'3Eni£ > '■ * f ^ essay; ON ^The Nature, Caufe, and Seat ^ OF BYSENTERY'^ ^ IN -. ^ ■ " A LETTER ■^ - TO ■'■" ")•-■•flOr. Henry Warren of BARBADOS^ BY ©tie Ingram Surgeon and Man-Midwife. Quibufcunque cruda deorfum feeedunt, jlrx acra Bile sunt, si plura, copiosiore, si ^auciora, V*™***-^^^^ ^^ BARBADOS.^ printed for William Beeby, at the Spring Clock, at the Corner Houfe in Cheap-* fide near the Cuftom-houfe. (7 PREFACE; TO the reader: Yl Eing recommended to many of you* "^ Favours, by feveral worthy Merchants jn Europe^ I think it is my Duty to make fuch Enquiry into Difeafcs as fmall feat* $ered Learning will permit me, that there?* by I may appear to you worthy of fuclj Eftimable Protections. The Care I have taken in the following JLines, I hope will be a Guard againft z\l Accufations of ptagiartfm, it is what by al{ Authors with the utmoft deteiT^icn cught f t® be ayoidedj and was always my Averfion, ty tracing the Fpo^fteps of Nature, am ec ifuiting thofe Laws which Ihe h*$ prr Tcribe4 to Mechanicks (or her own M tions) ths true foundation qf Bhilofopby i$ ts> be ftipportod, With thefe principles, rjcr Fashes bein» j>ave4 and checker'4, the E&dtavourer tq Jje at the fountain pf natural Knowledge cannot wander tp, and fro, at random, bu will be puibing directly towards, the Gpa: and in Procef$ of Year?, by fearching invc other Mens Works, he wilj be abjle to ra'-"- a fuperftrutfurc that wilj excite not on-. the ftudy pf the Reader, but. alfo it's £; , dence vvill force his Aflent. As this Enquiry is not built on abftrufij and hidden principles, I fomewhat flatte? my fclf |hat it villi be ufeful and agreeable, I hO .fcecaufe jhe wea^ejl Capacity will not h§ Med away by ohfcurt faftciis er interpreted P?earns. Plain Argument and ftri£t Sence I have fhofe rather than Elegancy or politenef? that it .may be eafy an4 intelligable t$ every Brpther, and profitable to thofc who are Strangers tp trie Profeflipn apprehend- jng the more familiar it is, the more ac- ceptable ; and that truth always §hin« cleareljc whenjt i$ not far removed from jt'f Qrbit, (viz.) Qonimm %tnfe% Companion tp our fhort Pe iod of Lir<^ find Humanity to the AfHi&edjajFe fu3i« Cient Motives to Spirit up the l,earnec\ tp ,{iq4 out the moll certain Remedy's for fttch piilempers, as we at prcfent ars lenil pro- vided agaiijft j and truly what Subp ffvves their attention jnofe than tlut, v^i^h Excites the moft Grievious complaints, fo-:; Life at beft is but a Toil, therefore if fliould promp them to a Vehement Defire , but by employing feme o£ fay Time in fearching into fuch Diforderf as have been deltrfac"tiVe to the well being of your own Healths, as well as, Ravaging that Eflential parf of your Plantations Qviz.*) *jke Lives of the flegro Sialics * The Method I have chofS in writing ■fftffTc few.-FS^S, is the fame with that of the Ancients as appears by Galen's Letter to Cecilianusi Alexanders epiftle on Worms to lheodorusy Diodes On health to jihti* gonas &c. for I humbly conceive every Ycung Autlior ought to write by way of Letter, to feme I earned Phyfician, whofe Scgacity will prevent the Tender Shoots in Phyfick, from having their Understanding kd with falfe Theorys. Injhe enfuing Pages 1 have given you the irue Caufe of the pcrinrdtick Motion of [ vn ] of the Bowels, the reafon of the Jaundice, Coftivenefs, the Alteration of the Air ..in , different Seafons, the Symptoms, Caufes^ and the various Stages of the Diftemper herein treated of; and aifo the Methods with which it has been handled by fome,of the Ancient and Modern Writers, all which I have given in as concife a Manner as poflible I was able. _ But if I could have had, the Barometer .and Thermometer with .ftme other proper Instruments, I would .rjave given you the weight and alteration;of the Atmofphere,,as alfo the different Eegrees of Heat that has occured (ince my Arrival, which would have made this Epiftle, fomewhat Com- pleat; the want of which as well as part f)i my Books with many other Neccflary's wete left in England, thro' the fmall No- [ vin ] kice arid Refoluticn of my Ccming Abroad, therefore hcpe for the prefent, ycu will ac- cept of thefe lccfe Cbfetvations. If this fuperfxial Performance will be of tJfe to ar.y of my Erothers, or Entertain- ment to ether Gentlemen, Or fhculd it txcite any to fatisfy this liland, with a fcore perfe£L»Efiay en the Subject than I fcave been able to doe; I fliall be well pleas'd and fatisfied. And if it meets with a favourable recep* tion, it will prcmpt me to make a diligent enquiry and Tryal of all the natural Spring* m this If and; which by various Experi- ments, Ifcall be able to give yen an Ac- count of, tc£ether v; ith the principles they abound,Awhether of SuJpher, Steel, Alh:ni, Cathartjck, Salt* &c. And alfo the quanV ["] tity each quart contains, and whether Sc- £erately cr Combined. After 1 lave fo far fatisfy'd you, and find it will be agreeable, I mall Endeavour to Entertain you (Jf I can find Leizure from the many Avocations I may meet with) with an'Account of all the Plants, Shrubs, Herbs &c. which are prcducjie here, to- gether with a true £)iftinclion of their Species, ^ai.d alfo defciibe their different Virtues as welf as the lime and Scafcns of perfection for Uie: Fearing I have irsce too free with your Time in thii. Preface, ft; all new take leave. and hope the follcwing Pages will net cnly be Amufing, but of Eeneficial Service to the Publick, whiift Zealcufly my future En- deavours ihall be employed to give ycii all the [*] the' Satisfaction you pcflible cah defire, that thereby I may Merit your Elleem and Regard, is the fincere Defire and Willi GENTLEMEN, ,, Your moft Obedient Servant^ DALE INGRA^ Barbados] February 20th 1743-4* .. :' >J*f3; 1. A LETTER TO Dr. HENRY WARREN. GIVING, AN ACCOUNT OF THE CAUSE,' OF • The Dyfentery that Reign'd with fuch fury thie lalt Seafon. IN BARBADOS s1R- rip HE Multitude that hare funk \mdct the fatal Dyfentery, which hath for fome time reigned in this Town and Ifiand in General, have fo far taken upmy Attention, 35 to ts to prompt Me to make lorn.* An.ttomica* Inquiry into that Liitemper, and as I know your Humanity and good Nature muft Commiferate this general Calamity, I am induced to think you will call a favourable Eye on an .Attempt to difcover t ic prin- cipal feat of the Difeafe; and if I mall bz Able to Pen:: cut thofe parts of the Body wherein tMs Li.order appears to take it's- £rft me, and \nj:* it thro5 it's c'r:ad-\il C':v::rfe, without: im iimn"; yonr Cer.lire., c* bei;i~ Guilty c>" r.i\y Trefpafs c/i the L:;ws of Mechaniim, Ifliall thLik my feL fu'Hd- •ently recommenced for this r.iy fniell L^!x> "■: towards the publick Service. It is with this View, that I take the li- berty of fending my Opinion to you, not doubting but that your accailomcd Genero- fry, [3] Hey, will give the following Lines an Exami- nation, and that the iar^e Lraeghis you lu.yv, taken oFphyflcal and other Laming as weil ns your Extenjive fudghunt in ,4rt\r and Sciences which huh long appeard to this r^rt of ths Won\J,* will be :. undent Guard againffc the Hazard of my Mi Heading i'-iiy One. by n greundiefs or Conjectural fiypotlielis. Indeed Sir, I cannot but fay that art Anatomical Inquiry into the Seat of any Di- feafe .md of the oarts aneeted thereby, fcems tome to be the proper if not the only fure Ground-work whereby to proceed to laveftigate it's apparent Caufe, and tho •proper Means of Curs to be applied. I beg leave therefore to proceed to the I * J *TP O form a right Idea of the Seat of thi* inveterate and direful Difeafe, I humbly conceive it to be highly necefTary to confi- c?er the natural Ufes of thofe Vifcera which ere principally affected, ( viz.) The Bowel* with their periftaltick Motion, the Livef end Gall-bladder, All that have attended Anatomical Lec- tures, muft have obferved this fine Motion of the Bowels, it being moll Elegantly and diftin&ly feen in the Rabbit (the common Sub jea for the Demonilration) which being dffefted alive, the Alternate contraaion and Dilatation appear plain, and Satis, faaory to every Curious Speaator, and convince every one of the Necefiity 0f fuch * Motion asabfolutelyUfeful for feperating §nd forcing the Chyle from the groue* partes r * ] partes of the Ailiment or Food, without which the Blood could not be recruited, nor the Human Body daily noutiftYd, and w« p::che:-.d'to be the Bile, becaufe it's ce :&u tue..it parts s;;e Saline and Sulphurious, Vwiieh -aniens are pungent, and have ar* active Quality, and coufequently arc moil capable to procure a Stimulus on the Ner- vous Coat o: the Howe's, and at pi-eftm I tow not ef any othet F'uid i* the Animal Syitem [7] Syitem fo vcti fiareed and pceeily reiryted for this acctOar. -i«'.'cnt c .' be.e::. 1 mult beg Jenv= to Gbbeve thet :hc"i ate two fer.s of Be; .he Hepttich and Cyflic ; The former is JVli der, Thinner end more Ienpbib thin th- letter, which is of p. deeper CoTcur, very bit er, pungent, a;.d Jhei" end abo Lb*'L ^ne iiieyejiej: .^ne in a. natural Sfe.e is connb.eeby bbliiny, ieej tee Duodenum thro' tee j^n\:u:., Cnol-n.ec. ms, v. inch is ce:~yes\i of the Jbenb or u.5 jrorus Bilarius .i.d Cyfli: "nib. This Fi ?e iinln-.'e^ . .'bh~ ' ;y the Cortes of ti.e b!ev:! e ' nnes ; - o i. lo: inaciireilar.l nhei-ht : : n- . . OJhei^ rnu lone wnsn . ^-...•■-- - - - ■ *■ ><~3 and \ery ^ ■->*.->-: *■■ — ■"- -- .....- u j-> beci.uf- tee Lbie inoeid ue. ;tod' yr^e'pi- i..:eV lately Ruih in. This is the employment o? the Hepatick Bile, whilft the Cyftic is laid tip in the Gall-bladder as in a Rcfervoir be-» ing partly feperated by Glands lying in tho Inward Coates of the Cyftic in like manner, as the Ceraihen or Ear-wax in the funnel of the Ear. That this Bile does not always flow ou£ is evident from the Cyftis having it's Cervix (a) StricJa, et fundo Alt tor^ but I confefs it may eafily be fqueez'd by Compreflion thro* any increas'd Aaion of the Abdd- minal Mufcles, or contiguous partes, or by a full Stomach which will prefs the Liver, & confequently the Gall-bladdert or violent Vomitings, &c. And I conceive bad if not fatal cnfequences would arife if this Bile, wa* (a) Dr. Bocrhavc'j own Words. r. r t was perpetually to flow, and as Byfea- teries are for the moft part attended with Neaufea's, Reachings, and Strainings, fo are t'ac Abdominal Mufcics fee in violent Aftion, by which the more pungent Bile is thrown into the Guts in greater quantitys X^o-'iV th:m at other times, which gives an addition.il Weight to the Diilemper. But to return j To ftrengthing this my Oyinien, admit me to obferve, that all Iclerical Perfcns have an uncommon diiten.. fion in their Bowels, and are fo very Cos- tive, that the moft ftimu'aiing Purges and Clyitrs have been for ined, (viz.) A Scirrhous Liver, and an Ob- ftruaion of the Biliary Canals, feein to be the mo ft general, and the Latter of which moft frequent. The r»] The Cafe of Mr. Menzies which wa$ communicated to the Royal Society in the Year 173o, by Dr. Alexand Stewart Phy- fckn thani to the Queen, plainly convinces us that k is impoffible to have Stooles with- out Bile, an Abftraa of which may not ba in this place improper < Mr. Menzies being in the 40th Year of c his Age, was wounded in ths Gall-Glad- c der about three in the Morning Oacber 1 50th 1728. c I was call'd November 2d. about Ele- c ven in the forenoon being the fourth Day c after he receiv'd the Wound. c The Surgeon who had attended him c from the Begining, told me that his Belly c had been all along di ft ended as I faw it 6- giving tiie appearance of a Tympany or Afcites, L ■ *3 J c Afcites, and it continued at the fame c picchof D ideation neither Dhninifhed nop fenfibly enereas'd to the time of his Death. Ke never once went to Stool from the time he received the Wound, tho' ftrong Purges and Clyfters were given ior fi-vera! T)zys, and without any Opiate hav.ng ever been given, which might have regarded Stooling; yet he took what was thought a fuhbcienc quantity of Drink and Liquid Food, c Upon opening the Body before feve- c ral Surgeons, the Abdomen appeared c diftended as faid before, and the Skin of ' the Belly tinged Yellow as Saffron in ma- * ny places, a Trianguler Wound appeared f about two inches on the right fide of the * Navel, the Direction flantiug upwards « Obliquely thro' the I arguments aae * penetrated thro' the bottom ®i i\v- GvdU C"»4l * bladder, without wounding the Liver or / the Neighbouring partes. The Gal 1-Bladder was flaccid or col- la pfed containing only a few drops of Gall, which fiightly flow'd out on Squeezing into the cavity of the Abdomen thro' the wound. It is a'fo obferved that the Bowels had loft ail Motion thro* a Total want ef hile wly i for a more perticular Account, Vid. Philof. Tranf. Abd. Vol. 6. Pr. 3d. Pag 24. Dr. Sieuarc has alio communicated an other Cafe of the like Nature, v.hich is that of a Serjeant of the Horfe Guards, whofe Gall-Bladder was wounded, without any other Powel being much Hurt. Thr Symptoms whilft he Lived (which was only feven Days after, the Wound given) were a great diihntion of his Belly, but without Ruaus &u&ua or Flatus, upwards or downwards, or Borborygmi, no Paflage by Stool, not- withftandins all the Art of the Froicfnon was Adminiftred. Ths further account of the Cafe you have in the Scotch Medical Ellays Vol. 3d. Pg. 405, where you will find it moft Beautifully defcribed and Lie-. srantlv Commented on, More Inftances to prove that Coftivenefs proceedes generally from an Obftruaion of the Biliary Canals might be recited ; But for Brevity fake, mail only acquaint you that whilftaPupil in Mr. Guys Hospital, 1 opened a Body that had large ftcnes in the Bile \relieis, fome of which were era Brcwnilh Colour, and neat as big as Nut- megs, which canted fo great a Retention of the Yj'iI° that they v/hhfkod ail tiic ei. n- beiviments of the Ableii .£i'culrpi in Ifn- i,:.icers r 1*1 gineers, nay even Mercury himfelf was noi able to force the Breach, for the Patient by Dr. Oldfields Order took near a Pound of Quick-Silver without any effea, all which I took out of his Stomach after his Difceafe which I believe to this Day may be fcen at the Apothecary's of the faid Eofpital. From hence, it is not to be doubted, but ■the Patient v.ce.ldhave had . ftoolcs, if the Concretion conhi have been Diflodgcd. I am fcnfible thai feme time there may be other caiifes, ten1 nor fo Gbvkus or common, which in?.y retard, cr even to- tally check; this. Vermkuler Motion -9 and of thefe, are ftich as, the want of a clue Energy, cr Activity in the lite it fdj, cr the want of a clue In flux of Animal Spirits into the Nerves fab-fervent to the Inteftines, o- [ 17 1 or a confiderable Stoppage, of any part of the Inteftinal Canal, thro' Spafmodic Cc-n- traaions, Volvulus or the Like: and alfo I am perfwaded that fome if not all of thefe (the Volvulus excepted) do frequently happen in the Colica Piaavorum, but here I muft fuppofe the Bile to be fumciently pungent, and Irritating, if it had it's due Courfe and no fuch Obftruaion in the Ihteftihes to happen. What is here faid of the Extraordinary :.-Effcas of a Retention of the Bile,, or a voluntary flowing into the'Interlines too abundantly, may be further and almoft de- monftrably proved by what is very frequently ©bferved in new Born Children, viz. Their whole Body's appearing very Tel lew , The Reafons for which be pleafed to give me ... . • 'vfc'. -, i. leave in this place to Confidcr, and it will with fi8 ] with much ftre'ngth Corroborate my Argu- ment' That Children newly Borii, and fome- times a few Days alter appear with a Dis- tina iaritious fuffufion over them, has often been taken Notice of by the prudent, tender Mother, as well as by Midwifes and careful Nurfcs* This Yellow Tawny difcolouring of th« Skin, is very evidently owing to nO other Caufe, than that of the Bile (which mult be derived to the' Foetus ivhilft in Vtero with the Mothers Blood thro' the Umbilical Vcfiels, and being as yet of no Ufe to the1 tender Babe, is ftored up plentifully in the Hepatick Channels and RcferVoir) being flopped from flowing into the Duodenum, by the thick and Glewy Mucus, with which [ *? 3 which the Inteftines at this time abound, and by which the Mouth of the Poruj Bilarius is ftrongly Obftruaed. This Pafiage being thus damm'd up,1 fome part of the plentiful Bile regurgitate* into the Hepatick Veines and is mixt with the Circulating Mafs of Blood, which i$ the caufe of a fort of Jaundice and ap* |>earance of the Yellow Hue, Probably, long, tedious, hard, cruel and difficult Labours, together with the ftrug- ling Efforts of the long confined Infant, tq rid the Mother from it's now no more wel- come Guefs, and as it were by Inftina of Nature ftrugling to appear beforei her, tq tefrefli h^r Spirits, to give comfort and in-, ftantly to wipe off the "cruel Tear, by call- ing fmiles on all the tired expeaing Friends. I I fey thefe tedious and almoft infupportable Labours tJwt contribute^ often to this re- gurgitation of the Bile, and Children with fomuch Difficulty brought into the World, are obferved' hot only to be fo difcolour'd, but are found exceeding Coftive, nay I have known a Child been Born three "Days with- out a Stool althd' Clyfters/ &c. has been adminiftred, As this Cafe too often hapi- pens, and internals frequently failei of Re- lief ; Natures providential and -'tender "Carb : the Milk feems moft properly ordainbd for Releif, for by it's then and Deterging qua*. lity, ic feems wifely adapted to this" very purpofe, and is capable to force away the j* thick Obftruaing- Mucus in the Bowels and1 promote Evacuati°ns, ••. • •": As vfeon -as 4this Stoppage, of the Bilt comes [21] comes to be removed, it flowes copioufly into the Bowel, infomuch that in fome of the firft Days we generally find the new born Babe to be much Griped, and have frequently greeniih Bilious Stooles, (called by Nurfes Loofnefs) which are owing to the great irritation of that ftimulating Li- quor the Jfth. Another Argument of Proof of what I have Advanced concerning the force of the Bile, may be faken from what is notori- oufly obferved in many old People of both Sexes, for it is certain that all the Takes of fuch are commonly ranker and more acrid than in younger People, as appears by their Spitle, Sweat, Urine,. Faeces &c. And con- fequently in fuch-ths Bile muft be ftiarper, and ^more Vellicatin^ (Ceteris paribus) than th?.n in younger People, whole Humours arc milder in general. And Ik w great a Number doe we daily Cce among the Aged dye of Diarrheas and Dyfentenes, .however thefe are the Symptoms that for the moft -part conclude their laft Scenes of Life, and many of thefe I am inform'd have fallen lately under the furiou* Rage of the prc- fent Diftemper. Having now Explain'd the chief and mOft immediate Inftrument, and the man- ner how the periftaltick Motion is carried on, and alfo th3 ill confequences of th« Biliary Pipes being blocked up, as well as the fatal Mifchief of the lofs of Bile, I fhall now confider the Scat and Symptoms with the various confiftancies of the Stcolea in a Dyfentery, and fliew the reafonablc- flefj of this my Opinion. From [ n 3 From the aforefaid convincing Proofs of the general Caufcs of a Retention of the Ibseccs in the Bowels, we may be aGiired that the ftrongeft Purges cannot Operate, neither can Natural Stooles any more be Evacuated, than the periftaltick Motion be carried On without, the ftimulating Force ©f Bile; therefore (vice verfa) it evidently appears for Truth, that the Dyfentry is '«• caufed by too great a quantity of Bilious Juices, flowing continually, and too abund- antly into the Duodenum, caufed by fome Difordcr of the Liver and Gall-bladder, from which arifes the Griping and Grumb- ling pains in the Bowels, which are well known to be the firft Symptom cf this Di- feafe, and moft commonly appear two or three Day* before bud Steoles fhew them- fi'Ves. This c>4i This Opinion feveral Centurys paft was hinted at by a Judicious tho5 Ancient Phy- fician, yet it has by moft Modern Writers that I have feen, been overlookt, or at leaft fmall notice taken, The Author I mean is ALEXANDER* who was a Grecian, and made a great Figure in Phyfick' at Rome in the Reign of Juftin Junior, which was in the Year jtfj, The Words are, in a Weaknefs of the Liver, and Dyfentery± Rbeubarh is good. The Conjunaion here made of the Liver with the Dyfentery, is evident Proof that he believed, that the former was affeaed in fuch a Difeafe. That a Dyfentery^fo many YearS fince was known appears plain from his ordering Rheubarb. For he mentions it only as an Aftringent, Auringent, anf^ truly it's purging quality in thofe Days were not known, for PAVLVS who wrote after ALEXANDER feems to be the firft who takes any Notice of the purging Quality of this excellent Root, and he tells us how we may make feme laxative Medicines ftronger by the addition of Rheubarb. Dr. William Coekburne late of London fo far Efpoufes this Opinion as to fay, that when a Flux proceeds from indigelled Food, Fruits or fuch like, it is cafy of Cure. hnt when Bile is the Canf, it is more dijlcult. It is no fraall Satisfa&icn to find my Hypothecs nearly tally wi:h not only that of Alexander's, who was the greateft in his tltf] his Age',' but alfo with that of fo Emmi- lient a Modern Writer. By all Hands it is agreed, that this Dis- temper has been % more fevere and frequent than heretofore, but it is not to be won- der'd at, when we confider and Examine the ftrong predifpofing Caufe that contri- buted to render the Dyfentery more Ob- ftinate and Fatal than Ufa.il (viz.) That there were fiix or fevon Months of conti- nual Dry and very Hot Weather, which made the Blood more aduft, and confe- quently all it's Secretions, particularly ths J) He new much more acrid, than in an ordinary courfe of Seafonable Weather ; TheOyls end Salts of which the Bile is chiefly corr.pofed, b?Tng by means of the extraordinary Heat, and Drought very grcatJy cxaltec; (as the Chymtf s Phrafe it.*) Brnde [ '7 3 B elide from fuch Caufe? we have te$ much reafon to fufpea that the Glands in the Myfentery became considerably ob^ ftruaed, and alfo of confequence ths Laaeal Veflels which pafs thro' them, which ought to receive a confiderable Mixture of thin foft Lymph, infomuch that a great part of the Chyle and Lymphatick Juice is, now hindered by fuch Obftruaion from performing it's natural Courfe, and^feems to be much bereeved of the necelfary* fup* ply of thofe mild Fluids. From hence we may learn that all Mc dicines which open and Deobftrua thofe Glands, are of moft Eminent Service in the Cure of Laxes, Diarrheas and Dyfenterys. To Proceed, From the firft Attack to it's fatal Period. The Patient complaines of a Violent inward Heat in his Stomach, and by L ** J by defiring his Hand to the place of Pain, the right Side is rather pointed at, and that part of the Diaphragm to which the Liver is by it's broard Ligament tyed to ; which Demonftrates that the Heat complained of is from an Inflamation of the Liver ^ for it is fjituated fo advantagicufly as to cover part of the Stomach, being ordain'd to amft digefting the Ailiment therein, as well as the immediate Organ for Secreting the Bile from the Blood, therefore if there is a Dis- temperature of the Liver, the Hepatick Juices will become vitiated and Depraved. If we reflea on the largenefs of the Liver (which in Adults is about four pounds) it will appear that Providence forefaw the Neceflity of fecreting a large quantity of Pile, as being abfo'utely neceflary for the well Being of the Animal Syftem, and tho' the [ *9 3 the Gall-Bladder is very fhioo! in.Proportioa to the Liver (being not above the fize of a fmall Heiin's Egg) Yet in healthy Bodies it is a fufiicient Refervoir for accepdngnll that the Liver prepares, becaufe hfawlpznsl continually ^ keeps drilling fmaM fo&ims into the Gut Duodenum for the Ufes before jnention'd. As this is the State in a healthy Confti- tution, fo will it appear contrary in fome Inflamatory Diforders of the Liver, for ths Gall-Bladder being feated in a Deprefiion on the Concave fid:, is fubjea to be com- preft or fqueezed by every fwelling or Dis- tention of the Former, and to fo great a degree as to be incapable of retaining i;-"s proper Contents viz/ The Cyftic 'Bile ; there- lore, inftead of diftlling (lowly the II-oa- tiek into the Bowels, i: is ccinpeiled alio to .1**1 difcharge S^with great Precipitation and force, having it's fides not only compreft, but alfo it's Coates relaxed. Another Caufe of the Dyfentery is chiefly frc'in the Southerly Air, that in one time of the Year blows here, and as focn as the Wind begins to Chop about to the South- ward, Dyfentery's make their appearance, for then as it were the natural Clymate is altered, the Air being at fuch times more mcift, Phlegmy and Light, than when it was Notheriy, therefore it is not to be wender'd at, that the Humane Struaure becomes too much unbraced, and when fo, the confequencc will be a Relaxation of the Liver and other Secretory Organs, they being by their natural Struaure more fub- jea to be Unbraced. That t 31 ] That the Body becomes Relaxed in a moift, Light, and Damp Air, is funhci- ently proved by the Barometer , for in fuch Air the Mercury always falls, whilft in a bright, fharp and ferene one it arifes high, and Dr. Hally fays he has found, that the c rifing of the Mercury in the Barometer c haftily, forebodes an Eaft or North-Eaft < Wind. c |That the falling of the Quickfilvcr por- c tends Southerly or Wefterly Winds, inter- c mix: now and then with Showers of Rain. Now as much Rain almoft always Sets in with the Southerly-winds, this Ifiand is fubjea to in one Seafon o£ the Year, it is not greatly to be wonder'd at, that Sick- nefs takes it's Birth or Date from thence, for moift Vapour's being cxhailed from the £arth, the Weight ^d fchiftx Force 6f the Afmofphere is Diminifhed. That fuch damp Air will caufe a Re- laxation of the Liver, and alio on the Gail- Bladder, is very evident from the lowncfs of Spirits which is felt by the Aflliaed at fuch times, as well as by all Hypochon- driacks: for the pores of the Skin being Hopped up the Materia Perfpirabilis is forced inwards upon the Inteftinesj and when ever the excretion of the Perfpirable Matter (which is much greater than all other excretions of the Human Body pu1: together) is inverted and precipitated on the Interlines, it falls thro' them as it were in a flood, Vellicating, and corroding their inward Membranes, and Ulcerating the the Mouths of their exhaling Vefihls, oc- cauoning thereby many of the fevere Symp- toms that attend this Diftemper. Now [33 ] How let us fuperadd this circumftance,1 of inverted perfpiratory Matter being forc'd violently into the Inteftinal Veflels, to What has already been related, of the Dire Effeas of the Bile, and we fhall be able to Form a clear and juft Idea of the Diftem- per, that yet too much Reigns, and has hitherto occafion'd fuch Fatality amongft alfforts of People in this Iiland. Surely no one can deny from what has been faid, that a fuperabundant quantity of Bile falling into the Bowels too haftily, will caufe a Dyfentery • however leaft I ave not made it clear to fome, admi: me > remind you that the very Bile it kit is en voided with the ftooles, which furely a fulucient Proof. From every one's Observation, it is evident t*4J evicfetit that a North-Eaft Wind Is moft healthy to this Ifland, but it is the con- trary in England, for when the Wind blows Out of this quarter every Perfon muffles up to fcreen himfelf as much as poffible from it, for Difeafes are well known at fuch times, to be more rife or frequent and more efpe- dally the Liver is obferved to be greatly affeaed, and very often fhews it felf Di- {c&fcd by figns of an approaching Jaundice, a Diftemper ftrialy and exaaiy reverfe to the Dyfentery, But as frequent m fuch Seafons in the Briti/h Ifle, as Fluxes in Y-..irbados during Southerly Winds. . „, Having kid my great Strefs ©n the Cyftic Bile as being chiefly the caufe of Dyfenterys, n hen by any means it is either perveitrJ by. Air, or fore'd out of it's *■ A Nidus [.35 ] Nidus in too great a quantity, by an ln<* flaiuation of the Liver, &c. I beg leer*? to remark that in all Infinmatory Diforders the, Liver and Bile are more or lefs afte&ed, This Dr. Deideir a French Phyfician has Obferved, and fays that Perfons who havft died of Malignant Feavers, have their Bilg pf a Grafs Greon Colour, and that thofe who in the Year 172 V died of the Plague at Marfeilles, had their Livers enlarged tq double their natural Seize, as well a$ fluffed with Blood, ^nd alfo their Gall blad* ders, full of black and greenjih Bile, I have hinted this to flievv that the Bile is fabjct to undergo alterations by Difeafes as well as capable to procure a Diice.nper, when it's fecretions and excrecions are feu foctive^ or when it is not in a natural healthy [ 3*.] State, and the Doaor further obferves, that the Bile of a Perfon who dies of the Plague, will kill either when it is outwardly ap- plied to wounds or injeaed into the Veines, and this he has many times made Experi- ments of upon Animals, Having now given you my Opinion of the Caufes of the Diftemper here treated of, I fhall humbly fubmit it to your Confix deration, whilft Icaft my Eye upon fome of the chief Symptoms that the Patients are atni&ed with, and fliall endeavour to point out their different States. The nnt Symptoms that attack the ten* der Body, are griping Pains for two or three Days, accompanied with frequent large Bloody and Slimy StooiYs. The Blood fo voided with the Excre-. ments, may be accounted for, by three dif- {erent Caufes. r viz ** The [37] The firft, is by a large and hard cjuari* tity of Foeces preffing and extending tho; Bowels beyond their natural conformity and juft Tone, fo that the HaemorrhcidaJ Veffels are thereby forced to let goe tnehr Contents, The fecond, proceeds from a violent Inflamation of the Bowels, which they are fubjea to in Dyfenter^.Cafes, and are very frequently fo diforder'd, from which the fmalleft Veffels that only in a natural State tranfmitted ferum or Lymph have their Diameters* fo enlarged as to give way to the red Globuler particles of the Blood to pafs thro' them, and by their exhaling Mouths into the Cavity of the Inteftinal Canal. Many inftances have likewife been taken notice by Phyficians c That in fome ' <*-vere Caf?« ef thi$ D;r~rde:;, IL'cod has L 3» J c nppearcntly flow'd both thrp* the Ductus c Cholidochus and Pancreaticus end fo * been carried thro' the Body wkh tha c Foeces,, The third Caufe, arifes from the fliarp and pungent quality of the Bile, irritating and Excoriating the Bowels themfeivcs, which it has great Power ever at this time, becaufe. by number of former Stool/s, their Safeguard (the natural Mucus) has been crcve oft, as it were by the torrent like exruhben by which the tender Bcwals are robbed of Natures providential Shield, and left guarclefs to the Stimulating Acid par- ticles of the Bilious juices arid Ccrrcfive Salts of the Excrement* About the fourth or fifth Day, the Stcol/s often appear like Drecrs or waffling of Meat, it is then that the Villous Coat of [ jp 3 of the Bowels is excoriated, anJ -as It were gnawed into by the depraved Bile. Hippocrates in his xxvi Aphorifin Cnyst if fmall peiccs of Ficfh be ejected with tho Excrement by him, who has a oleody- Fiux, it is Mortal i for the Guts are ex- coriated, coroded, and begins to Sprr.^ elate. The laft StooVs that are voided before Death, are moft cCiCiooob ere iilackiOi Yellow, and very frothy, which mews their confluence to be cornpofcd. partly ot Bile tho' frequently they are from a Morrifica- tion beyan. To-this, the Divine Obi. Pbv'icinri ob- ferves that a Flux proceeding from bl.ick cbnicr is Mortal. He a little further explaines, whac he means oy bleek Cheier, in faying it fi^nU fies depraved &U -xh-'b bus hftifs b*L fa>i:;,;& t 4° 1 famick partes; and is become fharp and Acid and hence corrodes the Guts and caufe fuch a Flux as muft needs prove Mortal, being a fign that all tends to a Mortification. And truly the horrid Stenches of the Stooles, the convulfive Hiccups, intermitting jpulfe, coldnefs in the Extremities clearly and evidently corroborate* and Teftify/ «Y-* this Opinion. Thefe are the Chief Symptoms of this inonftruous Diftemper, which has for many Years feem'd to be the opprobrium Medi- corum, as appears by the various Recipes that rilmoft infeauaily have been put into -raft-ice hitherto, a fmall Recital of which cd; for the Mechanifm; of our Bo-. ^dies,'is riot unlike to a chymifs Furnace^ which at firft well retaining the ■ Heat, i$ «ycry proper for the Operation of Art;, but at laft Chinks, and Crevices being madi 'thtrtinyit ceafes to:,be fo, ;the rHeat get- . ting away through them, what Fire foevcr you kindle therein. . ■ -*~ *.. [I, From Eence we £iay, learn, how Deatlj Derives (viz.) Firft by-a, gentle Debilita. ticn of Natures: Stength, 2d. a Confum* A«Ption ©f the moift principles of Life, laftly -« total Extinaionrof-Natural'Heat. ;)rrf A san florins makes the maintenance of Lift $0 depend upon the Rencvaticn of the partes ,:., iH'Mluflnous BACON conceived that 3Death Enfued. from an miequai repcration f f.the liquid or foft, and the dry or more folid Parts, or from a Deficcation of tha Radical Juices. This opinion is agreeable to Dr. SprengelVs Explanation of the xxviijth Aphorifm of (C) Hippocrates, who fays, ' When our * circulating Juices are wafted, and Ex- fc haufted by the violence of the Difeafe, * then Motion ceafes, and confequently * Heat, which is the Eftca of Motion, * not at once, but gradually, beginning at * the Extremes, and ending at the Center. (c) yermifius vero mortis est, cum vnimce calor supra umbilicum ad locum septo tr answer fo superior em ascendit, et omnis humor exuritur cum autem pulmo tt cor calore in mortiferis hcis coacervato b worem amiferint, calcris spiriti's cofIm fertim exhalat, cujus ope tctum cum Hto wmpaftum erat, - ^-wto—-*-■■- "TI N I S, riMWiKWMM^slAit Affe4. Hi W.