Loimologia: Or, an Historical Account of the Plague in London in 1665 Part 9

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 Circ.u.mstance 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.

? _Cpam majusculam, quam v. a. e. excavatam imple summit. rutae dcb.

exiccat. & pulveriz. ?+ _+ij.+ indantur etiam theriac. +Lond. ? iv.+ foramen operculo suo obturetur, cpa deinde charta bibula involuta sub cineribus a.s.setur, cui adde fic.u.m methodo eadem a.s.satam, c.u.m ol. lini, liliorum alb. ana q. s. simul macerentur, & conficiatur +cataplasma+, applicandum calide, bis de die immutandum_: This is also good against the Bites of venomous Creatures.

Or,

? _Fol. rutae, scordii contus. ana M +[ss.]+ medullae carnis ficuum +? ij.+ flor. meliloti p. +[ss.]+ salis marini pulveriz. +? ii.+ fermenti veteris +? [ss.]+ c.u.m s. q. aceti, paretur Cataplasma._

Or,

? _Rad. liliorum, althaeae, c.u.m aceto macerat: ana lib. +[ss.]+ sem. lini, faenugraeci ana +? [ss.]+ carnis ficuum +? iij.+ confectionis sinapi, c.u.m theriac. ana +? [ss.]+ axungiae suillae q. s. F. cataplasma._ Or, according to _Mayerne_, from whom I learned the Rudiments of Practice.

? _Succ. apii +? ij.+ melissae +? j.+ pimpinellae +? j.+ +[ss.]+ caepas majores Numero duas, ad intenerationem, sive putrilaginem sub cineribus caute a.s.satas, alliorum bulbos Numero +vj.+ clavos juglandium maj.

vetust. Numero +iv.+ tritis alii bulbis, & clavis, affunde succos, tum adde Caepas, in mortario marmoreo c.u.m aceti scillit. q. s. agitentur, & cogantur in Cataplasmatis consistentiam._

BUT the Hardness, p.r.i.c.king Pain, and intense Heat of the Tumour continuing, Medicines were used to dissolve such Hardness, and a.s.swage the Pain and Heat: As,

? _Rad. liliorum alb. +? ij.+ porrorum, medullae 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. Scabiosae, acetosae ana +M ij.+ charta bibula involut. & cineribus scintillantibus subditorum, quibus adde fermenti veteris +? ij.+ salis tantillum, agitentur probe in mortario c.u.m s. q. axungiae suillae, ad usum praememoratum._ 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 a.s.swage sharp Humours; yet, I say, because their frequent Repet.i.tion is sometimes on many Accounts inconvenient and disagreeable, I used to subst.i.tute the following _Cerate_ in their Room.

? _Emp. Oxycrocci +? iij.+ galbani colat gum. curannae ana +? j.+ picis navalis +? ij.+ e liquatis simul. c.u.m ol. chamemeli, & liliorum, v. a. e.

F. ma.s.sa 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. c.u.m vitello ovi solut. +? [ss.]+ theriac.

Lond. +? iij.+ farinae tritici +? ij. [ss.]+ c.u.m ol. hyperici & sambuc. ana q. s. coq. in Cataplasmatis consistentiam._

Or,

? _Ung. basilic. p. duas, linimenti Arcaei p. Tertiam, ol. terebinth. +?

[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 n.o.bler 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 Repet.i.tion, 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 a.s.swage 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 a.s.sati +? ij.+ stercoris columbini +?

j.+ confec. Sinapi +? v.+ euphorbii +? ij.+ c.u.m 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 s.e.x 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 a.s.swage 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 _b.u.t.ton_, being so shaped; but they are of little Service, except the Burning extends to the Compa.s.s 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 a.s.sisted by moistening it with new b.u.t.ter, 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 circ.u.mjacent Parts at first should be guarded by Defensatives, which would astringe the Laxity upon those Parts, keep the Pa.s.sages 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.+ e 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. affectae bis de die, quam caladissime, exin Cataplasma conficiatur e theriac. Lond. c.u.m 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 a.s.sisted 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 const.i.tute two in every Parish daily to visit every Family, and be satisfied whether every one belonging thereunto was well, and free from any Infection.