_Unction_, and in a few Days, the Force of what he had taken being
somewhat spent, he began to get Strength, and the very great Slough
(which was one of the Accidents mentioned to Dr _Friend_) not only cast
off, but also healed, as did also the old malignant _Ulcer_, and all
the Parts of the Mouth looked very smooth and well; and the Doctor was
very chearful, and in great Hopes of gaining the Point.
At this Time, it being eighteen Days since I wrote to Mr _Brown_,
I received a Letter from him, in which he mentioned nothing to the
Purpose. This, I must confess, did not a little warm me; and I the same
Night wrote to him again, but never received any Answer: Perhaps he
thought mine too hot; if so, if he desires it, both mine, and his that
occasioned it, shall be produced.
The Doctor seeing what had been done to have so good Effect, and
hoping what was before advised by Mr _Palmer_ and Mr _Brown_, would
effectually prevent any return of his Disorder, resolved to use a
_Mercurial Unction_. He had now more Strength, and therefore I complied
with him; I began with a small Quantity, and encreased it every Time,
until I had used even a larger Quantity than had been proposed by Dr
_Friend_: But it not in the least affected the Glands, or made him
to spit near so much, as when he took the _Calomel_; neither did the
_Unction_ or _Calomel_ produce the Smell, which generally attends
_Mercurial_ Courses; and to my great Surprize and Concern, whilst he
was using the _Unction_, the _Ulcer_ broke out again. And by this we
were discouraged from proceeding any farther; and in due Time the
Doctor endeavoured to Purge this off, but he had always so untoward a
Constitution, that neither now, nor at any Time before, could he by
Purges have any regular Evacuation; which was, no doubt in his Case,
very Injurious to him.
Now I perfectly desponded: But a Friend and Kinsman of the Doctor’s,
a _Surgeon_ of no small Reputation, assured him, that he had known,
when other Methods failed, a _Mercurial Fumigation_ had answered: And
what is it that a rational Man will not try to prevent the excruciating
Pains of a _Cancer?_ When the Doctor mentioned this to me, I confessed
I knew nothing of that Practice, and always had an ill Opinion of
the Fumes of _Mercury_: And he also owned to me, that he was wholly
unacquainted with it; but satisfied in his Friend, and therefore would
try it: He began the Course according to his Friend’s Directions;
I never pretended to order any thing afterwards; but however still
frequently visited my Good Friend, though with an aking Heart. The
Fumigation not only made him spit, whilst he was using it, but also
for some Hours afterwards; and the Patient continued to use it for
several Days, but without any good Effect upon the _Ulcer_. In about
ten Days after he had left off the Fumigation, a very hard Tumour began
to arise, upon the Muscles of the lower Part of the Face and Neck, and
increased very fast, and in a very short Time spread it self from Ear
to Ear: and, by the Bulk, in a great measure prevented his Swallowing,
and soon suffocated him. He was Chearful, and to all outward Appearance
tolerably easy to the last, and had what he now desired, a gentle
Release, _July 16, 1719_.
And thus, to the Misfortune of Mankind, it is manifest to me, that
_Mercury_ is not adequate to this _Herculean_ Distemper: but however,
this Case, and That I mentioned before to the Doctor, gives me good
Reason to believe, that _Mercurials_ do at least blunt the Acrimony
of the Humour, and so procure Ease. For, though that Patient had
most acute Pains, before he entered into a _Mercurial_ Course, yet
afterwards he was easy all a long, as he told me; for I was called in
but a few Days before he died. These, and other melancholly Cases,
should not however, I think, wholly discourage _Surgeons_ from making
rational Attempts upon a Distemper, which I fear is more frequently
met with, than formerly, in this Part of the World: It is to be hoped,
there is in Nature a Specific that may answer; and happy will that Man
be who shall discover it. He will deserve to be placed next to the
Great _Hippocrates_, and also to be rewarded, by the Publick, equally
with him that shall find out the _Longitude_.
I will not pretend to determine, how far the Fumigation might
contribute to the sudden growth of the Tumour mentioned, but I
should be very glad that the _Surgeon_ who recommended it, would be
so ingenuous, as to vindicate himself, by giving Instances of it’s
Innocency, and of the Advantages he has met with in the Practice of it.
And now I heartily beg Pardon of the Friends of the Deceased, who shall
give themselves the Trouble of Reading this Account, that I could not
bring it into a narrower Compass.
* * * * *
Having truly related what was done, in the Case of Dr _Keil_, I hope
it may appear, that I have acted an honest, and not an unskilful Part
in it: If what was prescribed by others of greater Fame, when it came
to be tried, had not better Success, I presume I shall no longer be
blamed for it. No Man would willingly lose any Reputation, who is to
live by it. I question not, but the best _Surgeons_ in the World will
allow, there are Cases for which there is no Remedy: And he who frankly
owns thus much, no more loses any Reputation, than the Quack, that
promises greater Matters than he afterwards performs, gets any: And I
think they, who have censured me, would have done more ingenuously, if
they would rather have looked upon the present Case as incurable by any
_Surgeon_, than have thrown their Aspersions upon me, as not treating
it properly.
_N. B._ The foregoing remarkable _Case_ of Dr _Keil_, was published
by Mr _Rushworth_ of _Northampton_, Surgeon at _Oxford_, in the Year
1719[3]. Under the _Imprimatur_ of _Robert Shippen_, Vice-Can. _Oxon._
[3] Mr _Rushworth_ died 1737, and it is here inserted in Justice to
his Memory.
_Some_ curious Observations _made_ (_by my Friend_ John Ranby,
_Esq_; _Surgeon to his Majesty’s Household_, _and F. R. S._) _in
the_ Dissection _of_ Three Subjects, 1728.
The _first_, a Man aged 70 Years, who died of a Suppression of Urine,
occasioned by a Stone stopping in the _Urethra_, just within the
_Glans_, of the bigness of a Horse Bean. This Appearance, with the
Symptoms that had attended this miserable Man, gave me reason to
expect something remarkable in the urinary Passages. The _Ureters_ and
_Pelvis_ were very much distended; which is common where great Numbers
of Stones have descended down them, from the Kidneys to the Bladder.
The Bladder contained about 60 Stones, the largest of which was about
the Size of a Walnut, the others smaller; and just within the Neck, was
a hard _Tumour_, as big as a Nutmeg, which almost closed the Orifice:
and indeed the Situation of this Tumour was such, that it not only made
the passing the _Catheter_ very difficult, and hindered our feeling the
Stones, by directing the Instrument upwards: but likewise would alone
produce the Symptoms of the Stone in the Bladder, by obstructing the
free Discharge of Urine through the _Urethra_, the inner Membrane of
which appeared as if lacerated in several Places, and the Tube filled
with a glutinous Matter tinged with Blood. On the back Part of the
_Vesiculæ Seminales_, near the _Prostata_, were several _Stones_, as
large as Peas, which closely adhered to the adjacent Membranes.
The _second_, a Boy aged 10 Years, killed by a Blow on the Skull; whose
Spleen weighed two Pounds, and possessed almost all the left Side
of the abdominal Cavity. The Bladder, when distended to its greatest
Capacity, would not contain an _Ounce_.
The _third_, a Man aged 25, who died of a Pocky Hectick, and some Days
before complained of a painful Swelling in the Testicle, which he said
came the Night before. I examined it, and found it to be a _Hernia
Aquosa_, and would have punctured it, if I had not felt (besides the
Water) a hard Body, which I could by no Means reduce. In a few Days
he died, which gave me an Opportunity of being satisfied. Opening
the _Scrotum_, and separating the common Membranes to the _Processus
Vaginalis_, it contained about 4 Ounces of Water, besides a great Part
of the _Omentum_; some Portions of which adhered to the Bottom of the
Cavity, and the _Albuginea_ that immediately covers the Testicle.
* * * * *
It has been likewise thought proper to preserve a _small Treatise_
of curing _Consumptions_ by a new Method, of administring
_Specific-Medicines_, more especially _such_ as proceed from _Ulcers_
of the _Lungs_.
This excellent Piece was written by the late eminent Mr _Thomas
Nevett_, of _Fen-Church Street_, Surgeon.
A NEW
METHOD
Of Curing
CONSUMPTIONS
BY
Specific Medicines.
INTRODUCTION.
I Remember a remarkable Passage in some _Observations_ upon the
_Bermudus_ Berries, by a Doctor of Physic in the Country, addressed
to the Hon. _Robert Boyle_, Esq; who professeth he had been for 50
Years an exact Observer of the _Methodus Medendi_; yet saith the
Doctor for my part I firmly believe, that (_Universal Evacuations_
being premised) the greatest Cures wrought in the World, are by the
use of _Specifical Medicines_. The higher the Attainments of any have
been in Understanding, the more freely have they acknowledged that
the greatest part of those _things_ they _did know_, was the least of
those _things_ they _did not know_; such Men account it not shameful
to renounce an Errour, tho’ ever so ancient, when persuaded thereunto
by Truth and plain Demonstration: There are other narrow Spirits
(abundantly satisfied in their own Knowledge) who believe the _Art_
of _Physic_ hath been taught by our Ancestors, in such an absolutely
perfect manner, as that nothing remains to the Industry and Diligence
of Posterity; it being too much their Humour to undervalue every
Medicine that they themselves are not Masters of, because they prefer
their private Interest to the public Good: But in the mean time where
is that cordial Love to Mankind, which is one of the Badges of true
Christianity? Nay, where is the Exercise of Reason? For how can a Man
give his Opinion against a thing that he never _heard of_ before, or at
least never _experienced_? I am sure, this unjustifiable Practice is
the way to put a stop to all useful Knowledge and Improvements: It is
therefore expected from the Ingenious and Candid Reader, that he should
adhere to the Cause of Truth, by whomsoever it is pleaded, weigh every
Invention, not in the deceitful _Balance_ of _Custom_, but in the just
and even _Scales_ of _Reason_; approve what is agreeable, and reject
what is contrary to it.
That I who am by Profession a Surgeon, should in such a polite and
inquisitive Age, venture my Thoughts in public concerning a _Physical
Case_, may be to some matter of Admiration, and to others of severe
Censure; especially such as may think I have invaded their Province. As
for the latter, I am persuaded nothing that I can say will remove their
Prejudices; and for the former, I shall only tell them, that being
alarmed by some of the _Symptoms_ mentioned in the following Discourse,
whereby I plainly perceived the Constitution of my own Body inclined
to a _Consumptive State_, I strenuously applied my Mind to study the
Nature of this _Disease_, and to find out, if possible, some noble
Specific Medicines, which might indeed deserve that Name, and be able
to oppose the growth of so fatal a Distemper, which hath insensibly
flattered so many into the Chambers of Death. What I then laboured
for, and searched after, I have since (by the Blessing of God) found,
and with great Advantage experimented on my self and many others, and
now think fit to disclose for the good of All, not doubting but if a
more excellent Method and Medicine than hath hitherto been generally
administered, or prescribed, be treasured up in the Hands of any
Person whatsoever, he doth more faithfully perform the part of a just
Steward, by a due Improvement, than a close Concealment of it. And on
the same Account, I judge it more my Duty to serve my Native Country,
than mind the Clamours of censorious Critics; not at all questioning
but in a little time, the Efficacy of _these Medicines_ will at once
bring Health to the Patient, and Reputation to their Author: And the
World will be convinced of the _Power_ of these _Remedies_, by their
Effects; tho’ ignorant Persons may be apt to contemn and neglect, till
their Opinions be altered by _Experience_, and their Prejudices removed
by _Demonstration_.
_Of the Nature, Causes, and Symptoms of Consumptions._
I. A _Consumption_, in general, is a wasting of all the solid parts
of the Body, for want of a due Distribution, or Assimilation of the
Nutritious Juices.
By some learned Men this is observed to be the _Endemical Distemper_
of _England_; and indeed our _Weekly-Bills_ at once declare both the
Strength of the Disease, and the Weakness of the Medicines wherewith
it’s Cure hath been hitherto attempted. Besides, that which seems to
justify this Observation, is the pernicious Custom of the Inhabitants
of this island, who immoderately and unseasonably indulge their
Appetites with several sorts of Meats and Drinks, whereby the Tone
of the Stomach is so vitiated, as that it cannot perfectly ferment
and volatilize the Chyle, which is commonly the internal procatartic
Cause of most Distempers among us, and consequently of _Consumptions_
from those Distempers, from whence comes a Colliquation of the Chyle
in _Lienteries_ and _Dysenteries_, tormenting _Cholic_ and _Iliac_
Pains, hypocondriac Melancholly, hysteric Fits, scorbutic Twitches,
troublesome Catarrhs, sluggish Passage of the Chyle thro’ the milky
Veins, scrophulous Tumours and Inflammations of the mesenteric Glands,
spasmodic Contractions or Convulsions of the Nerves, preternatural
Fermentation of the Blood and Spirits, _Cachexies_, _Atrophies_,
Obstructions, Fevers hectical, inflammatory and putrid, Exulcerations
of the Lungs and _Marasmus_, with many other Diseases, whence come they
originally and for the most part, but from the Weakness, ill Habit and
Indisposition of the Stomach?
Now the proper Action of the Stomach is Chylification; for tho’
the Meat we take into our Mouths receives some Alteration there in
Mastication, by the fermenting Juice that flows from the salivatory
Glands, together with the acrimonious Particles, and fermentaceous
Spirits of Liquors which we drink, yet it is not turned into a thick
white Juice, ’till it hath passed down thro’ the _Oesophagus_, or
Gullet, into the Stomach, where by the help of it’s Fibres it is
closely embraced, and mixed with specific fermentaceous Juices,
separated by it’s inner Coat, and impregnated by the Saliva, then
by a convenient Heat there is made a mixture of all; for that the
fermentaceous Particles entering into the Pores of the Meat, do pass
thro’ agitate and eliquate it’s Particles, dissolving the whole
_Compages_, in which the purer parts were intimately united with the
Crass, and making them more fluid, so that they make another form of
Mixture, and unite among themselves into the resemblance of a milky
Cream, after which together with the thicker Mass with which they are
yet involved, by the Constriction of the Stomach they pass down to the
Guts, where by the Mixture of the Bile and Pancreatic Juice they are by
another manner of Fermentation quite separated from the thicker Mass,
and so are received by the Lacteal Vessels, as the thicker is ejected
by Stool.
After the purer part of the Chyle hath been thus strained thro’ the
narrow and oblique Pores of the milky Veins, by the continual and
peristaltic Motion of the Intestines, it is yet farther attenuated
and diluted with a very thin and clear _Lympha_ from the Glands of the
Mesentery to expedite its passage thro’ those numerous Meanders into
the common Receptacle, from whence by the constant Supply of such like
_Lympha_ from the small Glands of the _Thorax_, it is safely conveyed
thro’ the _Ductus Chyliferus Thoracius_, subclavian Vein, and the _Vena
Cava_ into the Heart.
The Chyle now mingled with the Blood, passeth with it thro’ the
Arteries of the whole Body, and returns again with the Blood by the
Veins to the Heart, undergoing many Circulations before it can be
assimilated to the Blood; for every time the new infused Chyle passeth
thro’ the Heart with the Blood, the Particles of the one are more
intimately mixed with those of the other, in it’s Ventricles, and
the Vital Spirit, and other active Principles of the Blood work upon
the Chyle, which being full of Salt, Sulphur and Spirit, as soon as
it’s _Compages_ is loosned by it’s Fermentation with the Blood, the
Principles having obtained the Liberty of Motion, do readily associate
themselves, and are assimilated with such parts of the Blood as are of
a like and suitable Nature.
After the Chyle hath been thus elaborated, it becomes fit as well
to recruit the Mass of Blood, as to nourish the whole Body, seeing
it consists of divers Principles and Parts of a different Nature;
therefore, according to the various Use and Necessity of every part,
and also that it may conform and fashion it self to the different
Pores and Passages, it is severally appropriated; the most volatile
and subtil part is separated in the Brain, and adapted to refresh the
Animal Spirits, the glutinous to nourish the Body, and the sulphureous
to revive the native Heat: And in it’s Passage with the Blood thro’
all the parts of the Body, all the Mass of Chyle that is capable of
being turned into Blood is sanguified; the serous and saline part
precipitated by the Kidneys, and evacuated by Sweats or insensible
Transpirations, the bilious is deposited in the Liver, and the rest of
its Excrements retire to the several Emunctories of the Body.
Thus it comes to pass by the wonderful Sagacity of Nature, such
extraordinary Provision is made, that the purer part of the Chyle by
these ways and means is more purified; and when it is thus purified
and sublimed, it is more capable of reinforcing the Blood and Spirits,
as also of corroborating the Tone of every particular Part: Whereas
when the Chyle is sour and dispirited, the Blood necessarily becomes
vappid, the animal Spirits which reside in the System of the Nerves
are infected with a Morbid Disposition, and all parts of the Body
begin to flag and waste. For indeed there is no other way to recruit
the daily Expence of Blood and Spirits, but by a continual Influx
of laudable Chyle into the Blood-Vessels, which Chyle is made by
the Fermentative Juice of the Stomach, and this Fermentative Juice
supplied from the Mass of Blood, so that there plainly appears to
be a fixed Correspondence betwixt the Blood and the Chyle, and a
necessary Dependance all the Humours in the Habit of the Body have
on the Stomach; from whence it is reasonable to infer, That if the
Chilifying Faculty of the Stomach be depraved, the Blood and Humours
must necessarily sympathize therewith, and in a manner proportionable
to the Distemper of this part.
II. The immediate Cause of a _Consumption_ of the _Lungs_ is store of
sharp, malignant, waterish Humours, continually distilling upon the
soft spungy Substance of the Lungs, stuffing, inflaming, impostumating,
and exulcerating them, whereby their Action, which is Respiration, or
a receiving-in and driving-out Air is depraved, as will more clearly
appear by the following Description of these Parts. It will not be
impertinent to our Discourse if we should usher in the Description of
the _Lungs_, with a short Account of the _Trachea_, _Aspera Arteria_,
or _Wind-pipe_.
III. The _Trachea_ or _Aspera Arteria_ is a long Pipe, consisting of
Cartilages and Membranes, which beginning at the Throat or lower part
of the Jaws, and lying upon the Gullet, descends into the _Lungs_,
thro’ which it spreads into many Branchings, and is commonly divided
into two parts, the _Larynx_ and _Bronchus_; the _Larynx_ is the upper
part of the Wind-pipe, the _Bronchus_ is all the _Trachea_ besides the
_Larynx_, as well before as after it arrives at the _Lungs_.
The Substance of the _Lungs_ is soft, spongy and rare, curiously
compacted of most thin and fine Membranes, continued with the
Ramifications of the _Trachea_ or Wind-pipe, which Membranes compose
an infinite number of little, round and hollow Vesicles, or Bladders,
so placed as that there is an open Passage from the Branches of the
_Aspera Arteria_, out of one into another, and all terminate at the
outer Membrane that investeth the whole _Lungs_: These little Bladders
by help of their muscular Fibres contract themselves in Expiration, and
are dilated in Inspiration, partly by the Pressure of the Atmosphere,
and partly by the elastic Power of the Air, insinuating it self
into these Vesicles thro’ the Windpipe and it’s several Branches:
Their Lobes are two, the right and left, parted by the _Mediastinum_,
each of which is divided into many lesser Lobules, according to the
Ramifications of the _Aspera Arteria_; they have all sorts of Vessels
that are common to them with other parts, as Arteries, Veins, Nerves,
Lympheducts, but peculiar to themselves they have their _Bronchia_,
or the Branches of the Wind-pipe, for bringing-in and carrying-out
Air so necessary to Life, that we cannot Live without it: And when we
consider their admirable Structure, (as well as the Structure of every
individual part of our Body) how ought we to adore the infinite Wisdom
of our Creator! Now when these small Vesicles or Bladders are replete
with extravasated _Serum_, or purulent Matter, the natural Tone of
the _Lungs_ is so weakned, that we cannot enjoy the Benefit of free
and full Respiration, hard, scirrhous Tumours and Tubercles are bred,
attended with a dry and troublesome Cough, Oppression of the Breast,
difficult and short Breathing, preternatural Heats, Exulcerations, and
other deplorable Symptoms, according to the Degrees of Obstruction, and
different Nature of the included Humours.
IV. The external Procatartic Cause of a _Consumption_ of the _Lungs_
is cold Particles of Air, constipating the Pores of the Body, whereby
the _Serum_ which ought to expedite the Motion, and temperate the Heat
of the Blood is separated from it, and thrown upon the Glands of the
_Larynx_, and the spungy Substance of the Lungs themselves: For as the
_Lympha_ helps the Motion of the _Chyle_, so the _Serum_ accelerates
the Circulation of the Blood, being carried about with it thro’ the
smallest Capillary Vessels and remotest parts of the Body, lest it
should be inflamed with a burning Heat, or stagnate by excessive
Thickness; during which circular Motion they are both called by the
same common Name, but when some Portion of _Serum_ is separated from
the Mass of Blood, and retreats to some one or more of the Emunctories;
according to their various Dispositions, it derives a Name from those
particular Parts on which it seizeth, as when it distils upon the Eyes,
we call it _Opthalmia_, when upon the Nose _Coryza_, and when upon the
_Thorax_ it goes by the proper Name of a _Catarrh_.
Now forasmuch as there is nothing makes a Separation of the Blood
more commonly than the want of usual Transpiration, so nothing more
conduceth to the Preservation of Health, than that the Pores of the
Body should continually let out the hot Streams and Vapours that arise
from the Ebullition of the Blood; but when after taking Cold the Skin
and Habit of the Body are on a sudden stopped up, that the sulphureous
and waterish Excrements of the Blood cannot pass through the Pores,
they are again resorbed into the Mass of Blood, from whence proceeds
a feverish Disposition; unless they are carried off by Stool, or
precipitated by the Kidneys, are sometimes translated to the Glandulous
Parts of the _Lungs_, where by Degrees contracting more and more Heat
and Sharpness they inflame and exulcerate these tender Parts.