_Sic submersa fretris concharum & Carcere clausa,
Ad Lunæ motum variant animalia corpus._
It is very well worth the pains to enquire what share such an Alteration
in the Weight and Pressure of the Atmosphere may have in the _Crises_ or
Changes of Acute Diseases. The Ancients made great Account of _Critical_
Days, and regulated their Practice according to the Expectation they had
from them; This Part of Physick is grown now into disuse, quite
slighted, and even ridiculed; and that I suppose chiefly for these two
reasons. In the first place, because the earliest Observations of this
kind, which were drawn into Rules being made in _Eastern_ Countries,
when these came to be applied to the Distempers of _Northern_ Regions,
without allowance given for the difference of the Climate, they were
oftentimes found not to answer. And secondly, Fevers of old were treated
with few or no Medicines, the Motions of Nature were carefully watched,
and no Violence offer'd to interrupt her Work. The Histories therefore
of _Crises_, tho' of great Use, and certainty under such Management as
this, were at length unavoidably set aside and lost; when Acute Cases
came to be Cured, according to this or that Hypothesis, not only by
Evacuations, but hot or cold Alteratives too; there being no longer any
room for those Laws of Practice which supposed a regular and uniform
Progress of the Distemper.
Wherefore, in order to understand a little both what might Induce the
first Masters of our Profession to so nice and strict an Observance in
this point; and what grounds there may be now, for a more due regard to
their Precepts, even upon the score of the Lunar Attraction only, I
propose the following Remarks.
1. All Epidemic Diseases do in their regular course require a stated
time, in which they come to their height, decline, and leave the Body
free.
This is so constant and certain, that when a Fever of any _Constitution_
which is _continual_ in one Subject, happens from some other cause, in
another to be _intermitting_, the Paroxysms do always return so often as
all together to make up just as many days of Illness as he suffers,
whose Distemper goes on from beginning to end, without any abatement.
Dr. _Sydenham_, a sworn Enemy to all Theories, learn'd thus much from
downright Observation; and gives this reason why Autumnal Quartans hold
six Months, because by computation the Fits of so long a time amount to
336 hours, or 14 days, the period of a continual Fever of the same
Season.[43]
So _Galen_ takes notice that when an Exquisite Tertian is terminated in
seven Paroxysms, a true Continual at the same time has its Crisis in
seven days; that is, the Fever lasts as long in one as in the other, in
as much (says he) as _a Fit in an Intermitting Feaver answers to a day
in a Continual_[44]. Now this so comes to pass, because
2. In these Cases there is always a Fermentation in the Blood, which
goes not off till the active Particles are thrown out by those Organs of
Secretion, which, according to the Laws of Motion, are most fitted to
separate 'em. And
3. As different Liquors put upon a Ferment, are depurated in different
times, so the Arterial Fluid takes up a determined Period, of which it
is discharged of an induced Effervescence.
4. The Symptoms, during this Ebullition, do not proceed all along in the
same Tenour; but on some days particularly, they give such evident Marks
of their good or bad Quality, that the nature of the ensuing _Solution_
may very well be guess'd at, and foretold by 'em.
Things being thus, Those days on which the Disease was so evidently
terminated one way or other, might very justly be call'd the days of
_Crisis_; and those upon which the tendency of Illness was discovered by
most visible Tokens, the _Indices_ of the _Critical Days_.
And thus far the Foundation was good, but when a false Theory happen'd
unluckily to be joined to true Observations, this did a little puzzle
the Cause. _Hippocrates_, it is plain, knew not to what to ascribe that
remarkable regularity with which he saw the Periods of Feavers were
ended on the _Seventh_, _Fourteenth_, _One and Twentieth_ day, _&c._
_Pythagoras_ his Philosophy was in those Ages very Famous, of which
_Harmony_ and the _Mysteries of Numbers_ made a considerable part, _Odd_
were more Powerful than _Even_, and _Seven_ was the most perfect of all.
Our great Physician espoused these Notions,[45] and confined the Stages
of acute Distempers to a _Septenary_ Progression[46], upon which this
Inconvenience follow'd, that when a Crisis fell out a day sooner or
later than this Computation required, his Measures were quite broken;
and that this must necessarily oftentimes happen, will appear by and by.
Upon this score _Asclepiades_ rejected this whole Doctrine as vain,[47]
and _Celsus_ finding it to be too nice and scrupulous, observes that the
_Pythagorean Numbers led the Ancients into the Error_.[48]
_Galen_ being aware of this, succeeded much better in his reasoning upon
the Matter, and very happily imputed the Critical Changes not to the
Power of Numbers, but to the Influence of the Moon; which he observes,
_has a mighty Action upon our Earth, exceeding the other Planets, not in
Energy, but in Nearness_[49]. So that according to him, the Septenary
Periods in Diseases are owing to the _Quarterly Lunar Phases, which are
the times of the greatest Force, and which return in about seven
days_.[50]
The result of the whole Affair, in short is this, A _Crisis_ is no more
than the Expulsion of the Morbific Matter out of the Body, thro' some or
other of the Secretory Organs; in order to which, it is necessary that
this should be prepar'd and comminuted to such a degree, as is required
to make it pass into the Orifices of the respective Glands; and
therefore _as_ the most _perfect Crisis_ is by _Sweat_, (both by reason
that the Subcutaneous Glands do naturally discharge more than all the
other put together, and also that their Ducts being the smallest of any,
whatsoever comes this way is certainly wery well divided and broken)
_so_ the most _imperfect_ is an _Hæmorrhage_, because This is an
Argument that what Offends is not fit to be cast off in any Part, and
consequently breaks the Vessels by the Effervescence of the Blood. An
_Abscess_ in those Organs which separate thick, slimy Juices is of a
middle nature betwixt these two.
Now it is very plain, That if the time, in which either the Peccant
Humour is prepar'd for Secretion, or the Fermentation of the Blood is
come to its height, falls in with those Changes in the Atmosphere which
diminish its pressure; the _Crisis_ will then be more compleat and
large. And also, that this Work may be forwarded or delay'd a day, upon
the account of such an Alteration in the Air; the Distention of the
Vessels upon which it depends, being hereby made more easie, and a weak
Habit of Body in some Cases standing in need of this outward Assistance.
Thus a Fever which requires about a Week to its Period, may sometimes,
as _Hippocrates_ observed, have a good Crisis on the sixth, and
sometimes not till the eighth day.
In Order therefore to make true Observations of this kind, the time of
Invasion is to be considered, The genuine course of the Distemper must
first be watched, which is not to be interrupted by any violent Methods:
The strength of Nature in the Patient is to be considered, and by what
Secretions the Crisis is most likely to be performed; and it will then
be found, that not only the _New_ and _Full_ Moons, but even the
_Southings_, whether visible or latent, of the Planet, are here of
considerable Moment.
For Confirmation of which, we need only to reflect on what Mr. _Paschal_
has remark'd, _concerning the Motions of Diseases and Births and
Deaths_[51]. Dividing the Νυχθήμερον into Four Senaries of Hours,
the first consists of three hours before the Southing of the Moon, and
three after; the second of the six hours following, and the third and
fourth of the remaining Quarters of the natural day; He takes notice
that none are born, or die a natural Death in the first and third
Senaries, which he calls first and second Tides, but all either in the
second or fourth Senaries, which he calls first and second Ebbs. In like
manner, that in Agues, the tumult of the Fits generally lasts all the
Tiding time, and then goes off in kindly Sweats in the Ebbs. From whence
he very rationally concludes, that Motion, Vigour, Action, Strength,
_&c._ appear most, and do best in the _Tiding Senaries_; and that Rest,
Relaxation, Decay, Dissolution, _&c._ belong to the _Ebbing Senaries_.
[25] Τας τῶν ἐπιλήπτων τηρεῖ περιόδους. _De Dieb. Critic. lib._ 3.
[26] _Alexand. Trallian._ lib. 1. c. 15.
[27] Matth. c. 17. v. 15.
[28] _Apuleius de Virtutib. Herbar._ cap. 6. & 95.
[29] _Anatom. Centur._ 2. H. 72.
[30] _Observ. Med._ lib. 1. cap. 12.
[31] _De Morb. à serosâ Colluvie_, Obs. 28.
[32] _De Aere Aquis & Locis._
[33] Nᵒ 272.
[34] _Philos. Trans._ Nᵒ 171.
[35] _Medicin. Static._ Sect. 1. Aph. 65.
[36] _De Experiment. circa Sanguin._ p. m. 341.
[37] _Observat._ Lib. 2. c. 43. _vid. etiam Observ._ 52.
[38] _Asthma & Tuss._ § 22.
[39] _Treatise of the Asthma_, p. 17.
[40] _Observat. Anatomic._ 92.
[41] _Apud_ A. Gellium, lib. 20. c. 8.
[42] _Astronomic._ lib. 2.
[43] _De Feber. Intermit._ Ann. 1661. pag. _m._ 65.
[44] _Comment. in Aphor._ 59. lib. 4. & _de Crisib._ lib. 2. c. 6.
[45] _Epidem._ lib. 1. Sect. 3.
[46] αἱ μὲν οὖν ἡμέραι ἐπισημόταταί εἰσιν ἐν τοῖς πλείστοις αἵτε πρῶται
καὶ ἑβδομιαῖαι, πολλαὶ μὲν περὶ νούσων, πολλαὶ δὲ καὶ τοῖς ἐμβρύοις.
_de Septimestri Partu._
[47] _Vid. Celsum_ lib. 3. c. 4.
[48] _Ibid._
[49] _De diebus Decretor._ lib. 3.
[50] _Ibid._
[51] _Philos. Transact._ Nᵒ 202.