But for this, and other diseases of the breaft, I refer the reader to Bellini, De morbis capitis, pectoris,

c.

As

CHA P. VI.

Of the difeafes of the heart.

S the heart, the primary inftrument of all animal motions, and in fome meafure the fountain of life, is a mufcle, or rather a collection of feveral mufcles, it is liable to the fame indifpofitions with the other mufcles of the body.

But the diforder with which it is moft frequently feized, is a palpitation, whereby its motion is interrupted, for fome little fpace of time. This proceeds from very different caufes. For fometimes its fibres becoming paralytic do not drive the blood with fufficient force. At other times a polypus, formed

in its ventricles or auricles, obstructs its action. Again, when the blood is too thick, and too much in quantity, it is with difficulty thrown into the blood veffels. Likewife the motion of this muscle may be impeded by an over-great quantity of water in the pericardium; though this indeed be a rare cafe. Stony concretions alfo put it out of order. And it fometimes happens, especially in aged perfons, that the tendons in the orifices of the ducts have acquired the hardness of bone; whereby their elasticity is deftroyed, and too great a refiftance is made against the propulfive motion. Nor is it to be omitted, that the want of a proper quantity of blood may occafion this difeafe. For when this is the cafe, the animal fpirits

fpirits are fecreted too fparingly in the brain; whence the contraction of the heart is hindered, and there is an intermiffion in the pulfe.

But it is to be obferved, that this difeafe is generally a convulfion; and as, in this ftate, the heart is not able to throw out a due quantity of blood at one contraction, it repeats its effort: a remarkable inftance of what I faid in the introduction, that even thofe motions which are called involuntary, are governed and altered by our mind.

And let me add, by way of prognoftic, that this diforder, when it rifes to a high degree, and frequently returns, generally ends in a fyncope, or fatal weakness, which authors believe to be another difeafe of the heart.

Now, the method of cure is to be varied according to the nature of each of thefe various cafes. But this may hold good in general, that unlefs the patient be very weak, blood may be drawn; whereby the heart may be eafed of part of the load of blood, which it is too feeble to throw into the arteries. And indeed, I have often obferved, that not only the palpitation of the heart, but even a fyncope, arifes from fulness: and thus this fudden fainting frequently fucceeds the fuppreffion of any customary discharge of blood, for example, from the nofe or hæmorrhoidal veffels: whence it follows, that blood-letting must be very ferviceable for preventing this evil; but it will hardly bear any other evacuations. The paralytic weaknes of the fibres requires the medicines directed in the chapter of the palfy. Thick blood which engenders a polypus, is corrected by attenuating medicines, as volatile falts and fœtid gums. And blifters are very

proper to stimulate and roufe the patient, especially in cafe of fainting attended with fleepiness.

CHA P. VII.

Of the difeafes of the ftomach and intestines.

N the difeafes of the ftomach and intestines I

have fome things to propofe, relating not only to what is to be done, but likewife to what is to be avoided. And first, although it be fometimes extremely necessary to evacuate by vomit the vifcid phlegm which loads the stomach; yet by too frequent vomits to invert that natural motion, by which the aliments are carried downward, is giving great disturbance and impediment to the concoction of food.

Infufions of the bitter herbs whet the appetite, and often help digeftion: but there is reafon to fear, that a long ufe of them may over-heat the mufcular fibres. Upon which account, it is frequently more convenient to brace them with fome acids, especially Mynficht's elixir of vitriol; under this caution however, that they are not to be given, while the phlegm in the ftomach is tough. For a very common diforder of the ftomach is relaxation; and that certainly requires the bracing of its fibres.

SECTION I.

Of a Looferiefs.

A

Loofenefs is easily stopped. I fpeak of that fort which is without a fever: for when it comes

on a fever, we are to confider, whether it may not prove a crifis of the disease. But when the cafe is a loofeness alone, it will be generally fufficient, after a vomit or two with ipecacuanha wine, to purge with fome dofes of rhubarb, and then to strengthen the intestines with aromatics and chalk, or French bole.

The bloody flux.

BUT the cafe is attended with greater difficulty, when the loofenefs is accompanied with a bloody flux, or fevere gripes. For then the intestines are commonly ulcerated, and discharge blood; which comes away fometimes with liquid excrements, fometimes with flime, accompanied with fleshy particles. The patient is teafed with frequent irritations to ftool, and a pain in the anus; he difcharges but little at a time, and his pain is increased by every ftool, and as this difeafe arifes from an inflammation, there is always fome degree of fever with it.

Wherefore, to come to the cure, the first thing to be done is to draw blood. Then a vomit is to be given, for which ipecacuanha wine is very proper, and to be repeated two or three times more, every third or fourth day.

During this course, and afterward, medicines proper for stopping the flux and healing the ulcerated membranes, are to be administered. And of this fort, I know none better than the following bolus, compofed of the cordial confection and French bole, each one fcruple, Thebaic extract one grain; given three times a-day.

And it will be of fervice to inject clyfters, either

of

of fat broth with the addition of Venice treacle or electuary of fcordium: or of the white decoction and ftarch; or, in place of this laft, of the chalk julep, with two or three grains of the Thebaic extract, when occafion requires it.

Lastly, I recommend as an ufeful remark, that this courfe is fometimes rendered ineffectual by a bad habit of body. In fuch cafes, to the foregoing method it will be proper to add medicines, which correct the humours; and indeed fome dofes of rhubarb, with a fmall proportion of dulcified mercury fublimate, commonly called calomel, will prove very conducive to that end.

Befides thefe difeafes, a vomica or internal fuppuration, is fometimes formed in the ftomach. This indeed feldom happens, but yet I have obferved it more than once; when the patient vomited up a mixture of blood and purulent matter in large quantities. The cafe is terrifying indeed; but yet, generally fpeaking, it is not attended with any great danger; and it is cured by medicines which heal the ulcerated membranes, especially by Locatelli's balsam,

TH

SECTION II.

Of the Iliac Paffion.

His difeafe, by the Greeks named into, and by Celfus the difeafe of the fmaller gut, is very acute. It is a violent inflammation of the intestine, which, unless speedy relief be given, foon terminates in a gangrene, and death.

Wherefore blood must be plentifully drawn with

* Lib, iv. cap. 13.

great