseeds_; and in it was dissolved the Yolk of an _Egg_, _brown Sugar_, and ʒ iij. of _Diascordium_ or _London Treacle_; and when more Haste was required for Evacuation, ℥ j. or ℥ j. [ss.] was added of the Infusion of _Crocus Metallorum_. After the Clyster came away, the Patient was allowed a Draught of generous Wine, or of some Cordial Julap, or Broth, _&c._

AND whereas a Languor upon the Spirits very much contributed (as before observed) both to the Propagation and Violence of the Contagion; to remove such an Inconvenience, grateful Scents were made use of, such as are known to comfort the Brain; sometimes _Vinegar of Roses_ was sprinkled upon live Coals, and at others, were burnt such things as _Styrax_, _Labdanum_, &c. of which more hereafter, and all things avoided which might give any Offence to the Nose by its Smell.

HITHERTO we have treated of Antidotes, and the Regimen of our Patents; next we come to external Helps, amongst which _Blisters_ demand the first mention; and whose frequent and successful Application removed all Controversie about their Usefulness.

_BLISTER-Plasters_ were applied to several Parts; as the Nape of the Neck, within-side the Arms, the Thighs, and Legs; and by these the Vessels were warmed, the Juices rendered more fluid, a _Stimulus_ given to the Sluggishness of Nature, and Passage made sufficiently large, for the Evacuation not only of superfluous Serosities and noxious Humours, but also for the pestilential Poison, which by this Artifice seemed to be turned out this Way; not to say any Thing of the Revulsion made hereby of Venom from the nobler Parts.

FOR this Purpose, I once ordered a _Blister-Plaster_ to be applied within-side the Thigh, a little below a Buboe in the Groin, but by the Carelesness of the Nurse, it was laid upon the Buboe it self; which happening to prove fortunate, after obtained in Practice, in Expectation thereby to prevent the morbifick Humour from going back again, and to forward its Suppuration; but altho’ this was of Advantage in some Cases, it was yet much suspected by the more cautious Physicians and Surgeons, as for the most Part it brought too great an Inflammation all round it, and promoted a Strangury, which, by Excess of Uneasiness, greatly wasted the Spirits, and sunk the Patient’s Strength.

THAT these Applications may certainly answer their End, the most sharp ought to be used: The following Composition never failed me in all my Practice; but before its Application, the Part was always rubbed with Vinegar.

℞ _Picis navalis +℥ v.+ galbani colat. +℥ j.+ ceræ +℥ j. [ss.]+ quibus simul liquatis, & ab igne semotis, adde pulv. cantharidum præp. +ʒ vij.+ vel +℥ j.+ fermenti veteris, sem. ameos ana +ʒ iij.+ euphorbii +ʒ j.+ cum aceti scillit. q. s. incorporentur, assiduè agitando, quoùsque cogantur in Emplastri massam._

THE Parts thus vesicated were never suffered to heal, till the Malignity of the Disease was spent; and to prevent their suddain drying up, they were continually stimulated by _Melilot_ Plasters sprinkled over with some Powder of _Cantharides_; which kept up a constant Drein of noxious Humours; but to asswage the great Heat and Inflammations, sometimes occasioned hereby, _Cole-wort_ Leaves were applied to them.

YET although _Epispasticks_ did so much Service to the Infected, and sufficiently made amends for the Trouble and Pain they gave; yet they were not indifferently suitable to all Persons; As for Instance, where there was an Heat of Urin, or a continual Inclination to piss, where the _Sphincter_ of the Bladder was inflamed, or ulcerated, in an Hemorrhage, or to Women with Child, or having the _Menses_; and lastly, where there was a great _Languor_ upon the Spirits; it is also diligently to be considered when _Epispasticks_ are applied to Buboes or Carbuncles near upon Suppuration, that they do not fuse the Humours too much, to admit them going into a laudible _Pus_, and give such a _Stimulus_ to the Parts, as may sink the Spirits, and frustrate other Endeavours of Nature to help her self.

BESIDES _Epispasticks_, it is not lost Labour to apply proper Things to the Feet; I commonly used a Plaster made of the compound _Bettany_ Plaster, adding to it some _Euphorbium_, _Saffron_, and _London Treacle_; And I found this to do more Good than _Cataplasms_, which some, however, liked better to use, and were made of _Bryony_ Root steeped in Vinegar, the Flesh of _pickled Herrings_, _black Soap_, _Rue_, _Scordium_, and _Arum_, with a sufficient Quantity of Vinegar: Sometimes also Pidgeons were applied to the Feet.

BUT these, and other Medicines of the same Rank, were not applied in any Expectation to draw away by them the pestilential _Miasmata_ as by Attraction; but because the Multitude of Pores, and their Largeness in the Soles of the Feet, gave such Things an Opportunity of sending in that warmth, as would keep the Animal Humours more fluxile, and cherish the natural Heat that was almost extinct; and from thence the whole Body would be refreshed by their Influence: Applications were likewise made to the Wrist with the same View.

AND thus having gone through the curative Part of a Pestilence in general, we now come to the Management of particular Symptoms; and first of all of the Buboes.

IT highly concerns all who are concerned for the Sick in these Cases, both Physicians and Surgeons, to attend with Diligence to the Nature of these Tumours, and have their several Differences ready in their Minds, that at their first Sight they may know their Condition, and use Means of treating them accordingly. And first of all it is to be enquired, whether they are moveable or fixt? whether soft or hard? whether depressed or prominent? whether small or great? whether contracted or broad? whether with, or without Pain? and lastly, whether inflamed or not?

WHENSOEVER a Buboe is uncertain and dodges, sometimes appearing and then again going back, all Means is to be used to fix it; and this is very successfully done by cupping upon the Glands, which will fix a permanent Tumour upon them.

TO Buboes just in their first Formation, we have indeed applied _Discutients_, and very powerful ones too, in Order to dissipate them; and although they have several Times endeavoured to settle, yet we have not despaired to conquer the Enemy this Way: But we always found it for certain, that they who went through such Fluxes and Refluxes of the pestilential Venom, never recovered in such a perfect Manner, as they whose Buboes immediately fixed, and after Suppuration threw out a great deal of Matter.

If the Tumour is hard and painful from too great a Tension upon the glandulous Parts, not giving Room enough to receive the protruding Humours, the Part affected may be anointed with _Oil of Lilies_, _Roses_, _Elder_, &c. if no Inflammation forbids such a Method; in which Circumstance all Oils and Ointments are to be suspected, as they obstruct the Pores, and are no Ways suitable to the Nature of the nitro-saline pestilential Venom. When an Inflammation therefore is upon any Part, which is easie to be known by its Heat and Colour, it is better to make Use of the _Mucelages of Linseed_ and _Fenugreek_, with _Elder Vinegar_, and _London Treacle_; or a _Cataplasm of Wheat-Flower_, _Fenugreek_ and _Linseed_, _Elder Flowers_, _white Bread Crumbs_, the _Yolk of Eggs_, and _Powder of Saffron_.

THE _London_ Physicians at this Time spared no Trouble nor Application, to manage the Buboes rightly; some of the Cataplasms therefore by them daily used I shall here insert.

℞ _Cœpam majusculam, quam v. a. e. excavatam imple summit. rutæ dcb. exiccat. & pulveriz. ʒ+ _+ij.+ indantur etiam theriac. +Lond. ℈ iv.+ foramen operculo suo obturetur, cœpa deinde chartâ bibulâ involuta sub cineribus assetur, cui adde ficum methodo eâdem assatam, cum ol. lini, liliorum alb. ana q. s. simul macerentur, & conficiatur +cataplasma+, applicandum calidè, bis de die immutandum_: This is also good against the Bites of venomous Creatures.

Or,

℞ _Fol. rutæ, scordii contus. ana M +[ss.]+ medullæ carnis ficuum +℥ ij.+ flor. meliloti p. +[ss.]+ salis marini pulveriz. +ʒ ii.+ fermenti veteris +℥ [ss.]+ cum s. q. aceti, paretur Cataplasma._

Or,

℞ _Rad. liliorum, althææ, cum aceto macerat: ana lib. +[ss.]+ sem. lini, fænugræci ana +℥ [ss.]+ carnis ficuum +℥ iij.+ confectionis sinapi, cum theriac. ana +℥ [ss.]+ axungiæ suillæ q. s. F. cataplasma._ Or, according to _Mayerne_, from whom I learned the Rudiments of Practice.

℞ _Succ. apii +℥ ij.+ melissæ +℥ j.+ pimpinellæ +℥ j.+ +[ss.]+ cæpas majores Numero duas, ad intenerationem, sive putrilaginem sub cineribus cautè assatas, alliorum bulbos Numero +vj.+ clavos juglandium maj. vetust. Numero +iv.+ tritis alii bulbis, & clavis, affunde succos, tum adde Cæpas, in mortario marmoreo cum aceti scillit. q. s. agitentur, & cogantur in Cataplasmatis consistentiam._

BUT the Hardness, pricking Pain, and intense Heat of the Tumour continuing, Medicines were used to dissolve such Hardness, and asswage the Pain and Heat: As,

℞ _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.