A Discourse concerning the Difficulty of Curing Fluxes, Writ Occasionally on Reading Dr. de Jussieu's Memoire in the History, &c. of the Royal Academy of Sciences in Paris, for the Year 1729. By William Cockburn, M. D. F. R. S. and of the College of Physicians, London

III. A Discourse concerning the Difficulty of curing Fluxes, writ occasionally on reading Dr. de Jussieu's Memoire in the History, &c. of the Royal Academy of Sciences in Paris, for the Year 1729. By William Cockburn, M.D. F.R.S. and of the College of Physicians, London. In reading Dr. de Jussieu's Memoire, about the present Disgrace of Ipecacuanha in France, and the Method he proposes for redressing its Defects by Simarouba, a Root brought from Cayen in America, I was surpriz'd to find a Remedy almost ador'd for half a Century, to have fallen into the utmost Contempt; a Specifick, a very short and satisfactory Word, totally neglected by its most zealous Votaries. The learned Professor alleges, that this great Revolution, in the Fame of Ipecacuanha, proceeds from its having been unskilfully administered: Physicians commonly considering the general Appearance of a Looseness only, without penetrating into the particular Causes which support it, and that require, on that Account, different Methods of curing it. Mons. de Jussieu, avoiding all Extremes, is an Enemy to the banishing Ipecacuanha altogether out of the Practice of Phylick, as many of its disappointed Adorers now do; because it is not the infallible Specifick they vainly imagined it to be. This common Misapplication of Medicines, or our Ignorance of the particular Circumstances of a Disease, when it requires a different Method of Cure, is the very Reason why great Numbers of excellent Medicines, cines, among ancient Physicians, have been lost, because they were not understood. Take a broken Shin only, which has the Skin only rubb'd off, observe the Difficulty the best and honestest Surgeons have to cure it. Go to Aetius, and others, where you may find a safe, easy and speedy Cure; which, as the same Author on another Occasion observes, the People make Slight of, because they do not know the Danger or Trouble that often attend it. A Looseness is more liable to be mistaken than the greatest Number of other Diseases; because it is produced by two immediate Causes that are very different, when the rest have one Cause only, however great the Diversity of particular Cases may appear to be. A Fever, viz. has but one Cause, tho' the Variety of Fevers, or the various Appearances of a Fever are infinite, and never can be clas'd by Observation, I shall therefore consider the different Circumstances of a Looseness observed by Dr. de Jussieu, and that occasion the Misapplication of Ipecacuanha; but I shall afterwards endeavour to make his Account more perfect; for thereby Physicians will be able to have more perfect Intentions and Views of Curing than hitherto they have had. When great Crudities, says the Doctor, and indigested Stuff in the first Passages, or an Obstruction in the Bowels of the lower Belly are the Cause of a Looseness, we may always expect the common good Effects of the Ipecacuanha for a Cure. On the contrary, when Ipecacuanha is given against an Hepatick Dysentery, or against a great Discharge of Blood upwards or downwards, often occasioned by a purging Medicine that was given for a Cure a Cure of the Looseness, no Success can reasonably be expected from the Specifick, far less have we any Hopes, when Ipecacuanha is given for the Cure of a Looseness that subsists on an Inflammation of the lower Belly; or when sharp and fix'd Pains give us a Suspicion that the Dysentery has a cancerous Ulcer for its Cause. As there is no Difficulty that is peculiar to a Dysentery, and is not common with the Dangers of a Diarrhoea, the Terror of Blood not excepted, it must be acknowledged that any Vomit as well as Ipecacuanha, is a proper Cure against Indigestions and Crudities in the Stomach, as Hippocrates anciently observed, and has been believed by all Physicians since his Time: So that there is nothing in the French Specifick that is not in Salt of Vitriol; which we find held its Reputation, in curing Dysenteries, longer than Ipecacuanha is like to do. It is more wonderful that this Way of Curing a Looseness by Ipecacuanha was not sooner determined. Nothing besides the lazy Talk of a Specifick, that excludes all Reasoning and Reflection, could have made Men easy under so gross Ignorance. The very Instance given us by the late excellent Dr. Tournefort, in the Case of his Tutor Petrus Sylvanus, is a sufficient Proof that Ipecacuanha is no Charm of a Specifick, but that it cures by its Evacuating: For, when the Weakness of Sylvanus made them cautious in administering the Specifick, the Disease held its Ground against the Charm, and its Adorers, 'till Despair drove the Physician upon larger Doses, the last Resort of the Vanquished, and they produced Evacuations by Vomit and Stool, and thereby his Health in one Night It would be superfluous to observe upon what is said about the Simarouba, and how far it may remedy the Defects of Ipecacuanha, the Trials of it being few, not sufficient to determine the Universality of its Use. Far less shall I enquire, whether the West-India Plant has any relation to the Macir from the East-Indies, mentioned by Pliny*; though I wish Dr. de Jussieu had prepared the Simarouba with Honey, since the great Cures, recorded by Pliny, by the Macir might be assisted by its being prepared in that Way. I shall then proceed, and make the foregoing Account more perfect, and more obvious, better fitted to fix the Views of Physicians, in the Point they are to pursue. For this Purpose, I shall give a plain Account of the several Species of a Looseness, and in each of them apply the different Kind of Remedies employ'd for the Cure of them. Thus we shall perceive the proper Administration for every Looseness, and how far any of them is left without a Cure. The Anatomy of the Guts alone, informs us, that the immediate Cause of every Looseness, whether it be Symptomatic or Essential, must either be a quicker Conveyance of the common Quantity of concocted Food, and of the Liquors that are commonly mixed with it in the Guts. Or the Cause of a Looseness is a greater Secretion than ordinary, of a watry Substance from the Blood into the Guts, and brought into them by the Pancreas, and various other Glands. In both which Cases there must needs be a larger Discharge of liquid Excrements, by Stool, than usual, or there must be a Looseness. A Looseness produced by the first of these Causes, admits of great Variety; both on the Account of the different * Hist. Natur. lib. xii. different *Stimuli*, and even from the different Degrees of the *Stimulus* in each of them. The *Stimulus*, viz. of indigested Food, Fruits, and the like, differs very much from the *Stimulus* of *Gall*. The first Sort is confined to the *Stomach* and *Intestines*: In which Case, the Disease is often a Cure to itself; whereas the *Stimulus* of Gall is greater, and the Cause is more permanent and seldom carries off itself. The Degree of the *Stimulus* may be determined by some other concomitant Symptoms of *Slime*, *Glaire*, &c. But when the *Stimulus* is occasioned by the *Piles*, an *Ulcer*, or a *Stricture* in the Guts, it is vastly more Violent, and much departs from the common Cure of a Looseness, whereby Physicians are often subjected to fatal Errors, and gross Misapplications of their Medicines. The *Watry Looseness* produced by the other immediate Cause, is indeed deplorable; because a Method of Curing it is not commonly known. It is not only as a Principal, but it is a Second, in the Beginning, at the Ending, and in the intermediate Times of all other Diseases, and even in old Age, when Nature is submitting to the Power of Death; when Physicians call it a Colliquative Looseness, because it seems to melt away the Flesh of the Sick. *Petrus Salius Diversus*, a most approved Physician, affirms it to be vain for a Physician to attempt the Cure of it. *Carolus Piso*, who endeavours to explain it, and the most sagacious *Laz. Riverius*, after trying all the common Methods, give us no better Hopes of a Cure. It is now manifest why a Looseness, that in all outward Appearance is one and the same thing, and promises to submit to the same Remedy, is vastly different *Pag. 188, 189. lib. de Pestis.* in the manner of Curing it. Our Experience has contradicted our Belief, and the Remedy that has proved Effectual and Sufficient in one Case, has proved Ineffectual and Useless on other Occasions; on which Account Remedies are very liable to be misapplied. To prevent this Misfortune in a great Measure for the Future, I shall consider the Medicines commonly made use of by Physicians for the Cure of a Looseness; and next, how they may most properly be adapted to that End: For thus we must perceive the particular Cases wherein they are like to be useful, and when they are not like to be of any use at all. Astringents, or binding Medicines, were the first employed for the Cure of a Looseness, as well as of every other Evacuation: But Hippocrates observing that a Looseness was often the easiest cured when it was attended with Vomiting, Vomiting Medicines were introduced on that Account. On a like Consideration, Purging Medicines were admitted by Celsus, because he found the Purging the Cure of itself; or that the Looseness went off by going to Stool for a few Days: But he advises Physicians to take care that the Looseness does not run longer than seven Days, and that it is not attended with a Fever; for in that case the Looseness is not Critical and Salutary, but Symptomatical, and hastens on the Ruin of the Sick. All these Observations have not been found universally true in many other Countries; for Cælius Aurelianus, a most accurate Observer of Diseases, Rhaza and Avicenna blame this free Use of Purging and Vomiting, and may be justified by what will be shewn in the Progress of this Discourse. But, now that we may apply this Artillery of Physicians against the two general Causes of all Loosenesses, we shall begin with the most ancient of the mentioned Methods, which was practised by Prodicus Selym-brianus, whose School was adorned by the divine Hippocrates. Binding Medicines, as I lately observed, were employed for the Cure of every Evacuation, and are still the Refuge of Physicians when all other Methods have been baffled, under their own Conduct and Direction; they tacitly have the Preference given them to all other Medicines; for Instance, Ipecacuanha is preferr'd to any other Vomit, and Rhubarb to any other Purge, because they are more astringent than any other of the Tribe. So far do Physicians extol the Power of Astringents, that many of them affirm, that by them any Looseness may be repres'd, if they did not think it unseasonable or improper. However; it may stand with these Boasters, it is very certain, that these Medicines only affect a Looseness occasioned by a Stimulus, and if this is small, the Looseness may be cured by it; but if the Degree of the Stimulus is greater, the astringent Medicine is either not able to put a Stop to it, or it will tear the Sick with Gripes if it does. It is on the same Account of the Stimulus, that a Vomit or a Purge is properly premised to other Medicines, if it consists with the Strength of the Sick; but after all, the Store-house of Physicians seems to be exhausted in curing a Looseness that proceeds from Indigestion, or Gall; but if the Stimulus is from the Piles, an Ulcer, or a Stricture in the Guts, Physicians are lost without any Remedy, and too frequent- ly have recourse to the Omnipotent Astringent, without any Success. Here is a real Want, an Inability and Unskilfulness in our Work, and leaves too much room for misapplying Medicines. But if we turn these Engines of Vomiting, Purging and Binding, upon the other general Cause of a Looseness, they either fall very short, or like a little Water thrown upon a great Fire, they rather inflame than extinguish it. Hippocrates * indeed does not mention the Watry Looseness, but he says many things that peculiarly concern it; which Foesius not understanding, blamed him for Obscurity in this Place. Piso † gives a very plain Description of this Looseness, and his Observation is admitted by every succeeding Physician. The desperate State of the Watry Looseness was formerly mentioned from the Confession of Authors of the greatest Knowledge and Veracity; and Physicians shall for ever find that Looseness to become more violent the more you press it with Astringents, Vomits, or purging Medicines. The boasted Omnipotency of putting a Stop to a Looseness at Pleasure, must serve another use with the Sick, though it may not be able to put the desired Stop to his Purging. There is even a Singularity in the Cure of this Looseness which I think has not hitherto been observed. In every other Kind of Looseness the Stools acquire a Consistence, when they begin to be cured; but in the Watry Looseness, the Stools commonly lessen in Quantity though not in their Looseness. I should say something of Opium, a Medicine often made use of for the Cure of every Kind of Looseness, * Coac. Præpot. 134. Prædict. 81. † Sect. IV. cap. 1. Obs. 54. ness but as it neither acts as an Astringent, nor in a Way observed by Physicians, it must still remain among other Desiderata. IV. A Letter from Mr. John Dove to Edmund Halley, LL.D. F.R.S. and Reg. Astron. at Greenwich, containing an Account of a Comet seen on February 29, 1732. From on Board the Monmouth, James Montgomery Commander, in Table-Bay, March 17, 1732. SIR, I Had the Honour to wait on the Governor the 8th of February, in Latitude 33° South, where he parted with us for St. Hellena. The 29th of February, at about half an Hour past Ten at Night, I judge (having a good Observation at Noon) we were in Lat. 34° 28' South, and Long. 12° 35' West from Cape Bonne Esperance, the Moon shining very bright, being near the Full, we saw something very bright rise about West, which I judge to be a Comet: It set about East, passing from West to East in about five Minutes, between the Moon and our Zenith, and to the Southward of Spica Virginis; it carried a Stream of Light after it about