An Account of a Book

VI. An Account of a BOOK. Novae Hypothesos, ad explicanda febrium intermittentium Symptomata & Typos excogitatae Hypotyposis. Una cum Aetologia Remediorum; speciatim vero de curatione per Corticem Peruvianum. Accessit Dissertatiuncula de Intestinorum motu Peristaltico. Authore Guilielmo Cole, M.D. Lond. in 8°. 1693. The Learned Author declaring himself unsatisfied with the former Hypothesis about the Production of Intermittent Fevers, but supposing, from the Consideration of the Symptoms, that their Origine is owing to the Nervosum Genus, has, agreeably to that Conjecture, formed to himself a new one; by which, (having revolv'd it long in his Thoughts) he thinks he can give himself a clearer Account of the reason both of the Symptoms and Method of Cure, (particularly that by the Cortex Peruvianus) than from what others have laid down. To clear his way to it, he first takes notice of Four Hypotheses concerning them, which have either chiefly obtained, or, he thinks are the most considerable, viz. That of the Ancients, who deduce them from Humours putrifying in primis viis; of Sylvius, who places his Minera in the Pancreas; of Dr. Willis in the Mass of Blood; of Dr. Jones in the Habit of the Body: Of his Different from each of which he alledges some Reasons; though in the general, (agreeably to three of them) that a Ferment to be somewhere receded out of the Road of the circulating Blood, and there gradually maturated, is necessary to produce an interpolate Distemper. In order to determine both the Matter and Form of this Ferment, he lays down some obvious Conditions of it; of which though some may agree to one, some to another of the enumerated Hypotheses, yet he endeavours to shew, that All will not agree to any one of them, and therefore thinks such a one is to be searched for, to which they easily will. His own Opinion therefore is, That the Cortical part of the Brain may be the primary Seat of this Febrile Ferment; and that the Liquor to be there separated, becoming disproportionate to the Animal Functions, is the Minera of it; and, being thence dispensed into all parts of the Systema Nervorum, may by degrees rise to such a Maturation as may produce the Fits. Here he takes occasion to endeavour to establish the Existence of the Nervous Juice, in confirmation of what he had heretofore delivered, and indeed (for a main Argument to evince it) to revive and farther make out, by a somewhat long Deduction, the Opinion of Dr. Ent, Glisson, &c. That we are not only directly, but materially nourished by that Juice; for a particular Account of which we refer to the Author. To this Notion of his, he endeavours to shew, that the alleged Conditions all agree; which done, he lays down his Hypothesis of the manner of the Production of the Paroxysme minutely; supposing, that some Incongruous, though at first inoffensive, matter (on the score of Procatastic Causes he points at) being admitted into the Roots of the Nerves in the Cortical part of the Brain, is from them propelled into the Medullary, and thence into the Tracts of the Nerves and Fibres (which he takes to be but Propagines Nervorum) of the whole Body; in which moving slowly, it by degrees maturates into a Fermentative Substance, and acquires an Acrimony: With which when they are filled, and the Acrimony becomes troublesome, they contract themselves to expel it, it; but it being confined for some time (for Reasons alledged) does necessarily put them upon repeated Contractions (in which he places the Nature of the Rigor) till they at last expel it into the Mass of Blood, amongst whose very Heterogeneous Particles (many of which too, are Sulphurous) it makes a great Commotion, which cannot cease till both the Particles of this Ferment, and the disturbed Ones of the Blood, are subdued and reduced into order, or expelled. But this Atony of the Glandules of the Brain continuing, nay in some measure increased by the Disease, the fore-mentioned Admission of more Heterogeneous Matter must be repeated, as, in the same order, the Maturation, Eruption into act, and Extrusion of it, with the alledged Consequents; and that so often till either by Medicines, or the change of Season, or other Causes, these Glandules come to recover their Pristine Force. This Hypothesis he endeavours to confirm from some obvious general Considerations, and then proceeds first to enumerate, in their order of Invasion, the Symptoms which most usually offer themselves, and then to solve them from his Hypothesis. This done, he considers the Types; which not having been accounted for to his Satisfaction by former Authors, he takes himself to be obliged to try whether they can be from his Hypothesis, and therefore offers a new one about them to consideration. Therefore in the first place he considers that the three sorts of regular and usual Types, Quotidian, Tertian, and Quartan, do generally observe certain determinate Seasons of the Year, and not frequently happen at others, viz. Quotidians in the Winter, Tertians in the Spring, and Quartans in the Autumn; but that rarely Intermittents begin in the Summer. In the several Constitutions of these Seasons he supposes our Blood and other Juices obtain likewise different Constitutions, which he explains; so that there must, in general, be a difference in the circumstances of Diseases, though of the same Denomination, which happen in either of them. But to sign a reason why we have Periodical returns, he considers, First, That we generally Eat at determinate Times, from whence the admission, as well as distribution of the Nutritious Juice (which he before supposed to be by the Nerves) must be Periodical. But this being not sufficient, since most persons eat oftner than once a day, he considers, Secondly, That we sleep ordinarily but once in 24 Hours, at which time the Brain being relaxed, admits the Suppliments of Nourishment for the next day, as upon waking it begins, and all day after continues gently to protrude it (at least more vigorously) through the whole Fibrous Systeme; in which time it advances in its Maturation, as usually toward becoming a fit Nutritious Juice, so now, being in some degree incongruous, toward a Febrifick Ferment; so that, caeteris paribus, a Diary Period (unless when a greater, or more depraved, quantity than usual of Heterogeneous matter abounds) may be hence expected. But to determine the reason of longer Periods, he supposes, Thirdly, We must have recourse to the different Constitutions of the year: And in the Spring the Air abounding (by general consent) with Nitrous Particles, which though active, and thence apt to exagitate and exalt a Morbidick Ferment, yet helping to constitute the Principles of Vitality, and in some degree corroborative of the Tone of the Glandules, they hinder, in some measure, the encrease of the Morbid matter in them, so that so much cannot be congested in the Systeme of the Nerves and Fibres as to rise to a degree of Vellication able to produce a Paroxysme; whence there is a necessity of a second Night's supplies to yield a proportionable quantity to the effect. But in the Autumn, Acids abounding, which both in some degree repress Fermentation, and withal help to constringe the Tone of the parts, parts, the Congestion cannot be made so suddenly as in other Seasons; and therefore, since the admission of the matter is had in Sleep, enough cannot be taken in under a second Night's Interval to supply enough for a Turgescence; which the nature of the matter in some measure hinders from rising up to it. The longer Periods he supposes are deducible from a greater disposition to Acidity in the Nervous Juice. And that the Seat of the Distemper is there, the Consideration of the Symptoms, wholly or chiefly affecting the Nervosum Genus in those longer Periods, so far as he has observed, seem to him a cogent Argument. As to the Anomalies of them, he supposes them, in the Fourth place, deducible partly from the Variety of the Constitutions of Particular Persons, partly from particular Changes of the Air, Aliments, &c. and from external occasions, which cannot be enumerated. Then he comes to consider the Method of Cure: And since several Administrations are necessary (some at one time of the Distemper, some at another; and some for some Persons, some for others, according to various Circumstances) he goes through them, and endeavours to render an Account in general, on what Score Plebotomy, Vomits, Purgers, Diaphoreticks, Diureticks, Altering Medicines, as Digestives, Specifics, Opiats, and Pericarpia produce their effects, when 'tis proper in their turns to use them. After which he delivers a sufficient account of the particular Methods which he conceives proper for each of the three sorts of intermitting Fevers. But since the Cortex Peruvianus is become so Celebrated, as well as it is an effectual Remedy for them all, he in an entire Chapter offers an Aetiology of it, agreeably to the Hypothesis he has laid down of their Sources; and from Mechanical Principles. To form which, he, 1st, enumerates several Observables relating to its known effects and circumstances of its Exhibition. 2ly. He considers iders the Texture of it, which he takes to be very compact, and not quickly dissoluble by the Ferments 'tis now to meet with. 2ly. He enquires into the Scene of its Operation, where he traces it through the ways of the Chyle, those of the Blood, the Habit of the Body, and the Systema Nervorum; and thinking (for the Reasons he alleges) 'tis not to be found, adequately to the effect, in the three former, he places it in the last, and endeavours to make it out from several Deductions. 4ly. He describes in a Mechanical way the manner of its Action; supposing that some of its Particles having undergone several Commutations (though a Dissolution) from the various Ferments they have passed, arrive at last, with the Blood, at the Brain; and being, with some of its Vehicle, separated there from the grosser parts of both, in the Cortical Glandules, they are admitted into the tubulated Roots of the Nervous Tree, by the way that the Nutritious Juice is supplied; into which those of them, which are not small enough to pass those Straits along with the Juice, being just admitted, stick there till other appalling Substances give them a farther Commutation, and so preclude them along: But on the score of their irregular sides he supposes they leave room (indeed) between them and the sides of those round Vessels for the finer Juice to pass, but preclude the entrance to the grosser (which he has supposed, is the matter that makes the Febrile Ferment) and thereby prove no way injurious to the Animal Functions, since enough, and that the putrefaction may pass by them to actuate the Nerves. Whilst these Particles stick here, he conceives that by softly calcining the including Coats with their Angles, they may cause them to contract themselves to their due Tone, and they crumbling by degrees as that is doing, leave the part in its natural Estate, and so (without a fresh Cause) the Distemper ceases. 5ly. He endeavours to shew, that all the mentioned Observables agree to his Hypothesis. Lastly, To accommodate these Speculations to Practice, he lays down briefly the Method to be observed in relation to the giving it; thinking withal, it may be useful in most Chronical Periodical Distempers; and concludes with a couple of Histories, to confirm his Notion of the Seat of the Distemper, and the Scene of the Operation of the Cortex. His subjoined Discourse concerning the Spiral Fibres of the Intestines having been many years since published in English in the Philosophical Transactions, he now, at the importunity of some Friends, has thought fit to publish in Latine. LONDON, Printed for, and Sold by Samuel Smith, Printer to the Royal Society, at the Princes Arms in St. Paul's Church-yard. 1693.